November 24, 2010
To:
President Peter MacKinnon
VP Academic and Provost Brett Fairbairn
VP Research Karen Chad
From: Charles Shuler, DMD PhD
Harinder Sandhu, DDS, PhD
Re:
Academic Review of the University of Saskatchewan College of Dentistry
Please find following our review of the UofS College of Dentistry. We have followed the
format recommended in the Terms of Reference for this review. In each section we have
provided observations and a conclusion. These findings are based on our observations
during the 2.5 day review and should be taken as an overview of the particular area rather
than an exhaustive set of findings. Following the review section there is a set of
Recommendations listed as; Short term, Medium term and Long term. These
recommendations are focused on the steps that might be recommended to develop an
active program of productive research in the College of Dentistry.
We would like to thank all the individuals who spent some of their precious time with us
during the review. The discussions were frank and open, providing us with considerable
perspective on the current state of the College of Dentistry and the positions of the
University with respect to both the importance of research and the future of the College.
Dean Uswak was particularly open about the details of the review and it is clear that he is
carrying a very heavy load by maintaining a full teaching load, establishing community
partnerships, leading research in dental public health and completing all the
administrative responsibilities of the Dean in the College. We believe that this review
and the recommendations will be of great assistance to him in achieving his goals for the
College of Dentistry.
Effectiveness of the DMD curriculum including guidance for curriculum renewal
The dental education program is providing a strong foundation for the graduates
to enter general practice. The students are very pleased with their education and
confident that they are well prepared to enter the general practice of dentistry. The
College of Dental Surgeons of Saskatchewan confirms the students’ position reporting
that new graduates are well integrated into the dental profession and providing excellent
oral health care to patients in Saskatchewan. The curriculum has been recently changed
from a 5 year to a 4 year curriculum and this newer curriculum is achieving the intended
educational outcomes. The accreditation in 2004 resulted in 16 recommendations, which
is quite a large number and in some cases these recommendations pointed out serious
concerns in the DMD curriculum. In the subsequent 6 years all the recommendations
have been addressed to improve the educational model. The College of Dentistry will
have another accreditation site visit in early 2011. There is planning currently underway
to complete a curriculum review and update the content as necessary. One area that
should be addressed is a disciplinary compartmentalization of the curriculum such that
there is not much integration between the different disciplines in the College of Dentistry.
There appears to be considerable resistance to any change in some disciplines and this
situation will need to be addressed if a complete curriculum review and update is to be
achieved. There was also some hesitancy on the part of students to voice concerns to
either the Dentistry administration or the faculty members, in part because there was an
assumption that they would be identified as the initiator of a concern and there would be
some negative consequence. An arms length Student Affairs Officer would provide a
means to assure confidentiality for the student raising a particular issue.
Conclusion – The College of Dentistry has an effective DMD curriculum that
achieves the educational goals. It does not seem necessary at this time that considerable
faculty time should be committed to curriculum change. Similarly discussion/planning
for the development of other education programs in dental therapy, dental hygiene and
dental assisting should be deferred until the research programs are firmly established. An
arms length Student Affairs Officer would benefit students who raise concerns about
elements of the curriculum.
The effectiveness of the College’s administration and organizational structure
The College of Dentistry is very small with only 21.5 full-time faculty members.
The Dean is the administrative head and works with a small executive committee that has
one associate and one assistant dean. There was a discussion of “departments” but these
seem to represent the different dental disciplines and in many cases these “departments”
have only a single individual. In many cases these “departments” represent isolated silos
that act to control specific elements of the curriculum and curriculum time. The
“departments” do not appear to have any research focus or organization to stimulate
research and provide little mentoring to new junior faculty. The College leadership
group has a focus on the DMD curriculum and some related interest in community clinics
that support the DMD curriculum. There does not appear to be any representation for
research on the leadership team, there is no Associate Dean for Research. This is further
emphasized by the lack of attendance of a Dentistry representative at meetings of the
Research Advisory Committee of the Council of Health Science Deans. There are
opportunities for DMD student involvement in a greater range of outreach clinical
activities through collaborations with the Northern Health regions to meet the needs of
under accessed populations. There are several models for the organization of Dentistry in
a Canadian University, in some cases Dentistry is integrated with Medicine and in others
Dentistry exists as a separate Faculty/College. There are strengths and weaknesses in
both organizational structures and the choices for a particular structure have been made
on the basis of University-wide objectives.
