An Introduction to Occupational Medicine Using a Team-Based Learning Methodology.

OBJECTIVE: To explore the experiences of three cohorts of medical students where Team-Based Learning (TBL) methodology was used to facilitate the achievement of Occupational Medicine learning objectives. METHODS: The TBL Occupational Medicine sessions involved five components, pre-class preparation, readiness quizzes, application activities, full-group discussion, debriefing and feedback surveys. RESULTS: Learning objectives were met. Students gained a good introduction to return-to-work issues that they will likely face in a clinical setting, and commented that the process generated effective discussion related to realistic cases. Through authentic teamwork, students applied their collective knowledge and critical thinking skills to complex problems related to workplace health and safety. CONCLUSIONS: Traditional case based learning activities could be modified to incorporate aspects of TBL, including readiness quiz, team activities with realistic cases, and debriefing. TBL requires role and attitudinal changes from both faculty and students.

Interprofessional education in U.S. and Canadian dental schools: an ADEA Team Study Group report.

The state of interprofessional education (IPE) in U.S. and Canadian dental schools was studied by the American Dental Education Association (ADEA) Team Study Group on Interprofessional Education. The study group reviewed the pertinent IPE literature, examined IPE competencies for dental students, surveyed U.S. and Canadian dental schools to determine the current and planned status of IPE activities, and identified best practices. Members of the study group prepared case studies of the exemplary IPE programs of six dental schools, based on information provided by those schools; representatives from each school then reviewed and approved its case study. Six reviewers critiqued a draft of the study group's report, and study group members and reviewers met together to prepare recommendations for schools. This report identifies four domains of competence for student achievement in IPE and summarizes responses to the survey (which had an 86 percent response rate). It also includes the case descriptions of six schools' IPE programs and the study group's recommendations for dental schools. The report concludes that there is general recognition of the goals of IPE across U.S. and Canadian dental schools, but a wide range of progress in IPE on the various campuses. Challenges to the further development of IPE are discussed.

Beyond alcoholism: Wernicke-Korsakoff syndrome in patients with psychiatric disorders.

OBJECTIVE: Wernicke encephalopathy and Korsakoff syndrome (the combined disorder is named Wernicke-Korsakoff syndrome [WKS]) are preventable, life-threatening neuropsychiatric syndromes resulting from thiamine deficiency. WKS has historically been associated with alcoholism; more recently, it has been recognized in patients who have anorexia nervosa or have undergone bariatric surgery for obesity. However, patients with nutritional deficiencies of any origin are at risk for WKS. We present clinical histories and neuroimaging data on 2 young adults with underlying psychiatric disorders who became malnourished and developed WKS. METHODS: A young woman with bipolar disorder and somatization disorder was hospitalized for intractable vomiting. A young man with chronic paranoid schizophrenia developed delusions that food and water were harmful, and was hospitalized after subsisting for 4 months on soda pop. RESULTS: Acute, life-threatening Wernicke encephalopathy was confirmed in both patients by brain magnetic resonance imaging showing classic thalamic injury. The patients were left with persistent cognitive and physical disabilities that were consistent with Korsakoff syndrome. CONCLUSIONS: Failure to suspect a vitamin deficiency led to permanent cognitive and physical disabilities that may necessitate lifelong care for these patients. The neuropsychiatric consequences could have been prevented by prompt recognition of their thiamine deficiency.

Faculty impressions of dental students' performance with and without virtual reality simulation.

