dental education and critical thinking

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Challenge-Based Learning in Dental Education

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Challenge-based learning (CBL) is a novel learning framework for a collaborative and multidisciplinary learning experience. It allows students, teachers, stakeholders, researchers, families, and society to work together to identify and solve real-world challenges. CBL helps students develop a deeper knowledge of the subjects they are studying. The concepts of CBL originate from a variety of educational theories and approaches, such as problem-based learning and inquiry-based learning. The precursor to the CBL framework is problem-based learning. However, unlike in problem-based learning and other approaches, students formulate the challenges they will address in CBL. Furthermore, students need to create a solution resulting in concrete action. CBL takes into account the social impact of an idea rather than just the corporate benefits. Therefore, it can help students expand the scope and depth of learning, encourage teamwork capabilities, and raise their awareness about considering quality and ethics in decision-making. CBL is implemented in universities, schools, and institutions worldwide and its use is well-recognized in science, engineering, and medicine, but it has not been translated into dentistry. The aim of this paper is to describe the concept of inclusion, principles and design, implementation, and supervision of the CBL framework in a dental course for the adaption of this learning framework to dental education.

1. Introduction

Today’s students have instant access to information by using the web and informal learning. For this reason, the conventional ‘chalk and talk method’ of teaching is becoming less effective in engaging students in learning [ 1 ] and motivating them to achieve their goals [ 2 ]. These days, students are presented with content-centred coursework. This meets certain standards but lacks real-world settings and opportunities for active participation. An accessible, effective, and efficient framework to solve these problems is necessary. Challenge-based learning (CBL) was first developed by the technology company Apple, and it is now implemented in universities, schools, and institutions worldwide, as an advanced solution for educational learning systems [ 2 , 3 , 4 ].

Different studies emphasized the importance of active learning tools, which prepare students for lifelong, self-regulated, and cooperative learning; at the same time, these learning tools provide high-quality learning, according to students’ metacognitive and self-regulatory skills. From this perspective, Challenge-Based Learning (CBL) is a pedagogical approach, with roots in experimental learning, where the starting point for learning is an open-ended, real-life challenge [ 5 ]. CBL is an engaging multidisciplinary approach to teaching and learning. It encourages students to use current technology to solve real-world problems. Traditional teaching methods focus on imparting highly specific and methodical knowledge through teacher-centred didactic teaching (i.e., lectures, reading books, classroom-based activities, and the repetition of work) to help students gain a growing knowledge of the content [ 6 ]. In contrast, the new educational strategy allows students to be exposed to real-life situations where they face high levels of uncertainty and challenges. Furthermore, the new technologies, currently available, allow the identification of the preferred learning style of modern students and, at the same time, enhance the diversification of the teaching style [ 7 ]. The new model, based on skill development, develops a transition from a face-to-face classroom setting to an educational setting in the real world [ 8 ].

The concepts of CBL were derived from a variety of educational theories and pedagogical approaches, including problem-based learning (PBL), inquiry-based learning (IBL), and the conceive, design, implement, operate method (CDIO). PBL is considered the main precursor to the CBL framework. PBL has been widely applied in medicine and engineering education because it can improve critical thinking, self-guided learning, generic skills, and the long-term retention of students [ 9 , 10 ]. The ‘ASK’ (attitude, skills, knowledge) model distinguishes PBL from the traditional teaching method [ 11 ]. In PBL, a group of students are presented with a design, research, or diagnostic problem. Learning takes place through the process of finding a solution [ 12 , 13 ]. IBL is defined in different ways in the literature. Generally, it is a student-centred approach. In IBL, the instructor guides the students through questions they pose, methods they design, and data they interpret. The concept involves intensive questions on knowledge creation and problem-driven student projects [ 14 ]. IBL can be effective in enhancing students’ ability to search, research, and solve problems. However, it can also be perceived as a risk-taking process because it may result in lower satisfaction with students’ assessments [ 15 ]. The CDIO method is specifically used in engineering education. It is an educational framework that emphasizes engineering fundamentals in the context of imagining, designing, executing, and operating real-world systems and products [ 16 , 17 ].

Unlike the above mentioned learning frameworks, CBL requires students to formulate the challenges they will address. Furthermore, CBL is a multidisciplinary approach and engages teams composed of learners (students), facilitators (teachers), stakeholders, families, and society. CBL considers the social impact of an idea rather than just the corporate benefits. Therefore, CBL can expand the scope and depth of learning and encourage teamwork capabilities as well as personal awareness in students through considering quality and ethics in decision-making. In the process of designing scholarly and pedagogical education systems (CBL) for the next generation, as a learning group, we need to critique the systems we are developing and examine our theories and practices. At the same time, we need to reveal how the other parts of an education system interrelate and how this system works within the context of whole existing education systems [ 18 ].

It is now time to advance dental education via the CBL framework, as it is a truly student-centred community-based learning method for handling real-world situations. Medical and nursing schools have already implemented CBL in their course design [ 19 , 20 , 21 , 22 ]. In dentistry, CBL has not yet been implemented. Therefore, the aim of this study is to provide an overview of a course design for implementing CBL in dentistry to provide best practices, solve frequently asked questions, and adapt the learning approach to dental education.

2. CBL in the Education System

CBL is a collaborative and hands-on approach. A true student-centred education system requires students to work with their peers, teachers, communities, and experts worldwide to develop in-depth knowledge by identifying challenges and sharing their results with the world. Research has shown that student-centred learning approaches are effective in improving students’ learning [ 23 , 24 ]. The first outline of CBL was published in a white paper in 2008 [ 3 ]. Since then, academicians and schools around the world have gradually accepted and applied it to improve teaching and learning, allowing students to achieve distinction quickly in their communities. Later, in 2009, a detailed study design was published by the New Media Consortium for classroom practice. The study recruited six schools involving twenty-nine teachers and three hundred thirty students in seventeen disciplines. The study found that CBL is effective in promoting learning [ 24 ]. Furthermore, in 2011, the study was expanded to nineteen schools involving ninety teachers and one thousand five hundred students from three different countries and demonstrated that this pedagogical approach is an excellent way to engage students, meet curriculum standards, and achieve twenty-first-century skills. In addition, CBL was suggested for students of all age groups [ 4 ].

It has been reported that adopting this framework requires a profound transformation of the organizational culture. This involves teacher training, rebuilding infrastructure, and transforming it into an administrative framework that is both open and flexible to change [ 25 , 26 ]. The challenge method is not difficult to work with because most students are familiar with the concept, as they have watched multiple reality shows on television. The common theme is that competitors are presented with a challenge that requires them to use their creativity to draw on previous learnings, gain new knowledge, work as a team, and reach solutions. This idea is successful because participants are highly motivated by the general goal of winning an award afterward [ 27 ].

