Values related to professionalism in dental education at the University of Chile: Student and faculty perceptions.

OBJECTIVE: It is recognised that professionalism should play a central role in dental education. However, its implementation into the curricula of dental schools is still limited. Our objective was to identify the main values related to professionalism based on the perceptions of students and faculty members from the Faculty of Dentistry, University of Chile. METHODS: A Dental Values Survey was validated and culturally adapted in order to guarantee the greatest possible internal validity. The adapted survey was administered to students and faculty members (416 and 225, respectively). The final survey contained 64 items rated on a Likert scale of 1-5. Each item was categorised according to five dimensions: Altruism, Consciousness, Personal Satisfaction, Quality of Life and Professional Status. The values were compared between faculty and students and among students at different courses. A values scale was constructed by selecting the five items with the highest average score for each dimension. RESULTS: Survey respondents composed 34.32% of the universe, of which 50.46% were faculty and 49.54% were students. Values associated with Altruism, Consciousness and Professional Status, were the highest rated by students and faculty. Values associated with Personal Satisfaction and Quality of Life received the lowest scores for both groups. CONCLUSIONS: To provide the best possible attention to patients (Consciousness), and that patients have access to affordable dental care (Altruism), are the values at the top of our scale. On the other hand, to maintain financial stability and to be well paid (Quality of Life) were the less considered.

An "XL" endodontics intervention for dental students required to repeat the course: changing frustration to improved grades and attitudes.

Given the psychological and financial costs involved with failing a clinical course, especially in developing countries, an alternative educational method was tested with students who had to repeat the year-long endodontic course at the University of Chile Faculty of Dentistry. The objectives of the intervention were to deepen theoretical knowledge and practical experiences, as well as to reinforce personal confidence in an endodontic clinical setting for students who failed the regular endodontic course. The aim of this study was to evaluate the success of this new model of educational intervention. In the study, 28 students who had failed the endodontic course repeated it with an alternative teaching method. The students attended patients immediately following practical competence exams, and they had access to simulated models that used rotary instruments and access cavities and had emergency care practice. Feedback sessions were held after each clinical session. Final grades were compared with those of other students who repeated the course without the intervention from 2007 to 2009. A survey was administered to understand the causes of initial failure and their opinions of the intervention. Students who participated in the alternative course did significantly better than their counterparts from previous years who did not receive the intervention (5.7±0.3 vs. 5.4±0.2; p<0.05). Their overall perception of the intervention was positive, and the main cause for previous course failure was personal insecurity and slow clinical care performance (54.2% of the students). The intervention course not only improved grades but also generated interest in endodontics, a contrasting perspective to the frustration students usually express after repeating the course. The results of this study support the introduction of similar interventions in endodontics and perhaps other courses.

Metodologías complementarias de aprendizaje para la adquisición de competencias en la formación de especialistas y actividades profesionales confiables / Complementary learning methodologies for the acquisition of competencies in postgraduate medical education and Entrustable Professional Activities (EPAs)

El aprendizaje del residente se realiza a través del trabajo que desarrolla en diferentes contextos laborales como: la planta del hospital, el quirófano, el centro de salud, la participación en congresos o en comisiones, etc. Aun así, este desempeño tiene que complementarse con metodologías que conlleven actividades específicas para desarrollar aquellas competencias que no se pueden trabajar de forma planificada y explícita en el día a día como el pensamiento crítico, el trabajo cooperativo, la gestión de las emociones, etc. Más allá de las clásicas sesiones clínicas de casos o bibliográficas, existen otras metodologías activas dirigidas a favorecer estos aprendizajes para alcanzar una formación integral, como el aprendizaje basado en problemas, el método de caso y de proyectos, los incidentes críticos, la gamificación, los juegos de rol o el libro del residente. Destacamos las competencias que cada una de ellas ayudan a adquirir. Dedicamos un apartado a las actividades profesionales confiables (APROC) o entrustable professional activities (EPAs), por tratarse de un enfoque metodológico operativo que facilita la puesta en práctica de la formación y evaluación basada en competencias a través de tareas o actividades complejas. La combinación de metodologías complementarias con las actividades clínicas completa el mapa para adquirir las competencias requeridas en los programas de formación especializada. De este modo, se pretende ayudar al formador a planificar la formación del residente de acuerdo a su perfil competencial

