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Critical Issues in Dental Education |
Key words: dental education, faculty recruitment, academic careers, faculty shortage
Submitted for publication 10/25/05; accepted 07/31/06
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Abstract |
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In response to the recommendations, Haden et al. surveyed dental school deans and discovered that 91 percent of all responding schools reported either formal or informal efforts to prepare, recruit, and retain faculty.5 If recruiting efforts targeting dental students were effective, one would expect to see an increase in the number of graduating seniors who indicated plans to pursue an academic career. However, with one exception in 2003 when the number equaled 1.9 percent, ADEA has reported that the percentage of seniors indicating such plans has remained between 0.5 and 1.3 percent since 1980.5,6
Nevertheless, significant progress has been made by leaders at ADEA and others in raising awareness within the academic dental community about contributing factors and in making recommendations for both immediate and long-term solutions to the faculty shortage problem. Primary factors that are contributing to this impending crises are the income differential between private practice and an academic career, the dilemma of increasing educational debt among graduating seniors, and the aging of the present faculty.4–8 Studies by Shepherd et al.9 and Schenkein and Best10 have also identified the reasons why new dental educators choose to accept and maintain academic positions. What we do not have, with the exception of a study by Trotman et al.11 in which eight predoctoral dental students were interviewed, is an understanding of the knowledge level of dental students regarding a career in academic dentistry. The effect on career decisions of educational debt and the income gap between private practice and academics cannot be assessed accurately without first determining whether dental students possess a thorough operational knowledge of the options and benefits available in academic dentistry. Without offering students the necessary information in a forthright manner regarding such a career, it is unreasonable to expect them to make an informed decision concerning a career choice between academia and its alternatives.
Therefore, the current study was conducted to assess: 1) the self-report of fourth-year dental students in selected dental schools regarding fundamental knowledge of dental academic careers; 2) what effect, if any, this knowledge might have on the decision to pursue a particular type of faculty service (e.g., part-time, full-time) following graduation; and 3) factors contributing to the student’s decision, including the effect of exposure to a program designed to educate students about an academic career.
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Methodology |
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. Because of time constraints, the study sample was created by selecting a convenience sample of four schools from each of these three groups, for a total of twelve schools. Schools were selected from each group on the basis of one or more of the investigators having a personal contact at the school, in the hope that this relationship would facilitate cooperation in administration of the student survey.
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) was developed with questions addressing student knowledge of issues associated with a career in academic dentistry. The initial list of issues in and aspects of academic dentistry was developed by discussion among the investigators. The survey instrument was then pilot-tested on a convenience sample of first-year dental students (n=72) at Baylor College of Dentistry. Based on the results of the pilot study, survey items were modified to increase readability and reduce the possibility of misinterpretation. The list of knowledge items was shortened to include items that tended to generate unequivocal answers and that covered a sufficient range of topics, in the opinion of the investigators.
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Respondents were asked whether or not their school had a program or course designed to educate students about a career in dental education, which was the same question asked of each school administrator during the informal telephone survey. The students were also asked to indicate whether the program or course at their school was mandatory or elective and if they had enrolled or planned to enroll if the course was elective. Respondents who reported their school had a dental education career course were asked to identify, from a list of choices, the best description of the program at their school: a full-term formal course; a partial-term formal course; a seminar, lecture, or workshop; a teaching assistantship; or a research program.
Using a five-point Likert scale ranging from "None" to "Very High," students were asked to indicate their current level of knowledge regarding twelve topics/issues associated with a career track in academia. An overall "knowledge score" (KS) of these issues was calculated by assigning numeric values to the Likert scale descriptors (None=0, Very High=4). The KS for each respondent was calculated by summing these values across all twelve topics, yielding a single score with a possible range of 0–48.
Students were also asked to indicate the likelihood they would pursue the following dental faculty paths: 1) part-time, one to two half days per week (PT1); 2) part-time, two to three days per week (PT2); and 3) full-time, four to five days per week (FT). The Likert scale descriptors for this item were "Highly Likely," "Likely," "Neutral," "Unlikely," and "Very Unlikely."
A faculty member or administrator was contacted at each of the selected dental schools to administer the survey to all senior students and then return the surveys in a timely manner. The surveys were mailed to each school in a single large envelope and returned by the faculty member or administrator in the same way. The surveys were completed by fourth-year predoctoral dental students near the end of their final semester of dental school. Data entry was performed by Clearwater Research, Inc.,12 using dual data entry to minimize entry error and standardize reporting of qualitative data.
