Comparing dental students' perceptions of their educational environment in Northwestern Saudi Arabia

Objectives:

To compare the perceptions of dental students over a 5-year period.

Methods:

This cohort study was carried at Taibah University, College of Dentistry, Al-Madinah Al-Munawwarah, Saudi Arabia between 2009 and 2014. Data was obtained using the Dundee Ready Education Environment Measure (DREEM), which consists of 50 items, 4 of these were irrelevant to this cohort and were excluded. All students registered in 2009 were included and followed up in 2014. Their responses were compared using the paired student’s t-test.

Results:

Thirty-four students completed the questionnaire in 2009, and 30 of them participated in 2014 (12% drop out rate). The mean domain and total scores decreased over time. The mean scores for 6 items decreased significantly, while 4 of them had a significant increase. The lowest mean score in 2009 regarding support for stressed students increased (p=0.004) in 2014. However, the highest mean score in 2009 related to having a good social life, reduced (p=0.007) in 2014. This could be an indication of the high workload and its impact on their social lives.

Conclusion:

Student’s perceptions were relatively low at the beginning, and remained low throughout the study. There were no significant changes in mean domain, and total scores and although scores of some items improved, most decreased over the study period.

The Effects of Faculty Calibration on Caries Risk Assessment and Quality Assurance

Accurate caries risk assessment (CRA) plays a pivotal role in managing the disease of dental caries. The aim of this quality assurance study was to determine if faculty calibration training using a specific set of guidelines in a single session would improve the faculty members' CRA decision making. A calibration seminar was held in December 2014 at the Virginia Commonwealth University School of Dentistry, during which seven completed CRA forms for simulated patients were used to test 55 faculty members' risk assignment level before and after an instructional lecture was given. The results showed a statistically significant increase in the proportion of faculty members responding correctly for five of the seven cases on the pre- and posttests (p<0.01). One case showed no significant increase in correct responses (p=0.07), and on the seventh case, which presented low caries risk, there was a significant decrease in the percentage responding correctly (p<0.0001) due to an increase in the proportion overestimating caries risk. This study's findings were consistent with those in previous studies that, without calibration, faculty members are not necessarily accurate at CRA diagnosis. Since the calibration training improved these faculty members' caries risk assessment scoring, future studies should extend to evaluations for both faculty and students.

Development and Assessment of Discrimination Exercises for Faculty Calibration in Preclinical Operative Dentistry

The aims of this study were to identify the level of interexaminer agreement among preclinical operative dentistry faculty members when grading Class II preparations performed by first-year dental students; to develop discrimination exercises for specific preparation components where interexaminer agreement was poor; and to evaluate if the discrimination exercises were able to improve inter- and intraexaminer agreement. In the preliminary phase of this study, 13 components of 32 Class II cavity preparations were assessed by eight course faculty members at one U.S. dental school. Analysis of average interexaminer agreement on these components revealed that six were below 60%. These were proximal contact clearance, retention groove placement, retention groove depth, preparation walls, preparation margins, and preparation toilet/debris. A 30-minute calibration session was subsequently developed to provide discrimination exercises utilizing 3-D models and digital images of various levels of student performance for five of the six components. Immediately following calibration, the course faculty assessed the same 32 preparations (Phase I) followed by a delayed assessment without calibration (Phase II) approximately six months later. The results showed that overall interexaminer reliability improved after calibration. Although there was a decline in interexaminer reliability after an interval of six months (Phase II), the degree of variation among examiners was lower than in the preliminary assessment. These findings support the use of discrimination exercises for preclinical operative dentistry course faculty to increase interexaminer agreement and thereby improve the consistency of faculty-student communication.

The Role of Organizational Context in the Creation and Sustainability of Dental Faculty Development Initiatives

Dental faculty development programs exist for a variety of reasons: to improve teaching skills, develop and reinforce relationships among colleagues and mentors, foster career development, and support curricular initiatives and institutional priorities. These activities impact individual faculty members as well as the institutions in which they work. Each institution has a distinct culture that should be acknowledged and understood alongside conventional outcome measures. As such, this article provides an expanded view of faculty development programming, associated educational activities, and related organizational changes at the College of Dentistry, New York University (NYU) since 2005. Contextual factors include the existence of an Office of Professional Development established in 1999, an Academy of Distinguished Educators founded in 2010, and other programs for present and future educators that support the college's educational mission. Outcomes include a comparison study of one program, the creation of new courses, the sustainability and expansion of existing programs, participants' retention rate, and an increase in awards and other educational accomplishments such as publication of abstracts, oral presentations, and related activities by NYU faculty at national forums in dental education.

Faculty Development at One Midwestern Dental School: A Program Evaluation

Most dental school faculty members arrive on campus with a wealth of clinical experience but little to no teacher training. For the past two decades, there has been a call for schools to educate their faculty on a wide variety of topics including educational methodology and cutting-edge educational techniques through faculty development programs. Drawing on theories of general program evaluation as well as evaluation specific to educational programming, the aim of this study was to investigate outcomes of the Faculty Development Program at the University of Missouri-Kansas City School of Dentistry between 2007 and 2014. A mixed-methods research design gathered quantitative data via email survey sent to all eligible teaching faculty members; it received an overall response rate of 54% (N=51). Qualitative data came from open-ended survey questions and a focus group with seven volunteer faculty participants. The survey data suggested that the stated outcomes of faculty development were being met for all stakeholder groups with varying degrees of success. Focus group results indicated a need for a more formal new faculty orientation and better communication with all about the specific charge of faculty development within the school. Evaluation of faculty development activities in academic dental institutions is a necessary component of the ongoing improvement of dental education. Suggestions for future evaluations include the idea of collaborating with other dental schools to increase sample sizes, which would increase participants' perception of the level of confidentiality and make statistical analyses more robust.

