From the ivory tower: Dental students as curricula change agents

Change is a complex process for academic institutions and often proceeds at the rate of an anesthetized snail.

By Edward F. Rossomando, DDS, PhD, MS, Professor and Director, Center for Research and Education in Product Evaluation (CRETE), School of Dental Medicine, University of Connecticut, Farmington, CT

Change is a complex process for academic institutions and often proceeds at the rate of an anesthetized snail. In my 30 years as a faculty member, I have attended numerous dental faculty committee meetings convened to either update or revise a dental school’s curriculum. These meetings remind me of the game, “Three-Card Monty,” in which an ace and two other playing cards are placed face down and moved rapidly from one position to another. The object of the game is to find the ace, but only rarely is it located. Similarly, at faculty meetings convened to consider the introduction of a new course, the existing courses are moved from one time slot to another so rapidly that tracking the changes is difficult and locating the “ace” is almost impossible. It is only later, when the syllabus for the new curriculum is completed, that the new course is found buried to the point of obscurity among the curriculum’s previous offerings. In this way, curriculum revision meetings become more of a “Three-Card Monty” curriculum shuffle than an actual revision.

Dental students as change agents

While past dental school curriculum revisions often began with the faculty, today the dental students initiate many changes. One reason might be that dental schools provide more opportunities for students to comment about the curriculum through surveys and course evaluations. Another reason - and the one I favor - is related to the presence of the Internet. Today, students at one dental school communicate on a daily, if not hourly, basis with their counterparts at other dental schools. Through chat rooms and instant messaging, and sometimes during lectures, students share experiences and realize that changes considered radical at one school are already in place in another.

What do dental students elect?

Today’s dental students are confused by the difference between what is taught in dental school clinics and what they see and learn about on the “outside” from those in practice. Simply put, in some dental schools, the products and services offered are not the latest. Dental schools are only now beginning to require students to complete at least one implant case before graduation. Few dental schools expose dental students to lasers, and perhaps even fewer to CAD/CAM technology. Dental students are certainly aware of these new technologies and products from reading about them in trade journals, learning about them at trade shows, and seeing them used in private practices. While it is true that some of these students will learn to use these products in residency programs, others will not, and are frustrated that they are not included in their dental school education. Today, many students will graduate without having used these products, and yet will have to introduce them into their practice immediately if they are to provide the oral health care that many patients expect. Unprepared to make informed decisions on equipment and product purchases and on their proper use, these recent graduates will be compelled to take advanced courses at additional time and expense.

Including the DTA in dental curriculum reform

If the dental profession is to provide the best possible education for its students and care for its patients, it is imperative that dental school curricula undergo constant revision to stay current with the latest in new products, technologies, and services. One group noticeably absent from the list of those included in the revision of the dental school curriculum is the dental industry. Since the formation of the Dental Trade Alliance (DTA), most of the dental companies, including manufacturers and distributors, are represented by one entity. It is surprising that the DTA is not consulted regularly on curriculum because the DTA has access to the most recent technologies and products and, through its members’ sales records, is well aware of what is in use in private practice.

A collaboration between the DTA and dental schools would allow today’s dental students to be exposed to new products and technologies under conditions where their activities can be monitored and, when necessary, corrected by those most able to provide this instruction - the clinical faculty of our dental schools.

Biodontics: An elective to introduce curriculum change

The question is not, “Is change in the clinical dental curriculum necessary?” Rather, it is, “Can we develop a method to facilitate and encourage change?” We need to experiment and find a mechanism to provide students, faculty, and policymakers the means to introduce change into the dental curriculum rapidly and with appropriate oversight. Most of all, we need to encourage our students, faculty, and policymakers to become innovators of educational change. One experiment in curriculum change is ongoing at the University of Connecticut School of Dental Medicine. In July 2005, Biodontics, a new four-week educational program, was offered as an elective that provides students with exposure to new products and technologies. Biodontics is supported in part by a grant from the National Institute of Dental and Craniofacial Research, and in part by dental companies on a volunteer basis.

We hope that this course, by encouraging dental companies to participate under supervised conditions, will keep the clinical dental curriculum dynamic, thus avoiding stagnation. The goal of the Biodontics program and all innovative approaches to dental education is to be responsive to suggestions from students, faculty, and the profession and, equally as important, responsive to changes in our society, especially as the demographics of our population change. For, as noted by Charles Darwin, “It is not the strongest of the species that survive, not the most intelligent, but the one most responsive to change.”

Editor’s Note: Dental manufacturing, distributing, or marketing companies, as well as dental laboratories, interested in participating in the 2005-2006 Biodontics educational program should contact Dr. Rossomando at erossoma@nso2.uchc.edu.

This article was edited and abridged from an article by Dr. Rossomando that first appeared in the Compendium 26: 578-581, 2005.

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