If you believe the best way to learn dentistry is to do dentistry, a corollary is the more clinical experience students have, the better prepared they will be on graduation day. This is the vision ADEA President Dr. Ronald J. Hunt developed in his early years as Dean of the Virginia Commonwealth University (VCU) School of Dentistry.
For the past five years, a team of VCU dental educators has been hard at work designing and implementing an integrated curriculum that moves second-year students into the clinic and allows seniors to spend an entire year (under the supervision of general dentistry faculty) providing comprehensive care in the same way they will after graduation. To make room for increased clinic time, VCU condensed its didactic and preclinical curriculum, introduced full utilization of DentSim clinical simulation units, added a literature review course to teach self-directed learning, and created vertically integrated practice groups for its second-through fourth-year students.
"Change is always hard," says Dr. B. Ellen Byrne, who oversees academic programs as Senior Associate Dean at the VCU School of Dentistry, "but initial skepticism about whether the condensed curriculum would prepare students adequately is being put to rest. "She reports that students are leaving the shortened operative dentistry preclinical course better prepared than before, and scores on biochemistry board exams have remained level.
"We had students ready to see patients at the end of the first year. Now our brightest, most talented students are not being held back," Dr. Byrne adds. But moving students into the clinic earlier has created some challenges of its own. VCU didn't anticipate just how many more patients with simple needs would be required to accommodate the influx of students in the second year.
In response, the school established a friends-and-family planand a student-to-student plan, which allowed students to bring in their own patients and increased their numbers by 45% in 2008. These student-recruited patients typically have simpler needs than the more complex patients arriving at the clinic on their own. VCU is also addressing the need to increase patient flow by dedicating a new clinic this summer that will substantially increase the number of available chairs.
VCU's ADEA CCI Liaisons, Dr. Byrne and Dr. Sharon K. Lanning, have developed a project to measure the impact of the changes taking place on their campus. Using three established instruments, CSWOT, DSLE, and ClinicEdIQ [see "Appraisal of the Dental School Learning Environment: The Students' View" in the Journal of Dental Education for discussion of these], they have begun measuring how students perceive dental curricula and VCU's learning environment. The surveys will look at the most recent class of graduates, who received the traditional curriculum but spent their senior year in a group practice clinical setting, and at the next three years' graduates as the new curriculum is progressively introduced.
"In restructuring the D.D.S. curriculum, we aimed to produce a graduate better prepared for practice," says Dean Hunt. "Anecdotal evidence from faculty and students suggests we are succeeding. The rigorous restructuring assessment Drs. Lanning and Byrne designed will give us much valuable data that will tell us what is working well and what needs further development."