Assessing dental student perceptions after engaging in a longitudinal interprofessional education curriculum: A preliminary study

PURPOSE/OBJECTIVES

Baseline IPE perceptions for dental students were gathered prior to the implementation of a 2-year formalised IPE curriculum at a US institution. The goal was to establish a baseline of student perceptions and, in the future, continue to track student IPE perception data with IPE engagement as one measure of outcomes. The purpose of this paper is to analyse two dental student cohort perceptions of IPE after engaging in a 2-year longitudinal curriculum.

METHODS

First- and second-year students were required to participate in a 2-year IPE curriculum. As a requirement of the curriculum, students were asked to complete a validated IPE assessment, the Student Perceptions of Interprofessional Clinical Education-Revised instrument, version 2 (SPICE-R2). Students completed the SPICE-R2 survey, using a retrospective pretest/post-test design, after engaging in the 2-year curriculum.

RESULTS

Sixty-four students in cohort 2017 and 70 students in cohort 2018 completed the entire SPICE-R2. Statistically significant positive changes (p < .05) were found in both dental student cohorts after engagement in the 2-year longitudinal IPE curriculum.

CONCLUSION(S)

A longitudinal IPE curriculum has the potential to impact student IPE perceptions. Additional longitudinal multi-institutional research is needed to determine best practices in delivery and learning.

Developing Interprofessional Education at One U.S. Dental School: Establishing a Baseline and Moving Forward

Dental schools across the U.S. are in the process of incorporating interprofessional education (IPE) into their curricula. At Louisiana State University Health Sciences Center-New Orleans (LSUHSC), the process of educating competent students fully prepared to maximize patient outcomes through interprofessional care is under way. The aim of this study was to establish baseline data on three years of LSU dental students' perceptions of IPE prior to and as a new two-year IPE curriculum was being introduced. A survey was conducted of dental students in all four years from 2015 to 2017 using the Student Perceptions of Interprofessional Clinical Education-Revised instrument, version 2 (SPICE-R2). In 2015, 120 students participated in the survey for a response rate of 46%, followed by 160 students in 2016 (62%) and 170 in 2017 (67%). The results showed that the first-year students in 2017 had a higher total SPICE-R2 mean score than the first-year students in 2015 and 2016; the difference was statistically significant. Even though the 2017 first-year students had only received an orientation to the curriculum at the time they completed the survey, this change in attitude suggests the new focus on IPE was already having an effect on students. There were no statistically significant differences between mean scores for the three cohorts of second-, third-, and fourth-year students, none of whom had experienced the new IPE curriculum. Data from this study will serve as a baseline from which to evaluate the impact of the new IPE curriculum that is now required of all first- and second-year dental students. Through continued IPE exposure in the curriculum and ongoing faculty development, further improvements in students' attitudes toward IPE can be anticipated.

Dental rounds: an evolving process of curriculum integration at the LSU School of Dentistry

With the support for curriculum change expressed by the American Dental Education Association's Commission on Change and Innovation in Dental Education (ADEA CCI), the Louisiana State University Health Sciences Center School of Dentistry (LSUSD) initiated a course that vertically integrates the basic sciences and clinical sciences and promotes critical thinking. The resulting Dental Rounds course includes presentations by D3 and D4 students on interesting clinical cases, which the entire student body is required to attend. Following the third year of the program, a formal evaluation was conducted, in which surveys were disseminated to students, recent graduates, and faculty members to collect feedback on the efficacy of the course, its perceived value, and its success as an educational tool. Of the 242 students and graduates who were sent surveys, 181 responded, a 74 percent response rate. Of the eighty full-time faculty members, sixty-one responded, a 76 percent response rate. Most respondents reported that the objectives of the course were being achieved, but they identified case-related discussion as an area for strengthening critical thinking skills. As a result, modifications were planned to include formal participation of D1 and D2 students in the presentations, less frequent sessions to accommodate more complete cases, more emphasis on basic science, more structured mentoring, and a modified question format. Dental Rounds was a necessary integration step in dental education for LSUSD, and it is anticipated that the planned modifications will lead to strengthening of critical thinking skills in both students and faculty.

