ADEA CCI Liaison Ledger

The Changing Face of Allied Dental Education

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By Tami J. Grzesikowski, RDH, M.Ed., Dean, College of Health Sciences, St. Petersburg College

Remember overhead projectors and mimeograph machines? In reflecting on the past 30 years in allied dental education, I can say one thing for certain: there is very little I do today that I was doing 30 years ago. Some of us still stand up front and lecture to our students about infectious diseases, professionalism, instrument selection, and pathological conditions, but many more of us are assigning readings, creating discussion forums, and asking students to critically reflect on these same concepts.

The classroom experience looks and feels dramatically different. Not only have PowerPoint presentations and digital video clips replaced overhead projectors, but the multiple-choice exam has made room for newer assessment tools such as the Objective Structured Clinical Examination (OSCE), which assesses the application of concepts.

At St. Petersburg College (SPC), my academic home, curricular innovation and technological innovation have gone hand in hand. At the end of the last century, I threw away my transparency markers and 35 mm slides and embarked on an exciting journey. SPC strongly supported the development of an online degree completion program for dental hygienists and later for dental assistants. My job was to figure out a way to deliver online education to those students anywhere on the globe.

The need to address the aging population of educators and the nationwide shortage of qualified faculty at allied dental schools gave the impetus to this initiative. The resulting program was one of the first in the nation to deliver its entire curriculum online, without campus visits. We created cyber classrooms, which allowed us to leave behind battles over scheduling and space. Today we communicate with students through online discussions, email, and a variety of other tools. Currently there are many such online degree completion programs in dental hygiene meeting the needs of licensed practitioners, and the most forward-looking schools are continuing to turn to distance education to expand their reach rather than opening new campus-based programs.

Distance education is only one manifestation of curriculum innovation in allied dental education. Some of our allied programs have benefited from being embedded in large dental schools, which have access to state-of-the-art classrooms, simulators, and clinic equipment. Other schools, such as my own, have benefited from their independence, experimenting in ways that might not have been possible within a larger administrative unit. I suspect that many of the changes taking place in allied education are less visible than those occurring in dental schools. Most of us have been too busy to share our efforts with colleagues beyond our own campuses.

In the last four years, serving on the ADEA Commission on Change and Innovation in Dental Education (ADEA CCI) Oversight Committee has opened my eyes to the full array of innovations taking place across the country. I have had the opportunity to attend some summer ADEA CCI Liaison meetings and have picked up ideas to take back to my school. Allied dental programs are bringing technology into the classroom, enhancing critical thinking skills, and tapping into the plethora of learning resources available to us through various companies and publishers. Educators across the United States have established clinical affiliation agreements to serve patients in rural and remote areas.

Allied dental students still work at traditional sites such as veteran's hospitals, long-term care facilities, and public health departments, but they are also working with Native Americans and migrant workers, and at military installations, homeless shelters, and federally qualified health centers. Service-learning projects are taking students to foreign countries where they learn firsthand about cultural differences in various populations. These experiences are better preparing today's allied dental students to address the access-to-care issues that cripple our nation and our world.

No description of the recent evolution of allied dental education would be complete without noting the transformation of the student body. For the past decade, educators have remarked on the dramatic change in students' expectations. Millennials do not want to go to the library. They want everything instantly, ideally accessible at their fingertips, 24/7, through some electronic device. They love to multitask, so keeping their attention is challenging. In addition, today's students come to school with a lot of baggage. Many are not living at home, enjoying the security that comes with being on their parent's health insurance. They may be single parents themselves or career switchers who are trying to balance many major responsibilities. Our student body represents diverse cultures as well, with language a barrier for many students in our classrooms.

These changing student demographics and the greater availability of learning technologies are two of the forces spurring the evolution in how we deliver allied dental education. New standards and expectations for practitioners also play an important role. Hygienists no longer just clean teeth. In order to develop and execute dental hygiene treatment plans for their patients, they perform periodontal assessments, communicate with patients regarding their health histories and dietary intake, and occasionally consult with other health care providers. In some states, they perform additional tasks such as administering local anesthetics and placing restorations. They also educate patients about various therapies using an intraoral camera, and they use video and print materials to promote services, products, or both to their patients.

Adjusting to meet these new demands can be laborious. Adopting new technologies, for instance, can be a struggle for many people of my generation. Some of us feel we are too old to learn them, so we don't embrace them at first. Then once we figure them out, we wonder how we ever did without them. Establishing off-campus clinical sites requires managing administrative details and often a lot of red tape, but the rewards are plentiful when our students experience something they never would have seen or known in their college's clinic.

I encourage those who are considering ways to innovate to take the plunge. They don't need to develop entirely new programs. They just need to set a goal of incorporating one new thing in each course they teach. Something as simple as a discussion board can truly enrich a course. It is amazing what students want to talk about when they don't have to raise their hands. One minute they are texting, and suddenly they feel compelled to think!

Innovation is labor intensive, and organizational skills are a must, but I have learned to let go of some traditional classroom instruction and take my students' learning experience to a whole different level. With distance education, I may not be able to recognize my degree-completion students on the street or in the airport, but I know I have facilitated their learning one discussion at a time. Changing how I teach has brought me fulfillment and satisfaction. As I said before, there is very little I do today that I was doing 30 years ago, and I wouldn't have it any other way.

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