Career transition and dental school faculty development program.

Academic dentistry, as a career track, is not attracting sufficient numbers of new recruits to maintain a corps of skilled dental educators. The Faculty Development Program (FDP) at the University of Texas Health Science Center at San Antonio Dental School received federal funds to institute a 7-component program to enhance faculty recruitment and retention and provide training in skills associated with success in academics including:(1) a Teaching Excellence and Academic Skills (TExAS)Fellowship, (2) training in research methodology,evidence-based practice research, and information management, (3) an annual dental hygiene faculty development workshop for dental hygiene faculty, (4) a Teaching Honors Program and Academic Dental Careers Fellowship to cultivate students' interest in educational careers, (5) an Interprofessional Primary Care Rotation,(6) advanced education support toward a master's degree in public health, and (7) a key focus of the entire FDP, an annual Career Transition Workshop to facilitate movement from the practice arena to the educational arm of the profession.The Career Transition Workshop is a cap stone for the FDP; its goal is to build a bridge from practice to academic environment. It will provide guidance for private practice, public health, and military dentists and hygienists considering a career transition into academic dentistry. Topics will be addressed including: academic culture, preparation for the academic environment,academic responsibilities, terms of employment,compensation and benefits, career planning, and job search / interviewing. Instructors for the workshop will include dental school faculty who have transitioned from the practice, military, and public health sectors into dental education.Objectives of the Overall Faculty Development Program:• Provide training in teaching and research skills,career planning, and leadership in order to address faculty shortages in dental schools and under representation of minority faculty.• Provide resident and faculty training in cultural and linguistic competency.• Develop and conduct a collaborative inter professional education project with a Pediatric Medicine department, a nursing school, and other health professions' education programs.• Provide faculty and residents with financial support to pursue a master's degree in public health; and • Provide support and assistance for dental practitioners desiring to explore a transition into the educational environment.

An interprofessional education initiative: Introducing a local anesthesia dental course for nurse practitioner and physician assistant students.

PURPOSE/OBJECTIVE: To assess the impact of local anesthesia (LA) course for physician assistant (PA) and adult gerontology-acute care nurse practitioner (NP) program students on knowledge, attitudes, confidence, and intention to incorporate skills in clinical practice. METHODS: The course was conducted by dental faculty for forty-eight PA and seven NP students and consisted of two lecture hours on anatomy of the oral cavity, anesthesia and pain management, 2 hours of preclinic lab where participants practiced injection technique on mannikins, and a clinical practicum conducted by dental school faculty and residents where students observed dental treatment including administration of LA, and discussed symptom triage by NPs and PAs for patients with dental problems including orofacial pain, initial management including LA, and patient referral to dentists. An online survey was administered to all students before and after the course to assess changes in knowledge, attitudes, confidence, and intention to incorporate LA administration skills into clinical practice and elicit students' perception of program quality. Pre- to post-changes were analyzed by two-tailed t-tests and analysis of variance (ANOVA) with significance at 0.05. RESULTS: The response rate for pre- and post-course assessment was 96.4% and 87.3% respectively. Students' overall scale score for self-assessment of dental knowledge increased significantly from pre- (2.34) to post-assessment (4.19). An increase was seen in students' attitudes regarding management of dental emergencies (t = 2.181; p < 0.05). Furthermore, overall confidence of students related to managing patients with dental problems increased significantly (2.00 to 3.85) after taking the course. CONCLUSION: The LA course was well received by PA and NP students and resulted in increased knowledge and confidence in recognizing common oral health conditions, understanding dental pain management including administration of LA, and making referrals to dentists to optimize patient care.

Pilot test of an emerging leaders program for dental school faculty.