The CBL framework has been expanded to some new areas such as strategic planning and training in the workplace [ 28 ] and mobile software instruction and development [ 29 ]. Most recently, in 2016, the ‘Digital Promise’ team and the founding CBL team members jointly updated the CBL content. CBL was applied to the collaboration project ‘Apple Classrooms of Tomorrow’ with great success among public middle schools, universities, and research organizations [ 30 , 31 ]. They developed a website and published a book [ 2 ]. CBL is presented in three phases ( Figure 1 ).

The three phases of CBL (adapted from Nichols et al., 2016) [ 2 ].

The first phase is ‘Engage’. Through a process of essential questioning, learners (students) move from a big idea to a concrete and effective challenge. The second phase is ‘Investigate’. All students plan and take part in a journey that forms the basis of solutions and addresses academic requirements. The third phase is ‘Act’. Evidence-based solutions are created for application to authentic audiences. They will be evaluated based on the results.

3. Principles of CBL

CBL is a flexible framework that implements new concepts and study designs and generates new study models [ 2 , 3 , 4 ]. The following twelve items (a through l) are the basic principles of CBL:

• (a) A flexible and customizable framework that can be applied as a guiding pedagogy or integrated with other progressive methods of learning;
• (b) A walkable model with multiple points of entry and the capability to start small and create big;
• (c) An open framework without any proprietary concept, product, or subscription;
• (d) A process that puts all students in charge and manages learning;
• (e) An authentic environment to meet academic standards and establish a deep connection with the content;
• (f) A focus on global ideas, meaningful challenges, and the development of local and age-appropriate solutions;
• (g) An authentic relationship between academic disciplines and real-world experience;
• (h) A framework for developing twenty-first-century skills;
• (i) The purposeful use of technology for researching, analysing, organizing, collaborating, networking, communicating, publishing, and reflecting;
• (j) The opportunity for students to make a difference;
• (k) A way to document and assess both the learning process and products;
• (l) An environment for deep reflection on teaching and learning.

4. Design of CBL

Many of today’s problems cannot be solved with just one discipline. These problems require a multidisciplinary approach because solutions require technical knowledge, social perspectives, and communal understanding. In CBL, learners (students), facilitators (teachers), stakeholders, families, and society play different roles [ 2 , 3 , 4 ].

4.1. Role of the Learners (Students) in CBL

In CBL design, students are not passive learners. It is not like the traditional student-teacher role. They work together with facilitators, researchers, entrepreneurs, and external agencies (stakeholders) to explore and address current challenges.

Apprenticeship teams are usually formed by students from various backgrounds, such as different study levels and programs.

4.2. Role of the Facilitator (Teacher) in CBL

The role of the teacher is to be a facilitator for students, to help them with guidance, knowledge, and real-world information. The teacher provides relevant content skills. The teacher is an instructor in the student team, supporting them at various stages of the CBL and facilitating their learning. Teachers can play a role in defining learning outcomes at the course level. However, the contents of these lessons can be flexible according to individual students’ preferences.

4.3. Role of the Stakeholder in CBL

Sometimes, especially in community-involved learning, educating students with close guidance from stakeholders is important for their practical life and future engagement. In some courses, students will have to invite community stakeholders as guest lecturers or to be a part of their real-life projects. The stakeholder will guide the process. They will also get active feedback from the students. In ideal situations, they are partners of the students. Therefore, students should inform stakeholders about the pros and cons involved in the project when the students are trying to solve issues.

4.4. Role of Communities in CBL

In CBL, students face real-world challenges; thus, the involvement of all stakeholders and community members of society can effectively impact the investigation of the problem through their active participation in its actual solution.

4.5. Implementation of CBL

Each educational design is planned to follow a systematic process. Intellectually created educational designs have been proposed and implemented in the process. CBL has been adopted from some existing education systems. For this reason, we can easily implement it in our education system.

4.6. Redesigning Existing Courses

CBL can be included in existing courses. The challenge can be translated into a real-life application in accordance with the course. When incorporating challenges into existing courses, it is important to keep learning goals flexible. This is because students will make their own choices and manage their own learning. Teachers will not only be experts in the content of the course but will also be facilitators when students work on their challenges.

4.7. Extracurricular Learning Experiences

Extracurricular learning can also be applied in CBL. Students or outsiders will also focus on ‘big ideas’. The students then continue to do extracurricular activities along with other steps in the CBL curriculum to achieve good support. An experienced teacher can be a good trainer. However, the objects and strategies of learning will be defined by students in extracurricular learning. This will be beneficial when it is time to evaluate and earn credit.

5. CBL in Dental Education

Active learning strategies can engage students in a coherent discussion, causing them to comprehensively analyse situations and practice critical thinking. It can maximize the learning effect of the subjects on students [ 32 ]. PBL as an active learning method is widely used in medical and dental education. In PBL, real problems are used to trigger questions and create a learning setting for motivating students to be actively involved and to think critically [ 33 ]. This boosts students’ confidence. CBL is speculated to be a derivative of the PBL approach Therefore, it has quite similar characteristics, but it is different from PBL.

Those who are familiar with the PBL approach will be able to adapt and implement CBL in dental education more easily. Furthermore, CBL itself will drive the learning strategies by getting the entire learning team involved. Thus, CBL can be easily adapted and implemented in dental education and develop knowledge and skills through identifying problems in real-world situations and engaging communities with their challenges. Table 1 highlights some comparative characteristics of PBL and CBL.

Learning methods of problem-based learning and challenge-based learning.

The key point of CBL is that learning is driven by challenges that have more than a few solutions [ 2 , 3 , 4 ]. Unlike a more traditional curriculum, the design of CBL curriculums is similar to that of PBL curriculums. However, special attention should be paid to the mentality of the education team. In addition, it should be borne in mind that moving towards a new strategy (CBL) mindset itself is a big challenge. CBL leads students to be dynamic and complex thinkers and to stand out in unpredictable future tasks. In CBL, students work on multidisciplinary teams with challenges. It will improve their team skills and teach them how to solve problems and design solutions. Therefore, they develop their self-steering and learning skills. Additionally, CBL brings together interdisciplinary and disciplinary perspectives on problems and solutions related to environmental, social, health, education, and economic sustainability. Table 2 shows the CBL topics and descriptions. Appendix A is an example of CBL study design in dental education.

CBL topics and description (adapted from Nichols et al., 2016) [ 2 ].

