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Associate Editor's Note |
A major focus of my work with the Journal of Dental Education over the past four years has been coordinating the development of a series of commissioned articles published in a collaboration between this journal and the American Dental Education Association’s Commission on Change and Innovation in Dental Education (ADEA CCI). Collectively, the articles in this series are known as Perspectives and Reflections in Dental Education (PRIDE). The title of the series acknowledges the commitment of the academic dental community to reflect on current practices and future directions and also represents the pride of dental school faculty members in their educational responsibilities and accomplishments. I hope our readers have followed this series, which has included perspectives on contemporary issues in dental education, reviews of the literature, and reports of original research conducted for the Commission. The concluding articles in the PRIDE series appear in this issue of the journal. Accordingly, this seems like a good time to summarize the purpose of this series within the broader context of a national initiative to explore the future directions of dental education.
The ADEA Board of Directors in 2004 identified curriculum development to address the public’s evolving oral health care needs as a strategic direction of the Association. Then-ADEA President Eric Hovland created the ADEA CCI in 2005 to coordinate the Association’s efforts to assist the academic community in the development of educational models necessary to prepare general dentists for twenty-first century practice. From 2005 to 2008, the ADEA CCI was chaired by Dr. Kenneth Kalkwarf, dean of the Dental School at the University of Texas Health Science Center at San Antonio and 2006–07 ADEA president. Dr. Stephen Young, dean of the University of Oklahoma College of Dentistry, is the current chair of the ADEA CCI Oversight Committee.
Under the best of circumstances, implementing education enhancements is an arduous task fraught with countless pitfalls including inertia, protectionism, personal agendas, hesitancy to be critical, overeagerness to be critical, and lack of agreement on the need for change, the reform goals to pursue, and how to accomplish them. Another complexity in moving toward consensus about needed changes and strategies to make these changes "happen" is the sheer number of stakeholders with vested interest in the educational component of any profession. Many organizations within organized dentistry and the academic arm of the profession influence the goals, scope, structure, and directions of dental education in the United States including, but not limited to, faculty and academic leaders within dental schools and postgraduate dental education programs, representatives from organized dentistry, the various specialty organizations within dentistry, the dental licensure community, the Commission on Dental Accreditation, the ADA Council on Dental Education and Licensure, the Joint Commission on National Dental Examinations, and ADEA itself. Historically, these groups have operated independently of each other when developing policies and regulations that affect the education of future dentists. The core operational philosophy of the ADEA CCI is that effective innovation in dental education is most likely to occur when stakeholder organizations work together to reach agreement on fundamental goals. The ADEA CCI was created to be the forum in dental education where these constituencies could meet, agree on desired goals, and coordinate efforts to move forward.
Over the past four years, the meetings of these constituencies under the auspices of the ADEA CCI have stimulated several initiatives: 1) a special ADEA Council of Sections Task Force, chaired by Dr. Jerry Glickman, developed an updated set of competencies for the entry-level general dental practitioner, which are designed to provide a benchmark for predoctoral dental education; these "Competencies for the New General Dentist" were adopted by the ADEA House of Delegates in April 2008 and published in the July 2008 issue of the Journal of Dental Education; 2) a network of dental school faculty liaisons to the ADEA CCI was established to provide a mechanism for disseminating information about new educational and assessment strategies to the schools; national liaison conferences were conducted in 2007 and 2008, attended by representatives from more than forty-five schools each year; 3) ADEA CCI members collaborated with the Council on Dental Accreditation (CODA) to develop a modified set of predoctoral education accreditation standards, currently under review by dental communities of interest until May 2009; these standards emphasize important themes of the ADEA CCI: cultivation of critical thinking, self-assessment, and capacity for self-directed learning among our dental students; 4) through an ADEA CCI Task Force on Student Outcomes Assessment, the first-ever national investigation of competency assessment strategies used by U.S. dental schools was conducted, with participation by nearly 1,000 course directors at fifty schools; 5) the first-ever national assessment of dental school faculty members’ perceptions of the academic work environment was conducted, with participation by nearly 2,000 academic dentists; and 6) this series of twenty-one commissioned articles was sponsored by the ADEA CCI to stimulate new ways of thinking about the predoctoral curriculum, teaching and learning strategies, student assessment, educational leadership, and the academic work environment. These articles were published in the Journal of Dental Education between October 2005 and February 2009.
Figure 1
lists the articles in the ADEA CCI PRIDE series, plus the pivotal "Competencies for the New General Dentist," organized into the five themes of the series: Background/ADEA CCI; Visions of the Future; Finding, Cultivating, and Retaining Faculty; Assessing Students’ Progress Toward Competence; Leadership in Academic Dentistry; and Reflections. In this issue, Drs. Karen Novak and Huw Thomas reflect on what the ADEA CCI series has meant to them from their respective positions as mid-career dental school faculty member and dental school dean. These reflections bring the series to a close. If you have already explored these articles, or if you have an opportunity to do so in the future, you will note that none of the entries advocates for a specific educational model and there is no article advocating an "ideal predoctoral curriculum." This omission was intentional: the overriding goal of the series was to expose the dental education community and other stakeholder organizations to a collection of ideas and perspectives about educational practices and the environment in which dental students acquire the competence to enter dental practice. The purpose was to stimulate introspection by individual faculty members about teaching and learning and by faculty collectively within schools about how their predoctoral programs are implemented. A group of articles within the series was also designed to stimulate consideration of the academic environment within dental schools and encourage reflection about the type of leadership that is needed for dental schools to move forward.
