Several things came together to provide the impetus for ADEA to create CCI. In 2004, the Council of Sections approached the Board of Directors about developing foundation knowledge guidelines to assist test construction committees with Part I of the National Boards. The Council of Sections also recommended updating the ADEA Competencies for the New Dentist, originally adopted in 1997. The time was right to take a much broader look at dental education: the Council of Deans was becoming increasingly concerned about placing the wealth of new information affecting oral health care into their schools’ curricula, the Commission on Dental Accreditation was initiating its periodic assessment of its Standards for Predoctoral Dental Education, the Joint Commission for National Dental Examinations was beginning conversion of its exam delivery and incorporating interdisciplinary questions into Part II, and the dental licensure community was developing national licensure examinations.
These factors led ADEA to host a Forum on the Predoctoral Dental Curriculum in October 2004 with three objectives: 1) to provide recommendations to ADEA for the development of foundational knowledge guidelines and updated competency statements, 2) to identify challenges and opportunities related to curricular innovation and reform, and 3) to develop strategies to sustain continued interaction between ADEA and other dental education stakeholder groups. The forum included representatives from across dentistry and dental education.
Recommendations from the forum led the ADEA Board of Directors to appoint an oversight committee, engaging groups inside ADEA as well as from across the dental and health care communities. Based on recommendations from the forum, the ADEA Board suggested that the oversight group start with development of a document, "Competencies for the New General Dentist," supplemented with descriptions of foundation knowledge necessary to achieve each competency and educational guidelines to effectively deliver a new curriculum. The group also was expected to recommend policy and procedures for ADEA to interact with outside agencies that interface with dental education. The Commission on Change and Innovation in Dental Education was born!
Who are the members of CCI?
CCI consists of representatives from dental schools, the ADA Board of Trustees, the Commission on Dental Accreditation, the ADA Council on Dental Education and Licensure, the Joint Commission on National Dental Examinations, the dental licensure community, the ADA Foundation, and advanced dental education programs. CCI is unique because it is the only group that brings together the major stakeholders, including the external agencies that influence dental education, to discuss systemic efforts to foster change and innovation in dental education.
How would you describe CCI’s purpose?
CCI’s purpose is to build consensus by providing leadership and oversight to a systemic, collaborative, and continuous process of innovative change in the education of general dentists so that they enter the profession competent to meet to oral health needs of the public throughout the 21st century and to function as important members of an efficient and effective health care team. CCI is a facilitator of change and innovation. For example, starting with the development of New Competencies for the General Dentist (now being drafted by a Task Force of the ADEA Council of Sections), CCI will provide models, develop conduits of best practices, and create mechanisms to assist dental schools as they strive to modify their curricula. Recognizing that each dental school has a unique mission, CCI will NOT create a “national” curriculum for dental education or suggest that one be developed.
A number of studies over the past several decades have recommended major curricular reform, but have resulted in only isolated changes. What is different now?
CCI feels that past efforts have resulted in isolated changes for two reasons. First, previous activities to recommend or implement change were completed in relative isolation. Second, many of the concepts proposed (like active learning, evidence-based clinical care, competency-based education). were new and sometimes frightening to dental educators. While the second reason has lessened somewhat, primarily as a result of active discussion over the past decade, the first reason must be addressed. CCI recognizes that there are many entities (basic science educators, clinical educators, specialty organizations, accreditation standards, licensure examinations, the culture of existing dental practice, the milieu of higher education, and even other health professions) that influence and affect the process and outcomes of dental education. It intends to involve individuals from all these groups in the assessment of present strengths and weaknesses and the development of recommendations.
CCI quickly identified that broad-based inclusion of interested parties, and far-reaching efforts to involve all in the discussions leading to its recommendations, will be the only way to produce a final product capable of invoking substantive change. The composition of CCI will provide initial input from within dental education, and from groups and organizations that surround dental education. As draft documents and recommendations are created by CCI, it plans on far-reaching distribution and call for review for review and comment. CCI wants its process to be open and inclusive, with broad-based discussion and debate. We feel ultimate implementation of curricular change is dependent upon the input of all parties and that curricular innovations will take different forms based on the mission of the school. CCI is positioned to help schools facilitate change.
What is the relationship between CCI and other curriculum efforts within ADEA?
CCI recognizes that there are many groups currently discussing specific aspects of the predoctoral dental curriculum. The recent ADEA Council of Deans Meeting is an example of those discussions. The Council of Deans met with the ADEA Council of Faculties over a theme of “Deconstructing the Curriculum.” Deliberations over two days focused on “what can be removed from the curriculum.” CCI was not directly involved in designing this meeting or choosing the approach used to stimulate debate. However, CCI will use the outcomes of the discussions as a piece of information as it moves forward to create a coordinated plan of action. Likewise, outcomes from the Allied Dental Health Summit, activities of groups such as the Macy Group and the Santa Fe Group, and academic publications in the area will be carefully monitored and used as part of CCI’s process.
CCI ultimately wants to coordinate the various activities aimed at curriculum reform in dental education into an effort that will allow schools to change their curricula to facilitate the development of graduates competent to address the oral health needs of their patients, and the public, and have those changes supported across our profession.
How will CCI assist dental schools in fostering innovative change in their curricula?
One of dental education’s principal responsibilities is the development of graduates who are lifelong learners. Information supporting delivery of the most effective oral health care is too abundant and changing too rapidly to expect our traditional “expert telling the novice” approach to be effective. CCI will attempt, through the development of new competencies and identification of their supporting foundation knowledge, to develop a consensus framework for the contemporary education of a graduate of our predoctoral education programs--a competent, new general dentist. A dental school will be able to use this framework, if it chooses, to assess its curriculum and create points of discussion for its faculty about the future of its curriculum.
In addition, CCI plans to outline methodologies that schools could incorporate within their pedagogies to enhance the development of lifelong learners capable of effectively and efficiently accessing the most current and relevant information, assimilating that information, and using the information to provide the best care possible for their patients, and optimal oral health for our society. CCI will also work with ADEA to provide professional development opportunities for faculty members so they can successfully function in this academic environment.
How will CCI keep ADEA members informed about its activities?
As mentioned earlier, CCI feels open communication and broad-based debate are hallmarks to success. Communication will take place in many ways. Periodically there will be formal articles in the Journal of Dental Education and the Bulletin of Dental Education Online. In the near future, CCI will ask each school to identify four faculty members (two junior and two senior, two basic science and two clinical) to serve along with the dean and the academic affairs dean as liaisons to CCI. Materials will be distributed to the schools through these liaisons and they will be expected to act as conduits to the rest of the faculty members at their schools. As the draft Competencies for the New General Dentist and Fundamental Knowledge statements are created, they will be distributed widely for comment. Open forums at the ADEA Annual Sessions and the interim meetings of Councils will used to solicit additional comments. ADEA has just created a website to keep its members informed about CCI activities and to provide resources for curricular change. While the website will continue to evolve, members can find much more information now, including the recommendations from the October 2004 Forum and the report from the May 2005 CCI meeting, at www.ADEA.org.
CCI wants to hear from everyone. Change is difficult--we have certainly shown that to be true in dental education. An open process, focusing on the product we all want to assure is coming from our predoctoral education programs--a competent general dentist, has the most potential to achieve significant and beneficial change.