Conclusion – The College administration is overly focused on the DMD
curriculum with little impact on other strategic goals of the College and University. The
Leadership group must incorporate an individual capable of stimulating the growth of
productive research programs in the College.
The quantity and quality of the College’s research and scholarly activities
Research is a distinct weakness in the College of Dentistry. There is very limited
research activity and very little emphasis on the importance of research in the College.
The record of peer reviewed publications is very brief and there are very few externally
funded sources to support research activity. Faculties of Dentistry in Canada are
expected to have an active program of research and the accreditation process also
requires active research in the Faculty to ensure that the curriculum is current and based
on the best available evidence. Both the Association of Canadian Faculties of Dentistry
and Canadian Association for Dental Research emphasize the importance of an active
research program in dental schools. At the UofS College of Dentistry, senior faculty
members resist involvement in research and do not identify any incentive to be engaged
in research. Junior faculty members have some research interest and accomplishment
however they receive very little support from their faculty peers and the College
administration. Students have a limited research experience in a critical review of
literature course in the first year and a Research Table Clinic course in the third year.
The students did not rate this activity highly, there was a lack of sufficient mentors for
the table clinic research and few of the projects go forward into publications. The
considerable time and expense committed to the Table Clinics could be more
productively focused on projects with the potential to be published. The result of the
Table Clinic project does not lead students to choose careers in research and
consequently further diminishes the importance of research in the College of Dentistry.
There is only a very limited opportunity for dental students to engage in research during
the summers and this leads students to discount research as an area of career development.
A potential area that could represent a research focus is Dental Public Heath, however at
this time there is limited activity in this research and there are insufficient academically
prepared faculty members to develop a productive core of research. The leadership also
discussed developing some activity in research on dental materials but there does not
appear to be any members of faculty capable of directing a strong productive research
program in this area. There is the potential to leverage other expertise at the University to
build a materials science research focus however the faculty members are insufficiently
engaged with the University to recognize and develop these opportunities. The lack of
research prepared faculty with PhD degrees is a significant weakness. At this time there
are few faculty members with PhD preparation and this group has not contributed
sufficient research to constitute a nidus on which a stronger research program can be
established. There is an absence of collaborative interactions that represent an essential
component of current research programs and potentially productive research is being
missed by the lack of these established collaborations. Publications from the VP
Research identify many active programs in the University that could productively engage
dental faculty members but these opportunities are not being pursued. The VP Research
and the Research Advisory Committee have established numerous resources to assist in
the development of research including grant writing, proposal development and other
supportive infrastructure, however at this time Dentistry does not appear to be realizing
the potential of these support mechanisms. In particular the opportunity to engage a
Research Facilitator provided by the University has not been initiated by Dentistry.
Conclusion – Research and Scholarly activities are very limited in the College and
there is limited appreciation that these activities are an important focus of an academic
unit. The current faculty complement is not prepared to develop a strong research focus.
The absence of an individual in a leadership position responsible for the development of
the research programs in the College is a serious deficiency.
The quantity and quality of the College’s community outreach and engagement activities
Community Outreach is presented as a potential strength of the College of
Dentistry however on closer examination this appears to be more a potential strength than
an actual strength. Some College faculty members have the interest and populations exist
for both community service and community-based research however little has been
developed that would provide a school-wide base for either a community dental treatment
of research. Dental students have very limited opportunity in the curriculum to
participate in community outreach activities. This opportunity includes the potential for
an elective 1-2 week experience in the North of the province, however only a minority of
students indicated that they had/would participate in this community outreach rotation.