Because of inconsistencies in the pattern of responses regarding type of training (students’ responses regarding the presence of a program often differed from that obtained from the institution), the mandatory, elective, and no program groups defined by the institutional response in the telephone survey were restructured as two groups—the training group and the no training group—based on student responses. Our reasoning was that accepting the students’ own responses regarding experience in a program would more accurately reflect the number of dental students who had actually participated in a dental education career course or program while in dental school. The training group included all students who indicated taking a mandatory program or course plus those indicating they had enrolled in an elective program if their school offered such an option. The no training group consisted of all students who reported that there was no mandatory program at their school plus those who did not indicate enrollment in an elective program. This process yielded the training group, who reported having received some form of training, and the no training group, who reported receiving no training.
Data analyses were performed using the Statistical Package for the Social Sciences (SPSS). Frequencies and other descriptive statistics were calculated for all survey items and comparisons between groups made with either the chi square (
2) statistic for categorical data, and independent sample t-tests or one-way analysis of variance for parametric data. The level of significance was set at p<.05 for all comparisons.
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Results |
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Among the respondents from schools where an administrator had reported the presence of a mandatory academic career educational program (the original mandatory group), nearly 80 percent said their school had no such program or that they didn’t know. Of students at schools where an administrator had reported the presence of an elective program (the original elective group), 83 percent said no program existed or that they didn’t know. Overall, only 18.5 percent of respondents reported a dental education career program of any type at their school.
Student responses indicated that the most common format for a course on dental education careers was seminar/lecture/workshop, followed by the full-term formal course and the research program. The partial-term formal course and teaching assistantship formats were less common (Table 3). Sixty-nine percent of respondents reported having some teaching experience as a tutor before dental school or with religious or community groups (38.8 percent). Twelve percent of students reported they had actually been employed as teachers, and 18 percent reported "other" types of teaching experience, most commonly as coaches or teaching assistants. The most common types of teaching experience during dental school were informal mentoring (69.3 percent) and formal tutoring (33 percent) of other dental students, followed by experiences as a lab instructor, clinic instructor, and didactic course instructor. Write-in responses included experiences as a teaching assistant, an outside tutor, and a participant in a high school enrichment program (Table 4). Only about 20 percent of respondents indicated having teaching experience that could have been part of either a mandatory or elective teaching program per se, but this cannot be confirmed from the data available.
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To facilitate the analysis and reporting of data for the two Likert scale questions, the data were regrouped by combining responses for similar descriptors. For the survey question regarding the knowledge level of issues in academia, the "Very High" and "High" responses were combined into "High," while "Low" and "Very Low" were grouped into "Low." The same process was used for the question pertaining to the intent of respondents to pursue the various faculty career paths. "Highly Likely" and "Likely" were grouped as "Likely," while "Unlikely" and "Very Unlikely" were combined into "Unlikely." The response rates for the mandatory, elective, and no program groups were 69.1 percent, 75.7 percent, and 73.2 percent, respectively. After restructuring these three groups into the training (n=180) and no training (n=376) groups and accounting for invalid responses, the total sample was 556 individuals.
Knowledge Level of Issues in Academia and Knowledge Score
Regarding the twelve selected issues associated with a career track in academics, the self-reported knowledge levels of high, low, and none are summarized in Table 5. A significantly (p<.001) higher percentage in the training group reported a high level of knowledge compared to the no training group for the two issues of tenure/non-tenure-track appointments and the criteria for promotion and tenure. This was also true for the issue of private and/or faculty practice options (p<.05). The percentage of the training group indicating low knowledge levels for these three issues was likewise significantly (p<.05) smaller than for the no training group. For the remaining nine academic career issues, there were no significant differences in knowledge levels between the training and no training groups.
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=20.68) of students who had teaching experience during dental school was significantly higher (p<.01) than those who had no teaching experience while in school (=18.14) (Table 7). There was no significant difference in KS between those who had teaching experience before dental school and those who did not. Although the difference was not statistically significant, the fifteen dental students who were likely to enter full-time academics had a higher KS (=22.09) than that of all other respondents (=19.13).
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=21.13) than those without such plans (=18.49). Differences in KS between the training group and no training groups and with respect to gender, age, and having a parent in higher education were not significant.
Likelihood to Pursue a Faculty Career
Almost one-half (48.5 percent) of all respondents indicated they were likely to pursue the faculty option of one to two half-days/week (PT1) compared to nearly one-third (32.6 percent) who said they were unlikely; the rest were neutral. Ten percent were likely to choose the faculty option of two to three days/week (PT2), compared to 73 percent who were unlikely and 17 percent who were neutral. Only 3 percent (n=15) were likely to enter full-time (FT) academics while 7 percent and 90 percent were neutral and unlikely, respectively. Thirty percent of all students indicated they were unlikely to pursue any of the three faculty career options.