Interprofessional education in U.S. and Canadian dental schools: an ADEA Team Study Group report

The state of interprofessional education (IPE) in U.S. and Canadian dental schools was studied by the American Dental Education Association (ADEA) Team Study Group on Interprofessional Education. The study group reviewed the pertinent IPE literature, examined IPE competencies for dental students, surveyed U.S. and Canadian dental schools to determine the current and planned status of IPE activities, and identified best practices. Members of the study group prepared case studies of the exemplary IPE programs of six dental schools, based on information provided by those schools; representatives from each school then reviewed and approved its case study. Six reviewers critiqued a draft of the study group's report, and study group members and reviewers met together to prepare recommendations for schools. This report identifies four domains of competence for student achievement in IPE and summarizes responses to the survey (which had an 86 percent response rate). It also includes the case descriptions of six schools' IPE programs and the study group's recommendations for dental schools. The report concludes that there is general recognition of the goals of IPE across U.S. and Canadian dental schools, but a wide range of progress in IPE on the various campuses. Challenges to the further development of IPE are discussed.

Assessing dental students' competence: best practice recommendations in the performance assessment literature and investigation of current practices in predoctoral dental education

In this article, the Task Force on Student Outcomes Assessment of the American Dental Education Association's Commission on Change and Innovation in Dental Education describes the current status of student outcomes assessment in U.S. dental education. This review is divided into six sections. The first summarizes the literature on assessment of dental students' performance. Section two discusses catalysts, with a focus on problem-based learning, for development of new assessment methods, while the third section presents several resources and guides that can be used to inform selection of assessment techniques for various domains of competence. The fourth section describes the methodology and results of a 2008 survey of current assessment practices in U.S. dental schools. In the fifth section, findings from this survey are discussed within the context of competency-based education, the educational model for the predoctoral curriculum endorsed by the American Dental Education Association and prescribed by the Commission on Dental Accreditation. The article concludes with a summary of assessments recommended as optimal strategies to measure three components of professional competence based on the triangulation model. The survey of assessment practices in predoctoral education was completed by 931 course directors, representing 45 percent of course directors nationwide, from fifty-three of the fifty-six U.S. dental schools. Survey findings indicate that five traditional mainstays of student performance evaluation-multiple-choice testing, lab practicals, daily grades, clinical competency exams, and procedural requirements-still comprise the primary assessment tools in dental education. The survey revealed that a group of newer assessment techniques, although frequently identified as best practices in the literature and commonly used in other areas of health professions education, are rarely employed in predoctoral dental education.

Does faculty development enhance teaching effectiveness?

Academic dentists and members of the practice community have been hearing, for more than a decade, that our educational system is in trouble and that the profession has lost its vision and may be wavering in the achievement of its goals. A core of consistently recommended reforms has framed the discussion of future directions for dental education, but as yet, most schools report little movement toward implementation of these reforms in spite of persistent advocacy. Provision of faculty development related to teaching and assessment strategies is widely perceived to be the essential ingredient in efforts to introduce new curricular approaches and modify the educational environment in academic dentistry. Analyses of the outcomes of efforts to revise health professions curricula have identified the availability and effectiveness of faculty development as a predictor of the success or failure of reform initiatives. This article will address faculty development for purposes of enhancing teaching effectiveness and preparing instructors for potential new roles associated with curriculum changes. Its overall purpose is to provide information and insights about faculty development that may be useful to dental schools in designing professional growth opportunities for their faculty. Seven questions are addressed: 1) What is faculty development? 2) How is faculty development accomplished? 3) Why is faculty development particularly important in dental education? 4) What happens when faculty development does not accompany educational reform? 5) Why are teaching attitudes and behaviors so difficult to change? 6) What outcomes can be expected from faculty development? and 7) What does the available evidence tell us about the design of faculty development programs? Evidence from systematic reviews pertaining to the teaching of evidence-based dentistry, strategies for continuing professional education, and the Best Evidence in Medical Education review of faculty development outcomes are presented to answer this question: does faculty development enhance teaching effectiveness? Characteristics consistently associated with effective faculty development are described.