Students do participate in private practices in the summer between 3rd and 4th year but
this is non-curricular and not focused on populations with limited access to care. There is
a downtown dental clinic that is being completed and could provide community
experience for dental students and opportunities for interprofessional education, however
the potential for this clinic awaits realization and the planning for the site as a community
outreach location was presented in limited detail. The Saskatoon Health Region has
opportunities for both clinical treatment and research investigation and at this time the
Dean of the College appears to be carrying the entire load of these potentially productive
collaborations. There is an absence of data on the oral health needs and oral health care
of adult populations in remote areas in Saskatchewan and only a limited data set on
specific sets of children, the absence of this data represents a potential area for new
research and ultimately translational projects to improve oral health. The GPR program
at University Hospital provides care to members of the community especially medically
compromised senior citizens however there is no research activity linked to this program.
There are many opportunities to leverage community service and research programs with
the Colleges of Medicine and Nursing, both of whom show considerable interest in
collaborating with Dentistry.
Conclusion – Community Outreach is a potential strength that awaits realization,
however this represents an area that could be developed as an area of research emphasis
in the College of Dentistry without significant investment in research infrastructure.
The adequacy of the College’s human, infrastructure and financial resources to meet
current and future programming needs
Human Resources
The College has an aging faculty that resists change and commitment to
College and University research goals. Nearly half the faculty members are at or
approaching retirement age and this group resists any change in their activity profile and
additionally resist any change in the mission of the College. There are some junior
faculty who have been recruited and appear to understand that their career trajectory
needs to follow a different path from the more senior faculty members however there is a
pronounced lack of role models and a deficiency in mentorship for their career
development. There is a serious deficiency in that there is no designated individual to
facilitate research growth in the faculty, at this time the designated individual is an
emeritus faculty member who is at the school only part-time and does not appear to be
proactive in facilitating the development of research projects or mentoring of junior
faculty. Currently the College of Dentistry is not adequately represented on the Research
Advisory Committee of the Committee of Health Science Deans, the Dentistry
representative is most commonly not in attendance at the RAC meetings. Extending the
College of Dentistry’s potential human resources is possible through collaborations with
the School of Public Health, the School of Public Policy, the College of Kinesiology, the
Saskatoon Health Region and the Office of the Vice President of Research, All of these
units have indicated a willingness to help in collaborative research with College faculty
members. There has also been difficulty in holding Dentistry faculty members
accountable following actions that are not consistent with the highest levels of faculty
professionalism and ethics. Central support for the Dentistry Dean in these situations
would be very helpful in emphasizing the norms of behavior that are intended.
Conclusion – Significant changes in Human Resources are required. Faculty
renewal and revitalization is a critical element for the College of Dentistry. Realization
of available productive collaborations can only occur through the addition of individuals
with a focus on research. A leader of the research mission in the College needs to be
identified and become active in mentoring faculty members to develop their research
programs. Strong central administration support upholding the principles of the
University Strategic Plan and the core values of professionalism and ethics would be
beneficial to reaching the College research objectives.
Infrastructure
The dental clinic is satisfactory for the goals of the DMD curriculum and
has adequate space for the student learning through patient care. There is a goal to
update the technology in the clinic and an electronic patient record has been implemented.
Changes to digital radiology are planned. At this time changes in the clinic need not be a
high priority for infrastructure improvement.
The College of Dentistry lacks any dedicated research space. It is not
clear where a faculty member wishing to conduct a research project would work to
complete the research. There is the potential for basic research space in the new Health
Sciences building however there are no faculty members currently prepared to utilize this
space for their research programs. Research space alone will not solve the current lack of
research and scholarship rather it is critical that the infrastructure support research project
development. There are potential collaborations that would provide research space in
other units of the University however these have not been explored and faculty with a
research interest seem much more focused on developing isolated programs inside the
College of Dentistry building. A productive line of investigation will lead to adequate
research space.