Those who were likely to choose the PT1 and PT2 faculty options had significantly (p<.01) higher KS scores than those who were unlikely or neutral. Although the mean KS was higher for respondents who were likely and neutral with regard to entering full-time academics, the difference approached significance (p=.056) only for the neutral respondents.
Respondents who had some form of teaching experience either before or during dental school were significantly more likely to choose the PT1 (p<.001) and PT2 (p<.01) faculty career options than those who had no experience, and significantly fewer (p<.05) of those with some form of teaching experience indicated they were unlikely to do so (Table 8). The same comparisons of those who were likely, neutral, and unlikely to enter full-time academics approached significance (p=.06) for those who had teaching experience during dental school. Of the fifteen respondents who indicated they were likely to enter full-time academics, ten indicated they had teaching experience while in dental school.
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). There was no significant difference with respect to gender for those who were likely to enter full-time academics. However, of the fifteen respondents who reported they were likely to do so, ten were male, which mirrors the overall gender distribution of the sample.
Students who reported having a parent in higher education were significantly (p<.05) more likely to pursue PT1 and more likely to report being neutral with respect to full-time academia than those who did not. Students with plans to pursue a specialty were more likely (p<.001) to pursue the PT1 and PT2 faculty options than those not planning to enter a specialty (Table 8). The same comparison approached statistical significance (p=.07) for respondents likely to enter full-time academics. There were no significant differences observed in the respondents’ intent to pursue the various faculty career options with respect to age nor when comparing the training and no training groups.
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Discussion |
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Knowledge of Academic Careers
One of these factors was the overall self- reported knowledge level (measured in this study as knowledge score—KS) of respondents with respect to the twelve selected issues of a dental education career. Participating students who exhibited a higher KS reported a greater likelihood to pursue a part-time faculty career and were more likely to take a neutral position with respect to entering full-time academics. The absence of a significant difference for the KS of the training and no training groups does not imply that the academic career educational programs lack the potential for increasing the knowledge of students regarding the issues. It may well be that this survey’s selected issues related to academic life are simply not part of any participating schools’ programs. A remedy may be a consensus among dental educators on basic components of a program intended to educate dental students about a career in academics. Otherwise, when basic information related to issues such as salary, career, and/or lifetime benefits, the process (or lack thereof) of tenure, academic rank, the criteria for promotion and tenure, and others is largely unknown, how would the potential future faculty member be expected to make an informed decision regarding an academic career? By providing thorough and accurate information, the significant number of students who were neutral with respect to entering a full-time academic career would be able to make an informed decision and perhaps be more likely to choose a career in academics.
While the dental profession as a whole has done a superb job of selling the benefits of a private practice career, the same message regarding an academic career often goes unvoiced and therefore unheard by dental students, except for varied and anecdotal observations of faculty life, which students may encounter from individual instructors as they progress through dental school. In 1999, the AADS President’s Task Force recommended that dental educators address both the burdens and benefits of an academic career, but also observed that most students seem to be aware of only the burdens.4 Even though the widespread assumption is that the burden of student debt and the prospect of earning a larger income in private practice divert dental students from pursuing an academic career, we do not know the true impact these issues have on students’ decisions because the findings of this study indicate they lack necessary knowledge and information pertaining to fundamental issues in academia to make a well-informed career decision. In the annual ADEA survey of dental school seniors,6 it is noteworthy that students are asked to rate the adequacy of time devoted to instruction for practice administration, but are not asked about time dedicated to education and training pertaining to academic careers. The faculty shortage crisis may never improve until dental education teaches its students about the many career alternatives, including an academic career, in the same manner it teaches students to inform patients about the various treatment plan options available to them.
Teaching Experience
Another contributing factor to both the overall self-reported knowledge level (KS) of academic issues of respondents and their reported likelihood to pursue a faculty career was that of teaching experience in general, but especially teaching experience during dental school. Haden et al. recommended that "predoctoral teaching assistant opportunities should be a primary means of educating students about the rewards of academic dentistry."5 In support of this recommendation, the assessment of a predoctoral teaching assistantship program at the UCLA School of Dentistry revealed that "all but one [participant] indicated a desire to incorporate teaching into his or her future plans."13 If it is established that pre-doctoral academic career training programs produce measurable increases in the number of students pursuing academic dentistry, given the mounting faculty shortage crisis, a recommendation requiring the presence of such a program in each dental school would be appropriate.
