D E N TA L E D U C AT I O N
Australian Dental Journal 2002;47(3):194-201
A new era of dental education at the University of Sydney,
Australia
I Klineberg,* W Massey,† M Thomas,* D Cockrell*
Abstract
Dental education is currently under scrutiny in order
to most appropriately address community needs for
the new millennium. Educational outcomes need to
include a commitment to life-long learning, and an
emphasis on professional ethics and moral
responsibility. These needs are supported by new
forms of information delivery with a focus on the
electronic media, by student centred and selfdirected coursework, and by clinical stimulation.
Additionally, at the University of Sydney, selection
will follow a first degree. This will allow candidates
time for an informed decision to be made for their
future professional career and for a period of
experience in the tertiary education system.
Key words: Selection, graduate entry, learning methods,
simulation, vocational training.
(Accepted for publication 6 August 2001.)
Factors influencing the development of the University
of Sydney dental programme
Dental education needs to be considered within the
context of educational change and demand for
justification of health outcomes. Additionally dental
education itself is undergoing unprecedented change
with multiple demands requiring immediate, but
reasoned responses, and new and innovative
strategies.1,2
Changing community requirements and expectations
These demands include student demands for better
information that is more focused and relevant: students
are more critical, and have expectations that have
changed the relationship between teacher and student
and university and student. There is an expectation of
good communication skills.
The demand is continuing to increase for treatment
of an ageing population.
There needs to be a contemporary emphasis on skills
in clinical reasoning and evidence-based practice. In
*Faculty of Dentistry, The University of Sydney.
†Baltimore College of Dental Surgery, The University of Maryland,
Baltimore, United States of America.
194
addition, health issues centring on infection control
policies and procedures for clinical coursework are
changing the nature of the clinician/patient
relationship, and contributing substantially to the cost
of health care.
Faculty staff are under pressure to review their
coursework and to develop new methods of
information delivery for increasingly computercompetent students. Of particular importance is that
government funding for health and education is
reducing, whilst the cost of clinical dental education
continues to increase. Alliances between the health
professions are being encouraged for teaching, research
and patient care.
The global village and the World Wide Web
Electronic communication has already had a
profound effect on university research, teaching and
administration. In addition, a number of developments
are beginning to influence academic thinking, but the
full impact is yet to be recognized.
The increasing embrace of new methods of
information technology will provide a global network
for the sharing of scientific, technical and clinical
information on an unprecedented scale. University
faculties and departments will have available, via the
Internet, information which could be included in their
programmes to enhance and broaden their coursework.
It should be possible for internationally recognized
scholars to be able to provide advice, guidance,
seminars and courses. With appropriate marketing of
individuals and courses internationally, the concept of a
‘Global University’ will become a reality. This could
provide a mechanism for the almost instantaneous
sharing of knowledge at the cutting edge of research
and development, and will form a basis for
international benchmarking that has not previously
been possible.
Accreditation of professional courses could require
international benchmarking and the opportunity for
reciprocity of qualifications could be a by-product of
this process. Global competitive marketing will allow
university disciplines and faculties to expand their
Australian Dental Journal 2002;47:3.
curricula independently from the expertise of existing
discipline staff. Information beyond that which could
be offered from within each discipline will be readily
available. The cost of accessing these programmes
could be a limiting factor and budget priorities would
need to acknowledge these costs.
Strategic alliances between disciplines and faculties
will enhance research and teaching opportunities. This
is already occurring to an extent, especially with
national and international research collaboration.
However, entrepreneurial leadership will see this
become an increasing need.
The relationship between medicine and dentistry
Dental Education at the Crossroads3 summarizes the
extensive deliberations of a committee appointed by the
Institute of Medicine, to consider the future of dental
education in the United States of America. Although
the recommendations are designed to address issues of
particular importance in the United States, such as
dental workforce issues, they are also of relevance to
dental education in general, and have helped to refocus
the priorities of dental education.
There is a need for close links between education,
research and patient care. New initiatives in funding
and budget management are required to meet the
challenges of declining resources for dental schools.
