J Dent Educ. 73(2): 166-171 2009
© 2009 American Dental Education Association
What the ADEA CCI Series of Articles Means to Me: Reflections of a Mid-Career Dental Faculty Member
Karen F. Novak, D.D.S., M.S., Ph.D.
Key words: American Dental Education Association, Commission on Change and Innovation in Dental Education, dental education, change, leadership, curriculum, faculty development
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Abstract
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In this reflection article, Dr. Karen Novak, a mid-career faculty member at a U.S. dental school, identifies important messages and insights she gained from a series of twenty-one articles about the future of dental education published in the Journal of Dental Education from October 2005 to February 2009. This article addresses four questions: 1) What influence have these articles had on an academic dentist’s perspectives about her role and priorities as a dental school faculty member and her own career plans and future directions? 2) What are the key messages in these articles for other dental educators who are at similar places in their careers? 3) What additional topics concerning the future of academic dentistry should be covered in future articles? and 4) What issues and priorities should receive the most attention from academic dentistry in the next decade? The American Dental Education Association’s Commission on Change and Innovation in Dental Education (ADEA CCI) was established to provide a mechanism for stakeholders in academic dentistry to meet and consider future directions in the education of the nation’s dental workforce. Along with ADEA, these stakeholders included dental schools, the American Dental Association (ADA) Board of Trustees, the Commission on Dental Accreditation (CODA), the ADA Council on Dental Education and Licensure (CDEL), the Joint Commission on National Dental Examinations (JCNDE), the dental licensure community, the ADA Foundation, and advanced dental education programs. The ADEA CCI was created to build consensus within the dental community for innovative changes in the education of general dentists. One outcome of this process was a series of articles intended to raise awareness and stimulate dialogue about issues and forces shaping the future of dental education. Collectively, this series of articles is known as the Perspectives and Reflections in Dental Education (PRIDE) series to acknowledge the commitment of the academic dental community to reflect on current practices and future directions and also to represent the pride of dental school faculty members in their educational responsibilities and accomplishments.
The American Dental Education Association’s Commission on Change and Innovation in Dental Education (ADEA CCI) was established in 2005 to serve as a "facilitator of change and innovation" in dental education. Through this group, ADEA brought together individuals representing the major stakeholders in dental education: dental schools, the American Dental Association (ADA) Board of Trustees, the Commission on Dental Accreditation (CODA), the ADA Council on Dental Education and Licensure (CDEL), the Joint Commission on National Dental Examinations (JCNDE), the dental licensure community, the ADA Foundation, and advanced dental education programs.1 The purpose of the ADEA CCI is to "build consensus within the dental community by providing leadership and oversight to a systemic, collaborative, and continuous process of innovative change in the education of general dentists."1
As part of the process, the ADEA CCI commissioned a series of articles to address a variety of issues relevant to the future of dental education. This collection of articles is known as the ADEA CCI Perspectives and Reflections in Dental Education (PRIDE) series. Published from October 2005 to February 2009 in the Journal of Dental Education, these articles covered topics including a historical perspective on the development of the ADEA CCI, the rationale for change in dental education, the challenges associated with introducing change, the emerging picture of the educational and practice environments, evolving educational strategies for training practitioners of the future, standardized assessment of student achievement, and issues of faculty recruitment, development, and retention.
This article is one of the two final ones in the PRIDE series. Its purpose is to present the reflections of a mid-career academic dentist on this series. In doing so, I will address the following questions:
- What influence has this series had on my perspectives about my role and priorities as a dental school faculty member and my own career plans and future directions?
- What are the important messages in this series for other dental educators who are at similar places in their careers?
- What additional topics should be covered in future articles about curriculum and change?
- What issues and priorities should receive the most attention from academic dentistry in the next decade?
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Influences on My Professional Role and Priorities
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This section addresses the following question: What influence has this series had on my perspectives about my role and priorities as a dental school faculty member and my own career plans and future directions?