Inter- and Intrarater Reliability Using Different Software Versions of E4D Compare in Dental Education

The problems associated with intra- and interexaminer reliability when assessing preclinical performance continue to hinder dental educators' ability to provide accurate and meaningful feedback to students. Many studies have been conducted to evaluate the validity of utilizing various technologies to assist educators in achieving that goal. The purpose of this study was to compare two different versions of E4D Compare software to determine if either could be expected to deliver consistent and reliable comparative results, independent of the individual utilizing the technology. Five faculty members obtained E4D digital images of students' attempts (sample model) at ideal gold crown preparations for tooth #30 performed on typodont teeth. These images were compared to an ideal (master model) preparation utilizing two versions of E4D Compare software. The percent correlations between and within these faculty members were recorded and averaged. The intraclass correlation coefficient was used to measure both inter- and intrarater agreement among the examiners. The study found that using the older version of E4D Compare did not result in acceptable intra- or interrater agreement among the examiners. However, the newer version of E4D Compare, when combined with the Nevo scanner, resulted in a remarkable degree of agreement both between and within the examiners. These results suggest that consistent and reliable results can be expected when utilizing this technology under the protocol described in this study.

Five practices of efficient factories applied to dental education

Efficient factories, such as dental school clinics (DSC), are trying to improve the quality of their product by reducing inefficiencies, error rates, and wastage. Dental education is an expensive business for the student and the institution. Dental materials and equipment are costly, and students are novice providers who work slowly and inefficiently compared to an experienced dentist; this is not a good business model. The objective of this article was to present and apply five practices of efficient factories that could be applied to the DSC setting. I propose that this will lead to improved educational outcomes and improved patient outcomes in DSC.

The influence of examiner type on dental students' OSCE scores

The purpose of this study was to evaluate the difference in grading of objective structured clinical examinations (OSCEs) at Harvard School of Dental Medicine (HSDM) by full-time faculty examiners, part-time faculty examiners, and postgraduate resident examiners. The OSCE is an evaluation of clinical competence and is used as a multidisciplinary examination at HSDM. Two examiners are selected for each of ten disciplines. Evaluators meet to review the case before the OSCE is given, and faculty examiners are given the opportunity to write exam questions based on the students' expected level of knowledge and ability. All examiners also meet on the day of the OSCE to review the case and discuss relevant issues. Students are randomly assigned to examiners and meet with one examiner at a time in each discipline during the examination. Analysis of OSCE scores on four exams given to HSDM students between 2012 and 2013 suggests that part-time faculty members tended to score students significantly higher than full-time faculty members or postgraduate residents. This may be a result of reduced contact time between students and the part-time faculty although it may also point to a need for more efforts in calibration of the part-time faculty members who take part in the OSCE.

The perceived relevance of tooth carving in dental education: Views of practicing dentists and faculty in West India

BACKGROUND

Teaching dental anatomy includes observation and analysis of natural teeth and carving wax models to accurately reproduce the morphology of teeth. The aim of this survey was to assess the importance of tooth carving in its relevance to clinical practice in the opinion of practicing clinicians throughout west India.

METHODS

Faculties of 27 dental colleges and dental practitioners of the Rajasthan and Gujarat states in western India were contacted through e-mail, telephone and mail. A total of 1866 subjects were contacted of which 1722 responded. The perceived relevance of tooth carving in clinical practice was assessed through a 14-item multiple choice questionnaire. Questions ranged from the queries of clinicians' interest in tooth carvings, their opinion of the practical significance of this exercise during their training to their clinical practice, and their recommendations regarding tooth carving.

RESULTS

A total of 69.1% of respondent practitioners believe that the tooth carving exercise influences their clinical practice, and 93.4% recommend tooth carving to be continued in the undergraduate dental curriculum.

DISCUSSION

The results indicated that most dentists in west India valued what they learned through tooth carving and that they use this knowledge in their practice. This information supports the continued teaching of tooth carving in the undergraduate dental curriculum.

Use of lecture recordings in dental education: assessment of status quo and recommendations

This research project was part of a planned initiative at the University of Pittsburgh School of Dental Medicine to incorporate lecture recordings as standard educational support technologies. The goal of an institutional survey was 1) to gather current data about how dental educators across the United States and Canada use lecture recordings; 2) determine dental educators' perceived value and outcomes of using lecture recordings; and 3) develop recommendations based on #1 and #2 for the dental education community. Of the sixty-six North American dental schools at the time of the study, forty-five schools responded to the survey, for a 68 percent response rate. Of the respondents, twenty-eight schools were found to currently conduct lecture recording; these comprised the study sample. This study focused on the dental schools' past experiences with lecture recording; thus, those not currently engaged in lecture recording were excluded from further analysis. The survey questions covered a wide range of topics, such as the scope of the lecture recording, logistics, instructional design considerations, outcomes related to student learning, evaluation and reception, barriers to lecture recording, and issues related to copyright and intellectual property. The literature review and results from the survey showed that no common guidelines for best practice were available regarding lecture recordings in dental education. The article concludes with some preliminary recommendations based on this study.

Qualities of an effective teacher: what do medical teachers think?

BACKGROUND

Effective teaching in medicine is essential to produce good quality doctors. A number of studies have attempted to identify the characteristics of an effective teacher. However, most of literature regarding an effective medical teacher includes student ratings or expert opinions. Furthermore, interdisciplinary studies for the same are even fewer. We did a cross-sectional study of the characteristics of effective teachers from their own perspective across medicine and dentistry disciplines.

METHODS

A questionnaire comprising of 24 statements relating to perceived qualities of effective teachers was prepared and used. The study population included the faculty of medicine and dentistry at the institution. Respondents were asked to mark their response to each statement based on a 5-point Likert scale ranging from strongly disagree to strongly agree. These statements were grouped these into four main subgroups, viz. Class room behaviour/instructional delivery, interaction with students, personal qualities and professional development, and analysed with respect to discipline, cultural background, gender and teaching experience using SPSS v 13.0. For bivariate analysis, t-test and one way ANOVA were used. Multiple linear regression for multivariate analysis was used to control confounding variables.