Educational programmes are required that are
integrated with medicine, and the opportunities for
dental students to integrate with those of other clinical
disciplines for broadening clinical experience. Clinical
training should be community based and patient
centred, where the goal is management of overall oral
health needs, rather than specific items of service. In
this way, it should be possible to develop a dental
workforce that is a reflection of community diversity
and need, with dental and allied dental health
professionals sharing coursework, and working
collaboratively in the provision of community oral
health care.
It is recognized that there is a need to broaden the
educational base for dentistry and to develop links with
medicine and the medical sciences.4,5 Such educational
links help to cement an integrated clinical approach
and an understanding of patient needs and disease
processes. This should be based on a strong foundation
in medical sciences, which provides direct support for
clinical oral health sciences and research. These
educational links emphasize oral health within the
context of general health.
A greater emphasis on medicine and pathophysiology
as well as specific coursework in gerodontics, special
care dentistry and behavioural science, is required to
meet the diagnostic and management needs of a
progressively ageing community and those with
disability and chronic illness. Integrating information in
the biological sciences and biomedical sciences with
clinical coursework, helps to reinforce the nature of
oral diseases within the context of general biological
Australian Dental Journal 2002;47:3.
and biomedical sciences. The special features of the
head and neck and oral cavity must be placed within
the context of general body function, dysfunction and
pathology. Students must be encouraged to view the
stomatognathic system as yet another body system with
consequent similarities in structure, function and
development.
Coursework links with medicine are especially
relevant for certain dental clinical disciplines. Dental
students need didactic and clinical exposure to general
medicine, surgery and pathology to more fully
appreciate the context of oral medicine, oral surgery,
and oral pathology. Within the limits of curriculum
time, clinical medical experience may be presented by
rotations through general medicine, general surgery
and general pathology departments. A short hospital
residency programme in maxillofacial surgery has been
in progress in this Faculty for 15 years. It provides
dental students with first-hand experience in accident
and emergency and other aspects of trauma medicine to
emphasize the importance of medical training for
management of oral and facial trauma. These are
challenging and rewarding experiences for dental
students which provide significant opportunities for
professional contact with medical students and staff in
medical specialist disciplines. This broadening of the
educational horizon of dental undergraduate students
and of the nature of routine dental care, has become
increasingly important as dental management now
requires a greater knowledge of general medical
conditions, particularly for older patients.3,6
Other than for resource reasons, dental students can
benefit educationally from a shared initial one or two
years with medical students, as long as the unique
requirements of dental education (viz., early
development and assessment of psychomotor and
communication skills) are maintained and reinforced.
Curriculum design needs to reflect and support the
desired outcomes of dental training. At the Harvard
School of Dental Medicine, dental and medical students
share the vast majority of subjects in the first two years,
and on the recommendation of the General Dental
Council (GDC) many of the dental schools in the
United Kingdom now follow this plan. Other schools
have developed curricula with independent dental
coursework, but strong links with medical disciplines.
Equally important, for dentistry, is to recognize the
fundamental links with science and biology, not only to
provide an appropriate knowledge base in biological
and medical sciences, but to vertically integrate these
subjects with clinical coursework.
Specific requirements of dental education
With prosperity and improvements in lifestyles, diet,
nutrition and disease management, the ‘greying of the
community’ brings its own problems for oral health
management. This is observed most clearly in the
community need to provide adequate oral health care
for the elderly, including extensive restorative
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Table 1. Desirable features of dental undergraduate education
Academic competence
– Understanding biological and medical sciences
– Understanding clinical sciences
Clinical competence
– Ability to safely perform a range of treatments required for general dental practice, in healthy and medically compromised patients
– Ability to recognize conditions requiring specialist referral
– Ability to cope with the unexpected – dental and medical emergencies
– Emphasis on the team approach – dental practitioner, dental assistant, dental hygienist, dental technician, dental prosthetist
Further education
– Life-long interest in continuing profession education
– Ability to assess and embrace new technologies
Learning methods
– Experiential learning is most likely to engender a commitment to learning through self-directed, enquiry based and problem centred learning
– Educators must accept that all clinical and diagnostic requirements cannot be learned during an undergraduate programme
Vocational training
– Is needed to extend clinical training, to advance clinical competence and confidence
– Post-graduation and possibly pre-full registration
management for tooth surface loss. This need is
magnified with the highly specialized care required for
the frail, as well as the medically compromised, and the
elderly and these issues need to be specifically targeted
by governments and health departments. The special
needs of managing oral health care in nursing homes
are becoming more important and unfortunately have
often been overlooked in the past. Student experience
in these specialized environments is an essential
component of undergraduate training and is required
to fully appreciate the extent of the diversity of oral
health care needs in the community.
