Community-Based Education

“New Dental Schools”
What Are They Doing Out
(And Do We Really Need Them?)
 1986 – 2001:
7 Dental Schools Closed
 1997 – 2009:
5 Dental Schools Opened
 2011-2014:
7 new schools
 Future:
8 new schools being considered
 There are still many in the profession who remember
the last time the system was expanded
 Influence of practicing profession on applicant pool
 1980 – 6,000 graduates; 227 million = 1:38,000
 1990 – 4,000 graduates; 250 million = 1:62,500
 2000 – 4,200 graduates: 281 million = 1:67,000
 2010 – 4,800 graduates: 308 million = 1:64,000
 2020 – 5,600 graduates: 335 million = 1:60,000
Why Connected to Osteopathic
• The Osteopathic Philosophy
• Health is more than the absence of disease
• Health involves the whole person (body, mind
and spirit) and the person’s relationship to
others and the world
• Oral Health is essential to Overall Health
Framing the Debate
“Do We Need New Dental Schools?
“If We Are Going to Have New Schools, How Can
We Take Advantage of the Opportunity?”
Opportunities for New Dental
 Many reports/articles/discussions about the need to
reinvent dental education
 Similar documentation of the slowness of real change
 Dozens of presentations over the years about new
ways of doing things but progress seems slow
 Don’t new schools have an obligation to help move the
profession forward?
 Are these really “New Models?”
 Or, is it that the new schools have a better chance?
Opportunities for New Dental Schools
 A “Blank Slate”
 Responsibility to the Profession to Lead Change
 Innovative Curriculum models
 Efficient/Effective Patient Care models
 Community-Based Education models
 Inter-Professional Education
 Oral – Systemic Connection
UNE - Mission
 The University of New England provides students with a
highly integrated learning experience that promotes
excellence through interdisciplinary collaboration and
innovation in education, research and service.
College of Dental Medicine
 The mission of the University of New England College of
Dental Medicine is to improve the health of northern New
England and shape the future of dentistry through
excellence in education, discovery and service.
• Holistic Admissions Criteria
• Humanistic Environment: student and patient friendly
• Strong Foundation in Science
• Curriculum built around patient care
• Integrated teaching and learning model that is innovative
and evidence-based (use of varied methods)
• Appropriate use of modern technology and Realistic
• Early and Extensive Clinical Experiences
• Comprehensive Care in Group Practice Model
 Prevention-Oriented Teaching and Practice
 Promotion of community and dental public health
 Significant community-based education experience
 Development of strategic partnerships to help achieve
mission and goals
 Research and critical inquiry, inter-professional practice, lifelong learning
 Professionalism, Ethics, Leadership, Communication,
Business Management Skills
UNE CDM Graduates
 Will be ethical, caring people;
 Will be life-long learners;
 Will be capable clinical practitioners who will have the
ability to provide complex, high-quality care in an interprofessional health care delivery system;
 Will embrace scientific and technological advances ;
 Will understand the connections between oral health
and general health;
UNE CDM Graduates
 Will be partners in the inter-professional health care
delivery systems of the future;
 Will be leaders of their own oral health care teams, as
they enhance and extend the quality of life in their
 Will collectively engage in clinical oral health care,
public health practice, biomedical and health services
research, education and administration;
 Will fulfill their professional obligation to improve the
oral health of all members of society;
 Behaviorally oriented Whole File Admissions Reviews
 Use of Multiple Mini Interview (MMI) protocol
 “Single Pillar” Organizational Structure
 No departments or divisions
 Generalist model of education and practice
 Competency based
 Integration of Pre-Clinical Curriculum
 Hi-tech Simulation based on clinical case scenarios
 Integrated Oral Health Science Curriculum
 General Dentistry based supported by specialists
 Patient Centered, Group Practice, Grand Rounds Approach
CDMI (Continued)
 Use of varied teaching learning methodologies
 Small groups
 Case-based
 Problem based
 Biomedical Sciences integrated and system based
 Connected to Oral Health Sciences where facilitated by timing
and scheduling
 Spiral model of curriculum progression in which basic concepts
are revisited throughout curriculum
 Capstone, team-taught course in Yr. 2, 2nd Sem
 Review and reinforce prior learning in B.S.
 Motivate critical thinking through use of cases
 Provide better preparation for NBDE
CDMI (continued)
 Interprofessional Learning and Practice
 Core inter-professional course attended by all first year
students from nine professional programs
 Second year course in Head and Neck Diagnosis codirected by Osteopathic Medicine and Dental Medicine
 Inter-professional health care facility with dentistry as
“anchor tenant” but with all other professional programs
USN Educational Model –
Mastery Education
Active and
Block System
 Block system for didactic courses
 36 hr course = six 6 hr. days
 Supported by contiguous breakout room configuration to
allow for small group, PBL, and active collaboration
 Immediate exploration and clarification of core concepts
with faculty
 Mastery Education Model
Criterion Referenced and Competency Based
Pass/No Pass
90% passing grade
Assessments occur within block on Friday with
remediation the following Monday
 Additional remediation opportunity in summer for those
with three or more “no pass”
 General Dentistry Group Practice Teams
 Community-based education for most of 4th year
 Focused approach to research
1 Individual Course
Block System:
 Focused Learning / 1 Topic
 Mastery of Topic
 Increase Active Learning
 Rapid Instructor Assessment/Feedback
 Peer Teaching
 Remediation
Contemporary Classroom
 Classroom “in the round”;
 No one more than 4 rows away from teacher;
 5 Breakout rooms – small-group teaching/discussion;
USN’s Classroom
Typical Teaching Day
 8-9 am:
Formative Assessment / Prior Day
 9-10 am: New Material (lecture)
 10-11 am: Team Activities + Feedback
 11-Noon: Lunch
 12 – 1 pm: New Material
 1-2:30 pm: Team Activities
 2:30-3:00 pm: Feedback, Wrap-up, Loose Ends
Western University of Health Sciences
College of Dental Medicine
 Western University College of Dental Medicine will be a premier
center for integrative educational innovation; basic and
translational research; and high quality, patient-centered,
interprofessional health care, all conducted in a setting that utilizes
advanced technology and promotes individual dignity and potential
for personal and professional growth.
