An introduction to the ADEA Commission on change and innovation in dental educatioN.

New developments in dentistry are appearing rapidly, and new electronic means for making information available are already in the hands of our dental students. Recognizing a dramatic shift in the landscape, the American Dental Education Association developed, in 2004, the Commission on Change and Innovation. The commission has coordinated a national effort to identify a new dental education curriculum, beginning with a revision of the Competencies for the New General Dentist. From this starting point, the association is working to identify foundation knowledge and skills that support these competencies and new assessment methods. There is now a network of faculty liaisons at most schools throughout the United States and Canada. The future will likely see much of dental education delivered in community and other settings besides the traditional lecture room.

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.

ADEA-ADEE Shaping the Future of Dental Education III: From interprofessional education to transprofessional learning: Reflections from dentistry, applied linguistics, and law.

The World Health Organization has indicated that Interprofessional Education (IPE) occurs when "students from two or more professions learn about, from, and with each other".1 These IPE experiences are widely thought to provide students with the opportunity to learn and practice the knowledge, skills, behaviors and attitudes that will ultimately translate into the provision of safer, higher quality, team-based patient care when they become health care practitioners in collaborative care environments. At the joint American Dental Education Association (ADEA) and Association for Dental Education in Europe (ADEE) 2019 Shaping the Future of Dental Education III conference in Brescia, Italy, delegates explored the concept of transprofessional learning, where students learn skills across a wider range of professions than health professions alone. The workshop continued the dialogue that began during the 2017 ADEA-ADEE Shaping the Future of Dental Education II conference in London, England as previously reported by Davis et al.,2 and explored the use of transprofessional learning through the lenses of dental education, applied linguistics education and law education focusing on the use of reflective practices. The workshop brought together educators from around the globe in a highly interactive setting where they had the opportunity to discuss and develop tools and practices for teaching reflective practice by using a transprofessional learning approach.

ADEA-ADEE Shaping the Future of Dental Education III: Assessment in competency-based dental education: Ways forward.

Assessment in competency-based dental education continues to be a recognized area for growth and development within dental programs around the world. At the joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education III, the workshop on assessment was designed to continue the discussion started in 2017 at the ADEA-ADEE Shaping the Future of Dental Education II.1 The focus of the 2019 conference involved examining the potential of entrustable professional activities (EPAs) and current thinking about workplace-based assessment (WBA) within competency-based education in the 21st century. Approximately 30 years ago, George Miller wrote about the assessment of competence in medical education and challenged faculty to reach for higher levels of assessment than knowledge or skill.2 Acknowledging that no one assessment method can result in a valid assessment of competence, Miller proposed a four-level framework for assessment. The lowest level involves measuring what students know ("knows"), followed by assessment of the skill with which knowledge is applied in relevant tasks or problems ("knows how"). Next is an assessment of task performance in standardized settings ("shows how"), and finally, the highest level assesses the student's performance in the unstandardized clinical workplace ("does"). The 2019 assessment workshop focused on advances in the assessment of learners in the unstandardized workplace-the highest level of Miller's assessment pyramid ("does"). Research has shown that dental education has struggled to implement assessment strategies that meet this level.3 The workshop brought together individuals from around the world, with an interest in assessment in dental education, to consider how assessment in the "does" level, specifically EPAs and WBA, factors into competence assessment in dentistry/dental education.

ADEA-ADEE Shaping the Future of Dental Education III: The impact of scientific technologies and discoveries on oral health globally.

The central purpose of scientific research and emerging dental health technologies is to improve care for patients and achieve health equity. The Impact of Scientific Technologies and Discoveries on Oral Health Globally workshop conducted joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education III, highlighted innovative technologies and scientific discoveries to support personalized dental care in an academic and clinical setting. The 2019 workshop built upon the new ideas and way forward identified in the 2017 ADEE-ADEA joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education II held in London. During the most recent workshop the approach was to explore the "Teaching Clinic of the Future". Participants applied ideas proposed by keynote speakers, Dr. Walji and Dr. Vervoorn to educational models (Logic Model) in an ideal dental education setting. It is only through this continuous improvement of our use of scientific and technological advances that dental education will be able to convey to students the cognitive skills required to continually adapt to the changes that will affect them and consequently their patients throughout their career. This workshop was a valuable experience for highlighting opportunities and challenges for all stakeholders when aiming to incorporate new technologies to facilitate patient care and students' education.