The recognition of systemic diseases with oral
manifestations as well as knowledge of specific oral
diseases has increased, and predictable management of
conditions affecting the oral cavity is now, to a large
extent, achievable. However, of great concern is the
increased incidence of oral cancer in industrialized
nations.7,8 The reasons for this increase are unknown,
although Johnson and colleagues7 have indicated that
screening for oral cancer has been of doubtful value,
whilst randomized clinical trials have not been
supported in the United Kingdom.8 This problem which
has significant general as well as oral implications,
requires new management strategies. Emphasis is being
placed on an understanding of the molecular
mechanisms of carcinogenesis in an effort to better
understand and manage these problems.
Clinical competence and confidence in oral health
management depends on an understanding of the
biological and biomedical sciences and their relevance
to clinical dentistry. It also requires sufficient dedicated
training in the full range of dental clinical disciplines.
The limiting of laboratory coursework for dental
undergraduates to the early development of coarse
psychomotor skills, a basic understanding of the
properties of laboratory materials and an ability to
critique the quality of technical work, will allow the
undergraduate curriculum to emphasize the priority of
patient care, without the need for dentistry students to
learn laboratory procedures that have little relevance in
routine clinical practice.
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Early clinical training requires access to a realistic
(simulated) clinical environment, as well as a fully
equipped clinical environment, for dental students to
acquire the procedural skills needed to safely perform
the range of treatments relevant for general dental
practice. Of particular importance is the need for
undergraduate programmes to emphasize community
health issues and health economics as well as focusing
on evidence-based oral health care.9-11 A knowledge of
general medicine and pathology, pharmacology and
infectious diseases provides a broad base for developing
skills in diagnosis and treatment planning. New
graduates need skill in diagnosing diseases, in
recognizing their own limitations in providing a
comprehensive oral health service, as well as when
specialist referral is more appropriate.
Dental graduates also need to acquire resourcefulness
in coping with the unexpected, as dental and medical
emergencies are common in general dental practice. Of
greatest importance is the leadership role which
dentists need to display in co-ordinating a team
approach, where the integration of clinical expertise is
supported by allied oral health professionals including
dental chair side assistants, dental hygienists, dental
technicians and dental prosthetists.
Dental education must also engender in its graduates
a life-long interest in continuing professional education
so that they are able to fully appreciate new
developments in science and oral health and apply them
for the benefit of the community they serve. This ability
to critically assess new technologies and new materials,
can begin during undergraduate coursework by
encouraging student appraisal of information,
interaction and comment in each year of the course.
The written or spoken word, regardless of origin,
should be questioned, particularly when the
information departs from accepted practice. Table 1
summarizes dental educational requirements.
Contemporary learning methods
The new emphasis in health education is on clinical
reasoning with the seeking of information as required,
Australian Dental Journal 2002;47:3.
in a self-directed manner. This is a deliberate move
away from the traditional requirements of memorizing
large volumes of information. Team work and
communication are recognized as increasingly
important for the dental team as well as for all health
professionals. There is evidence from the medical and
other literature that suggests6,11,13-16 that problem-based
learning (PBL) is effective in developing these skills.
Problem-based learning is carried out in small groups
where staff managing a group, provide a directional
role only and guide the group to ensure that students
are at the forefront in driving the learning process,
rather than being dependent on staff as is customarily
the case in the more traditional lecture-type learning
programmes.17-18 Students are presented with a task
(a problem) to investigate and follow structured
guidelines; the sharing of information and peer
interaction strengthens the educational experience and
fosters self-confidence and competence in obtaining
and interpreting information.