RESULTS

The top three desirable qualities of an effective teacher in our study were knowledge of subject, enthusiasm and communication skills. Faculty with longer teaching experienced ranked classroom behaviour/instructional delivery higher than their less experienced counterparts. There was no difference of perspectives based on cultural background, gender or discipline (medicine and dentistry).

CONCLUSION

This study found that the faculty perspectives were similar, regardless of the discipline, gender and cultural background. Furthermore, on review of literature similar findings are seen in studies done in allied medical and non-medical fields. These findings support common teacher training programs for the teachers of all disciplines, rather than having separate training programs exclusively for medical teachers. Logistically, this would make it much easier to arrange such programs in universities or colleges with different faculties or disciplines.

Guidelines for the organisation of continuing professional development activities for the European dentist

AIM

Free movement of dental professionals across the European Union calls for more uniform continuing education in dentistry to ensure up-to-date, high-quality patient care and patient safety. This article provides guidelines for the management and delivery of high-quality continuing professional development (CPD) by European dental schools and other CPD providers.

METHOD

The guidelines are based on an extensive literature inventory, a survey of existing practices (both available as separate publications), discussions during meetings of the Association for Dental Education in Europe in 2011 and 2012 and debate amongst the members of the DentCPD project team representing six dental schools.

RESULTS

On the basis of the literature review, survey and discussions, we recommend that (i) every dentist should be given the opportunity for CPD, (ii) providers should be quality-approved and impartial, (iii) educators should be approved, impartial, suitably trained, and with educational expertise, (iv) the mode of CPD delivery should suit the educational activity, with clear learning objectives or outcomes, (v) effort should be made to assess the learning, (vi) participant feedback should be collected and analysed to inform future developments and (vii) uniform use of the pan-European system of learning credit points (ECTS) should be implemented.

CONCLUSION

Implementation of these guidelines should make dental CPD more transparent to all relevant parties and facilitate the transferability of earned credits across the European Union. It will also enable better quality control within dentistry, resulting in enhanced dental care and ultimately the improvement in patient safety.

Characteristics of effective clinical teachers identified by dental students: a qualitative study

This qualitative research study identified criteria for clinical teacher quality preferences as perceived by dental students. Third and fourth year dental students at New York University College of Dentistry were given a two question, open-ended survey asking what qualities they liked most and least in a clinical teacher. Responses were collected until data saturation was achieved. A total of 157 respondents provided a total of 995 written comments. Descriptive words within the responses were coded and grouped into key words, according to similar relationships, and further refined into 17 defined categories. Three core themes, Character, Competence and Communication, emerged from these 17 categories, which were validated according to specific references found in the existing educational literature. 'Character' comprised nine of the 17 defined categories: (caring, motivation, empathy, patience, professionalism, available, fairness, happiness, patient-centred) and yielded 59.1% of total student responses; 'Competence' consisted of five categories: knowledgeable, expertise, efficient, skilful, effective (29.2%); and 'Communication' represented the remaining three categories: feedback, approachable and interpersonal communication (11.7%). Positive and negative responses related to the defined category of caring were cited by 59.2% of all students. Motivation was the next highest category, cited by 45.9% of students. Non-cognitive attributes, especially those in the Character theme, comprised the majority of student comments. Because students' perceptions are so critical to understanding clinical teaching effectiveness in dental education, these findings can be used to develop assessments to measure clinical teaching effectiveness, to create criteria for the hiring and promotion of clinical faculty and to plan faculty development programming.

Effective and ineffective supervision in postgraduate dental education: a qualitative study

INTRODUCTION

Research suggests that students' perceptions should be considered in any discussion of their education, but there has been no systematic examination of New Zealand postgraduate dental students' learning experiences. This study aimed to obtain in-depth qualitative insights into student and graduate perceptions of effective and ineffective learning in postgraduate dental education.

METHODS

Data were collected in 2010 using semi-structured individual interviews. Participants included final-year students and graduates of the University of Otago Doctor of Clinical Dentistry programme. Using the Critical Incident Technique, participants were asked to describe atleast one effective and one ineffective learning experience in detail. Interview transcripts were analysed using a general inductive approach.

RESULTS

Broad themes which emerged included supervisory approaches, characteristics of the learning process, and the physical learning environment. This paper considers students' and graduates' perceptions of postgraduate supervision in dentistry as it promotes or precludes effective learning. Effective learning was associated by participants with approachable and supportive supervisory practices, and technique demonstrations accompanied by explicit explanations. Ineffective learning was associated with minimal supervisor demonstrations and guidance (particularly when beginning postgraduate study), and aggressive, discriminatory and/or culturally insensitive supervisory approaches.

CONCLUSION

Participants' responses provided rich, in-depth insights into their reflections and understandings of effective and ineffective approaches to supervision as it influenced their learning in the clinical and research settings. These findings provide a starting point for the development of curriculum and supervisory practices, enhancement of supervisory and mentoring approaches, and the design of continuing education programmes for supervisors at an institutional level. Additionally, these findings might also stimulate topics for reflection and discussion amongst dental educators and administrators more broadly.

Improving the quality of educational strategies in postgraduate dental education using student and graduate feedback: findings from a qualitative study in New Zealand

INTRODUCTION

Research suggests that students' perceptions should be considered in any discussion of their education. However, to date, there has been no systematic examination of New Zealand postgraduate dental students' learning processes in both the research and clinical settings. This study aimed to obtain in-depth qualitative insights into student and graduate perspectives of effective and ineffective learning experiences during their postgraduate dental education.

METHODS

Data were collected in 2010 using semi-structured individual interviews. Participants included 2010 final-year students and 2009 graduates of the University of Otago Doctor of Clinical Dentistry programme. Using the Critical Incident Technique, participants were asked to describe at least one effective and one ineffective learning experience in detail. Interview transcripts were analysed using a general inductive approach.