ADEA-ADEE Shaping the Future of Dental Education III: Engaging with global networking to enable global oral health.

Global networking has been identified as an important method of enhancing health care education and services in the field of dentistry.1 The ability to share expertise, resources, knowledge, and experience to benefit all is highly desired among students, educators, health care professionals, and communities globally. Both our student and patient populations are dynamic societies that are becoming increasingly complex and facing growing needs and expectations, which is a constant challenge for educators and health care professionals to satisfy.2 The key question, stemming from the Global Networking (GN) workshop of the 2017 ADEE-ADEA Shaping the Future of Dental Education II meeting, was identified as, "How can dental educators around the world network to share ideas, experience, expertise, and resources to improve our curricula and teaching and learning environments for our educators, students, and communities that they serve?" The action plan devised by the GN workshop from the 2017meeting indicated two key steps in these early stages of setting up a global network: 1) "…grassroots participation for input and consumption of meaningful and needed content," and 2) "…advisors/consultants for organizational top-down guidance to define and maintain the global networking philosophy and platform…".1 The GN workshop of 2019 SFDE meeting aimed to deliver guidance and discussion with those experienced in engaging local communities from both a grassroots and an organizational approach.

Leadership development for early-career educators: Association report on the ADEA summer program for emerging academic leaders.

There is a continuous challenge in academic health education to retain early career faculty members and staff. Attrition rates in the field can be as high as 42% in the first five years of an individual's career and are principally due to a sense that academic careers do not progress at a satisfactory rate. In response to this ongoing issue, the American Dental Education Association launched the Summer Program for Emerging Academic Leaders (ADEA EL) in 2012. The program has supported 301 participants from over 74 academic programs and private practice institutions. This current study describes data collected from program participants in an effort to conduct a thorough review of the program. In all, pre- and post-program data were assessed from faculty members and staff who have participated in the program over its eight-year history. The outcomes of this mixed-methods study describe an assessment of the curriculum (including changes that have occurred over the tenure of the program), the fit of the intended learning outcomes, reasons why a program such as the ADEA EL is needed, and what can be done to provide additional leadership resources and support for faculty members in dental education. This study represents the first time a longitudinal report of a professional development program designed exclusively for early-career faculty and staff has been described in the literature. Its outcomes are intended to be supportive of institutions and other programs focused on support and retention of early faculty and staff.

Integrating Oral and Overall Health Care: Building a Foundation for Interprofessional Education and Collaborative Practice.

Interprofessional education (IPE) and interprofessional practice (IPP) are game-changers. They will completely alter the way that health professionals are educated and the way that health care is delivered. The transition from our current silo-based approach to team-based education and practice is under way, and there is nothing that can be done to stop them from happening. This article will provide a historical context to the development of IPE in health professions education, identify ways in which the dental professions have addressed these developments, and provide recommendations for opportunities for the dental professions to engage in IPE and IPP, especially for the benefit of the people we serve as patients and current students and learners who will be practicing in a collaborative environment with other health professionals in the future.

Women's oral health: the evolving science.

The evidence base for women's oral health is emerging from legislative action, clinical research, and survey documentation. The Women's Health in the Dental School Curriculum study (1999) followed a similar study (1996) of medical school curricula. Both of these major efforts resulted from statutory mandates in the National Institutes of Health Revitalization Act of 1993 (updated October 2000). A major study of the Institute of Medicine (IOM) National Academy of Sciences in 2001 concluded that "the study of sex differences is evolving into a mature science." This IOM study documented the scientific basis for gender-related policy and research and challenged the dental research enterprise to conduct collaborative, cross-disciplinary research on gender-related issues in oral health, disease, and disparities. This report chronicles some of the factors that have and continue to influence concepts of women's oral health in dental education, research, and practice. Gender issues related to women's health are no longer restricted to reproductive issues but are being considered across the life span and include psychosocial factors that impact women's health and treatment outcomes.