This emphasis will help develop an ability to interact
with fellow students in group discussions, to review
new developments and accept or reject claims for the
superiority of treatment procedures materials or
products. Self-directed learning challenges each
student’s independence and ability to access resources.
It is also a prelude to life-long learning.
Appropriate information technology facilities and
coursework guidelines are required. Comprehensive
library support, computer and Internet access and
educational software are necessary to support selfdirected learning. Additionally, self assessment and peer
assessment through group interactions, broadens each
student’s learning experiences and confidence, which
will support staff assessment.
The importance of clinical simulation
Clinical simulation is becoming a necessity to allow
psychomotor and procedural skills to be developed in a
realistic clinical environment and to maximize
achievements in clinical encounters. The development
of procedural skills, with observance of infection
control protocols (an essential requirement for effective
patient management) in the simulated environment
allows for an ease in transfer to the clinical setting.
Ideally, procedural skills are developed in a similar
environment and layout to the clinic, utilizing identical
cutting instruments, hand instruments, lighting, and
patient and operator positioning, as well as appropriate
infection control protocols. The use of audio-visual
aids for repeated presentation of pre-clinical procedures
is helpful in initial learning, reinforcement and
refinement of procedural skills. Additionally, selfassessment in the pre-clinical environment plays a
critical role in establishing personal standards that will
ensure clinical quality control and patient satisfaction.
A 40-place clinical simulation unit was established in
1996 as an integral part of undergraduate coursework
in the University of Sydney, Faculty of Dentistry. It has
Australian Dental Journal 2002;47:3.
provided an exciting focus for students learning
procedural skills. The introduction of high resolution
microscopy as an aid to displaying tooth preparation
procedures in conjunction with audio-visual aids has
greatly assisted instruction. The clinic is also used for
continuing education and post-graduate speciality
programmes.
The development of vocational training programmes
The desirability for vocational training to extend
clinical training and enhance clinical competence and
confidence, has become recognized internationally.19,20 In
many European dental schools (including those of
Sweden, Denmark and the United Kingdom), vocational
training programmes have been introduced postgraduation. In the United Kingdom vocational training
has become a requirement before new graduates may
enter private practice within the National Health
System. With the increase in biomedical and clinical
knowledge it has become increasingly obvious that the
time available throughout an undergraduate
programme is insufficient for undergraduate students to
become fully conversant and competent in all clinical
fields required for general dental practice. Specific
procedures that have greatest relevance for general
dental practice, should provide the major content and
focus for undergraduate programmes. Significant
additional skills and confidence will be gained during
practice; advanced skills and knowledge will require
further postgraduate training.
Vocational training is designed to assist in developing
confidence and competence in procedural skills and to
provide opportunities for enhancing diagnostic and
treatment planning ability through experience in
different practice environments. Whether the
vocational training programme is taken postgraduation but prior to full registration, needs to be
determined by universities and governments. However,
a vocational training programme occurring postgraduation and with preliminary registration, would
allow independence in practice, in conjunction with a
mentor and an assessment requirement to confirm that
standards have been reached, before full-registration is
granted. The young graduate would work
independently whilst receiving general guidance and
advice, but would not be required to work strictly
under supervision. This would allow greater flexibility
in service delivery and work opportunities (urban, rural
public or private practice). Vocational training
coursework would serve to advance the general level of
clinical knowledge and provide reinforcement of
information that had previously been provided, but at
a time in the undergraduate programme when it was
perhaps not fully appreciated.
The Committee of Dental Deans of Australian and
New Zealand Dental Schools, The Australian Dental
Association Inc and the Australian Dental Council,
endorse the need for vocational training. The
possibility of implementing a scheme for vocational
197
training will need to be considered separately by each
State or Territory and to reflect regional need.