Each of the topics covered by the series has influenced my perceptions of my own career responsibilities and goals. Perhaps most important has been in understanding the role of the ADEA CCI and many of the factors associated with changing the face of dental education. First, although I had heard of the ADEA CCI before the series began to be published, I really did not understand the rationale for the development of this group and the leadership role it was to play in fostering change in dental education. Therefore, reading the first article in the series, "ADEA Commission on Change and Innovation in Dental Education,"1 provided me with a brief, but very informative, overview of the role of the Commission and the series of events that led to its development. This article also highlighted the breadth of expertise represented on the Commission, helping me understand that this effort represents a serious commitment on the part of ADEA, as well as the other stakeholders represented, to provide comprehensive leadership and oversight in issues related to dental education. In reading this first article, I also gained a new appreciation for the commitment ADEA is making in providing tools and resources to the dental education community as we move forward in implementing changes that will direct the future of dental education.
The issue of where we are in the change process was introduced in the second article in the series, "The Case for Change in Dental Education."2 Of all the articles I subsequently read, this one had the greatest impact on me. Having spent several years as a faculty member, I had often heard discussions on the significance of the findings of the Institute of Medicine (IOM) report Dental Education at the Crossroads: Challenges and Change.3 This report was always cited as the landmark publication that should have served as a catalyst for change in dental education. As such, I assumed that significant change was occurring at the national level. After all, we had moved to competency-based education, worked to improve integration of basic and clinical sciences, and developed and implemented better teaching and assessment methods to promote critical thinking and lifelong learning. To realize that it was still necessary to make the "case for change" eleven years after publication of the IOM report was surprising to me. This took me back to the lead sentence in the first article in the series, which stated, "It’s easier to move a cemetery than to change a curriculum."1 Following this lead statement was a discussion about the difficulties and frustrations that have been encountered by schools and individuals attempting to create significant change in their institutions. I realized that while the IOM report provided the rationale for change, perhaps it did not provide a "roadmap" for accomplishing change. After reading the series and becoming more aware of the ADEA CCI’s principles and initiatives, I now believe that the Commission is trying to provide this roadmap.
Let me return to the first question regarding the impact of these articles on my priorities as a mid-career faculty member. After reading the first two articles in the series, I decided that although creating change is difficult, I would try to be an agent of change at two levels—first in my own individual teaching and mentoring, and, second, in our institutional curriculum evaluation. My knowledge in these areas was enhanced by reading the articles that focused on the educational strategies we need to employ, and the culture we need to create, to graduate dentists who are competent in critical thinking, adept at linking basic and clinical sciences, committed to practicing evidence-based dentistry, and eager to be lifelong learners.4–6
The information in these articles served as a rich resource as I assessed my own teaching and mentoring activities. As a result, I began to reevaluate the content and structure of a second-year course in which I serve as the course director. This reevaluation led me to make several changes. In an attempt to bridge basic and clinical sciences, I began pairing sequential lectures that directly link a basic science content area with a clinical correlate. Typically, two faculty members who present the information are guided to work together in order to organize the two lectures so they complement and reinforce each other. During the latter part of the course, the students are divided into small groups to assess and discuss interdisciplinary cases designed to further reinforce the concepts presented in the didactic portion of the course. The course information and cases are presented in a web-based format, with small-group discussions being managed through online interactions. However, the details of what I did and how I did it to redesign my course are not the point I wish to make. What I would like to emphasize is that the information in the series of ADEA CCI articles provided a knowledge base and also helped me realize that change can start with one person trying something different. Change does not have to be earth-shattering or even hugely innovative. However, even if what we do as individual faculty members in our courses most likely will not transform an entire curriculum, it can be a step towards incremental change that may ultimately have a broader impact.
In the bigger picture of institutional change and innovation, the same articles4–6 were also important to me because they provided information about principles that are critical in shaping the dental curriculum of the future. I have been fortunate to have been given an opportunity to put these principles in place by serving as interim associate dean for academic affairs at my institution. In this role I am chairing a Curriculum Task Force that has been charged with evaluating our current curriculum and developing recommendations for future directions. I have already learned that curriculum evaluation and revision are complicated tasks and that the very words "change" and "innovation" are not always regarded as necessary and/or positive. The article in the October 2008 JDE titled "Managing Change in Dental Education: Is There a Method to the Madness?"7 has been a valuable resource as I try to understand the issues related to organizational change. This article covers topics such as different types of change and the principles of managing change, with much of the information coming from the higher education literature. This article has helped me put curriculum change in the broad context of organizational change, where basic concepts of organizational development are important. With both the principles of dental education and the principles of change in mind, the ADEA CCI series of article has thus provided me with an excellent overview of the issues being addressed as the Commission’s roadmap is developed. In doing so, these articles have served as an essential resource as I become more involved in change and innovation at my own institution.