Today’s globalization, with its knowledge-based economy, creates a growing need for individuals to practice creative thinking skills. Creative thinking has become relevant in many advanced fields such as education, art, medicine, information and communications technology, and social media. Recent evidence has shown that creative thinking skills can be taught to improve problem-solving skills [ 40 , 41 , 42 ]. In this context, CBL has appeared as a quite new approach for engaging students in creative and advanced learning [ 24 ]. CBL incorporates modern technology, teamwork, self-learning, peer learning, and real-world problem-solving in its teaching tools. The learning process can be extended from the classroom to the local or global community. CBL has been found to develop students’ ability to learn by deepening their understanding of the material and extending their practical skills and engagement [ 4 , 24 , 31 ]. CBL has also been found to help learners perform better in group interaction, integration, and synthesis of concepts [ 28 ]. It has attracted academics through its immense learning outcomes [ 27 , 43 ].

In CBL, students are expected to ask questions, search the literature, conduct a primary survey, consult experts, and attempt to answer the essential questions hands-on. Based on the results, they will find challenging problems and may reframe the essential questions or guiding questions. Then, they will spend more time and effort generating innovative but realistic solutions for the problem, with an outline of the details of their resources and activities to develop the answer. In this approach, students will explore the ‘big ideas’ provided and creatively try to analyse and uncover the problems. However, in the beginning, it can be difficult to implement. Thus, facilitators may modify the strategic plan to avoid falling into the wrong path in learning. We believe this will help enhance students’ ability to innovate and learn. They will be good at generating new ideas and getting out of old thoughts. Logically, they will be able to share their creativity and innovation in useful and practical dental fields like disease management, dental product selection and innovation, best services, or related new program development. To date, we cannot find any published literature on the application of CBL in dental education. We will be using CBL in dental education in our institute and will observe the result. We certainly believe that this will be a great teaching approach. With the increase in life expectancy, promoting sound oral health is a global obligation. Therefore, the new dental student must be ready to deal with real-world challenges.

6. Conclusions

In conclusion, CBL is a collaborative and multidisciplinary learning experience for identifying and solving real-world challenges. It can be applied to dental education to allow dental students to create challenging questions from ‘big ideas’ and solve them based on a logical practical point of view. CBL enables students to gather knowledge from different sources and create a framework so that they can work together as a team to plan solutions to address the challenges. CBL can improve students’ general knowledge about different various specialties and products, the application of technologies, community involvement, and the management and treatment of orofacial diseases. CBL enables students to meet the real-world challenges of dentistry.

An example of CBL study design in dental education

Big idea: Dental caries

Essential questions: What is a caries-free healthy life?

Challenge: Caries prevention

Big idea —Suppose the team starts with a topic, ‘dental caries,’ which has broad meaning and importance to dentists, patients, dental educators, students, stakeholders, and society.

Essential questions —After developing a topic, the team will come up with some essential questions that reflect the interest in learning and the needs of society.

• Questions will be developed by the students —The ideas will define the topics according to the aetiology, prevention, and management of dental caries and the consequences and social impacts, including to general health and the economy, caused by caries.
• How does the question emphasize the learning outcome? —Depending on the developed questions, students will start thinking. They will go to the facilitator, stakeholders, or the public, involving both internal and external elements of the team to develop guidelines and solutions.

The topic ‘dental caries’ can be stated with the essential question: What is a caries-free healthy life?

Challenge —For every essential question, a challenge will be created to ask students to come up with a specific answer or solution. If we think about caries, the challenge is ‘caries prevention’. Students may come up with challenges related to:

• - Development and prevention of caries;
• - Effects on health and the economy related to caries.

Guiding questions —Students will generate questions to which they need to discover solutions to meet the challenges. Some guiding questions may be:

• - What is dental caries?
• - How are people affected by dental caries?
• - How do people get protection against dental caries?
• - How can mass education reach society, and how can dentists give the solution?
• - What is the prevalence of caries in different ethnic groups, age groups, genders, etc.?
• - What treatment strategies are available to solve the problem?
• - What occurs in the absence of treatment?
• - What are the strategies for configuring protection and prevention to serve society?
• - How can stakeholders and the community be involved to serve society?
• - How do dentists educate and create awareness in society?
• - How do we find a realistic solution for treatment?

Guiding activities —Students will hold weekly discussions with facilitators, learn basic cariology from websites, lectures, seminars, and group discussions, and organize a discussion with the community (patients and dentists), social welfare officers, authorities from companies that make dental products and devices, etc. To achieve practical knowledge, students will attend university health clinics, local clinics, hospitals, or other dental schools and other classes.

Guiding resources —Students will use their research books, class lecture notes, literature, the internet, and expert opinions to develop solutions to their guiding questions. Videos on the internet will help them to learn how different communities and health and social workers applied preventive and restorative strategies.

Solutions —Students will create situation-specific solutions as well as general solutions during their evaluation. The critical aspects of data collection and management will be itemized and worked on by the entire group. Students will learn how to acquire the knowledge needed to solve each question, verify event logs for possible break-ins, and update existing treatments and applications. The group discussion on management will come up with a solution to prevent dental caries through enhancing social awareness and applying dental treatment. In general, they will have more than one solution to a problem. The solutions will be determined by the latest and most advanced knowledge, and they will be openly discussed.

Study assessment and result publication —Students will be evaluated based on their activities for implementing their knowledge to solve real challenges. They can compile records of experiences and results on a digital platform (e.g., audio, video, and photography; Word files; or PowerPoint presentations). It should be borne in mind that they must record their reflections with descriptions of the challenges, learning processes, solutions, and implementation outcomes. Finally, these results can be shared with the world through web-based communities. In addition, the arrangement of a public event to publish their results will boost their leadership skills.

Funding Statement

This study was funded by the Health and Medical Research Fund (19180782).

Author Contributions

M.Z.I.N. conceived the conceptual design, interpretation, and writing—original draft preparation; V.W.X. revised the draft; A.W.Y.W., O.Y.Y. and C.Y. critically comments; C.H.C. revised the draft. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

Informed consent statement, data availability statement, conflicts of interest.

The authors declare no conflict of interest.

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• Published: 10 July 2020

A guide to critical thinking: implications for dental education

• Deborah Martin 1  

British Dental Journal volume  229 ,  pages 52–53 ( 2020 ) Cite this article

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Critical thinking is a key element of complex problem-solving and professional behaviour, which is a desirable skill for dental professionals. However, critical thinking is poorly defined in the clinical environment. Current research indicates the answers to critical thinking lie in educational theory, but the answer may be, instead, in epistemology theory. A review of the literature suggested that critical thinking in dentistry may relate to learning about the different lenses that a professional can adopt. Therefore, it may be prudent for dental professionals, especially those involved in the diagnosis of complex diseases in patients, to continue their learning, ensuring they become familiar with the different theoretical perspectives. Currently, this form of multiple theoretical perspective teaching is not included in the adult learning sector.