Our response
The Faculty of Dentistry, University of Sydney has
implemented a new graduate entry PBL curriculum
with the first intake of students in 2001. An overview
of issues addressed by the Curriculum Committee, and
the faculty, is briefly summarized here. Of particular
importance to the Faculty and the Curriculum
Committee was the overwhelming agreement of Faculty
in May 1997 to require graduate entry into the new
four-year programme. This agreement, to discontinue
the current policy of enrolment directly from school,
has major implications and will allow selection of older
students, who have already proven themselves within
the tertiary education sector. The Faculty of Dentistry,
University of Sydney has, through this initiative,
become the first of the Australian Dental Schools to
adopt graduate entry.
The University of Sydney dental programme
Overview
We believe that the combination of student-centred,
PBL and a more mature and focused cohort of students,
will produce quality graduates and address concerns
raised by the profession relating to communication and
problem solving as well as faculty concerns regrading
progression and retention rates and life-long learning
skills in the existing curriculum.
The University of Sydney dental programme
(USydDP) features an educational philosophy based on
student centred learning with computer-based teaching
and assessment strategies as a ‘core’ element.6,11,12
Students spend considerable time using computer-based
programmes and interaction to study the basis of
modern dental practice. Computer-based teaching
(CBT) provides a means by which important
educational aspects can be investigated and reinforced
when the student wishes rather than when it is
convenient for Faculty. Computer-based teaching may
take the form of computer models of function and
patient encounters, interactive and adaptive computer
based tutorials and student-student and student-staff
exchanges via electronic mail or electronic forums.
Computer-based teaching allows adaptation of
curriculum content to student and campus
requirements as well as modification and development
of material by supervizing staff. Computer-based
simulations of clinical encounters enhance contact with
real patients, develop professional and problem solving
skills, and within the limited time available for clinical
skills development and treatment, maximize achievements in the clinical setting. Most importantly, CBT
allows students to participate in truly interactive
learning through the process of reflection and selfassessment.
198
Goals
The development of ethical practitioners who are
responsive to the health needs of the individual and the
community, with attitudes, behaviours, knowledge and
skills to enable them to practice dentistry in the 21st
century. This also requires graduates who appreciate
that the development of their attitudes, behaviours,
knowledge and skills is a life-long process and one for
which they need to take responsibility; and whose
practice is based on sound scientific principles with a
broad understanding of the medical, dental and
biomedical sciences.
Key features
The prerequisite programme of study is a primary
degree in any discipline. Admissions requirements
include performance in a primary degree, in the
Graduate Australian Medical Schools Admissions Test
(GAMSAT – Australian Council for Educational
Research, Melbourne – a test of verbal and quantitative
reasoning), a semi-structured interview, and an
assessment of psychomotor skills. The programme
extends over four years (Years 1 and 2 – 35 weeks;
Years 3 and 4 – 42 weeks) and graduation is to occur
on completion of the fourth year. Vocational training
could be offered subsequent to this four year
programme.
There is sharing of ‘core’ content in the first two
years with the University of Sydney Medical
Programme. Students in medicine and dentistry study
almost all the same problems, and share most lectures
as well as many practical sessions in the biomedical
sciences. Both programmes have access to web-based
resources through each Faculty’s educational site.
Assessment is integrated, by theme, and will be
largely formative and ongoing. It is referenced to
explicit criteria. A formal assessment of basic dental
skills in the total patient care (TPC) theme is held at the
end of Years 1 and 2. Summative assessment of written
knowledge in all themes will be held at the end of
Year 2.
Clinical material is introduced from Year 1. In Years
1 and 2 students attend dental school for at least one
day each week, whilst in Year 3, students attend the
dental clinical school full-time, and Year 4 students will
spend time between the clinical schools, hospitals,
community and rural practice. An elective experience
will be offered in Year 4. The weekly timetable in Years
1 and 2 includes: three problem-based tutorials, up to
six lectures, two hands-on practical sessions, one
personal and professional development/dentist and the
community (PPD/DC) session and one full day at the
dental school.
It is recognized that the longer academic year will
impact on students and staff as has been the case in
other faculties with a longer teaching year. This will be
monitored as it applies to the Australian dental
educational environment, and will be assessed and
reported. Strong student support through continuous
Australian Dental Journal 2002;47:3.
feedback of coursework components, will allow
difficulties experienced to be addressed immediately,
which will help the management of student learning
and indirectly the longer academic year.