The resident's learning is developed through the work in different settings such as: the hospital ward, the primary health center, the operating room, the participation in congresses or in committees, etc. Even so, this performance has to be complemented with methodologies that involve specific activities to develop those competencies that cannot be worked on a day-to-day basis (critical thinking, cooperative work, emotion management, etc.). We present other methodologies aimed to achieve those competencies, such as problem-based learning, the projects method, the case method, and the critical incidents, gamification, role-playing games or the resident's logbook, highlighting the competencies that each of them help to acquire. We dedicate a section to entrustable professional activities (EPAs), an operational methodological approach that facilitates the implementation of competency-based medical education and evaluation through clinical activities. The combination of complementary methodologies with clinical activities completes the map to acquire the competencies required in specialized training and guide the tutor in order to plan the training of the specialist

Professionalism in dental education

Several authors as well as professional and educational institutions have advanced the issue of professionalism in the field of dentistry, agreeing that, even though professionalism plays a central role in the training of dentists, its incorporation in the curriculums of dental schools worldwide is limited. Therefore, graduates have poor training in dental professionalism. This review article will analyze the concepts of cross-disciplinary skills, such as professional values and the formation of professionalism in different areas during the dental career, with the purpose of highlighting the importance of these aspects in the training of dentistry students and, on the other hand, the responsibility of educational institutions in providing students with such training.

Diversos autores e instituciones profesionales y educativas han desarrollado el tema del profesionalismo en el ámbito odontológico y han coincidido en señalar que, aunque se reconoce que el profesionalismo juega un rol central en la formación de los odontólogos, su incorporación en los planes de estudio de las facultades y escuelas de odontología a nivel mundial es limitada. Esto hace que los estudiantes egresen con un nivel mínimo de formación en profesionalismo odontológico. Esta revisión profundizará en los conceptos de competencias transversales, como los valores profesionales y la formación del profesionalismo desde diferentes ámbitos durante la carrera de odontología, con el propósito de destacar, por una parte, la importancia que tienen estos aspectos en la formación del estudiante de odontología y, por otra, la responsabilidad que tienen las instituciones educativas de lograr que éste adquiera tal formación.

La carrera de odontología en el contexto actual de la educación superior chilena / Dental programs in the current context of Chilean higher education

La carrera de Odontología se ha constituido en un fiel reflejo de lo que sucede actualmente en la educación superior en Chile: está en crisis, al igual que todo el Sistema de Educación. La "Ley General de Universidades", promulgada en 1981, exalta la "libertad de enseñanza" dejando sin embargo en manos del mercado la oferta y regulación de la educación. La transformación desde un Estado garante de la educación como un derecho, a lo que sucede hoy donde la educación es un bien de consumo donde los estudiantes son clientes y las instituciones educacionales prestadoras de servicio y cuyo principal objetivo es la ganancia por el servicio prestado, ha desencadenado consecuencias que resultan en extremo preocupantes, especialmente en nuestra disciplina. La carrera de Odontología forma profesionales fuertemente ligados a las necesidades de salud del país y de las personas menos privilegiadas, y posee un alto prestigio transversal en la sociedad chilena. Sin embargo, hoy es una de las carreras en Chile con mayor aumento de matrículas y titulación, con los mayores costos de aranceles para los estudiantes y sus familias y con una escasa regulación de la acreditación necesaria para impartirla y, por lo tanto, con muchas de sus escuelas de cuestionable calidad. Adicionalmente, la sobreoferta de profesionales ha provocado que estemos siendo testigos de las primeras generaciones de odontólogos desempleados o con una importante precarización de sus trabajos. En este contexto, resulta imprescindible abordar a fondo la crisis estructural del sistema de educación superior en Chile, que afecta directamente a la educación odontológica, para que sus objetivos principales estén nuevamente entrelazados con las necesidades de las personas, de la sociedad y del país. Estos son algunos de los desafíos de transformación que necesita de manera imperiosa nuestro sistema de educación superior en general y la carrera de Odontología en particular.