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• Introduction
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Critical Thinking and Assessment

• Conclusions
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• Appendix A. Author's Impressions of Vignettes

As faculty seek to make CTS the gold standard and the aim of dental education, it is important to consider how much time and effort they will invest. It is also important to consider the purpose of formal assessment.

The purposes of assessment can range from diagnosis to research and accountability. For example, asking students to take critical thinking skills test inventories allows researchers to diagnose students' critical thinking skills. This information could be used to make decisions about where to focus instruction. Also, test scores could be shared with students so that they become aware of their CT strengths and weaknesses. The scores resulting from administration of a critical thinking skills inventory midway through students' program, or at the end, can inform teachers about the effectiveness of their efforts to teach students CTS. When critical thinking scores become available, researchers can explore how instructional practices or the design of the curriculum influenced outcomes. For example, qualitative inquiry could be used to examine the amount of time used (e.g., by documenting the frequency of critical thinking strategies) to develop students' CTS in didactic or clinical learning environments and compared to empirical changes in students' CTS. Qualitative inquiry could also be used to interview faculty and students about the quantity or quality of instruction aimed at developing students' CTS. Providing information about students' CTS might also result in holding dental schools accountable for the students' critical thinking skills prowess. 83

Currently some dental schools are participating in a study that will correlate third and fourth year dental students' critical thinking skills as measured by the CCTST with their GPAs and National Board scores for Part I and Part II. As more dental schools participate in studies like this one, information about the usefulness of the CCTST measure may become better known. However, because data have not yet been collected, publications may not be available until 2012.

In a study about the predictive validity of the CCDTI and CCTST on dental hygiene students' performance on the National Board Dental Hygiene Exam (NBDHE), William et al. reported that CCTST explained a statistically significant (p < .05) amount of the variance (exceeding GPA, number of college hours, and student's age) in students' (n = 76) multiple-choice and case-based NBDHE scores 84 . The CCDTI scores were not a significant predictor of either outcome.

The CCTST and HRST are measures of general CTS not specific to dental skills. Other researchers may develop a measure of critical thinking that specifically measures dental skills. Such an endeavor is likely to take several years.

More studies in dental schools are needed to explore how instruction leads to changes in students' dental critical thinking and whether variables like GPA, demographics, or board scores predict pre-test to post-test changes in mean scores.

Dental schools might also consider qualitative studies of instruction in conjunction with using the CCTDI and CCTST; the HRST, the CCTDI, and CCTST; and the PJRF or the HRST and CCTST. It is important to point out that the use of pre-test and post-test comparisons are also fraught with problems. For example, if a control group is not used, then the findings are dubious. Also, as Ennis points out, "The use of the same test for pretest and posttest may alert students to the test questions." 85

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Assessment of Critical Thinking in a First-Year Dental Curriculum

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• Published: 03 February 2020
• Volume 30 , pages 367–374, ( 2020 )

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• Dharini van der Hoeven   ORCID: orcid.org/0000-0002-8409-6104 1 ,
• Thuy Trang LeAnn Truong 2 ,
• Julian Nathaniel Holland III 2 &
• Ryan L. Quock 3  

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We studied how students in a Doctor of Dental Surgery (DDS) program perceived the importance of critical thinking and the extent to which critical thinking was perceived to be included in each of 25 courses of the first-year curriculum at The University of Texas School of Dentistry at Houston (UTSD). Sixty-nine of the 102 second-year students who were invited participated in an online survey. The survey had three parts, with all statements of each part evaluated on a five-point Likert scale ranging from strongly agree to strongly disagree. The first two parts assessed the importance of critical thinking in dental education and the criteria by which critical thinking in didactic curriculum can be measured. In the third part of the survey, students evaluated how well each course of the first-year curriculum achieved critical thinking. More than 90% of the respondents strongly agreed/agreed that critical thinking is essential to making clinical decisions. Students strongly agreed/agreed that 19 of 25 of the courses incorporated critical thinking. However, when students were asked to rank the top five of the 25 courses, only two courses (Human Biology, Neuroscience) emerged above all others in their weighted ranks, with another seven courses standing out, leaving 16 courses with low weighted rankings for their inclusion of critical thinking. In summary, students agreed on the importance of critical thinking in dental education, and on the criteria by which the incorporation of critical thinking should be measured in didactic and pre-clinical courses.

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Acknowledgments

We thank Dr. John Valenza (Dean, UTSD) for his insightful feedback on our manuscript. We thank Mr. Patrick Finnerty for providing assistance with administering the survey on Qualtrics.

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Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge, Houston, TX, 77054, USA

Dharini van der Hoeven

School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA

Thuy Trang LeAnn Truong & Julian Nathaniel Holland III

Department of Restorative Dentistry and Prosthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA

Ryan L. Quock

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van der Hoeven, D., Truong, T.T.L., Holland, J.N. et al. Assessment of Critical Thinking in a First-Year Dental Curriculum. Med.Sci.Educ. 30 , 367–374 (2020). https://doi.org/10.1007/s40670-020-00914-3

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Change in students' critical thinking over the course of dental education

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• 1 Department of Oral Diagnostic Sciences, University at Buffalo School of Dental Medicine, Buffalo, New York, USA.
• PMID: 37414088
• DOI: 10.1002/jdd.13287

Purpose: The purpose of this study was to test whether critical thinking changes over the course of dental education by assessing dental students at the beginning and toward the end of their training.

Methods: Dental student participants completed a survey at the beginning of their first year (August 2019) and at the start of their last year of dental school (August 2022). The survey consisted of two instruments designed to measure the disposition and metacognition components of critical thinking. The study used a pretest-posttest design. Paired t tests were used to determine whether critical thinking scores changed over the 3-year period.

Results: Surveys were completed by 85 of 94 students (90%) on the pretest and 63 of 93 students (68%) on the posttest. Of the 92 students who were members of the class at both testing periods, data were available for 59 students (64%). There were significant mean decreases in disposition and its tolerance for cognitive complexity subscale, as well as in metacognition and its metacognitive strategies subscale (p < .05). There was no significant mean change in either open-mindedness or metacognitive thinking.