Comparisons with Previous Surveys
Although it was not the primary intent of this study to report findings from the informal telephone survey to each of the fifty-five dental schools regarding the presence of an educational program on academic careers, it was interesting to note that only seven schools (12.7 percent) reported mandatory programs, twenty (36.4 percent) reported elective programs, and twenty-two (40.0 percent) reported no programs. Of the six remaining schools, three reported something other than mandatory or elective (e.g., lectures in various courses with no formal structure), while the appropriate contact could not be made for the other three. In other words, only a little over half (52 percent) of the responding schools (given a 94.5 percent response rate via the informal telephone survey) reported having some form of course or program "designed to educate students about a career in dental education."14 This finding differs from that reported by Haden et al.,5 in which a 2000 survey of U.S. dental school deans with an 82 percent response rate found that all but four dental schools reported formal or informal efforts intended to "attract students to academic careers." This difference may be due to the fact that the survey questions in the present study differed from those of Haden et al. in focusing specifically on identifying types of programs designed to educate students about academic careers and not simply on methods of attracting them to such careers.
The difference between the words "educate" and "attract" may also explain the reported distinction between the two studies regarding the primary formats for preparing students for academic careers. Haden et al. found that, of the 40 percent of responding schools indicating formal methods of attracting students to academia, "student research programs were the predominant means used by these schools to stimulate students to consider academic careers."5 The informal telephone survey of our study did not inquire as to the exact nature of various programs among schools. Instead, the student respondents reported the seminar/lecture/workshop format as the major (55 percent) type of academic career educational program, whereas research programs were reported to fulfill this purpose by only 14 percent. This study’s finding of fewer research programs is, therefore, understandable due to the belief that research programs alone do not adequately educate predoctoral dental students nor provide them with the necessary knowledge and information to seriously consider an academic career. In 1994, the National Academy of Sciences said that student research programs funded through the National Institute of Dental Research (now the National Institute of Dental and Craniofacial Research) "supply, on average, [less] than one clinical scholar or potential scholar per year."15
It was also remarkable to note that, in our study, 3 percent of respondents from the eleven participating schools reported they were likely to enter full-time academics following graduation. This finding differs from percentages reported by ADEA between 1980 and 2004 (0.5 percent to 1.3 percent, except for 1.9 percent in 2003) of graduating seniors with immediate plans to enter full-time academics.5,6 This difference may be due to the fact that our study deliberately phrased the survey question so as to include those reporting the possibility of pursuing a faculty career at any future time following graduation from dental school. However, if the criteria used in the current study to define program types were applied to the annual senior survey by ADEA, the varying results may be explained by the fact that our study sample consisted of a higher percentage of schools with training programs than the ADEA survey, which attempts to survey all dental school seniors. If the latter is true, then the academic career training programs at the participating schools in this study may in fact be having a positive impact on students. In any event, it will be interesting to compare the findings related to this topic in the results of the 2005 annual ADEA survey of dental school seniors, because a portion of the samples were the same between our study and ADEA’s.
While the dental profession as a whole is responsible for recruiting, developing, and retaining future dental faculty, dental educators have the potential to take the lead in these efforts. They need to educate as well as attract potential academicians who may choose academia immediately following dental school, but also those who may consider an academic position later in their careers, by planting the seeds of awareness and information in all dental students. After all, dental school is the first and last time the profession has both the collective and individual attention of all who become dentists.
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Conclusion |
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These data also suggest positive correlations between the students’ reported likelihood to pursue a faculty career and their personal teaching experience before and during dental school and their gender. In addition, positive associations were observed between students’ overall knowledge level (measured as KS) of the academic issues and teaching experience while in dental school and with respect to plans to specialize.
Moreover, the academic career educational programs, as presently structured at the dental schools represented in this study, apparently contribute little to the students’ overall knowledge of the selected academic career issues in this survey and do not appear to affect the students’ intent to pursue faculty careers. Students who reported receiving formal instruction regarding dental education careers (training group) exhibited a significantly higher knowledge level than those who did not receive the same instruction (no training group) for only three of the twelve academic issues addressed. Furthermore, there appears to be a sense of confusion among these dental students as to whether or not they have or have not received training related to an academic career during their dental education, even in schools where an assistant or associate dean indicated the presence of a mandatory or elective program. This finding brings into question the impression the programs may be making on dental students. Future studies should be directed at examining specific subject matter of individual programs and assessing effectiveness relative to their curricular content.
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Footnotes |
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REFERENCES |
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This article has been cited by other articles:
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  J. M. Roger, M. M.H. Wehmeyer, and M. S. Milliner Reflections on Academic Careers by Current Dental School Faculty J Dent Educ., April 1, 2008; 72(4): 448 - 457. [Abstract] [Full Text] [PDF]
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R. H. Hsu, M. W. Roberts, J.F. C. Tulloch, and C.-A. Trotman A Study of Military Recruitment Strategies for Dentists: Possible Implications for Academia J Dent Educ., April 1, 2007; 71(4): 501 - 510. [Abstract] [Full Text] [PDF]
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