 The WesternU College of Dental Medicine will realize this vision by
educating and training highly competent, diverse groups of clinical
practitioners who have the ability to provide complex, integrative,
high-quality, evidence-based care for patients, families and
Western University of Health Sciences
College of Dental Medicine
 WesternU College of Dental Medicine will produce graduates who
will be ethical, caring life-long learners; who will collectively engage
in clinical oral health care, public health practice, biomedical and
health services research, education and administration; and who will
fulfill their professional obligation to improve the oral health of all
members of society, especially those most in need. They will
embrace scientific and technological advances and understand the
connections between oral health and general health. They will be
partners in the interprofessional health care delivery systems of the
future, as well as leaders of their own oral health care teams, as
they enhance and extend the quality of life in their communities.
Guiding Principles
Critical Thinking
Self Assessment
Lifelong Learning
Science Based Curriculum
Integration of basic/behavioral/clinical sciences
Focus on Overall Health/Oral Health Connections
Early entry into clinic
Use of appropriate technology
Leadership/Communication/Management Skills
Curriculum Highlights
 Basic/Behavioral Sciences
 Systems based approached to basic sciences
 Challenges with simply taking med school curriculum
 Evolving into dental school ownership of biomedical sciences
with integrated case based approach
 Interprofessional Experiences
Case-base instruction, didactic coursework, community
education as well as clinical training and rotations
Integrated Dental Sciences
Essentials of Clinical Dentistry
 “Bucket approach” based upon patient care
 Close juxtaposition of didactic material with simulated
exercises and patient care
 Learn procedure, practice to competency, apply in patient
Curriculum Highlights
 Comprehensive Patient Care
Group Practice Model
Patient Centered
Competency Driven
 Community-Based Education
 Real Life Experiences
 Practice Management
 Service to Community
 Faculty
 Coming from private practice or directly from residency programs
 Possibly contributing to a net gain in faculty?
 Will require well planned faculty development programs
Inter-Professional Patient Care Center
Interprofessional Clinic
Western University
 Evidence-Based Decision Making and Clinical
Research – First Year Course
 Course Topics and Objectives:
 Introduction to Epidemiology
 Introduction to Clinical Trials
 Introduction to Biostatistics
 Ethical and Regulatory Issues in Clinical
 Introduction to evidence-based practice
 Developing a precise question
Western University
 Introduce students to clinical research methods as well as basic
and advanced concepts of evidence-based practice in the
health professions.
 Train students to appropriately utilize and evaluate the
biomedical literature across health professions.
 Prepare students to engage in evidence-based decision
making, providing the skills needed to locate relevant online
scientific/medical information as well as to evaluate the quality
of the research methodologies and statistical analyses reported
in the clinical research literature.
 Focus is from a clinical practitioner/researcher standpoint rather
than that of a basic sciences researcher. This is an introduction
to several key concepts, and students are not expected to have
a deep mastery of statistics, research methodology, or online
bibliographic databases prior to taking the course.
Western University
 Develop and utilize effective evidence-based practice search
 Critically appraise the evidence for its validity and importance
regarding diagnosis and screening, prognosis, therapy and
 Apply the results to practice
 Instill in the student an approach to health care that requires the
judicious integration of systematic assessments of clinically
relevant scientific evidence in the context of patient treatment
needs and preferences.
Other Initiatives
 University owned remote clinics
 Community Service Learning Centers
 Located in Rural, Underserved areas
 Faculty, residents, dental students, staff practicing
 Expose students to patients with more complex medical
and oral health needs
 One goal is to have the dental graduates go back to those
rural areas to practice
General Thoughts
 The more I learn, the less I’m sure of
 This is simply an overview
 CCI principles do form the basis for much of what is happening
 “New” schools, like existing schools, are unique, with individual
missions and goals
 Doing “new” things or doing “old” things differently will require
paradigm shifts, risk taking, extreme flexibility, and willingness to
 Possible to create a different culture, but can it be maintained?
 When the going gets tough, will we revert back to what we know?
Special Thanks To:
 Dr. Lex MacNeil, Midwestern University-Illinois
 Dr. Rick Buchanan, University of Southern Nevada
 Dr. Steve Friedrichsen, Western University of Health
 Dr. Rick Valachovic, ADEA
 The thousands of people who have taught me over the
years, both formally and informally