Conclusion: Results of this study suggest that some aspects of critical thinking (metacognition and disposition) decrease over the course of dental education. Future research should investigate why this is the case, and explore different instructional methods designed to improve critical thinking.

Keywords: critical thinking; curriculum; dental; students.

© 2023 American Dental Education Association.

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Exploration of Critical Thinking in Dental Hygiene Education

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Purpose: This qualitative study explores the perceptions of dental hygiene faculty regarding issues surrounding critical thinking skills integration within their associate degree dental hygiene programs.

Methods: Twenty faculty participated in the study, as drawn from 11 accredited associate degree dental hygiene programs in one Midwest state. Multiple sources of data were collected, including email questionnaires, individual follow-up phone interviews and artifacts. Interpretive analysis was conducted.

Results: Data analysis revealed that faculty generally understood critical thinking, but interpretations varied. Most do not use varied teaching strategies to promote critical thinking skills, and focus on one particular strategy – that of case studies. The participants identified the need for allied health-focused faculty development opportunities, and noted that calibration of instruction was needed. Despite challenges, faculty felt responsible for teaching critical thinking skills, and identified the need for time to build critical thinking skills into the curriculum.

Conclusion: This study was conducted in response to the American Dental Education Association Commission on Change and Innovation's challenge for dental hygiene educators to comprehend their own knowledge on the concept of critical thinking related to research-based pedagogical approaches to teaching and learning. Findings revealed a strong desire among the dental hygiene faculty in this study to incorporate critical thinking into their work. They want to do what they believe is the right thing, but their actual knowledge of the definitional and application theories about critical thinking is still in the early stages of development. Regular and targeted faculty development opportunities are needed.

• critical thinking
• teaching strategies
• dental hygiene
• Introduction

Twenty-first century health care is dynamic and challenging. On a daily basis, health care professionals make decisions which require calculated and structured thought, incorporating the use of critical thinking skills. 1 - 3 As health care evolves to include even more complex patient treatment options, increased pharmaceuticals and a diverse population, so should the manner in which professionals are taught in educational programs. Indeed, the Institute of Medicine has concluded that all health care professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence based practice utilizing critical thinking skills, quality improvement approaches, and information. 2

Historically, educational programs for health professionals, including the dental profession, have taught students by lecture and rote memorization with the goal to pass the national and state licensure exams. 4 - 6 As indicated by numerous researchers in dental education, dental programs often have overcrowded curricula which are locked into a specific time frame, contain redundant or marginally useful information, and do not allow for unique educational experiences to develop critical thinking skills. 4 - 11 Dental education reform and curricular change has been needed to educate students using the best teaching methods currently available. This has led to the rethinking of practices in post-secondary preparation programs for dental hygiene, along with a number of other professional preparation programs in health and dental care. 5 , 12

Abundant literature also substantiates the need for inclusion of critical thinking skills in education. 13 - 21 In addition, allied health programs, such as dental hygiene education, must provide evidence of meeting accreditation standards which indicate graduates are competent in the use of critical thinking and problem-solving skills related to comprehensive care of patients. 22 - 24

Specifically, if the preservation of dentistry as a learned profession with sustainable vitality in education and research is to continue, there is a call for serious curricular change and innovation in both the classroom and clinical setting for dental education. 6 , 10 , 12 Dental education commissions, such as the Commission on Dental Accreditation, the American Dental Association Council on Dental Education and Licensure and the Joint Commission on National Dental Examiners, have unanimously recognized the need to change dental curricula as a part of improving the nation's oral health. 22 The American Dental Education Association Commission on Change and Innovation suggests that changing science, technology, and disease patterns will transform oral health care delivery greatly impacting all disciplines of oral health education. 23 This, in turn, creates both a set of implications and a sense of urgency for rethinking dental education.

While it is generally agreed that instruction in dental hygiene programs must incorporate critical thinking and decision making skills, there is an absence of research on the cognitive components of clinical decision making, which includes concepts of critical thinking. 7 , 8 , 10 , 24 As a result, it is difficult to chart a course for such change in dental hygiene programs without examining the current status of faculty regarding their understanding and practice of teaching critical thinking skills in their discipline.

Therefore, the goal of this research was to examine dental hygiene faculty perceptions and thinking surrounding critical thinking issues within their accredited associate degree dental hygiene programs. The focus was on faculty who teach or have taught first and/or second year clinical theory courses within their dental hygiene program. For the purposes of this study, critical thinking is defined as an art of analyzing and evaluating thinking by self-discipline, self-correction and self-monitoring within a framework to improve one's thinking. 25 , 26

The work of Paul and Elder was chosen as a lens for the study. 26 - 30 In alignment with other theorists and researchers, 13 , 14 , 18 Paul and Elder believe that within the critical thinking process there are 3 levels of critical thinking, and methodical practice is needed for a person to move from the lowest level to the highest level. These authors have also identified effective teaching activities and practices that offer opportunities for deeper learning which are based upon the use of their critical thinking model. Their model has been used by various higher education institutions and their ideas promoted through various faculty development centers, including those within the state where this study was conducted. 31 - 33 In addition, Cosgrove et al developed an “international critical thinking basic concepts and understanding test” which has been demonstrated to have a high degree of consequential validity. 34 Their white paper titled “Consequential Validity: Using Assessment to Drive Instruction” goes into further detail supporting this critical thinking skills test. 35 It was therefore appropriate to use their work for the study of dental hygiene faculty in this state, while the work of other critical thinking experts may serve as the lens for similar studies in other states.

Specifically, this study pursued the following research questions:

How do dental hygiene faculty define the concept of “critical thinking” (as viewed through the lens of Paul and Elder's work), and the process of becoming a critical thinker within the field of dental hygiene (including when and how they learned about the concept of critical thinking)?

How do these faculty describe their personal and departmental rationale and decision regarding the integration of critical thinking skills into their curriculum?

How do they describe their strategies and processes for teaching critical thinking skills in their discipline?

What challenges do they experience as they address new curriculum standards for integrating critical thinking in the classroom or clinic?

• Methods and Materials

A qualitative study approach is often used to examine the social and cultural aspects of a particular program, group or organization, and thus was used in this study to assess the perceptions of dental hygiene faculty regarding various critical thinking issues. 36

The selection criteria was all faculty members who have taught and/or teach first and second year clinical theory courses within each of the 11 accredited associate degree dental hygiene programs in one Midwestern state. The theory courses are those that focus on clinical theory as applied to clinical procedures, and were chosen because they focus on helping students learn to think critically and with substance when treating a patient, including assessment, diagnosis, planning, implementation and evaluation. These courses also cover similar content across the 11 programs in this state as part of preparation for the North East Regional Board Exam, the clinical exam for this state and the National Board Dental Hygiene Exam.

