Humanism in Dental Education: A Comparison of Theory, Intention, and Stakeholder Perceptions at a North American Dental School.

In today's dental education environment, a humanistic culture is an expectation for all U.S. dental schools, codified in 2013 by its inclusion in the Commission on Dental Accreditation's standards for accreditation. The University of the Pacific Arthur A. Dugoni School of Dentistry has made an active commitment to humanism since the mid-1970s. The aim of this study was to determine how well the school's students and faculty and staff members perceived the school was living up to its formal aspirational values and who was benefitting from the humanistic culture. Using an electronic survey, data were collected from a total of 195 students, faculty members, and staff members in 2014. Respondents were 15% of the 492 full- and part-time faculty members; 9% of the total student population of 540; and 29% of 255 staff members. In the responses, humanism was described as manifest by attributes such as caring, understanding, respect, and compassion. Although the findings confirmed the value of a humanistic culture, some portions of the school's formal definition and goals, such as good work ethic, professional responsibility, high ethical standards, increasing independence, and attainment of competence, appeared less frequently in responses. Authentic assessment of institutional culture proved challenging. Focus groups offered additional ways to assess how effectively the school lives its core value of humanism. There was recognition that more varied, robust methods were needed to assess institutional alignment with stated goals for a humanistic learning environment.

Teaching Skill Acquisition and Development in Dental Education.

Development of dental faculty members is paramount to providing outstanding education and role modeling for students. With the large number of second career educators in dental schools, an efficient method of acquiring teaching skills is important for new faculty members. Knowing the skill progression and learning experiences identified by dental educators of varying rank may lead to more efficient, effective faculty development. The aims of this study were to identify the perceptions of a group of faculty members about the knowledge, skills, attitudes, and learning experiences that contribute to developing teaching expertise and to compare and contrast the perceptions of new and more senior faculty members on these subjects. The Dreyfus skill acquisition continuum of novice to expert performance was used as a construct reference. The study used a mixed-methods approach in which qualitative and quantitative data were collected concurrently in an electronic survey of faculty members at one U.S. dental school. Of the 492 total faculty members, 80 survey responses were received, for a 16% response rate. Open coding and analysis of responses revealed some common themes. Building rich content knowledge and learning varied methodologies for teaching and assessment, supported by an awareness of peer role models, were perceived to be features of early growth. Content prioritization, clarity, and customization appropriate for the learner characterized mid growth. As theorized in the Dreyfus model, more experienced faculty members described a fluid, less structured teaching process, increased reflection, and appreciation of the strength of the educational community. The results of this study may help increase dental educators' understanding of teaching skill acquisition and inform faculty development and support.

Using a Dental Student Exercise on Shear Bond Testing to Both Provide Skills Practice and Demonstrate a Research Process.

This article describes an exercise with junior dental students at the University of the Pacific Arthur A. Dugoni School of Dentistry designed in part to serve the requirement for dental accreditation Standard 6-3 ("Dental education programs must provide opportunities, encourage, and support student participation in research and other scholarly activities mentored by faculty"). The exercise has been conducted for seven years and has been found to provide a distinctive and important experience to the education of these dental students. The exercise has three aims. First, it is an exercise in which students practice their skills with dental bonding; second, it serves as a tool to give immediate feedback on these skills that is otherwise not possible in a real patient situation; and third, it demonstrates to the students how data from the exercise with the students as subjects can be used in a research study. The project thus serves as an innovative way to use a skill-building exercise to educate students about research at the same time.

Understanding root resorption with diagnostic imaging.

This article presents the clinical, radiographic and histopathologic features of various types of tooth root resorption. Tooth resorption may occur in a tooth internally or externally with distinctively different treatment approaches for each type of resorption. Given that proper diagnosis of the type of resorption is important, the use of cone beam computed tomography (CBCT) and conventional 2-D intraoral images in evaluation of resorptive lesions is discussed.

Underreporting of bloodborne exposures in a dental school clinic.

This study explored the rate of underreporting of bloodborne exposures among dental students in a U.S. dental school during the final two years of clinical practice. It also explored the reasons students cite for failing to report bloodborne exposures. Surveys of the dental students found that senior students reported only 43 percent of the exposure incidents they experienced in their final year of clinical education and that the rate of reporting declined from the junior year to the senior year. We subsequently undertook an educational campaign to raise awareness among the students regarding the importance of reporting exposure incidents. Surveys were repeated for the next two years at the end of each academic year. The following year, the senior class indicated they had reported 79 percent of the experienced exposure incidents. This was not only a significant improvement over the previous year, but also demonstrated an improvement in reporting from their junior year to senior year, reversing the previously noted trend for exposure reporting to drop off in the senior year.

The case of the pregnant adolescent.

In this case an adolescent, minor female presents herself for routine dental care, but is pregnant without parental knowledge. She asks the dentist not to reveal the pregnancy to her parents. Three experts including one attorney, one dental educator with 25 years of private practice experience, and one member of a state psychological association's ethics committee comment on the difficult ethical and legal issues found in this actual case.

The dental patient who is "high:" ethical and scientific recommendations for the standard of care.

Patients sometimes appear for dental appointments after consuming alcohol or marijuana. There is presently no consensus standard of care in this area, and dentists vary in their responses to such patients. This paper includes interviews with practitioners and a review of the relevant biochemical and physiological science. The ethics of various ways to handle this challenging situation are examined, and evidence-based recommendations for dental practice are offered. While there is reason for caution, the authors conclude that a blanket "do not treat" policy is unwarranted. Informed consent and transportation safety issues pose significant moral challenges when a dental patient is "high."

Leadership.

Leadership opportunities are all around us as dental professionals. In fact, dentists may not realize the expectations that are placed on them as health care professionals to provide leadership. This article will address the various stages of a dentist's career giving examples of leadership opportunities and responsibilities that a dentist encounters, with ideas as to how these might be approached and managed.

Clinical quality assurance surveillance and targeted interventions: managing unfavorable trends in a dental school clinic.

Dental schools establish quality assurance (QA) programs that are intended to improve patient care, comply with requirements of liability carriers and regulatory agencies, and maintain accreditation. Data collection, trend analysis, and interventions are typically used in QA programs to monitor and improve compliance. The purpose of this article is to discuss unfavorable trends and examine the effect of targeted interventions in three clinical operations: infection control, removable prosthodontics, and case reviews of students' patient care in progress (interim case reviews) at a U.S. dental school. Infection control compliance was evaluated and interventions were implemented beginning in 2002 to correct unfavorable trends in two protocols: placement of students' mobile supply cart and the use of overgloves. A predelivery esthetic consent was introduced in spring 2004 to decrease esthetic failures in removable prosthodontics. For interim case reviews, two areas received interventions going back to 2003: reevaluation following initial periodontal therapy and orthodontic screening. The data presented are not meant to show conclusive success of particular interventions, but to display broad trends and suggest methods to manage quality assurance parameters. These trends suggest we had better success with the interventions that were simple, valuable, measurable, and repeatable than with interventions that less fit these criteria.