Consideration of this matter for staff is being
addressed by rotating PBL teachers between the PBL
block sessions (to avoid overload), and to develop a
shadowing of PBL tutors by junior staff or those
beginning the process. This helps share the teaching
load and the educational responsibility. In addition,
consultations with and support from Faculty of
Medicine staff has been encouraging and significant in
managing staff training and coursework planning; and
the sharing of aspects of coursework, e.g., evidencebased practice large group sessions, has been helpful for
dental staff and students.
Educational advantages
Of clinical importance is the selection of more
mature students and those with specific talents for, and
interest in, dentistry. New methods of learning, e.g.,
problem-based tutorials and access to web-based
resources, challenge student abilities, generate
independent learning, foster group interaction, develop
powers of critical assessment and encourage a
commitment to life-long learning. This is a central
issue, as diagnostic mechanisms and treatment
modalities change, requiring the ability to readily
embrace new technologies and seek confirmation of
their appropriateness.
It is hoped that these more mature and better trained
graduates will provide a better community service and
be more attuned to the needs of the community. The
changing nature of community expectations recognizes
that individuals are more informed about their
condition and options for treatment, and the ageing of
the community requires greater knowledge of the
medical status of individual patients.
Selection procedures
The Bachelor of Dental Surgery
In 1995, Faculty supported the need for a new
selection process for dentistry and this was
implemented for the 1996 academic year. Selection was
no longer to be based solely on academic merit, but
included testing of verbal and quantitative reasoning, a
semi-structured interview as well as an assessment of
English language aptitude and psychomotor skills. Before
these new selection procedures, students from school
were selected based on the tertiary entrance rank as the
only criterion used. This resulted in their selection from
the top 1 per cent of the matriculating group.
Since introduction of these selection procedures
(1996), retention and progression rates have improved
and students selected by the new procedures appear to
be more capable in their ability to communicate with
staff and patients and adapt readily to small group
teaching and learning. Similar selection procedures have
now been adopted by all other Australian dental schools.
Australian Dental Journal 2002;47:3.
The University of Sydney dental programme
Selection for the 2001 academic year is based on the
selection of graduates in a three-step process: firstly,
applicants are ranked on their Weighted Average Mean
(WAM) scores above pass, in previous tertiary study;
secondly, GAMSAT performance, which is based on:
reasoning in the social sciences and humanities,
reasoning in the sciences, and written expression; and
thirdly, an objective semi-structured interview.
The focus of the new selection procedures is to assess
those characteristics that are considered important for
the practice of dentistry and to ensure that applicants are
committed to this career path and understand what it
means to be a dentist. Criteria that are assessed include
communication and team skills, empathy and sensitivity
towards others (a caring and concerned attitude), the
ability to problem solve as well as knowledge of, and a
strongly motivated attitude towards, dentistry.
Central themes of the University of Sydney dental
programme
Curriculum content throughout the four year
programme has been organized on the basis of three
themes: life sciences (LS); TPC; and PPD/DC. Personal and
professional development and DC are combined to
facilitate management and efficient integration of
information. Themes are not independent and are
integrated throughout the programme. In the first two
years of the programme the content ratio is
approximately: LS 50 per cent, TPC 25 per cent, PPD/DC
25 per cent. In Years 3 and 4 the content ratio has been set
at LS 20 per cent, TPC 60 per cent, PPD/DC 20 per cent.
The sharing of coursework links with medicine,
provides a foundation of medical science knowledge in
LS, upon which dental-specific coursework is based.
This emphasizes the close relationship that exists with
medicine, and is progressively developed for integrated
patient care.
Total patient care
Total patient care centres on the acquisition of those
clinical and communication skills necessary for
diagnosis and the performance of important procedures
in general dental practice. The aim of this theme is to
produce a progressive, self-critical dental practitioner
who is able to empathically and accurately examine any
patient, competently perform a full range of common
dental clinical procedures, and appreciate, diagnose
and appropriately refer the more complex problems.