This population of faculty was purposefully chosen, both because of their particular knowledge of the phenomenon being studied, and because the researchers had a connection with this state's dental hygiene educator's association, making it more likely that faculty would be willing to participate in this study. 37 Initially, 26 faculty members were identified who met the selection criterion, and received an email invitation to participate. Three had left their institution or no longer taught those courses. Of the 23 remaining faculty members in the target population, 20 (87%), with at least 1 from each of the 11 programs in the state, offered their assent to participate (following the protocol approved by a Human Subjects Institutional Review Board).

To support triangulation of the data, 3 types of data were collected for this study. 38 First, open-ended questions were created and piloted tested with 2 dental hygiene colleagues to enhance face validity. These 2 colleagues were out of state and have embraced the concepts of Paul and Elder through various faculty development workshops. After appropriate revisions, the questions were sent by email to participants to elicit their understanding of what critical thinking is, and the strategies or methods used to teach students to think critically. The researchers choose this approach because it allowed time for participants to reflect upon the questions and craft their response by email.

A second data set was obtained via follow-up phone interviews, with specific interview questions developed for participants to probe beyond their initial email responses. These interview questions were also pilot tested and revised prior to usage. Each phone interview was approximately 20 to 40 minutes in length, and was recorded for later transcription.

A third data set involved a review of artifacts collected from participants which demonstrated their integration of critical thinking, such as class activities, syllabi, scoring rubrics and program web pages. These items were reviewed to see if they provided concrete evidence to back up (or not) what participants had indicated they were doing in relation to the topic of critical thinking.

The phone interview responses were transcribed, and the process of interpretative qualitative analysis began. The researchers first analyzed the verbatim transcripts and responses to narrative questionnaires, identifying themes related to understanding the concept of critical thinking. An initial list of commonalities was created, and then refined by sorting each commonality into similar categories and subcategories. This was followed by the identification of common themes until an emergence of repeating premises or regularities resulted. 36 - 38 Through this process, the researchers were able to eliminate redundancies and create a list of themes that emerged from analysis of the data related to the research questions.

The integrity of the research methods was enhanced by utilizing several approaches suggested by Creswell. 38 The email questions, as well as the follow-up interview questions, were piloted with 2 dental hygiene colleagues prior to their usage, and revisions were made to enhance the face validity of these tools. 37 Member-checking was used whereby each participant was allowed to review the narrative constructed from their interview and offered clarifications as needed.

Limitations

It is important to note that this research study had a specific targeted population and therefore cannot be generalized to populations beyond the faculty within these 11 accredited associate degree dental hygiene programs in one Midwest state. 36 - 38 However, while the findings cannot be generalized, they may be of informational interest to other dental hygiene programs that are working to include critical thinking skills within their programs.

In addition, the primary researcher chose to use the work of Paul and Elder as a framework for this study, while the work of other critical thinking experts may serve as the lens for similar studies in other states. 26 - 30

Participants included 19 females and 1 male, ranging in age from 30 to 60 years old. Years of teaching experience ranged from one to 25 years. Two participants held doctoral degrees, 12 held masters and 6 had baccalaureate degrees. It should be noted that participant demographics were collected as a means to describe the population in the study, not to look for differences within this qualitative study.

Analysis of data revealed themes which were subsequently grouped under the core research question areas.

Research Question 1: Knowledge of the Concept of Critical Thinking

Research question 1 examined how dental hygiene faculty define the concept of “critical thinking” (based upon the framework of the concepts of critical thinking from Paul and Elder's work), and the process of someone becoming a critical thinker within the field of dental hygiene (including when and how they learned about the concept of critical thinking).

Three themes emerged to address this research. First, most faculty members offer at best only a partial definition of the concept of critical thinking (theme 1.1). Only 5 of the 20 participants were able to give a complete and specific definition of critical thinking as defined by Paul and Elder. 26 Such responses included all essential elements such as clearly formulating vital questions and problems, assessing relevant information, determining well-reasoned conclusions and solutions, thinking open-mindedly with alternative systems of thought, and effectively communicating with others. For example, participant #8 (via the open-ended questionnaire) provided this complete definition of critical thinking, “Students critically think when they can assess information, define the problem, draw a conclusion, devise possible solutions, come up with a plan of action, and can evaluate whether their idea or plan worked.” The other 15 participants offered only segmented critical thinking concepts.

The second theme which addressed this research questions was that most participants initially learned about the concept of critical thinking in a formal manner (theme 1.2). Eighteen of the 20 participants indicated they learned about the concept of critical thinking through different forms of educational opportunities, with 12 of these 18 first learning about the concept of critical thinking skills through some sort of faculty development opportunity. Several noted that they had initially learned about the concept as part of their own formal training as a student dental hygienist or dental student in the classroom.

The third theme for this research questions was that all participants indicated they learned how to teach critical thinking skills through various faculty development opportunities (theme 1.3). All 20 participants learned how to teach what they believe to be critical thinking skills during faculty development workshops and seminars. Thirteen reported such workshops were offered by their own educational institutions, while the other 7 attended training at other institutions.

Research Question 2: Decisions to Teach Critical Thinking Skills

Research question 2 examined how dental hygiene faculty describe their personal and departmental rationale, and their decisions regarding the integration of critical thinking skills into their curriculum. Two themes emerged to address this question. The first theme was that the majority agreed as a faculty group to include the teaching of critical thinking skills into their programs (theme 2.1). Thirteen of the 20 participants indicated they agreed as a faculty group to implement the teaching of critical thinking skills into their curriculum. For example, participant #3 (via the open-ended questionnaire) shared this response, “program faculty (full time) decided together how to implement critical thinking skills into the curriculum. This is something that has evolved over time for us.” The other 7 participants indicated they decided on their own to teach critical thinking skills in the curriculum.

The second theme for research question 2 was that a majority of faculty expressed limited resistance to changing their curriculum to include the teaching of critical thinking skills (theme 2.2). Fourteen of the 20 participants expressed no major resistance to the changes needed as they incorporated the teaching of critical thinking skills into their coursework. Most participants embraced the teaching of critical thinking skills, indicating that teaching critical thinking skills is a must for health care providers. For example, participant #2 (via the follow-up phone interview) shared this statement, “I love teaching this way. It allows and encourages students to share their personal experiences, what has worked and what has not. It incorporates all of their personal experiences to be applied and utilized as health care providers.”