The status of dentistry in Chile is accurately reflected by that of the country's higher education system in general ­ crisis. The "Higher Education Act" passed in 1981, and kept in force for more than three decades, exalts a "freedom of education" but leaves the realization and regulation of this idea in the hands of the free market. The resulting transformation has led from the State guaranteeing education as a fundamental right to education being treated as a consumer good, with the students as clients and educational institutions as suppliers whose objective is to turn a profit. This ideological shift has triggered a number of highly troubling consequences, especially in the field of dentistry. From a cultural perspective, dentistry was founded with an objective to train professionals strongly aligned with the health needs of the country and of the less privileged, which has resulted in the prestigious position that dentists transversally hold across Chilean society. The current rates of dentistry program enrollment and graduation are among the fastest growing within Chilean higher education. However, dentistry programs also have some of the highest financial costs for students and their families, and limited regulation in terms of accreditation means that many dentistry schools are of questionable quality. Additionally, the oversupply of dentistry graduates has meant that Chile is now witness to the first generations of unemployed or underemployed dentists. Considering this current situation, an in-depth analysis of the structural crisis within Chile's higher education system is essential. This crisis directly affects dentistry education, and realignment is needed to bring this field back to its foundation of focusing on the needs of people, the society, and the country. These are some of the transformational challenges facing the Chilean higher education system in general and dentistry education in particular.

Diez claves pedagógicas para promover buenas prácticas en la formación médica basada en competencias en el grado y en la especialización / Ten pedagogical keys to promote good practices in competency-based Medical Education, for undergraduate and postgraduate

Durante la pasada década, la formación basada en competencias ha sido un término muy utilizado en Educación Médica. Los autores de este artículo argumentan que aunque se han desarrollado cambios relevantes en algunas facultades y centros sanitarios de formación de especialistas, en muchos otros lo único que ha cambiado es el nombre de las cosas para continuar haciendo lo mismo y no producir ninguna modificación en el perfil competencial de los estudiantes y los residentes. También se da el caso de instituciones que ni siquiera se plantean algún tipo de movimiento. Sin embargo, la situación social actual requiere pensar en una educación basada en competencias y establecer perfiles competenciales que respondan a las nuevas necesidades sociosanitarias. Por ello, el paso de una formación tradicional a una formación mediante competencias tiene que generalizarse y consolidarse en las instituciones educativas y sanitarias. Los autores del artículo argumentan que el cambio de la formación tradicional a otra apoyada en competencias tiene que liderarse desde las direcciones, los gestores y los docentes/tutores, y que las decisiones que ellos adopten han de estar fundamentadas en un marco pedagógico que concretan en 10 claves pedagógicas. Finalmente, concluyen que los currículos y programas de formación asentados en estas claves pedagógicas garantizan tanto el desarrollo de un perfil competencial de estudiantes y residentes comprometidos con un mundo más humano y más justo como el desarrollo de una buena práctica de formación en Educación Médica

During the past decade, the competency-based training has become a familiar term in Medical Education. The authors of this article argue that, although there have been outstanding changes in some universities and medical centers, in many others the only thing that has been changed is the name of concepts, but keeping on doing the same without producing any changes in the competence profile of students and residents. Also, there are institutions that do not even consider some kind of movement. Nevertheless, the current social situation requires to think of a competency-based education and to establish competency profiles to address the health needs. Therefore, the transition from a traditional training to a competency-based training must be broadened and strengthened in educational and health institutions. The authors argue that the shift from traditional training to a competency-based one has to be led for the directors, staff, and teachers/tutors, and that the decisions they make need to be founded on a pedagogical framework. They also specify this framework in 10 pedagogical keys which they set out throughout this reflection. Finally, they conclude that the well-established curricula and training programs based in these pedagogical keys, guarantee not only the development of the competency-based profile of students and residents committed to a more humane and fair world, but also the development of a good training practice in Medical Education