PURPOSE/OBJECTIVES: The School of Dentistry at The University of Texas Health Science Center at San Antonio (UTHSA-SoD) implemented an SoD Emerging Leaders Program (SoDELP) in 2020-2021. This case report describes the leadership training needs of junior faculty that stimulated SoDELP development, the inter-institutional collaboration that facilitated program implementation, SoDELP curriculum content, and outcomes of formative assessment for two pilot cohorts of the SoDELP. METHODS: The 32-h curriculum was comprised of readings, reflection exercises, seminars by the Center for Professional Excellence at the University of Texas at San Antonio, case discussion, analysis of leadership dilemmas, and self-assessments. For a capstone project, participants created a case depicting a challenging leadership situation they experienced as a team leader or member. The SoDELP commenced in a face-to-face format but was completed online due to COVID 19. Formative evaluation included participants' pre- and post-training perceptions elicited by the Leadership Attitudes, Confidence and Concerns Inventory (LACCI) and qualitative appraisal of program components obtained by surveys and focus groups. RESULTS: All 18 participants completed SoDELP and provided positive evaluations of program content, organization, teaching quality, and value. Analysis of pre- and post-assessments indicated that participants' confidence in performing an array of leadership tasks was significantly enhanced, and participants' concerns about assuming leadership roles, such as not being ready for the job, impact on friendships, or concerns about ethical challenges, were significantly reduced. The LACCI displayed promising reliability in assessing participants' confidence, attitudes and concerns, demonstrating the potential to serve as a measurement tool to appraise outcomes of leadership training in the health professions. CONCLUSION: Outcomes suggest that SoDELP enhances faculty members' sense of readiness for leadership roles, and the LACCI may be a useful assessment tool for leadership training.

Teaching evidence-based practice at the University of Texas Health Science Center at San Antonio dental school.

The overarching goal of the Evidence-Based Practice Program at San Antonio is to provide our graduates with life-long learning skills that will enable them to keep up-to-date and equip them with the best possible patient care skills during their 30-40 years of practice. Students are taught to (1) ask focused clinical questions, (2) search the biomedical research literature (PubMed) for the most recent and highest level of evidence, (3) critically evaluate the evidence, and (4) make clinical judgments about the applicability of the evidence for their patients. Students must demonstrate competency with these "just-in-time" learning skills through writing concise one-page Critically Appraised Topics (CATs) on focused clinical questions. The school has established an online searchable library of these Critically Appraised Topics. This library provides students and faculty with rapid, up-to-date evidence-based answers to clinical questions. The long-range plan is to make this online library available to practitioners and the public.

The San Antonio CATs Initiative.

There is evidence from medicine that schools and practitioners are slow to adopt new and proven effective treatments while marketing efforts lead practitioners to too quickly adopt unproven modalities. To address these problems, the dental school at the University of Texas Health Sciences Center at San Antonio, has developed a program designed to teach students, faculty, and practitioners the skills of accessing the literature as an intrinsic part of treatment. The Critically Appraised Topics (CATs) program is described and evidence is presented showing that participants can be taught to prepare high-quality summaries of the literature pertinent to clinical problems.

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.

Case Report of a Program to Enhance Dental Students' Interest in Academic Dentistry.

This case report describes a Teaching Honors Program (THP) at the UT Health San Antonio School of Dentistry and presents findings from an outcomes assessment covering the initial 11 years of the program. The program goals are to enhance dental students' awareness of academic career options, promote student and faculty collaboration on educational development projects, and provide students with training in teacher toolkit skills to increase their readiness for peer teaching during dental school and faculty roles early in their careers. The THP curriculum consists of six core courses and nine electives extending across the four years of dental school. THP graduates receive the academic designation "Distinction in Dental Education" at commencement. Outcomes data are organized by Kirkpatrick's Hierarchy of Educational Outcomes: reaction (participants' satisfaction with THP), indicators (students' attitudes and intentions pertinent to teaching and academic careers), learning (changes in knowledge and skills relevant to teachers' tasks), behavior (students' ability to apply teaching skills in classrooms, labs, and clinics), and results (changes in the infrastructure and capacity of the school as a consequence of the THP). Positive outcomes were found in multiple layers of the assessment hierarchy. In 2016, 51% of students participated in the THP, and 31 graduated with Distinction in Dental Education; in 2017, 50% participated, and 44 graduated with that honor. THP students provide approximately 1,400 hours of supervised peer teaching annually in the predoctoral curriculum and pre-matriculation programs, and 21% of the initial 106 THP graduates entered academic dentistry soon after graduation.