RESULTS

Broad themes which emerged included supervisory approaches, characteristics of the learning process and characteristics of the physical learning environment. The focus of this article is to report and discuss the learning processes that participants identified as promoting and precluding effective learning experiences in the clinical and research settings. Students and graduates in the study had largely similar perspectives of learning processes likely to result in effective clinical and research learning. These included self-directed and collaborative learning; timely, constructive and detailed feedback with directions for further improvement; and discreet clinical feedback. Learning processes that precluded effective learning included unsupported and isolated learning, delayed and overly critical/destructive feedback and open criticism in the clinical context.

CONCLUSION

The in-depth findings of this study contribute to the scientific literature that identifies learning process characteristics which facilitate effective learning from New Zealand postgraduate students' and graduates' perspectives. Additional cross-sectional and longitudinal studies (both qualitative and quantitative) would lead to a better understanding of what constitutes effective teaching in postgraduate dental education.

Development of ethical practices and social responsibility in dental education at the university of Chile: student and faculty perceptions

BACKGROUND

The authors argue that dental curricula in Latin America are noted for providing highly technical and individualistic training that may fail to address society's problems or instil in the dentist the idea that he/she has a social responsibility to contribute to his/her community.

OBJECTIVES

This study's main objectives were to determine whether the curriculum and the faculty teaching practices of the School of Dentistry at the University of Chile contribute to its students' commitment to ethical and social responsibility.

METHODS

This was a qualitative study that investigated the perceptions of sixteen subjects (eight students and eight faculty members). Data were collected in thorough deep interviews. The interview process model conceptualised and organised the information into sets of dimensions and categories. The dimensions studied were ethical commitment and social responsibility. The categories assessed within ethical commitment were honesty, tolerance, responsibility and respect. In the social responsibility dimension, the categories were solidarity, teamwork and concern for and communication with the patient. Analysis of the textual data was performed using a method of content analysis based upon constructed qualitative matrices.

RESULTS

Our results show that students and scholars alike realise that ethical commitment and a sense of social responsibility are not promoted in the curriculum. They do, however, recognise the importance of these qualities in dental practitioners.

CONCLUSIONS

These results indicate that the current curriculum and teaching practices used in our School of Dentistry need to be reviewed and that programmes promoting professionals' commitment to their role in society need to be implemented.

Quality considerations in dental education in India

Undergraduate dental education programs have grown tremendously in India over the last five to six decades, mainly in the private sector, putting significant pressure on resources including faculty. This has raised concerns about the quality of dental education in the country. This article examines the concept of quality as applicable to higher education. It provides a roadmap for application of quality concepts, including steps for improving the effectiveness of teaching and applying Total Quality Management to dental education. It also makes suggestions for college-level and structural-level changes to meet the requirement of improved quality, which includes the addition of dental education as a subject in postgraduate dental programs.

Toward a model of institutional scholarship in health professions education

Using an expanded definition of scholarship that goes beyond the scholarship of discovery (research) to include the scholarship of integration, the scholarship of application, and the scholarship of teaching, this article explains interrelationships among these scholarship types in health professions and specifically dental education. Such interrelationships can lead to meaningful expansion of scholarship especially in the form of translational research, which relies on the development of all four of these types of scholarship. In recent years, health care-related organizations have been seeking ways to expand translational research. At the same time, an increasing number of academic institutions have been considering how to redefine what qualifies as advancing one's discipline in ways that go beyond mere number of publications and grants to better reflect the faculty member's overall scholarly effort. These redefinitions and a new attention to scholarly collaboration have led to the concept of a "complete scholar": one who makes contributions in all four areas of scholarship by collaborating with other scholars, practitioners, and members of the community. Expanding the concept of a complete scholar to that of a "complete institution" is the basis for what we propose as a Model of Institutional Scholarship. This model is exemplified by the Cochrane Collaboration, a gold standard for a complete vision of research on evidence-based health care. In the Model of Institutional Scholarship, an institution can visualize, plan, develop, and orchestrate all scholarship being conducted within its realm, creating collaborations among individual efforts that will enhance effectiveness and the creation of new knowledge.

Communication skills instruction: an analysis of self, peer-group, student instructors and faculty assessment

OBJECTIVE

To explore the correlation of student and faculty assessments of, second-year dental students' (D2s) communicative skills during simulated patient interviews.

METHODS

Eighty-two D2s, 14 student instructors and 8 faculty used a 5-point scale, (1=poor-5=excellent) to assess 12 specific communicative skills of D2s generating assessment sources of self, peer-group, student instructor, and faculty. Mean scores and comparisons between assessment sources were calculated. Spearman correlations evaluated relationships between specific skills and assessment sources.

RESULTS

Mean assessment score and standard error for peer-group (4.14 ± 0.04), was higher than self (3.86 ± 0.06, p<0.05) yet slightly higher than student instructor (4.07 ± 0.04) and faculty (3.93±0.10). Regarding assessment sources, the degree of correlation from highest to lowest was peer-group and student instructor (ρ=0.46, p<0.0001), self and student instructor (ρ=0.35, p<0.002), self and peer-group (ρ=0.28, p<0.02). The correlations between student instructor and faculty, faculty and self, and faculty and peer-group were nonsignificant.

CONCLUSION

Student assessments were different from faculty by mean score and correlation index. Future studies are needed to determine the nature of the differences found between student and faculty assessments.

PRACTICE IMPLICATIONS

Peer, student instructor and faculty assessments of dental students' communicative skills are not necessarily interchangeable but may offer uniquely different and valuable feedback to students.

Use of an action learning model to create a dental faculty development program

Dental educators are often talented practitioners who may have little knowledge of educational concepts and current teaching modalities. Dental schools have recognized the need to offer instruction in teaching skills to their clinical faculty members to support their roles as educators. Since 2005, New York University College of Dentistry (NYUCD) Office of Professional Development has sponsored the Excellence in Clinical Teaching Program, an introductory program in pedagogy and teaching skills. The Action Learning model was used to drive development and implementation of Class ACTS (Advanced Clinical Teaching Scholars), a new advanced teaching skills program. Action Learning is a collaborative educational approach that has its origins in the business world. The learning is problem-driven and occurs in a supportive and reflective environment. The Action Learning approach culminated in a seminar series, Class ACTS, that offers an in-depth opportunity for faculty members to sustain and improve their teaching skills in a small-group setting. Class ACTS is open to NYUCD faculty members who have successfully completed NYUCD's Excellence in Clinical Teaching Program or a comparable program and have a basic background in pedagogy.