There are major research initiatives and resources on the University
Campus however there is limited Dentistry involvement. The Synchotron is a unique
resource at UofS that does not appear to have been utilized by dental faculty. Core
research support is also available through the Council of Health Science Deans and
available to support projects in Dentistry. Biostatistics support is available to
investigators through a Stats support group in the School of Public Health. There is
considerable University infrastructure available that can be applied to Dentistry projects.
The new Health Sciences building also presents many opportunities for the College of
Dentistry that have yet to be explored. Despite a perception by the faculty members in
Dentistry that there is nothing for Dentistry in the new building this is not the case. A
new library, new learning/studying spaces, new teaching facilities and shared laboratory
spaces are all available to Dentistry. There has been a lack of planning to appropriately
use the many opportunities available in the new space.
Conclusion – The clinic infrastructure is adequate to meet educational goals, there
is an absence of any research infrastructure in the Dentistry building. University
infrastructure exists that can be utilized to support Dentistry research. Planning needs to
occur for Dentistry to take advantage of the new space that will be present in the Health
Sciences building.
Financial Resources
There is considerable discussion about the finances however at this time it
appears that the College of Dentistry has about $600,000 annually that could be used to
support either new initiatives or improvements. A development officer has been recruited
and appears to have a excellent ability to develop a fundraising strategy to support the
College. The strategic use of the finances has not been considered with respect to the
growth of research in the College. At this time there is a critical importance to recruit
faculty members with a research focus and research ability so it becomes important at this
time to build the research capability of the College of Dentistry through recruitment of
faculty members to replace retiring faculty members and add new faculty positions with a
focus on research. Dentistry appears to believe that resources need to be provided prior
to the completion of planning. The President, Provost, VP Research and Dean of
Medicine have all indicated that additional resources could be available if appropriate
plans for the future that are in line with University goals are prepared. Planning for the
future is the key element for identifying future financial resources.
Conclusion – Finances appear adequate to support current activities, to recruit
new research faculty members and to initiate research projects. Dentistry must complete
a detailed and comprehensive plan for the future that addresses the key strategic goals of
the University. In particular detailed short and long-term plans for the development of a
productive research enterprise in Dentistry must be developed.
The effectiveness of the College’s faculty practice model
Faculty members who have dental registration restricting their practice to the
dental clinic in the College of Dentistry practice in the faculty practice. Each faculty
member who has a faculty practice operates their practice as a personal business,
managing all the personnel, dental supplies, revenues and expenses, which include some
payment to use the College clinic for their practices. The Faculty Practice appears to be a
means for dental faculty to supplement income and does not appear to have any goals to
support the mission of the College. The College of Dentistry provides 1.5 staff positions
to help manage the Faculty Practice and it is not clear if this cost is compensated by the
providers working in the facility. The amount of time that an individual faculty member
works in Faculty Practice is not clearly defined and some new junior faculty members are
committed to practice 30% (3 half days) time, which will negatively impact the
development of their research program.
Conclusion – The Faculty Practice appears to work adequately as a site for dental
faculty to maintain their clinical skills and provide supplementary income. The
involvement of faculty members in private practice should be limited so that it does not
negatively impact their research.
The contributions of the College to interdisciplinary and to the Health Sciences group
The Dean of Dentistry played a critical role in the early formation of the Council
of Health Science Deans and continues to be a well accepted member of the Council.
The role of Dentistry in other elements of the Council structure is less clear. Dentistry
has not been represented in the Research Advisory Committee importantly losing the
opportunity for a voice in the new Health Sciences bldg. Dentistry is involved in some
interprofessional activities with Nursing and there is a willingness on the part of
Medicine to include them to a greater degree. The insular nature of Dentistry has greatly
limited the interdisciplinary activities. One example would be the absence of Dentistry
participation in the Interprofessional Problem Based Learning experiences that contribute
considerably to integration into the Health Science disciplines and the University. There
are also numerous resources available as core activities to the members of the Council
and it does not appear that the faculty members in Dentistry are aware of these. There is
tremendous support for Dentistry by all the other members of the Council of Health
Science Deans and willingness to support the development of a research program in
Dentistry.