Dental school vacant budgeted faculty positions, academic years 2005-06 and 2006-07.

The annual turnover of dental school faculty creates a varying number of vacant budgeted positions at any given time. The American Dental Education Association (ADEA) conducts an annual survey to determine the status and characteristics of these vacant faculty positions. In addition, ADEA conducts an annual survey of dental educators to maintain a database on the size and characteristics of dental school faculty, including data on the distribution of full-time, part-time, and volunteer faculty, reasons for faculty separations, and sources of new faculty. The number of vacant budgeted faculty positions within U.S. dental schools increased throughout the 1990s, with a peak of 358 positions in 2000. Following this peak, the number of vacancies declined, falling to 275 in 2004-05. Since that time, there has been a rapid increase in the number of estimated vacancies, reaching 417 in 2005-06, then falling slightly to 406 in 2006-07. The 2005-06 and 2006-07 faculty vacancies surveys explore these increases, along with information relevant to trends in the faculty workforce, factors influencing faculty vacancies, and the impact of vacant positions on dental schools.

U.S. dental school applicants and enrollees, 2006 and 2007 entering classes.

The number of applicants to dental schools in the United States continues to rise at a double-digit rate, 12 percent from 2005 to 2006 and 14 percent from 2006 to 2007. The number of applicants to the 2006 and 2007 years' entering classes of U.S. dental schools was 12,500 and 13,700, respectively. The number of first-time enrollees (4,600) in 2007 was the highest recorded since 1989. Men continue to comprise the majority of all applicants, 55 percent in 2006 and 53 percent in 2007. However, the percentage of women applicants to each school ranged from a third to more than half. Underrepresented minority (URM) applicants comprised 12 percent of the applicant pools in both 2006 and 2007. For the 2007 entering class, URM enrollees comprised 13 percent of enrollees. As in previous years, in 2007, the largest number of applicants and enrollees came from states that are among the largest in population in the United States: California, Texas, New York, and Florida. Grade point average and Dental Admission Test scores were the highest in more than a decade. More than three out of four of the 2007 first-time, first-year enrollees earned a baccalaureate degree either in biological/life or physical sciences or in health. Regardless of major field of study, the percent rates of enrollment generally exceeded 30 percent, though there were exceptions (e.g., engineering and education). The majority of enrollees to the 2007 entering classes were twenty-two or twenty-three years of age.

The case for change in dental education.

The 1926 Gies Report on Dental Education was the first of many calls for major reform in dental education over the past 80 years. Significant changes in the way dentists were educated were implemented after the Gies Report, including the closure of proprietary dental schools and general acceptance of a three-to-four-year course of study leading to the dental degree with a sound foundation in basic and clinical sciences. In many ways, little has changed since then. This presentation explores possible reasons for why this is true and evaluates opportunities for the future.

Implications for the Dental Care of Vulnerable Populations if Medicaid Is Cut Back.

Good oral health affects academic performance, employability and annual earnings, military readiness, overall health care costs, and general health status and well-being. The Affordable Care Act (ACA) has enhanced the ability of many Americans to receive dental care through the expansion of Medicaid and the inclusion of pediatric oral health as 1 of the 10 "essential health benefits." Almost all of the proposals presented by the current Congress and Administration to modify the ACA call for changes to Medicaid that would cut back funding and/or give states more control over programs. Limiting federal support to Medicaid will eventually increase the pressure on states to cut costs, and dental care is usually one of the first benefits on the chopping block. If this happens, all of the gains that have been realized as a result of the Medicaid expansion would be diminished or lost, with a significant impact on the overall health, well-being, and success of those who will suffer the consequences of a lack of access to dental care.