The other 6 participants expressed frustration and or felt resistance from their students to engage in classroom teaching strategies that included using critical thinking skills. For example, participant #18 (via the open-ended questionnaire) shared her frustration: “With increasing demands on instructors for quality assurance, the necessary steps to provide a quality accredited program, there seems to be less and less time to perfect the pedagogical skills involved in the goal of actually teaching critical thinking skills!”

Research Question 3: Teaching Strategies Using Critical Thinking Skills

The third research question examined how faculty described their strategies and processes for teaching critical thinking skills in their discipline. Three themes emerged. The first theme was that many faculty described using research-based teaching approaches to help students learn critical thinking skills (theme 3.1). Fifteen of the 20 participants indicated they are using several specific strategies to teach critical thinking skills, including: self-assessment, concept mapping, case studies, Socratic questioning and substantive writing. Some participants indicated that case studies were used most often.

The other 5 participants provided responses of other teaching strategies not identified by Paul and Elder as the most effective ways to teach students critical thinking skills (e.g., lecture, group work; question and answer). 26 For example, participant #8 (via the open-ended questionnaire) shares this content, “In my Theory course, I lecture to students, and ask them their opinions or ideas, rather than just asking for “the right answer.”

The second theme which addressed research question 3 was that all participants expressed they felt responsible to teach critical thinking skills in order to prepare students for the work world (theme 3.2). All 20 participants believed they have a duty to teach students critical thinking skills, helping them to engage in real world experiences. For example, participant #20 (via the follow-up phone interview) noted, “The primary responsibility lies with the individual instructors to integrate critical thinking into the various courses that they teach. As a faculty we are always working on ways to bring critical thinking skills into the clinical environment modeling the real work world.” In congruence, participant #9 (via the open-ended questionnaire) noted: “Critical thinking is purposefully installed within courses by individual faculty. Critical thinking skills are something that must be implemented within our curriculum as often as is possible.”

The third theme for this research question was that the majority of participants reported that second year students are given more autonomy, and as a result teaching strategies used to teach critical thinking skills become more complex (theme 3.3). Twelve of the 20 participants identified students having more autonomy as they progress through the last semester of the curriculum, and teaching strategies used to teach critical thinking skills become more complex. For example, participant #6 (via the open-ended questionnaire) noted: “Methods taught to first year students are self-corrective, and self-disciplined. Methods taught to second year are how to increase knowledge, skill assessment, and evaluate continuing care to patient case types.” The other 8 participants were not consistent with their responses when questioned about the complexity of teaching strategies as students progressed through the curriculum.

Research Question 4: Challenges with Today's Students Teaching Critical Thinking Skills

The fourth research question focused on the challenges faculty experienced as they addressed new curriculum standards for integrating critical thinking in the classroom or clinic. Two themes appeared: the first theme is that many reported their students simply have a “tell me what I need to know” approach rather than a desire to learn how to learn to think critically (theme 4.1). Thirteen of the 20 participants believe most students want to be taught what they need to know to pass the boards and not how to learn to think critically. For example, participant #10 (via the open-ended questionnaire) wrote: “The challenge is that students want faculty to spoon-feed them everything and tell them the answers because that may have been how they learned and were taught in the predental hygiene courses.”

The second theme which addresses this research question is that many participants' indicated there should be more calibration of instruction when teaching critical thinking skills in didactic and clinical settings (theme 4.2). As one major challenge, 11 of the 20 participants agreed that more work is needed to truly integrate critical thinking skills both in the classroom and the clinic. As the participants responded, it was almost as if this was a self-realization as to what steps the participant and/or the program was taking in regards to the cohesive teaching of critical thinking skills.

Other participants shared broad categories of challenges they face when teaching critical thinking skills within dental hygiene programs. Some shared the fact that time, reduction of credit hours per program, and awareness of students' different styles of learning creates the need for congruency among faculty teaching in the program.

Overall, on varying levels, all participants mentioned the difficulty of preparing students to critically think as required for such a demanding health care profession. As noted earlier, participants voiced the need for more time to teach the required dental hygiene course content utilizing teaching strategies incorporating critical thinking skill, especially as they strive to ensure that students actually learn the content by critically thinking.

The overall goal was to understand dental hygiene faculty perceptions and understanding of critical thinking issues. After reviewing the themes found in this study, 8 major findings were identified. These findings are only applicable to the population involved in this study and while the framework for this research was based upon a single theory, it should be noted that there are more theoretical models researchers could explore.

First, the dental hygiene faculty in our study generally understood the concept of critical thinking, but interpretations varied, and not all could offer a complete definition. This finding is similar to work by who found most general education faculty believe they knew what critical thinking is, but could not give a concrete understanding of the concept. 25 Indeed, over 75% of the faculty were unable to adequately define the constructs underlying critical thinking.

Second, dissimilar to aspects of previous research by Paul and Elder, 26 Williams et al, 39 Giddens and Gloeckner, 40 and Hessheimer et al 41 which reveals multiple researched-based teaching strategies to promote critical thinking skills, most of our participants primarily focused on one particular teaching strategy throughout the curriculum - that of case studies. Faculty did note the importance of other research-based teaching strategies, but cited case studies as the most important. This reveals a serious disconnect between the theories of how critical thinking should be taught (i.e., with case studies being just one of many strategies), and what was actually happening in the field with the faculty in this study (and perhaps what is happening elsewhere as well).

Third, adding to the previous research of Asadoorian et al, 5 Hessheimer et al, 41 and Kassebaum et al, 42 which found that faculty development opportunities on the instruction of critical thinking are essential, our participants identified the need for specific allied health-focused faculty development opportunities. The shift to teaching critical thinking skills requires a commitment from organizations to help faculty understand what critical thinking is, and identify what educational strategies can be used to effectively teach critical thinking and assess changes in students' critical thinking skills. Organizations must offer continuous allied health-focused faculty development opportunities, and venues to discuss, implement and examine the scholarship of teaching.

Fourth, while participants believed all faculty were teaching the concept of critical thinking, they expressed concerns of not knowing specifically what others were doing, or how well things were working. The need for faculty time, to share their experiences and assess what methods are really helping the students to learn critical thinking skills, was very apparent. Participant recommendations were that calibration of instruction was needed so that all faculty can make the necessary changes in an effective way, and allow them to focus on effective teaching strategies. No similar finding could be found in previous research.

Fifth, adding to the previous work of Doyle, Tagg and Weimer, who identified a paradigm shift in teaching, the participants in this study identified challenges with teaching today's students. 14 , 19 , 21 , 43 Faculty found resistance from students who did not want to engage in the teaching strategies to promote critical thinking, and some students just wanted “to be spoon fed in order to know what was going to be on the boards.”