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Messages for Other Dental Educators
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This section addresses the following question: What are the important messages in the ADEA CCI PRIDE series for other dental educators?
In addressing this second question, I would like to highlight my perceptions of several general messages introduced in the ADEA CCI series that at first glance may seem somewhat disconnected. To do this, I must put these articles in the context of another personal experience I have had over the past year—serving as the 2008 ADEA/Gies Foundation Education Fellow. How does this activity relate to the series and my personal priorities and career directions? There are two main ways: the gift of time and the gift of exposure. As the recipient of this fellowship, I have spent three months of cumulative time at the ADEA headquarters. This gift of time, away from the daily activities that consume each of us as faculty members, has allowed me to focus on issues in dental education and to actually read and reflect on the ADEA CCI series. Without this opportunity, would I really have been able to do these two things? Maybe, but it certainly would not have been as easy. Therefore, to be agents of change we need time to reflect on and react to ideas presented in venues such as this series.
The second gift—that of exposure—was received from both the series and the staff of the ADEA Center for Educational Policy and Research, who were my colleagues during the fellowship. Each of these individuals has a strong background in higher education. Exposure to them has helped me recognize the value of interacting with individuals at our own institutions representing these broader educational backgrounds. Doing so will expose us to a different set of perspectives that may enhance our dental education programs. The concept of exposure links to the broader issue of the role of faculty development in initiating and implementing curricular change and innovation. Two articles in the ADEA CCI series focus on this issue.8,9 The first highlights the role of faculty development in creating a culture that is ready for curriculum change and in subsequently preparing faculty members to teach and assess learning in the new curriculum. The second provides "information and insight about faculty development that may be useful to dental schools in designing professional growth opportunities for their faculty."9 Both articles helped me realize that those of us who are mid-career faculty members need to be proactive in identifying the new tools and skills we need to be effective teachers and mentors in a new curriculum. Once those needed tools and skills are identified, we need to communicate those needs to our administrators responsible for faculty development and encourage them to identify resources, and time, to help us meet those needs.
Several articles in the ADEA CCI series focused on another area I believe is relevant to mid-career faculty members: development of future faculty and satisfaction with academic careers.10–12 These three articles highlighted the differences in perception and expectations of careers among the generations, students and faculty, and faculty of various academic ranks and status (e.g., part-time versus full-time). First, the information on generational differences was of particular interest to me as a mid-career faculty member who is part of the baby boomer generation. I knew the term "Generation X," but did not really appreciate the characteristics of that generation that could influence their perceptions and actions as faculty members. Described as individuals desiring "portable careers," "freedom," "self-command," and "work-life balance" from the very beginning of their careers, Gen Xers don’t fit the mold of academicians who are accustomed to continuous service at one institution, wanting "money, title, and a corner office," and willing to sacrifice quality of life until attaining a certain level of rank and recognition in their careers.10 Given that the majority of faculty members and administrators in dental schools are more boomer than Gen Xer, a culture clash may exist that will need to be overcome. In reading these articles, I recalled hearing discussions about the outspoken nature of new, young faculty members and how bold they can be in expressing their opinions to their more experienced colleagues. These articles helped me understand that they aren’t being rude or out of line; they are just representing cultural differences that as a boomer I need to learn to appreciate. So as a mid-level academician, the next time I hear those conversations I need to remember that our new, young faculty members represent a new generation that may have different perspectives on their careers than those of most mid-career faculty members.
This same group of articles highlighted work-life questions for academic dentists. I was pleased to read that, even in times of increased workloads and expectations, the majority of dental school faculty members are satisfied with their careers and work-life balance.12 In trying to encourage students to consider academic dentistry as a career option, I think it extremely important to convey this message. For those of us who have been in academics for several years, we need to let our students and new, young faculty members know why we have chosen to be academic dentists for our careers. That means showing how much we enjoy the teaching, research, and service activities that make our careers challenging and exciting. It also means being a good mentor for both of these groups. The article in the series titled "Creating the Dental School Faculty of the Future: A Guide for the Perplexed"13 describes the characteristics of a good mentor. To me, it described individuals who project that they are confident in, happy with, and proud of the career path they have taken. This is demonstrated by their positive interactions with students and colleagues, which is an essential component of being a good mentor and role model. Therefore, an additional message I took from these articles is that we need to maintain enthusiasm for our careers and project this enthusiasm to both our students and our new, young faculty members.