U.S. Dental School Applicants and Enrollees, 2017 Entering Class.

The American Dental Education Association (ADEA) collects information on U.S. dental school applicants and first-time, first-year enrollees as part of the administration of dental school applications. This report presents an analysis of the data on the characteristics and academic qualifications of the 11,873 applicants who applied to U.S. dental schools during the 2016-17 application cycle and of the 6,122 first-time, first-year enrollees who began dental school in fall 2017. Among the key findings are the following: the number of applications decreased in 2016-17, while enrollment continued its steady 12-year rise; the number of women applicants exceeded the number of men by a larger margin than the previous two years, reversing the long-term trend of having more men apply to dental school (although men continued to have slightly higher levels of enrollment); when race/ethnicity was viewed alone or in combination, the number of applicants and first-time enrollees from most race/ethnic groups increased, although falling slightly were Native Hawaiian or other Pacific Islander and White applicants and enrollees; regionally, the Mid-Atlantic had the highest share of its population applying to dental school and the Northwest had the highest share to enroll in dental school; and applicants overwhelmingly had a biological or biomedical science educational background. The data and analysis presented in this report offer a unique picture of dental school applicants and enrollees. It provides school administrators with a national view of the qualifications of applicants, and it provides prospective applicants with a better understanding of the qualifications they likely need to enroll. The analysis also gives policymakers a preliminary view of future trends in the dental workforce.

Interprofessional Collaborative Practice: How Could Dentistry Participate?

There is a remarkable phenomenon occurring among health professionals: the development of ongoing, routine collaboration, both in educating the next generation of providers and in delivering care. These new approaches, commonly referred to as interprofessional education and interprofessional collaborative practice, have been introduced into academic health settings and delivery systems throughout the U.S. and the rest of the world; however, the full integration of dentistry in health care teams remains unrealized. In academic settings, dentistry has found ways to collaborate with the other health professions, but most practicing dentists still find themselves on the margins of new models of care delivery. This article provides a perspective on the history and context of the evolution of collaborative approaches to health care and proposes ways in which dentistry can participate more fully in the future.

Emerging allied dental workforce models: considerations for academic dental institutions.

The U.S. surgeon general defined the national oral health care crisis in 2001 in Oral Health in America: A Report of the Surgeon General. The report concluded that the public infrastructure for oral health is not sufficient to meet the needs of disadvantaged groups and is disproportionately available depending upon certain racial, ethnic, and socioeconomic factors within the U.S. population. Now, several new workforce models are emerging that attempt to address shortcomings in the oral health care workforce. Access to oral health care is the most critical issue driving these new workforce models. Currently, three midlevel dental workforce models dominate the debate. The purpose of this report is to describe these models and their stage of development to assist the dental education community in preparing for the education of these new providers. The models are 1) the advanced dental hygiene practitioner; 2) the community dental health coordinator; and 3) the dental health aide therapist.

U.S. dental school applicants and enrollees, 2005 entering class.

There were 10,731 applicants to the entering dental school class in 2005. This represents a 13.8 percent increase over the number of applicants to the 2004 entering class and almost a 45 percent increase over the number of applicants in 2001. Dental schools reported 4,558 first-time, first-year enrollees in 2005, an increase of 101 first-time, first-year enrollees over the number reported in 2004. The percent of applicants that were enrolled in 2005 was 42.5. The percent of applicants enrolled in 2001 was 57.6. Women were 44.2 percent of the applicants and 43.8 percent of the first-time, first-year enrollees in 2005, slight increases from what they were in 2004. Underrepresented minorities comprised 12.8 percent of the applicants and 12.6 percent of the first-time, first-year enrollees in 2005. These percentages are little changed from those reported in 2001. The average GPA of the first-time, first-year enrollees increased slightly in 2005, from 3.4 to 3.5; there was little change in DAT scores, standing at 18.9 for Academic Average, 17.4 for Perceptual Ability, and 18.4 for Total Science.

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.