Online Case-Sharing to Enhance Dental Students' Clinical Education: A Pilot Study.

Dental students' clinical learning is dictated by patients' needs. Thus, not all students have identical educational experiences. Even routine treatment can require different approaches depending on concurrent dental problems, patients' health status, or unexpected complications. No curriculum can expose students to all treatment alternatives when issues arise. Consequently, mechanisms to facilitate students' learning from the collective experiences of their classmates can augment their clinical acumen. The aim of this pilot study was to investigate a blended learning experience consisting of a website on which third- and fourth-year students posted and discussed PowerPoint presentations depicting patient treatment and weekly seminars in which students and faculty discussed posted cases to retrospectively assess treatment decisions. All 49 students in two of the school's general practice groups (23 fourth-year and 26 third-year students) in academic year 2011-12 participated, using a PowerPoint template to create cases to share with their peers. The students completed the Clinical Education Instructional Quality Inventory (Clin-EdIQ) before and after the case-sharing experience. The results showed statistically significant pre- to posttest increases on the four ClinEdIQ dimensions: overall clinical learning experience, specific learning opportunities, interaction among students and instructors, and collaborative learning. These students also reported that the online case-sharing and follow-up seminars were a valuable educational experience. However, students not involved in case-sharing had similar pre to post ClinEdIQ score changes. The results suggest that online case-sharing supported by case analysis seminars facilitated exchange of clinical insight among students and instructors, but may not have altered students' perceptions of the clinical learning environment.

Assessing dental students' competence: best practice recommendations in the performance assessment literature and investigation of current practices in predoctoral dental education.

In this article, the Task Force on Student Outcomes Assessment of the American Dental Education Association's Commission on Change and Innovation in Dental Education describes the current status of student outcomes assessment in U.S. dental education. This review is divided into six sections. The first summarizes the literature on assessment of dental students' performance. Section two discusses catalysts, with a focus on problem-based learning, for development of new assessment methods, while the third section presents several resources and guides that can be used to inform selection of assessment techniques for various domains of competence. The fourth section describes the methodology and results of a 2008 survey of current assessment practices in U.S. dental schools. In the fifth section, findings from this survey are discussed within the context of competency-based education, the educational model for the predoctoral curriculum endorsed by the American Dental Education Association and prescribed by the Commission on Dental Accreditation. The article concludes with a summary of assessments recommended as optimal strategies to measure three components of professional competence based on the triangulation model. The survey of assessment practices in predoctoral education was completed by 931 course directors, representing 45 percent of course directors nationwide, from fifty-three of the fifty-six U.S. dental schools. Survey findings indicate that five traditional mainstays of student performance evaluation-multiple-choice testing, lab practicals, daily grades, clinical competency exams, and procedural requirements-still comprise the primary assessment tools in dental education. The survey revealed that a group of newer assessment techniques, although frequently identified as best practices in the literature and commonly used in other areas of health professions education, are rarely employed in predoctoral dental education.

Critical Thinking in Dental Students and Experienced Practitioners Assessed by the Health Sciences Reasoning Test.

To date, there has been a lack of published studies examining the validity of the Health Sciences Reasoning Test (HSRT) to assess critical thinking among dental students. The aim of this study was to examine the construct validity of the HSRT using a novice-expert model consisting of first-year dental students as novices and experienced general dentists as experts. Novice cohort subjects were recruited from all 105 students in the first-year dental school class at the University of Texas Health Science Center at San Antonio during a regularly scheduled course in August 2015. A total of 83 students participated, for a 79% response rate. Thirty individuals personally recruited from the same school's faculty and from private practitioners made up the expert cohort. The results showed that the adjusted mean overall score for the expert cohort (25.31) was significantly higher than that of the novice cohort (22.64) (p=0.04). The expert cohort achieved higher adjusted mean scores in all scales (Induction, Deduction, Analysis, Inference, and Evaluation), with the difference in the Analysis scale being significant (p=0.02). In this study, experienced general dentists achieved significantly better overall scores on the HSRT as compared to first-year dental students, suggesting the instrument was able to measure differences between novice and expert. Further efforts to validate the instrument in a dental education setting and to understand its correlation with strategies and practices aimed at developing critical thinking in dental students are warranted.