Conclusion – Dentistry has had a limited involvement in interdisciplinary
activities. Dentistry must take advantage of the very supportive positions of the other
health science disciplines to the success of Dentistry.
RECOMMENDATIONS
SHORT TERM
 Appointment of an individual from outside the College of Dentistry with a strong
record of research to be the Associate Dean of Research with the responsibility
and authority to build a productive research program in the College.
 A detailed and comprehensive plan for the development of productive research
programs must be developed and shared broadly within all the health science
disciplines at the UofS.
 Develop an active mentorship program for the pre-tenure junior faculty to assist
them in developing the research profile necessary for promotion and tenure.
 Use the current flexibility in budget revenues for targeted hiring to bring in new
faculty members with a record of productive research activity.
 Develop strategies that promote and require full productivity by faculty at all
career stages and that take advantage of opportunities for faculty turnover to
create a research-oriented complement of faculty members.
 Develop community outreach activities and community partnerships that result in
a research focus in the area of Dental Public Health.
 Develop partnerships with the School of Public Policy and the School of Public
Health to expand the research potential of the Community Initiatives.
 Create a pool of research seed money to assist College of Dentistry faculty
members to begin research activities.
 Engage a Research Facilitator provided through the offices of the Vice President
of Research.
 Review the Integrative Plan in the College of Dentistry to insure that all faculty
members recognize the importance of research to the College and develop a
commitment to the formation of 2 different foci of research.
 Publicize the Integrative Plan to all College Stakeholders and emphasize the
importance of research to the long term goals of the College.
 Review the promotion and tenure guidelines and annual review guidelines to
insure that research accomplishment is recognized as a critical area of
productivity.
 Develop messaging strategy to College Stakeholders that breaks the cycle of
blaming the University for College problems and emphasizes a more positive
relationship.
 Strong messaging from the Central University administration on the acceptable
norms for professionalism and ethics.
 Recruit a Student Affairs Officer to provide a resource for students having any
concerns about activities in the College.
MEDIUM TERM
 Continue targeted recruitment and appointment to build research strength in
identified research foci and avoiding dilution of research potential.
 Initiate a program of faculty renewal and revitalization through turnover in the
faculty complement.
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Stimulate the submission of grants to external agencies by providing
workshops/courses on grant writing and submission.
Publish research findings and engage individuals with expertise in the area to
assist in the preparation and submission of manuscripts.
Build community research collaborations with the Schools of Public Policy and
Public Health.
Engage graduate students in the Schools of Public Policy and Public Health in the
College of Dentistry community research projects.
Convert the current 3rd year Table Clinic course into a program that accomplishes
research suitable for publication and submit the outcomes of the projects to
journals.
Develop a Summer Research program for dental students to engage them in the
generation of new information with relevance to improving patient care.
Investigate opportunities for joint dental and public health degrees and for dental
faculty members to earn a MPH.
Encourage College of Dentistry faculty members to become more involved in the
life of the University through service on University committees.
LONG TERM
 Continue targeted hiring of new faculty members with an emphasis on research in
their academic careers.
 Continue to focus on the development of the research programs in the College of
Dentistry and avoid dilution of research focus.
 Develop strong research programs funded by CIHR or NSERC sources that are
recognized nationally as measures of research achievement.
 Foster a culture shift in the College of Dentistry away from isolation and towards
involvement in the life of the University.
 Publicize the research accomplishments of the College of Dentistry and how these
achievements improve the oral health care of patients.
 Develop an active record of mentoring the research activities of MSc and PhD
graduate students.