Academy: strengthening the educational mission in academic health centers.

A dental school in the modern academic health center often finds that its traditional mission of educating dentists has become more complex as a result of the increased emphasis placed on research and patient care. Although health care education clearly benefits from a rich environment including research and patient care, faculty often find themselves conflicted about their roles in the complex mix of activities in the health center. In order to support faculty in their educational activities, several schools have formed organizational structures with the specific purpose of providing financial and developmental assistance. This article describes a model for an organizational structure within the Harvard School of Dental Medicine designed to promote educational excellence and then describes two academies dedicated to promoting teaching quality at Harvard Medical School and at the University of California at San Francisco.

A survey of information technology management at U.S. dental schools.

The purpose of this project is to assess how information technology (IT) is being implemented and managed in U.S. dental schools. Recent advances in IT have restructured many of the administrative, curricular, and clinical functions in dental schools. Purchasing hardware and software and hiring personnel to maintain IT present significant financial and administrative commitments for these schools. A nine-question survey was sent to all U.S. dental schools via email with a follow-up postal mailing. Forty-six surveys were returned (83.6 percent response rate). The analysis indicates that dental schools are managing IT in vastly different ways. For example, 71 percent of the schools report a centralized structure, and 61 percent have a line item in the budget to manage IT. On average there are 4.4 full-time equivalents hired to manage IT, with the majority of these people being trained in IT (eight schools reported dually trained IT/dental personnel). The majority of schools report using software to manage their admissions process (70 percent), curriculum analysis (72 percent), and delivery of curriculum content (72 percent), as well as to manage their student clinics (91 percent, business aspect; 87 percent, patients; 65 percent, grading on clinic floor; 76 percent, managing clinical evaluations) and faculty practices (85 percent, business aspect; 65 percent, patients). The use of multimedia (50 percent) and simulation (52 percent) in the preclinical area is mixed. The purchase of laptops (24 percent) and PCs (11 percent) is required in almost a third of all schools participating in this survey. Dental schools in the United States are managing IT in a variety of different ways, using various internally and commercially available tools. The cost to institutions can be large and is usually handled in centralized structures in the school with fixed budgets. The results of this survey can be used to assist schools in the planning and implementation of IT at their institutions.

Membrane type (MT) 1-matrix metalloproteinase (MMP) and MMP-2 expression in ligature-induced periodontitis in the rat.

BACKGROUND: Matrix metalloproteinases (MMPs) have been shown to be involved in the degradation of the extracellular matrix (ECM). In particular, MMP-2 and MMP-9 (gelatinase A and gelatinase B, respectively) have been identified as the predominant MMPs during periodontitis. Recent studies have indicated that a novel transmembrane MMP, mebrane-type 1 matrix metalloproteinase (MT1-MMP), can activate pro-MMP-2 in tumor metastasis. This study aims to elucidate the presence and localization of MT1-MMP and MMP-2 in periodontitis in a rat model. METHODS: In 2 groups of 40-day-old male Sprague-Dawley rats, periodontitis was initiated by ligating floss around maxillary second molars. A group of control animals were left untreated. Maxillary dentoalveolar segments were isolated after 7 and 21 days postinduction and were prepared for gross and radiographic analysis of bone loss and for histological analysis. Samples were also prepared for gel zymography to detect the presence of MMP-2, and for Northern blot analysis and in situ hybridization with MT1-MMP probes. RESULTS: MMP-2 expression increased at 21 days following ligature placement, in conjunction with MT1-MMP expression. MT1-MMP mRNA expression was observed in epithelial cells, fibroblasts, and in multinucleated cells in the periodontium. CONCLUSION: Our data suggest that MT1-MMP may play a role in extracellular matrix degradation during periodontitis, in concert with MMP-2 and other proteinases.

Tutoring in a problem-based curriculum: expert versus nonexpert.

Many studies have examined whether being an "expert" influences the success of a tutor in a problem-based learning curriculum. There are, however, no established standards by which to determine expertise. The purpose of this study was to examine whether students evaluate expert and nonexpert tutors comparably and to determine whether setting different standards to determine expertise influences the outcome of the above findings. Tutor evaluations, consisting of eight Likert-type questions completed by first-, second-, and third-year dental students, were analyzed. Tutors were ranked by the authorswithin three different categories of expertise based on the highest educational degree they had attained, familiarity with the specific subject matter, and previous problem-based learning (PBL) experience. Linear regression analyses were then performed between each category and student evaluation results. A statistically significant difference was found in the way students evaluated experts, but only when expertise was defined by the tutor's previous tutorial experience. The findings of this study underscore the importance of the retention of dental faculty with PBL experience in a PBL-based curriculum.

Learning disabilities in dental education: trends, management, and concerns in U.S. dental schools.

The prevalence of learning disabilities (LD) in higher education has drawn significant attention at the undergraduate level. College freshmen reporting learning disabilities have increased significantly in the past twenty years. Although anecdotal evidence suggests an increase in the number of dental students with learning disabilities, nothing has been published regarding how dental education is affected by this general trend. The purpose of this study was to obtain information from U.S. dental school administrators regarding the incidence and prevalence of learning disabilities in dental education. We hypothesized that there has been an increase in diagnosed cases of learning disabilities in dental education. Following a pilot study to identify individuals responsible for working with students with learning disabilities in U.S. dental schools (response rate 91 percent, n = 49), a eighteen-item survey instrument was distributed to specific contact individuals (response rate 81 percent, n = 44). Mean cumulative incidence of diagnosed cases of learning disabilities was 0.3 percent; mean prevalence of identified diagnosed cases of LD 0.7 percent. Pearson analysis revealed a statistically significant weak positive correlation between mean prevalence and year, suggesting an increase in identified diagnosed cases of LD in U.S. dental schools over the past seven years (r = 0.24, p = 0.002). We conclude that the presence of learning disabilities in dental education is silent, pervasive, and deserves increased attention.