This study compared faculty perceptions and expectations of dental students' abilities using virtual reality simulation (VRS) to those who did not use virtual reality simulation (non-VRS) in an operative dentistry preclinical course. A sixteen-item survey with a ten-point rating scale and three open-ended questions asked about students' abilities in ergonomics, confidence level, performance, preparation, and self-assessment. The surveys were administered three times to a small group of preclinical faculty members. First, faculty members (n=12, 92 percent response rate) gave their perceptions of non-VRS students' abilities at the end of their traditional course. Secondly, faculty members (n=13, 100 percent response rate) gave their expectations of the next incoming class's abilities (VRS students) prior to the start of the course with traditional and VRS components. Finally, faculty members (n=13, 100 percent response rate) gave their perceptions of VRS students' abilities after completion of the course. A Tukey's test for multiple comparisons measured significance among survey items. Faculty perceptions of VRS students' abilities were higher than for non-VRS students for most abilities examined. However, the faculty members' expectations of VRS training were higher than their perceptions of the students' abilities after VRS training for most abilities examined. Since ergonomic development and technical performance were positively impacted by VRS training, these results support the use of VRS in a preclinical dental curriculum.

1Health, the Center for Interprofessional Education, the University of Minnesota.

The Center for Interprofessional Education within the Academic Health Center at the University of Minnesota is launching a new initiative called 1Health. 1Health requires health professional students to participate in courses and/or experiences to achieve competencies set by the Academic Health Center prior to graduation. This new initiative will launch with Phase I in the fall of 2010 and will include all beginning health professional students enrolled in participating programs.

Experience with virtual reality-based technology in teaching restorative dental procedures.

This article reports on extensive experience with advanced simulation at the University of Pennsylvania, School of Dental Medicine (UPSDM). Virtual reality-based technology (VRBT) or advanced simulation is currently available for the instruction of dental students in preclinical restorative procedures. UPSDM was one of the first schools in the world to have extensive experience with VRBT technology using an advanced simulation unit (DentSim) from DenX, Ltd. UPSDM's experience consists of several years of research using control and experimental groups, employing students to participate in an investigative project, and using the units for remediation and a supplement to the preclinical laboratory. Currently, all first-year students (Class of 2007 and Class of 2008) are receiving most of their preparative operative training on the VRBT units. UPSDM started with one (beta) version unit in 1998, which was later updated and expanded first to four units and recently to fifteen units. This communication is presenting the studies that were of fundamental importance in making the decision to acquire fifteen units in 2003. The areas of main interest to the SDM concerning this technology were its use in teaching, refreshing, and remediating students in restorative procedures and its effectiveness as a teaching methodology in relation to time, efficiency, and faculty. Several studies with varying parameters were performed at various time points. The limited statistical analysis conducted was not conclusive for all measures, and in some cases the data only suggest areas of possible significance. This is due to the low number of students who could access the limited number of available units and the change of protocols in response to student and faculty input. Overall, the results do suggest, however, that students learn faster, arrive at the same level of performance, accomplish more practice procedures per hour, and request more evaluations per procedure or per hour than in our traditional laboratories. Students' attitudes, as measured by surveys, group interviews, and private interviews, are mixed. Our overall evaluation of our experience with this technology has been positive and led to the purchase of additional units, its full incorporation into our curriculum, and curriculum revision to maximize its potential. Our conclusion is that this technology offers significant potential in the field of dental education and that further use and investigation are both desired and justified.

Improving the oral health status of all Americans: roles and responsibilities of academic dental institutions: the report of the ADEA President's Commission.

Academic dental institutions are the fundamental underpinning of the nation's oral health. Education, research, and patient care are the cornerstones of academic dentistry that form the foundation upon which the dental profession rises to provide care to the public. The oral health status of Americans has improved dramatically over the past twenty-five to thirty years. In his 2000 report on oral health, the Surgeon General acknowledges the success of the dental profession in improving the oral health status of Americans over the past twenty-five years, but he also juxtaposes this success to profound and consequential disparities in the oral health of Americans. In 2002, the American Dental Education Association brought together an ADEA President's Commission of national experts to explore the roles and responsibilities of academic dental institutions in improving the oral health status of all Americans. They have issued this report and made a variety of policy recommendations, including a Statement of Position, to the 2003 ADEA House of Delegates. The commission's work will help guide ADEA in such areas as: identifying barriers to oral health care, providing guiding principles for academic dental institutions, anticipating workforce needs, and improving access through a diverse workforce and the types of oral health providers, including full utilization of allied dental professionals and collaborations with colleagues from medicine.