A faculty group practice-driven credentialing and privileging infrastructure in a school of dental medicine

Credentialing and assigning clinical privileges are well-established practices in institutions that need to verify a clinician's ability to provide direct patient care services. The credentialing process verifies a provider's credentials to practice his or her profession, while privileging authorizes the individual to perform enumerated procedures within a specific scope of practice. All clinical faculty members at Harvard School of Dental Medicine (HSDM) practice in the Faculty Group Practice (FGP). Because of the number of practitioners in the FGP, the organization instituted a more formal process of credentialing that verifies that practitioners are not only licensed to practice, but also are competent to provide direct patient care. In contrast to other dental schools that have established similar protocols, HSDM approached the process not from the academic side, but rather from the clinical practice side, explicitly taking into account whether the FGP could accommodate another practitioner when an academic department wished to appoint a new faculty member. In doing so, we had to be careful to reconcile our educational and research needs with those of the FGP. In this article, we describe how, within this framework, we established a credentialing and privileging program in which all full- and part-time faculty members, as well as advanced graduate students, were included.

The role of observational research in improving faculty lecturing skills: A qualitative study in an Italian dental school

BACKGROUND

This pilot study is based on observational research of lecturing skills during the annual Oral Medicine course at the Milan Dentistry School.

AIMS

Our goals were to explore how teachers exhibited desirable lecturing skills, to observe how their attitudes and lecturing skills affected students' attention and thereby learning, and to provide feedback.

METHOD

We prepared a structured observational grid divided into four categories: explaining, questioning, visual aids, and lecturer attitude. The grid was filled in by a participant, nonactive researcher.

RESULTS

Two main types of lecture were observed: "traditional" and "interactive". Both of these can result in a high level of attention among students. Among the categories, only "lecturer attitude" appeared to affect student attention. In particular, the skills of "speaking aloud" and "sustaining verbal communication with vocal inflection" appeared to have the greatest impact on lecturer attitude. The data were then presented blindly to the five lecturers, who were able to identify their own lesson.

CONCLUSIONS

Our grid proved to be a valid instrument although it was very expensive. When integrated with other strategies for improving lecturing, such as student scoring, peer evaluation, and microteaching, observational research can be a cost-effective method to stimulate guided reflection and to improve the lecturing skills of faculty members.

Differences in clinical grading associated with instructor status

PURPOSE

The purpose of this study was to determine whether the clinical evaluation of pre-doctoral students is associated with instructor status. The hypothesis was that there would be no association between instructor status and clinical evaluation grades.

MATERIALS AND METHODS

Retrospective analysis of pre-doctoral clinical evaluations for class II amalgams, class III composites, and periodontal scaling and root planing was performed. The grade averages were based on a rank scale. Descriptive statistics were computed to summarise the predictor and outcome variables. Bivariate statistics were computed to evaluate any associations between the predictors and outcomes. Multiple linear regression models were computed to evaluate the simultaneous effects of multiple predictors on clinical evaluations.

RESULTS

The study sample consisted of 238 class II amalgams, 246 class III composites, and 675 scaling and root planings which occurred between August 2003 and June 2005. The procedure averages for these procedures were 1.8 +/- 0.67, 1.8 +/- 0.66 and 2.1 +/- 0.56 respectively. The management averages were 2.0 +/- 0.63, 1.5 +/- 0.58 and 1.4 +/- 0.54 respectively. In bivariate analyses, faculty status was associated with treatment averages for all three procedures.

CONCLUSIONS

Faculty status was associated with treatment score for all three procedures evaluated. Full-time faculty gave the best grades for restorative procedures. For periodontal procedures, part-time faculty gave the best grades. More studies are warranted to elucidate the nature behind these differences.

Short- and long-term effects of training on dental hygiene faculty members' capacity to write SOAP notes

Calibration among faculty is challenging to achieve and maintain. In this study, calibration refers to the training process by which standardization of chart documentation in a SOAP note format was achieved. In the SOAP format, chart entries by health care providers are written in the following categories: Subjective data, Objective data, Assessment, and Plans. The primary training "effect" or outcome that was measured in this study was the capacity of faculty members to write a SOAP note that adhered to prescribed standards for chart documentation. This study was conducted to assess the short-term effects of training and determine whether faculty members' capacity to write appropriately constructed SOAP notes could be sustained for one year. Eight dental hygiene faculty members at the University of Minnesota participated in a pre-training assessment in which they prepared a SOAP note based on a patient case, completed a training session on writing SOAP notes, and completed a post-training test shortly after training that also consisted of writing a SOAP note based on a patient's case. One year later, a follow-up test, similar to the pre- and post-tests, was conducted. Each component of the SOAP note was compared and scored against a gold standard benchmark score of 29 that represented the number of items that should have been included in an ideal SOAP note in the estimation of the investigators, based on chart documentation guidelines of the University of Minnesota Dental Hygiene Division. The mean score for the pre-test was 18.25 (SD=2.82), which represented 63 percent of the benchmark gold standard score of 29. The post-test mean score immediately after training was 24.63 (SD=2.13; 84.9 percent of the benchmark score), and the one-year follow-up mean score was 22.75 (SD=1.83; 78.4 percent of the gold standard benchmark). From the pre-test to the post-test administered in close approximation to the SOAP note training, faculty members' approximation of the gold standard benchmark increased by 35 percent, or 6.28 points, and from the post-test to the follow-up test one year subsequently, approximation of the benchmark score decreased by approximately 1 percent or 1.88 points. Friedman's test indicated that the differences in mean scores for the pre-test, post-test, and follow-up test were significant. The Sign test was used for post hoc tests; alpha was adjusted using Bonferroni's procedure. Conclusions support a hypothesis that faculty capacity to write a SOAP note that adheres to standards can be increased through training and that the effects can be maintained over a period of approximately one year.