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, who gave generously of their time, insights, and expertise. Unlike symposia or conference proceedings often published in academic journals, the lead authors and their coauthors in the series were invited to develop original contributions to address designated topics or issues, often under tight timeframes. In the winter of 2005, ADEA CCI Chair Ken Kalkwarf, Karl Haden, lead consultant to the ADEA CCI, and I met to identify themes and potential authors. In anticipation that "sorry, my plate is full" would be a common response, we wrote numerous names on a flipchart for each potential article; I still have that flipchart page pinned to my office door with the numerous potential authors who were "targets of opportunity." The long list turned out to be unnecessary, which should be no surprise given the personal investment that many educators and practitioners have in the future of dental education. For the majority of the articles, the first person I contacted quickly said "yes" without hesitation, a testimony to the eagerness of individuals involved in the academic wing of dentistry to contribute to its evolution. The individuals who contributed to the development of these articles are, collectively, a reflection of the "central forum" mission of the ADEA CCI. Members of the dental school community, both faculty and administrative leaders, the ADA and organized dentistry, the licensure community, and other components of higher education outside of dental education are all represented. These individuals devoted considerable time to creating original work and serving as reviewers, sounding boards, and sources of information over the past four years. All should be congratulated for "above and beyond" service, which undoubtedly impacted their other responsibilities.
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Dental students’ perspectives on their education are not addressed among the CCI-sponsored articles, in part because of a previously published three-part series by Henzi et al. in this journal that reported the findings of the ADEA Council of Sections Project Pool-supported "Students’ Perspective Project."2–4 These three articles report the findings of a study involving nearly 3,000 U.S. and Canadian dental students in academic year 2003–04. The study obtained students’ assessments and insights about 1) the environment for learning in dental schools and interactions with faculty members, 2) the quality of their clinical education, and 3) the overall strengths and weaknesses of predoctoral dental education.
Although the ADEA CCI series endorsed no prescriptions for ideal dental school curricula, the intertwined questions of "Are we doing it right?" and "Are there better ways?" are always on the minds of dental educators, and hopefully the work of the ADEA CCI will lead to closer inspection of these questions in the future. The benchmark article for consideration of dental school curriculum structure and teaching and learning formats is by Kassebaum et al.5 This "lay of the land" article reported the results of a comprehensive national survey about the dental school curriculum and schools’ priorities for future development and modification. It is probably the most cited dental education article published in this journal since 2000 and represents a good starting point for individuals interested in what other schools are doing with their curricula and what they would like to do in the future. The data reported by Kassebaum et al. were collected in 2002–03, and from my perspective, it’s probably time to start planning for a follow-up study to see what changes have emerged from our recent focus on dental education innovation.
As a final companion article to round out the ADEA CCI series, I recommend the 2008 article by Licari and Chambers6 that examined the extent to which basic concepts of competency-based education (CBE), the designated educational model for the predoctoral curriculum endorsed by both ADEA and the Commission on Dental Accreditation for more than ten years, is actually understood by dental educators. When I first read this manuscript during the JDE peer review process, the findings from the study were an eye-opener that prompted me to reflect on ways I could help spread the word about CBE. The ADEA CCI article "Assessing Dental Students’ Competence: Best Practice Recommendations in the Performance Assessment Literature and Investigation of Current Practices in Predoctoral Dental Education" by Albino et al. (see citation in Figure 1
) contains a section describing competency-based education with an emphasis on assessment principles and specific techniques that are consistent with the CBE model.
I also recommend the additional sources included with this note7–13 to round out your "issues in dental education" reading. This is an admittedly eclectic collection of articles that address various aspects of dental education ranging from fundamental classroom instructional practices to big picture issues such as what should be the product of the dental education process. Although countless others could have been listed as supplemental readings, these articles open the door to several issues central to the shape and scope of dental education, including financial considerations, and augment the ADEA CCI series.
In closing, I want to thank my colleagues at the Journal of Dental Education for their invaluable help in making this series come to life. The editor, Dr. Olav Alvares, has been tremendously supportive, cooperative, and patient during the writing and publication of these articles, which sometimes "pushed the envelope" of JDE submission deadlines. Lynn Whittaker, the managing editor, played a huge role in getting these articles into the journal and also exhibited much-appreciated patience and editorial support for a collection of manuscripts that ranged widely in format, scope, and content.
To help raise awareness of the PRIDE series and promote further discussion of the perspectives shared by the authors, ADEA will produce in 2009 a bound edition of the series for dissemination to the dental education community.
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This article has been cited by other articles:
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  N. K. Haden, W. D. Hendricson, J. W. Killip, P. N. O'Neill, M. J. Reed, G. Weinstein, J. N. Williams, and R. W. Valachovic Developing dental faculty for the future: ADEA/AAL Institute for Teaching and Learning, 2006-09. J Dent Educ., November 1, 2009; 73(11): 1320 - 1335. [Abstract] [Full Text] [PDF]
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D. G. Dunning, T. M. Durham, B. M. Lange, and M. N. Aksu Strategic Management and Organizational Behavior in Dental Education: Reflections on Key Issues in an Environment of Change J Dent Educ., June 1, 2009; 73(6): 689 - 695. [Abstract] [Full Text] [PDF]
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