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Future Issues and Priorities in Academic Dentistry
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This section addresses the following questions: What additional topics should be covered in future articles about curriculum and change? What issues and priorities should receive the most attention from academic dentistry in the next decade?
Although I have highlighted several articles from the ADEA CCI series in the previous sections, future articles might introduce topics that will continue to be discussion points in the academic dentistry community. One is the impact that standardized exams, specifically the Dental Admission Test (DAT) and the National Board Dental Examination (NBDE), have on the dental school curriculum. Future articles also could expand on discussions of the relationship between the prerequisite courses for dental school admission, the DAT, and the basic science courses currently taught in the curriculum. In addition, with the expanding knowledge in basic sciences and a focus on translational research and patient care, a discussion of strategies to transition the NBDE to a more integrated, case-based format would be of benefit to the education community. Another area of interest is the decision of the Joint Commission on National Dental Examinations (JCNDE) to report the results of the NBDE as pass/fail. Future articles should focus on the development of new assessment tools designed to assist postgraduate program directors in identifying applicants who best match the goals of their programs. These same articles on assessment tools would be of value in identifying the best means to assess the overall didactic and clinical competence of our predoctoral dental students. The article on assessment of dental student competence in the December 2008 issue of the JDE is a starting point for closer consideration of how we determine our students’ readiness for entry into unsupervised practice in the community.14
Beyond the issues of curricular change and new methods of assessment, future topics also could include expanded discussion on the role of dental schools in access to care issues. Qualitative and quantitative analyses of the impact that new community-based dental school curricula have had on developing students who are culturally competent and dedicated to addressing access to care issues would be of interest. Similarly, analysis of the impact that new dental schools and the new patient care models they represent are having on alleviating oral health disparities could be of benefit to dental schools that are considering moving their clinical programs in similar directions. Finally, the topic of how we can attract students into academic careers will continue to be an area of focus. Recognizing that current approaches are not as successful as one would hope, creative models that address financial issues facing graduates, as well as the image of academic dentistry, must be developed.
These are both challenging and exciting times in dental education. The issues facing us as dental educators, while not new, remain of great importance as we strive to prepare our students to be the practitioners and dental academicians of the future and to maintain our dental schools as financially viable academic institutions. The work of the ADEA CCI and the information provided in its series of articles have provided the dental education community with a useful roadmap to address these issues as we begin the process of innovative change in dental education.
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Figure 2. Summary of general messages for dental school faculty members regarding the ADEA CCI PRIDE series
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Author Information
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Dr. Novak is Associate Professor, Director of Graduate Studies, and Interim Associate Dean for Academic Affairs, University of Kentucky College of Dentistry and the 2008 ADEA/Gies Foundation Education Fellow. Direct correspondence to her at the University of Kentucky, College of Dentistry, 414 Health Sciences Research Building, Lexington, KY 40536-0305; 859-323-8705 phone; 859-257-6566 fax; knova2{at}uky.edu.
This article is one in a series of invited contributions by members of the dental and dental education community that have been commissioned by the American Dental Education Association’s Commission on Change and Innovation in Dental Education (ADEA CCI) to address the environment surrounding dental education and affecting the need for, or process of, curricular change. This article was written at the request of the ADEA CCI but does not necessarily reflect the views of ADEA, the ADEA CCI, or individual members of the ADEA CCI. The perspectives communicated here are those of the author.
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REFERENCES
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- Field MJ, ed. Dental education at the crossroads: challenges and change. An Institute of Medicine Report. Washington, DC: National Academy Press, 1995.
- Hendricson WD, Andrieu SC, Chadwick DG, Chmar JE, Cole JR, George MC, et al. Educational strategies associated with development of problem-solving, critical thinking, and self-directed learning. J Dent Educ 2006; 70(9):925–36.[Abstract/Free Full Text]
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- Albino JEN, Young SK, Neumann LM, Kramer GA, Andrieu SC, Henson L, Horn B, Hendricson WD. Assessing dental students’ competence: best practice recommendations in the performance assessment literature and investigation of current practices in predoctoral dental education. J Dent Educ 2008; 72(12):1405–35.[Abstract/Free Full Text]
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Abstract
Influences on my professional...