Improving the quality of clinical teaching in a restorative clinic using student feedback

INTRODUCTION

A large proportion of the undergraduate curriculum is spent within Restorative Dentistry at the University of Liverpool. As well as supportive "phantom head" courses the undergraduates receive significant amounts of teaching within the clinics themselves. In 2004, to help inform the clinical tutors as to their areas of strengths and weaknesses, undergraduates were invited to complete an anonymous questionnaire on the quality of teaching they received from their clinical supervisors. This process has been repeated subsequently in 2005 and 2006.

METHOD

A 19 parameter questionnaire, employing a 5-point Likert scale and space for open comments, was circulated to every clinical undergraduate student. Questionnaires were returned anonymously and all data collected by one researcher. Descriptive statistical analysis was performed and the staff provided with individual feedback within the context of the overall departmental profile. The pooled data from each of the years was then compared to determine if any changes had occurred. Statistical analysis used Kruskal Wallis tests to determine whether these were statistically significant.

RESULTS

Although the range varied, median scores of 4 (agree) were gained for each question each year. Following statistical analysis 18 of the parameters showed a statistically significant improvement (P < 0.05) between 2004 and 2006 with only one remaining constant throughout.

CONCLUSION

It would appear that the use of a questionnaire based feedback system can result in a tangible and demonstrable improvement in the delivery of clinical teaching.

The state of the art in evaluating the performance of assistant and associate deans as seen by deans and assistant and associate deans

This study explores the little-understood process of evaluating the performance of assistant and associate deans at dental colleges in the United States and Canada. Specifically, this research aimed to identify the methods, processes, and outcomes related to the performance appraisals of assistant/associate deans. Both deans and assistant/associate deans were surveyed. Forty-four of sixty-six deans (66.7 percent) and 227 of 315 assistant/associate deans (72.1 percent) completed surveys with both close-ended and open-ended questions. In addition, ten individuals from each group were interviewed. Results indicate that 75-89 percent of assistant/associate deans are formally evaluated, although as many as 27 percent may lack formal job descriptions. Some recommended best practices for performance appraisal are being used in a majority of colleges. Examples of these best practices are having at least yearly appraisals, holding face-to-face meetings, and setting specific, personal performance objectives/benchmarks for assistant/associate deans. Still, there is much room to improve appraisals by incorporating other recommended practices. Relatively high levels of overall satisfaction were reported by both assistant/associate deans and deans for the process and outcomes of appraisals. Assistant/associate deans rated the value of appraisals to overall development lower than did deans. Qualitative data revealed definite opinions about what constitutes effective and ineffective appraisals, including the use of goal-setting, timeliness, and necessary commitment. Several critical issues related to the results are discussed: differences in perspectives on performance reviews, the importance of informal feedback and job descriptions, the influence of an assistant/associate deans' lack of tenure, and the length of service of deans. Lastly, recommendations for enhancing performance evaluations are offered.

A few good faculty

Faculty shortages have been in concern in dental academia for the past several years. The American Dental Education Association has taken the lead in bringing this issue to the forefront of dental education, creating initiatives that begin to turn academia into a worthwhile career option for dentists. Income opportunities, faculty development, lifelong learning and job satisfaction must all be addressed, in order to fill vacancies and avoid high turnover. Contemporary dental education needs faculty who don't just want a job: they need to want to create a career out of teaching. How we provide inspiration and preparation for these individuals throughout their careers is critical to dentistry's success.

Characteristics of effective classroom teachers as identified by students and professionals: a qualitative study

This qualitative research study identified criteria for teacher quality preferences as perceived by current and past students. A two-question, open-ended survey asking what qualities learners liked most and least in a teacher/presenter was given to two groups: students (Group A) from medicine, dentistry, and related residency programs; and dentists and physicians (Group B) who had graduated at least three years previously and who attended a minimum of two days of continuing education courses in lecture format each year. A total of 300 subjects provided 2,295 written responses. Descriptive words within the responses were coded and grouped according to similar relationships, resulting in the emergence of twenty-one defined categories that were further refined into three core categories: personality, process, and performance. Results showed that the two groups appear to have different preferences in teacher/presenter characteristics. For Group A (students), the categories of content design, content organization, and content development were at the forefront of their preferences. Group B (professionals) overwhelmingly favored elements of speaker self-confidence and expertise. Both groups highly valued expertise and speaking style. These findings can be used to develop curriculum, enhance faculty members' teaching skills, and plan continuing education programs.

Staff recruitment, development and global mobility

This paper considers issues that relate to staff recruitment, staff development and global mobility of dental academics. Published literature, which has a North American bias, is reviewed. Recommendations, which may be applicable world-wide, are made to address evident and pertinent areas of concern in terms of the availability of quality dental teaching staff in dental teaching institutions so as to sustain the global dental academic enterprise at appropriately high levels of achievement.

Barriers to scholarship in dentistry, medicine, nursing, and pharmacy practice faculty

There has been an increased emphasis on scholarly activities by health sciences faculty members given the importance of the promotion of public health over the last 50 years. Consequently, faculty members are required to place greater emphasis on scholarly activities while maintaining their teaching and service responsibilities. This increasing requirement of scholarly activities has placed great demands on clinical practice faculty members and it has made their management of clinical practice, teaching responsibilities, and expectations for promotion and tenure a difficult task. This retrospective literature review identifies barriers to the scholarship activities of clinical faculty members in dentistry, medicine, nursing, and pharmacy and discusses strategies for enabling faculty members to pursue scholarly activities in the current health science academic environment. The review indicates commonalities of barriers across these 4 disciplines and suggests strategies that could be implemented by all of these disciplines to enable clinical practice faculty members to pursue scholarly activities.