The dental education environment

The second in a series of perspectives from the ADEA Commission on Change and Innovation in Dental Education (CCI), this article presents the CCI's view of the dental education environment necessary for effective change. The article states that the CCI's purpose is related to leading and building consensus in the dental community to foster a continuous process of innovative change in the education of general dentists. Principles proposed by CCI to shape the dental education environment are described; these are critical thinking, lifelong learning, humanistic environment, scientific discovery and integration of knowledge, evidence-based oral health care, assessment, faculty development, and the health care team. The article also describes influences external to the academic dental institutions that are important for change and argues that meaningful and long-lasting change must be systemic in nature. The CCI is ADEA's primary means to engage all stakeholders for the purpose of educating lifelong learners to provide evidence-based care to meet the needs of society.

Educational strategies associated with development of problem-solving, critical thinking, and self-directed learning

This article was developed for the Commission on Change and Innovation in Dental Education (CCI), established by the American Dental Education Association. CCI was created because numerous organizations within organized dentistry and the educational community have initiated studies or proposed modifications to the process of dental education, often working to achieve positive and desirable goals but without coordination or communication. The fundamental mission of CCI is to serve as a focal meeting place where dental educators and administrators, representatives from organized dentistry, the dental licensure community, the Commission on Dental Accreditation, the ADA Council on Dental Education and Licensure, and the Joint Commission on National Dental Examinations can meet and coordinate efforts to improve dental education and the nation's oral health. One of the objectives of the CCI is to provide guidance to dental schools related to curriculum design. In pursuit of that objective, this article summarizes the evidence related to this question: What are educational best practices for helping dental students acquire the capacity to function as an entry-level general dentist or to be a better candidate to begin advanced studies? Three issues are addressed, with special emphasis on the third: 1) What constitutes expertise, and when does an individual become an expert? 2) What are the differences between novice and expert thinking? and 3) What educational best practices can help our students acquire mental capacities associated with expert function, including critical thinking and self-directed learning? The purpose of this review is to provide a benchmark that faculty and academic planners can use to assess the degree to which their curricula include learning experiences associated with development of problem-solving, critical thinking, self-directed learning, and other cognitive skills necessary for dental school graduates to ultimately become expert performers as they develop professionally in the years after graduation.

The case for change in dental education

This article introduces a series of white papers developed by the ADEA Commission on Change and Innovation (CCI) to explore the case for change in dental education. This preamble to the series argues that there is a compelling need for rethinking the approach to dental education in the United States. Three issues facing dental education are explored: 1) the challenging financial environment of higher education, making dental schools very expensive and tuition-intensive for universities to operate and producing high debt levels for students that limit access to education and restrict career choices; 2) the profession's apparent loss of vision for taking care of the oral health needs of all components of society and the resultant potential for marginalization of dentistry as a specialized health care service available only to the affluent; and 3) the nature of dental school education itself, which has been described as convoluted, expensive, and often deeply dissatisfying to its students.

Bacterial biofilm: a source of contamination in dental air-water syringes

This study examined the bacteriology of dental air-water syringes, and found that the water delivered by these syringes can be persistently contaminated with bacteria. Flushing of the water line reduced but did not eliminate this contamination. Even after six minutes' flushing, some water samples still contained more than 10(4) viable bacterial cells per milliliter, although coliform counts were less than two per 100 milliliters as measured by a Most Probable Number assay. Sterilization of the tip or the entire syringe did not eliminate this contamination. Scanning electron microscopy revealed bacterial biofilms on the inner wall of the plastic tubing supplying water to the air-water syringe, but not on the air line or on new, unused tubing. Such biofilms probably can be found in any tubing which supplies water to components of dental units. The inoculum for these biofilms comes from ubiquitous environmental aquatic bacteria, some of which can cause disease in compromised patients. Biofilms can be held in check by regular flushing of the water lines with a biocide, and the authors affirm the use of the ADA guidelines for treatment of contaminated dental-unit water lines to control possible cross-infection.