Preclinical skills development commences in the first
year of the USydDP and is largely complete by midYear 3. Clinical training emphasizes comprehensive
care and students will be assigned to treatment teams
comprising third and fourth year student operators,
first and second year student assistants/observers.
Life sciences
Life sciences aim to integrate the relevant basic
sciences in a clinical context. A problem centred
199
approach to learning, with a combination of didactic
teaching and PBL. The ‘core’ of PBL material shared
with the University of Sydney Medical Programme is
supplemented with additional learning topics and PBL
case material of specific relevance to dentistry. This
theme will integrate with the TPC theme and extends
into the senior clinical years as a series of topic
‘modules’.
Personal and professional development and dentist
and the community
The PPD theme focuses on the student as a
developing professional. It aims to encourage the
development of empathic behaviour and the ability to
work efficiently with patients and other members of the
dental health team.
Students will be introduced to topics relating to
clinical and professional ethics; professional
responsibilities
and
personal
development;
development of skills relevant to evidence-based
practice for dentistry; and realistic self-appraisal.
The DC theme emphasizes a holistic approach to
patient management through a greater understanding
of the influence of social and community factors on
treatment and prevention. The goal is to emphasize that
oral health is a society issue and not simply a problem
for the individual. Over the four year programme the
following issues will be developed: those elements of
population-based thinking that impact on individual
patient/clinician encounters; the practice of dental
health care in general, e.g., technology, funding, cost,
equity, planning; and the dental health issues of the
community, e.g., burden of dental disease, role of the
media and industry.
Staff development
An essential requirement of major change in
curriculum design is the need for staff development
programmes. This has been undertaken as a prelude to
the introduction of the programme. It will be a
continuous process for continuous staff recruitment
and curriculum modification in response to feedback.
Staff development has taken the form of theme
faculty workshops as well as individual staff
development programmes on PBL, small and large
group teaching, as well as evidence-based practice and
the development of computer literacy skills.
CONCLUSION
It is apparent that apart from the need to instill
specific information and a desire for life-long learning,
quality control and critical self-appraisal are essential
ingredients of an undergraduate programme.
Opportunities will vary in different universities and
different countries in providing coursework and links
with medical and science disciplines. However,
coursework should be focused on the needs of the
community that the graduates will serve. Variation in
educational expectations between countries are
200
significant but fundamental community requirements
need to be met. The real challenge involves giving
graduates the skills necessary to continue to change and
modify their knowledge as community expectations
alter and as new diagnostic techniques, treatment
procedures, materials and equipment are introduced.
‘Sowing the seed’ of a commitment to life-long learning
and a flexible attitude towards new developments is at
the core of professional education.
Finally, a commitment to one’s profession may take
many forms, but being proud of one’s identity and
recognizing the role that oral health care plays in
managing the general health of the community will
reinforce the strength of the profession and the
confidence of its members.
AC K N OW L E D G M E N T S
We acknowledge with gratitude the many helpful
suggestions in the final preparation of the manuscript
by Professor Ann Sefton AO. Professor Sefton accepted
a half-time appointment in the Faculty of Dentistry, as
Associate Dean for Curriculum Development in 1999,
and has played a crucial role in the development of the
University of Sydney dental programme. Professor
Sefton has also been intimately involved in the planning
and implementation of the graduate medical
programme as Associate Dean for Curriculum in the
Faculty of Medicine. The authors wish to acknowledge
the funding support that has been provided to allow the
development of the programme by the University of
Sydney; The College of Health Sciences of the
University of Sydney and The Commonwealth
Government (DETYA). The authors also wish to
acknowledge the support and encouragement from the
Pro-Vice Chancellor (Health Sciences) Professor John
Young AO, the Dean, Faculty of Medicine, Professor
Stephen Leeder, and staff of the Department of Medical
Education and in particular Associate Professor Jill
Gordon.
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Address for correspondence/reprints:
Professor I Klineberg
Professorial Unit, Level 3
Westmead Centre for Oral Health
Darcy Road
Westmead, New South Wales 2145
Email: ivenk@dental.wsahs.nsw.gov.au
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