Quality assurance and benchmarking: an approach for European dental schools

This document was written by Task Force 3 of DentEd III, which is a European Union funded Thematic Network working under the auspices of the Association for Dental Education in Europe (ADEE). It provides a guide to assist in the harmonisation of Dental Education Quality Assurance (QA) systems across the European Higher Education Area (EHEA). There is reference to the work, thus far, of DentEd, DentEd Evolves, DentEd III and the ADEE as they strive to assist the convergence of standards in dental education; obviously QA and benchmarking has an important part to play in the European HE response to the Bologna Process. Definitions of Quality, Quality Assurance, Quality Management and Quality Improvement are given and put into the context of dental education. The possible process and framework for Quality Assurance are outlined and some basic guidelines/recommendations suggested. It is recognised that Quality Assurance in Dental Schools has to co-exist as part of established Quality Assurance systems within faculties and universities, and that Schools also may have to comply with existing local or national systems. Perhaps of greatest importance are the 14 'requirements' for the Quality Assurance of Dental Education in Europe. These, together with the document and its appendices, were unanimously supported by the ADEE at its General Assembly in 2006. As there must be more than one road to achieve a convergence or harmonisation standard, a number of appendices are made available on the ADEE website. These provide a series of 'toolkits' from which schools can 'pick and choose' to assist them in developing QA systems appropriate to their own environment. Validated contributions and examples continue to be most welcome from all members of the European dental community for inclusion at this website. It is realised that not all schools will be able to achieve all of these requirements immediately, by definition, successful harmonisation is a process that will take time. At the end of the DentEd III project, ADEE will continue to support the progress of all schools in Europe towards these aims.

Effectiveness of faculty training to enhance clinical evaluation of student competence in ethical reasoning and professionalism

This study evaluated the short- and long-term effectiveness of faculty training to enhance clinical evaluation of ethical reasoning and professionalism in a baccalaureate dental hygiene program. Ethics, values, and professionalism are best measured in contexts comparable to practice; therefore, authentic evaluation is desirable for assessing these areas of competence. Methods were the following: 1) a faculty development workshop implementing a core values-based clinical evaluation system for assessing students' professional judgment; 2) subsequent evaluation of the clinical faculty's use of core values for grading and providing written comments related to students' professional judgment during patient care for three academic years; and 3) evaluation of program outcomes assessments regarding clinical learning experiences related to ethics and professionalism domains. Results revealed the clinical faculty's evaluation of professional judgment during patient care was enhanced by training; written comments more frequently related to core values defined in the American Dental Hygienists' Association (ADHA) Code of Ethics; and faculty members reported more confidence and comfort evaluating professional judgment after implementation of this evaluation system and receiving training in its application. Students were more positive in outcomes assessments about their competency and learning experiences related to professionalism and ethics. This article shares one approach for enhancing clinical faculty's authentic evaluation of student competence in ethical reasoning and professionalism.

In the students' own words: what are the strengths and weaknesses of the dental school curriculum?

Dental students have little input into the selection of course topics and subject matter included in their dental curricula. Curriculum requirements are framed by the Commission on Dental Accreditation, which has stipulated competencies and associated biomedical and clinical knowledge that must be addressed during dental school. Although these competency requirements restrict the variance of educational experiences, students are eager to share their views on the curriculum within the realm of their educational experience. The objective of this research project was to elicit the perspectives of dental students from a broad cross-section of U.S. and Canadian dental schools about their education. A total of 605 students (285 sophomores, 220 seniors, 100 residents) from twenty North American dental schools completed a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis to communicate their perceptions of the curriculum. Students were also asked to provide their impressions of the overall quality of the educational program in an open-ended written format. The students' qualitative comments were then reviewed and categorized into key issues or themes. Resulting themes for each category of the Curriculum SWOT (C-SWOT) analysis were the following. Strengths: 1) clinical learning experience, and 2) opportunity to work with knowledgeable faculty. Weaknesses: 1) disorganized and inefficient clinical learning environment, 2) teaching and testing that focus on memorization, 3) poor quality instruction characterized by curricular disorganization, and 4) inconsistency among instructors during student evaluations. Opportunities: 1) develop strategies to provide students with more exposure to patients, especially early in the curriculum, and 2) opportunities to learn new technology/techniques. Threats: 1) cost of dental education, 2) students' concerns about faculty "brain drain," i.e., lack of sufficient numbers of dental faculty capable of providing high-quality instruction, and 3) questionable treatment of patients in the dental clinic as a consequence of pursuing procedural requirements. This report presents commentaries selected from 2,421 total responses that communicate students' perspectives related to C-SWOT themes. Students at seven schools in this study reported that they completed all or portions of the first two years of the curriculum in combined classes with medical students. Sophomore and senior students at these schools provided their thoughts on this curricular approach; these perceptions are also reported. Findings from this study are compared to results from a similar investigation of dental student perceptions conducted fifty years ago. We conclude that students participating in this study were positive overall about their learning experiences in dental schools, but identified several areas that appear to be problematic for many students at a variety of different schools including fundamental concerns about instructional quality in some areas of the curriculum. Academic program administrators in dental schools can use these findings to guide modifications that will enhance the overall dental education experience.

The state of the art in evaluating the performance of department chairs and division heads

This study explores the little understood process of evaluating the performance of department chairs/division heads in dental schools. Specifically, this research aimed to elucidate the methods, processes, and outcomes related to the job performance of department chairs/division heads. Forty-three deans and 306 chairs completed surveys with both close-ended and open-ended questions. In addition, ten deans and ten chairs were interviewed. Results indicate that 80 to 90 percent of department chairs are formally evaluated, although as many as 50 percent may lack job descriptions. Recommended best practices for performance appraisal--such as having at least yearly appraisals, holding face-to-face meetings, and setting specific, personal performance objectives/benchmarks for chairs--are being used in most schools. Still, there is much room to improve appraisals by incorporating other recommended practices. Overall high levels of satisfaction were reported by both chairs and deans for the process and outcomes of appraisals. Qualitative data showed some convergence of opinions about appraisals with the notable exception of informal feedback. We explore some implications of these results, especially as they relate to improving performance appraisals.

