The 21st-Century Dental Curriculum: A Framework for Understanding Current Models.

This article provides an overview of the emergence of professional education and academic dentistry, in particular into the comprehensive research university. The development of academic dentistry as a vital member of the academic health center at the research university and beyond is described. Summaries are provided of major studies and innovations in dental education models and curricula, ranging from the Gies report in 1926 to the 1995 Institute of Medicine study Dental Education at the Crossroads, the U.S. surgeon general's report on oral health in 2000, the Macy study report in 2008, and the American Dental Education Association Commission on Change and Innovation in Dental Education (ADEA CCI) series of articles published from 2005 to 2009. The article also tracks changes in number and institutional affiliation of U.S. dental schools. This article was written as part of the project "Advancing Dental Education in the 21st Century."

Change Is Here: ADEA CCI 2.0-A Learning Community for the Advancement of Dental Education.

On May 12, 2005, the inaugural meeting of the American Dental Education Association Commission on Change and Innovation in Dental Education (ADEA CCI) was convened. Comprised of thought leaders representative of dental education and practice, the ADEA CCI published groundbreaking white papers that effectively helped bring dental education across the threshold of the 21st century. Twelve years later, a new ADEA CCI has been convened-ADEA CCI 2.0. The ADEA CCI 2.0 is a broad-ranging, strategically interconnected, flexible, and multifarious community of stakeholders situated within and across all facets of oral health education and practice. Whereas the first iteration of the ADEA CCI made the case for change regarding revisions of the dental curriculum and learning environment, the ADEA CCI 2.0 will focus on external domains that are having a global impact on the content and delivery of health care and health professions education and, ultimately, how health care benefits people. The principal work of the ADEA CCI 2.0 will be to create educational and implementation resources and opportunities for dental educators to contemplate, investigate, and ultimately define the future needs of their academic dental institutions in this constantly changing world.

Chanqes in dental school curricula, 2003-2009.

This 2009 study of dental school curricula follows a similar one conducted in 2002-2003. Through a Web-based survey, the authors gathered information from dental schools about: (a) trends in curricular change over seven years; (b) changes underway in dental school curricula; (c) significant challenges to curricular innovation; and (d) projected trends in curricular change and innovation. In a significant change from the 2002-2003 study, a high proportion (91%) of the responding schools require community-based patient care by all students, with just over one-half ot them requiring five or more weeks of such experience. Respondents reported that priorities for future curriculum modification included: creating interdisciplinary curricula that are organized around themes, blending the basic and clinical sciences, provision of some elements of core curriculum in an online format, developing new techniques for assessing competency, and increasing collaborations with other health professions schools. Respondents identified training for new faculty members in teaching skills, curriculum design, and assessment methods as the most critical need to support future innovation.

Curriculum change in dental education, 2003-09.

This 2009 study of dental school curricula follows a similar one conducted in 2002-03. Through a web-based survey, the authors gathered information from dental schools about 1) past trends in curricular change over seven years; 2) current changes under way in dental school curricula; 3) significant challenges to curricular innovation; and 4) projected future trends in curricular change and innovation. Fifty-five schools (fifty U.S. and five Canadian) responded to the survey for a response rate of 86 percent. In addition to background information, the survey requested information in four broad areas: curriculum format, curriculum assessment, curriculum innovation, and resources needed for curriculum enhancement. Forty-nine percent of the respondents defined their curriculum format as primarily organized by disciplines. Half of the respondents reported the use of problem-based and case-reinforced learning for a section or specific component of some courses. In a significant change from the 2002-03 study, a high proportion (91 percent) of the responding schools require community-based patient care by all students, with just over half requiring five or more weeks of such experience. Competency-based education to prepare an entry-level general dentist seems well established as the norm in responding dental schools. Forty-three percent or less of the responding schools indicated that their students participate with other health professions education programs for various portions of their educational experience. Since the 2002-03 survey, dental schools have been active in conducting comprehensive curriculum reviews; 65 percent indicated that their most recent comprehensive curriculum review is currently under way or was conducted within the past two years. Respondents indicated that the primary reasons for the configuration of the current curriculum were "perceived success" (it works), "compatibility with faculty preferences," "faculty comfort," and "capacity/feasibility." Key catalysts for curricular change were "findings of a curriculum review we conducted ourselves," students' feedback about curriculum, and administration and faculty dissatisfaction. There was an increase in the percentage of schools with interdisciplinary courses, especially in the basic sciences since 2002-03, but no change in the use of problem-based and case-reinforced learning in dental curricula. Respondents reported that priorities for future curriculum modification included creating interdisciplinary curricula that are organized around themes, blending the basic and clinical sciences, provision of some elements of core curricula in an online format, developing new techniques for assessing competency, and increasing collaborations with other health professions schools. Respondents identified training for new faculty members in teaching skills, curriculum design, and assessment methods as the most critical need to support future innovation.

The dental curriculum at North American dental institutions in 2002-03: a survey of current structure, recent innovations, and planned changes.

This study examined the current format of curricula at North American dental schools, determined curriculum evaluation strategies, and identified recently implemented changes as well as planned future innovations. The academic affairs deans of sixty-four North American dental schools received an email survey in August 2002; a second, follow-up survey was sent to nonresponders in February 2003. Online responses were collected and analyzed using SurveyTracker software. The final response rate was 87 percent, with forty-eight U.S. schools and eight Canadian schools responding. Respondents were asked to select descriptive statements about the general organization of their curricula and the degree to which problem-based learning (PBL), case-reinforced learning (CRL), curricular integration, and community-based clinical treatment experiences were incorporated. They were also requested to identify strategies employed to evaluate the curriculum and to report recently completed and desired future curriculum modifications. In regard to desired future curriculum innovations, respondents identified why they were considering curriculum changes and identified resources needed to implement the planned changes. Sixty-six percent of those who responded defined their current curriculum organization as primarily discipline-based with a few interdisciplinary courses. Nearly 60 percent of schools reported that they used PBL and CRL in specific courses or for components of certain courses, but only 5 percent of the respondents indicated that all of their courses used PBL. Regarding integration of major sections of the curriculum, only 7 percent reported that their entire curriculum was organized around themes of interrelated topics. Sixty-four percent reported that their curriculum had required community-based clinical treatment experiences for students. The most frequent innovations in the past three years were increased use of computer and web-based learning (86 percent), creation of patient care experiences early in the curriculum (84 percent), enhancement of competency evaluation methods (84 percent), and curriculum decompression (79 percent). These items plus increased community-based care were the most frequently identified future curricular innovations. There were virtually no differences between the responses of Canadian and U.S. dental schools. The results of this study help to broadly characterize dental curricula at North American dental institutions and identify curriculum modifications anticipated by the academic dean respondents.