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Perspectives on dental education in mainland China.

The Chinese dental education system has undergone major changes over the past three decades. Although a number of approaches have been adopted for the modification of the dental curriculum, the greatest challenge remains as to how to develop enough qualified dentists to meet the dental care needs of China's 1.3 billon population. In many areas the limited funds have been mainly used for the enhancement of academic status while the clinical training programmes for the improvement of practical skills of the clinicians has been greatly neglected. In addition, the discrepancies in the distribution of dental resources have been increasingly alarming and have the tendency toward becoming even more serious in the future. The aim of this review is to describe dental education in China in the hope that more favourable changes could take place and the system itself could be further optimised.

China↗

Mental health and dental education.

The relationship between mental health and the educational process in dental school has rarely been explored. In the author's experience as the mental health consultant at the USC School of Dentistry, several focal points of conflict do influence academic effectiveness. These problem areas are often marked by a variety of physical or psychological symptoms such as anxiety--sometimes of panic proportions--gastrointestinal disturbances, and the like. These are frequently related to fear of failure, being exposed as being intellectually inept and fraudulent, neurotic competitive needs, real and unreal paranoid attitudes toward instructors, the student's expectations as to what his or her "silent partners" require to him or her, and the effect dental education has on marriage.

Anxiety↗

A chronology of dental education in the United States.

Formal dental education in the United States began in 1840 with the opening of the Baltimore College of Dental Surgery. Other dental schools slowly began to emerge, gradually displacing the traditional preceptorship method of training for dentistry. The period of the late 1800s saw a surge in the number of dental colleges in the United States. These schools were largely proprietary in nature, meaning that they were not affiliated with major universities, were private, and were of a commercial nature and, usually, established to benefit their owners. As the trend toward affiliation of dental schools with universities gained impetus at the beginning of the 20th Century, and with the establishment of the Dental Educational Council of America, the trend continued. Finally, the Carnegie Foundation for the Advancement of Teaching formed a committee, under the direction of Dr. William J. Gies, to study the entire system of dental education in America. Out of this landmark study came the strong recommendation that all dental schools become affiliated with major universities. Shortly after that study, in the early 1930s, the last proprietary school was abolished. This article traces the histories of dental schools, past and present, in the United States.

Education, Dental↗

Context as a critical influence on dental education.

The problems which beset dental education in many African countries are not unique to the African continent. While modified by the continent's history and present stage of development many of the difficulties are similar to those in developing and industrialised countries throughout the world. The need for oral health education programmes to produce, in the most cost-efficient manner, competent, high-quality graduates capable of coping in diverse situations is universal. This article reviews the limitations that the local context places on achieving these dual objectives and highlights the significance of the role of consumer demand for dental care in creating viable dental education programmes, particularly in poorer countries.

Africa↗

Changing the course of dental education to meet future requirements.

Dental education is burdened by outdated curricula, which are based on yesteryear's concepts. As a result, caries and restored teeth are still largely "managed" by traditional operative dentistry. This leads into a repeat restoration cycle, which fails to address the fundamental bacterial nature of caries, the primary raison d'être for this form of therapy. At the same time, many fundamental changes have taken place in the parameters that affect, or should affect, dental care. These range from an improved scientific understanding of the caries process, to a realization by society that maintaining oral health through regular preventive dental care, as opposed to ongoing restorative dental procedures, is a worthwhile and achievable goal. Dental education needs to rise proactively to the challenges presented by the new parameters of modern dental care, or it will be forced to make changes from a defensive position. The ultimate change, which most readers would not consider trivial, would be the closure of one or more of Canada's 10 dental schools.

Canada↗

The effect of changes in caries prevalence on dental education.

While rising levels of dental caries were primarily responsible for the growth in dental schools in developed countries, the recent decline in caries prevalence has not resulted in a major decline in dental education. Indeed, the reduction in caries prevalence has had very little influence upon a group of major changes that arguably should have had a marked effect upon dental education in recent years, but which have failed so to do. These include a quantum leap in applying the scientific basis of caries management, focused down to the teaching of minimally invasive restorative care within a context of risk assessment and maximum non-invasive care where appropriate. A possible way forward in accelerating the necessary changes in dental practice would be for only a proportion of dental undergraduates in the future to be taught practical restorative procedures, leaving the remainder to concentrate on diagnostic and non-invasive care without the distraction of possible restorative treatment.