Renewing professionalism in dental education: overcoming the market environment

The most important mission of dental education is development of student professionalism. It is only within the context of professionalism that specialized knowledge and technical expertise find meaning. Altruism, integrity, caring, community focus, and commitment to excellence are attributes of professionalism. Its backbone is the obligation of service to people before service to self--a social contract. Professionalism can and should be acquired by targeted interventions, not as an assumed by-product of dental education. Top-down, rule-based professionalism is contrasted with its experience-based, mentor-mediated, socially driven counterpart. Moral principles are inherent in professional development and the professional way of life. Unfortunately, American society, including higher education, glorifies a market mentality centered on expansion and profit. Through formal and hidden curricula, dental schools send mixed messages to students about the importance of professionalism. Institutional consensus on professionalism should be developed among faculty, administration, and students through passionate advocacy and careful analysis of dentistry's moral convictions. The consensus message should communicate to stakeholders that morality and ethics "really count." Maximum student exposure to faculty exemplars, substantial service-learning experiences, and portfolio use are likely to enhance professionalism, which should be measured for every student, every semester, along with faculty and institutional assessment. Research reveals a significant relationship between levels of student moral reasoning and measures of clinical performance and shows that moral reasoning ability can be enhanced in dental students. Valid and reliable surveys exist to assess student moral reasoning. Documented student unprofessional behavior is a predictor of future state professional board disciplinary action against practitioners, along with low admissions test scores and course failures in the first two professional school years. ADEA Policy Statements recognize the importance of professionalism in student development. From day 1 of dental school, faculty and students should have no doubt as to what constitutes acceptable and unacceptable behavior in academic and clinical settings. With education and experience, dental students and dentists are likely to elevate their standards of professionalism.

Identification of competencies for effective dental faculty

A faculty of sufficient size and possessing the appropriate skills is critical to dental education. Faculty shortages have been identified, but little has been written about the skills and abilities necessary for dental faculty to be effective. This project identified consensus lists of competencies in the areas of teaching and research. A panel of dental education experts used a web-based Delphi method to refine competency lists. The final lists of competency statements were organized into foundational competencies that applied to all areas and several areas of major competencies that were defined by supporting competencies. The panel rated the importance of each competency statement for each of three dental faculty categories: 1) clinical teachers, 2) clinical scholars, and 3) research-intensive scholars. The identification of a consensus list of competency statements for effective dental faculty will facilitate the development of programs for faculty to attain and maintain these competencies. ADEA could play a coordinating role in this faculty development effort.

Faculty credentialing: a survey of forty-six U.S. dental schools

This study was undertaken in June of 2005 to evaluate the status of credentialing of clinical faculty in United States dental schools. A short survey on the process of credentialing was developed and emailed or mailed to all clinical deans. The survey contained a standard definition of health professional credentialing to which the respondent was to compare his or her school's procedures. Of the forty-six respondents, only 46 percent were conducting credentialing as defined on the survey. Recredentialing of clinical faculty was occurring in most of these schools; however, 23 percent did not report a process of recredentialing. Each institution required different items in its credentialing application: 95 percent required information on licensure; 86 percent, educational background; 67 percent, academic appointments; and 67 percent, specialty board status, among other items that were included at lower rates. Health status was only requested by 29 percent of the institutions. Only 34 percent of those institutions doing credentialing verified the data collected during the application process. Given the legal implications of adverse outcomes, prudent risk management calls for a strong credentialing program. Results of this survey indicate the need for an ongoing effort to standardize credentialing procedures among dental schools and to select appropriate data to be included in the process.

Students' perceptions of effective classroom and clinical teaching in dental and dental hygiene education

Effective teaching behaviors have been studied in various arenas in higher education. However, there is limited research documenting effective teaching behaviors in dentistry and dental hygiene. Our qualitative study attempts to define effective teaching in both the classroom and clinic for dentistry and dental hygiene students. A total of 175 dental and dental hygiene undergraduate students nominated a total of forty instructors for teaching awards, providing a total of 695 qualitative statements reflecting their teaching in two learning contexts: the classroom and the clinic. Seven categories of effective teaching qualities were identified: individual rapport, organization, enthusiasm, learning, group interaction, exams and assignments, and breadth. Based on the frequency of the themes, effective teaching in the classroom was best defined by organization and rapport, whereas in the clinic, rapport was the most frequently described behavior. Moreover, dentistry students perceived enthusiasm as an effective teaching quality more frequently than did dental hygiene students, whereas dental hygiene students provided more responses to learning. These findings can provide guidance in preparing undergraduate dental and dental hygiene educators to enter the teaching environment. The ultimate goal to be achieved from identification of effective teaching qualities, as determined in this study, is improvement in clinical and classroom teaching for dentistry and dental hygiene programs.

Rater reliability: short- and long-term effects of calibration training

The purpose of this investigation was to evaluate the immediate effects of calibration on inter-rater agreement to a gold standard (GS) and to determine whether the effects can be sustained over a ten-week period. Valid criteria for a Class II amalgam preparation, a three-point rating scale, and a grade form were developed. Three tests were administered: prior to calibration training, immediately following training, and ten weeks later. Each test consisted of faculty independently evaluating ten prepared teeth. Agreement with GS scores for most of the grading criteria improved as a result of training and did not deteriorate over time. The overall percent agreement was 54.5, 66.9, and 64.6 percent across test periods. The most impressive gains in agreement occurred when the criteria evaluated had a GS score of either "standard not met" or "ideal." There was very little gain when the gold standard score was "acceptable." It is concluded that, with training, inter-rater agreement with a gold standard can improve and such improvement is reasonably resistant to deterioration after ten weeks. Nevertheless, future training ought to consider the use of a mastery approach in calibration training to ensure that a satisfactory degree of agreement with the GS is obtained.