Does faculty development enhance teaching effectiveness?

Academic dentists and members of the practice community have been hearing, for more than a decade, that our educational system is in trouble and that the profession has lost its vision and may be wavering in the achievement of its goals. A core of consistently recommended reforms has framed the discussion of future directions for dental education, but as yet, most schools report little movement toward implementation of these reforms in spite of persistent advocacy. Provision of faculty development related to teaching and assessment strategies is widely perceived to be the essential ingredient in efforts to introduce new curricular approaches and modify the educational environment in academic dentistry. Analyses of the outcomes of efforts to revise health professions curricula have identified the availability and effectiveness of faculty development as a predictor of the success or failure of reform initiatives. This article will address faculty development for purposes of enhancing teaching effectiveness and preparing instructors for potential new roles associated with curriculum changes. Its overall purpose is to provide information and insights about faculty development that may be useful to dental schools in designing professional growth opportunities for their faculty. Seven questions are addressed: 1) What is faculty development? 2) How is faculty development accomplished? 3) Why is faculty development particularly important in dental education? 4) What happens when faculty development does not accompany educational reform? 5) Why are teaching attitudes and behaviors so difficult to change? 6) What outcomes can be expected from faculty development? and 7) What does the available evidence tell us about the design of faculty development programs? Evidence from systematic reviews pertaining to the teaching of evidence-based dentistry, strategies for continuing professional education, and the Best Evidence in Medical Education review of faculty development outcomes are presented to answer this question: does faculty development enhance teaching effectiveness? Characteristics consistently associated with effective faculty development are described.

Is Dental Students' Clinical Productivity Associated with Their Personality Profile?

The aim of this study was to assess the relationship between personality preferences of incoming fourth-year dental students at the University of Texas Health Science Center at San Antonio as measured by the Keirsey Temperament Sorter II and their third-year clinical productivity and percentage of broken appointments. All 105 incoming fourth-year dental students in 2016 were invited to participate in the study, and 92 students completed the temperament questionnaire, for a response rate of 87.5%. Those students' clinical activity during their third year was measured by production points and percentage of broken appointments extracted from the electronic health record. The results showed that the majority of the respondents were extroverts rather than introverts and that the extroverts had significantly higher production points and significantly fewer broken appointments than the introverts. The most common personality preferences were sensing and judging. More than two-thirds of the respondents represented the Guardian temperament, one of four categories on the temperament measure. These findings help highlight the traits that may contribute to success in clinical training during dental school and support the notion that clinical success may be influenced by certain personality characteristics as well as the technical and specialized skills of dentistry.

The case for change in dental education.

This article introduces a series of white papers developed by the ADEA Commission on Change and Innovation (CCI) to explore the case for change in dental education. This preamble to the series argues that there is a compelling need for rethinking the approach to dental education in the United States. Three issues facing dental education are explored: 1) the challenging financial environment of higher education, making dental schools very expensive and tuition-intensive for universities to operate and producing high debt levels for students that limit access to education and restrict career choices; 2) the profession's apparent loss of vision for taking care of the oral health needs of all components of society and the resultant potential for marginalization of dentistry as a specialized health care service available only to the affluent; and 3) the nature of dental school education itself, which has been described as convoluted, expensive, and often deeply dissatisfying to its students.

Educational strategies associated with development of problem-solving, critical thinking, and self-directed learning.