Sixth, supporting the previous findings of Barlett, Ellerman, and Paul and Elder, which revealed that intellectual traits must be taught in health curricula moving from the novice to the expert thinker, the participants agreed that coursework intensifies throughout the curriculum and so should the students' ability to think critically. 25 - 29 , 44 , 45 Faculty identify that first year students are learning large amounts of foundational content, and that students become more autonomous as they move through the second year of the curriculum.

Seventh, participants in this study felt responsible for teaching critical thinking skills to students as part of workforce preparation. Many acknowledge that a health professional must be able to think critically during patient clinical treatment. Clinical dental hygiene practice demands critical thinking and as such faculty are attempting to include critical thinking activities daily in their teaching practices. In addition, faculty recognized that critical thinking skills had been taught to them during their own experiences as students in dental hygiene school, and felt responsible to now teach critical thinking skills to others. Faculty reminisced that they remembered hearing and learning about critical thinking while being a student in their undergraduate dental hygiene program, and have been fortunate to receive institutional support to now learn how to teach critical thinking skills themselves. Boud et al 46 and Mezirow 47 would have indicated that these faculty are engaging in the reflective process from their own student experiences in the clinical setting, connecting it to prior theoretical knowledge in order to improve future clinical practice, and ultimately, learning from one's own experience.

Lastly, participants identified a lack of time to adequately teach critical thinking skills in the curriculum. Research indicates it takes time to develop increased levels of critical thinking and students must progress through the various levels. 25 Paul and Elder also indicate faculty must be willing to move students through the various levels of thinking utilizing research-based teaching strategies employing critical thinking skills. 26 - 30 While our participants expressed willingness to engage in such activities, and had an understanding of how such skills become more complex over time, they identified time as a constraint when trying to incorporate critical thinking skills into their coursework.

The findings of this study serve as one response to the American Dental Education Association Commission on Change and Innovation's challenge for dental hygiene educators to expand their research-based pedagogical approaches to teaching and learning with a particular emphasis on the concept of critical thinking. 11 This research provides an interpretation of how dental hygiene faculty in one Midwest state define and understand the concept of critical thinking within their dental hygiene program.

While a qualitative study focusing on the dental hygiene programs within a single state cannot be generalized to all dental hygiene programs, this study revealed a very strong desire among these faculty to incorporate critical thinking into their work. They want to do what they believe is the right thing, but their actual knowledge of the definitional and application theories about critical thinking is still in the early stages of development. It is important for the profession to ascertain if other faculty across the country are also in a similar position, and if so, energy should be expended via targeted faculty development to help move the profession toward their ultimate goal – having well trained health professionals using critical thinking skills in their daily practices.

Kimberly S. Beistle, PhD, RDH, CDA, is Program Coordinator of Dental Hygiene and associate professor in the College of Health Professions at Ferris State University. Louann Bierlein Palmer, EdD, is Professor and the Educational Leadership PhD Program Coordinator in the Department of Educational Leadership, Research and Technology, Western Michigan University.

This study supports the NDHRA priority area, Professional Education and Development: Investigate the extent to which new research findings are incorporated into the dental hygiene curriculum.

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May 15, 2024 | Courtney Chandler - UConn Health

Tackling the Future of Oral Health and Education

Dr. Sophia Saeed has been appointed to a national task force addressing challenges facing dental education and patient care delivery

Dr. Sophia Saeed is the associate dean for clinical affairs at the UConn School of Dental Medicine (Tina Encarnacion/UConn Health photo)

Dr. Sophia Saeed, associate dean for clinical affairs at the School of Dental Medicine, has big ideas on how to change the future of dental education and patient care.

Saeed, along with a group of deans and faculty members from dental schools across the country, has been appointed to tackle issues facing dental education and patient care on the American Dental Education Association’s (ADEA) Envisioning and Transforming the Future of Oral Health & Education task force.

The task force is a culmination of the ADEA thought leader’s assembly titled “Imagining Oral Health Education for a Connected World” that convened last fall. The thought assembly, along  with a nationwide climate study of dental education, landmark reports, presentations, and initiatives led by ADEA, have all influenced the development of the task force.

“ADEA for the past few years has been working on figuring out how to gather the data necessary to drive the change we know we need in dental education,” Saeed says.

According to ADEA, the task force is aiming to develop a shared vision for ideal oral health that involves its essential integration with overall health, while considering constant expansion of knowledge and expertise and emphasizing optimized access and public/patient health and wellness as the ultimate priority.

“The purpose that dental education exists is to provide better care for patients, so we really have to put the patient at the center of it,” Saeed adds. “We have to look at the data, we have to see where we have moved the needle the past couple of decades, and where we have not.”

The data tells a very complicated story. ADEA reports show the challenges that some dental schools are facing, including with succession planning, leadership development, and belonging and inclusion with students and faculty. For national trend data, there has been progress made with children’s oral health care—with an increase in preventive care, and overall, less disease burden. For adults, it’s a different story. The number of adults and older adults with cavities or missing teeth remains high.

Technological advances are on the rise, with digital dentistry and new cutting-edge treatments becoming popular, however access to these technologies varies. In addition to barriers to treatments, lack of access to prevention, nutrition counseling and healthy foods continue to pose issues for underserved communities. The gap between high income and low-income individuals continues to grow.

Another hurdle is the cost of dental school. Across the country, the cost of dental education continues to increase, with many students graduating with an considerable amount of debt. While educational debt has been increasing, third-party reimbursements for services has been decreasing steadily.

“We have a lot of great ideas for what care should look like. We want to see a reduced burden of disease, and to do that we have to see what has to change in the oral health care delivery system, and what has to change in the education of the folks that are joining that workforce” says Saeed.

Saeed is hopeful that the task force—made up of sharp, forward-thinking leaders in academic dentistry—will start to move the needle in the right direction.  The task force will continue to meet through 2024 with the goal of a full report of recommendations at the 2025 ADEA Annual Session.

“We need a high level of disruption to really reimagine what the care delivery model looks like to better meet patient’s needs. And that requires we get out of the box that we’ve been in for decades.”

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by Mary Beth Versaci

May 10, 2024

Original Article

Dental School Snapshots: April and May

The U.S. boasts more than 70 accredited dental schools, all charged with educating the next generation of dentists.

This series from the ADA News highlights facts about each to help paint a picture of the current dental education landscape.

From the year they were established to their total enrollment across all programs, learn more about the Ohio State University College of Dentistry and University of Pittsburgh School of Dental Medicine in the fact boxes below, and stay tuned for details about more schools in upcoming ADA News issues. 

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