Adult↗

Use of a problem-oriented dental record in undergraduate dental education.

This paper describes how the concepts and methods of problem-orientation have been applied in the clinical education of dental students. It makes the point that the problem-oriented dental record is only one part of a complete system which has five interrelated components. The problem-oriented dental record is discussed in detail, and the paper includes examples of all four sections of the record. All sections of the record are interrelated, and the steps in identifying and resolving problems follow a logical sequence: (1) collect the data base, (2) write the cue list, (3) write the problem list, (4) write the initial plan, (5) write the final plan, and (6) record progress. The problem-oriented dental record is seen as a tool for patient care, audit, and education. The main advantage lies in the way information is organized and recorded. The record is highly communicative and permits everyone involved an opportunity to relate the data collected to the problem list and to the decisions made regarding how problems will be resolved. The record and the systems were borrowed from Weed and are being adapted for use in dentistry. Although still in the trial stages, this system has proven to have many more advantages than other record-keeping systems and is invaluable as a tool for education. In the future we plan to use computers to help store and retrieve data from these records. We anticipate that a dental education built on this record will have a lasting impact on the graduates' approach to patient care. This should result in a graduate who is conversant with medical colleagues and systematic in the collection of data, listing of problems, and resolution of patient problems. Finally, we believe that the problem-oriented dental record is also a good tool to help the dental graduate become more empathetic with patients and more aware of their total health needs. The record provides a mechanism for recording physical and emotional information as well as the oral status.

Dental Records↗

The DERWeb project--dental education resources on the Internet.

The delivery of dental education, in common with other forms of higher education, has altered considerably over the last decade. The introduction of the World Wide Web enabled resources for dental education to be delivered in a new and innovative manner. DERWeb was funded by HEFC-JISC. The primary resource consists of a library of 1600 clinical dental images each with keywords and a description. Selected images were used to create teaching materials to demonstrate to dental educators world wide how the image library could be used by individual institutions. Hands-on courses were held to demonstrate the new resource and to evaluate computer skills in the dental community. Since the commencement of the project in September 1994 DERWeb has become one of the leading resources for dental education world wide. The site has been accessed by 79 countries with approximately 107000 accesses in October 1996. DERWeb also designs and maintains the British Dental Association pages together with other professional organisations. Its resources also include dental contact addresses and links to quality dental sites world wide. Further funding has enabled DERWeb to expand further and explore new technologies to develop interactivity on the Web.

Computer Communication Networks↗

The scope and objectives of graduate dental education.

Seven objectives of graduate dental education (GDE) and the current types of GDE programs are defined and discussed. The author recommends that objectives for GDE should be established, and that each GDE program should be designed and designated to meet specific objectives that are appropriate to the setting and resources available. The author further recommends that GDE programs should be evaluated with respect to attainment of their own designated objectives and also against standards set by the Commission on Accreditation of Dental and Dental Auxiliary Education (now the Commission on Dental Accreditation). The author notes that this latter commission must have adequate financial support and staffing to be able to evaluate many diverse GDE programs. Forces that have contributed to the gradual shaping of GDE programs are described, including societal need, institutional motivation, specialty organizations, and the Commission on Accreditation. The availability of money is cited as the catalytic component that often determines the balance among these forces. The author recommends that long-term objectives should not restrict program diversity and that societal need should be the paramount factor giving shape to future GDE programs. The author suggests that an emphasis on quality research training programs may prove most socially advantageous if advances in knowledge can prevent dental problems. The author also recommends that predoctoral students should have adequate information and counseling resources to enable them to make wise career decisions.

Accreditation↗

Trends in dental education: a literature review.

The dental literature for the past 30 years, with emphasis on recent publications, was reviewed for articles on trends in dental education. A keyword search of the MEDLINE database identified 6,055 papers, from which those most likely to predict future trends are considered in this article. Particular emphasis is placed on the Institute of Medicine of the National Academy of Sciences 1995 study, "Dental Education at the Crossroads: Challenges and Change." Reactions to this U.S.-based study are also detailed. Trends in curriculum analysis, curriculum change and reform, curriculum length, dental school financing, dental student costs, dental school and university relationships, dental school patient care, dental research, accreditation, oral health and trends from outside North America are documented. In addition, a series of predictions are made, and a brief bibliography of the 51 most relevant references is included.

Accreditation↗

Dental education.

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Education, Dental↗