This article was developed for the Commission on Change and Innovation in Dental Education (CCI), established by the American Dental Education Association. CCI was created because numerous organizations within organized dentistry and the educational community have initiated studies or proposed modifications to the process of dental education, often working to achieve positive and desirable goals but without coordination or communication. The fundamental mission of CCI is to serve as a focal meeting place where dental educators and administrators, representatives from organized dentistry, the dental licensure community, the Commission on Dental Accreditation, the ADA Council on Dental Education and Licensure, and the Joint Commission on National Dental Examinations can meet and coordinate efforts to improve dental education and the nation's oral health. One of the objectives of the CCI is to provide guidance to dental schools related to curriculum design. In pursuit of that objective, this article summarizes the evidence related to this question: What are educational best practices for helping dental students acquire the capacity to function as an entry-level general dentist or to be a better candidate to begin advanced studies? Three issues are addressed, with special emphasis on the third: 1) What constitutes expertise, and when does an individual become an expert? 2) What are the differences between novice and expert thinking? and 3) What educational best practices can help our students acquire mental capacities associated with expert function, including critical thinking and self-directed learning? The purpose of this review is to provide a benchmark that faculty and academic planners can use to assess the degree to which their curricula include learning experiences associated with development of problem-solving, critical thinking, self-directed learning, and other cognitive skills necessary for dental school graduates to ultimately become expert performers as they develop professionally in the years after graduation.

The dental education environment.

The second in a series of perspectives from the ADEA Commission on Change and Innovation in Dental Education (CCI), this article presents the CCI's view of the dental education environment necessary for effective change. The article states that the CCI's purpose is related to leading and building consensus in the dental community to foster a continuous process of innovative change in the education of general dentists. Principles proposed by CCI to shape the dental education environment are described; these are critical thinking, lifelong learning, humanistic environment, scientific discovery and integration of knowledge, evidence-based oral health care, assessment, faculty development, and the health care team. The article also describes influences external to the academic dental institutions that are important for change and argues that meaningful and long-lasting change must be systemic in nature. The CCI is ADEA's primary means to engage all stakeholders for the purpose of educating lifelong learners to provide evidence-based care to meet the needs of society.

Expansion of a Predoctoral Surgical Implant Selective for Dental Students.

Historically, predoctoral dental education programs have focused on the restoration of implants in the clinical environment; however, given the increase in dental implant therapy being performed by general dentists, the need to incorporate surgical implant training is becoming evident. This article describes a predoctoral surgical implant selective at the University of Texas Health Science Center at San Antonio and its evolution across five years to include emerging techniques and technology to enhance students' understanding of dental implant therapy, both surgical and restorative. From virtual implant planning and guided surgery to intra-oral scanning of implants for custom abutments and restorations, students obtained first-hand experiences with a wide spectrum of aspects of implant therapy. The results of anonymous surveys completed by 2014-15 students before and after the year-long selective regarding their impression of the program are also discussed.

Assessing and helping challenging students: Part One, Why do some students have difficulty learning?

When students struggle with routine assignments and fall behind classmates, a busy teacher may pigeonhole them as slow, give up on them, or become frustrated from failed efforts to bring them up to speed. Well-intentioned efforts to help struggling students by providing repetitions of the same experiences may fail because the specific cause of the sub-par performance was not identified. Six potential causes of inadequate student performance can serve as a diagnostic framework to help teachers pinpoint why a student is struggling academically: 1) cognitive factors, including poorly integrated, compartmentalized information, poor metacognition that hinders the student's ability to monitor and self-correct performance, bona fide learning disabilities that require professional assessment and treatment, and sensory-perceptual difficulties that may hinder performance in certain health care disciplines; 2) ineffective study habits, which are more common among professional students than faculty realize; 3) an inadequate educational experience (unclear objectives, poorly organized instruction, absence of coaching and timely feedback) or a punitive environment in which students avoid approaching instructors for assistance; 4) distraction due to nonacademic issues such as social relationships, health of a spouse, or employment; 5) dysfunctional levels of defensiveness that hinder student-teacher communication; and 6) underlying medical conditions that may affect student attentiveness, motivation, energy, and emotional balance. The objective of this article is to help faculty recognize potential underlying causes of a student's learning problems. Strategies for helping the academically struggling student are also introduced for several of these etiologies.

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.