By Nicole Fauteux
The impact of globalization is clearly visible in the Kingdom of Saudi Arabia (KSA), where Saudi dental educators are looking abroad for inspiration in designing a contemporary dental school curriculum that will prepare Saudi dentists to meet the country’s needs in the
21st century and beyond. This outward orientation shouldn’t be surprising. Although few ADEA members have firsthand knowledge of the Kingdom, Saudi dental educators are well acquainted with dental education on our shores as many have received their advanced degrees at our institutions.
Professors at the University of Dammam College of Dentistry (Dammam) are no exception. Dean Fahad Al-Harbi, B.D.S., M.S.D., FACP, D.Sc.D., studied his specialty at Boston University Henry M. Goldman School of Dental Medicine. According to Dr. Al-Harbi, KSA has a long-term plan
to invest in its human capital, including sponsoring potential candidates for advanced education at institutions worldwide.
“The government has education and health fields as priorities compared to any other field,” he says. “This investment is continuously nourishing the educational institutes in the country with well-trained professionals.”
This is evidenced in the country’s budget, which prioritizes educational spending. According to the World Bank, KSA allocated 18% of its budget to education in 2008. This funding has made it possible for Saudi dental schools to build facilities that rival those in ADEA
member schools, including oral maxillofacial surgical suites that surpass those in many U.S. hospitals.
Although dental education in the Kingdom is only three decades old, the government’s generous investments in higher education have also inspired a number of Saudi dental schools to seize opportunities to enhance their curricula. Dammam is one of these eager innovators. The college
invited the Association for Dental Education in Europe (ADEE) to conduct a site visit in 2012. Dr. Al-Harbi says it gave faculty at the College an opportunity to share ideas with their European colleagues and refine Dammam’s plan for curricular revision.
Dammam is also looking to the Commission on Dental Accreditation (CODA) standards for guidance. The school’s goals for its new curriculum are consistent with current trends in dental education and the goals that ADEA member schools are in the process of adopting. These include:
- Ensuring that learning outcomes for courses are aligned with program outcomes.
- Integrating biomedical and clinical learning.
- Creating more opportunities for active learning.
- Expanding community-based education.
- Ensuring that topics such as evidence-based dentistry, lifelong learning, professionalism and ethics are assessed as part of the curriculum.
According to Dr. Al-Harbi, cultural competency will also be introduced. He says that the curriculum development team was “keen to introduce topics related to treating patients with different backgrounds early in the program.” Approximately 10 million non-Saudis reside
in the Kingdom, and another 2 million pilgrims visit the Kingdom’s holy sites each year. KSA offers free medical and dental care to all Saudi citizens and residents free of charge, either through hospitals operated by the Ministry of Health, the military or universities
Like his counterparts within ADEA, Dr. Al-Harbi is concerned that curricular change will meet with some resistance, especially from individuals at the peak of their professional careers. “The isolated, course-based, teacher-centered style is currently dominant,” he says.
Damman is using several of the approaches identified by ADEA CCI to encourage faculty to accept the proposed changes. Everyone on the faculty has been invited to participate in the process, and regular communication has built trust and kept everyone interested and involved. Dr. Al-Harbi
believes the new pedagogies and evaluation methods put in place will enrich the teaching experience for the faculty, and that resistance can be eased if faculty understand that the curriculum will be kept open for improvement and further innovation.
While these strategies and goals may sound very familiar, Damman and other Saudi schools also face some distinctly Saudi challenges. Universally accessible higher education is a relatively young enterprise in KSA. The Kingdom’s first university was established in 1957, and
its first dental school in 1976. Public schools first opened their doors to girls as recently as 1964, and today women and girls make up more than 50% of all school enrollment and 50% of enrollment at the country’s two oldest dental schools.
In KSA, all education is gender segregated, and dental education is no different. Although students and educators consider this the norm, it does pose administrative challenges in the dental school environment. Administrators must duplicate all facets of their programs for the
two groups, including clinical facilities, classrooms and laboratories. Dr. Al-Harbi also points out that teaching and assessment efforts have to be duplicated for each group, creating extra work for the faculty and administrators.
“Imagine having to address any of the challenges faced by U.S. dental schools, but in an environment that is still in development,” says Tobias Rodriguez, Ph.D., Vice President at AAL. “The things that our schools depend on—accreditation specifically for dental schools, standardized
educational policies, and the like—are still being developed in Saudi.”
Dammam has engaged AAL to provide expertise and technical assistance in achieving its curriculum reform goals. “What impresses me about Dammam is that they are being extremely innovative with the efforts being put forward at their school,” Dr. Rodriguez says. “They are
looking at trends in dental education and ensuring that their students and faculty are congruent with international standards. They have developed a really great curriculum that would be considered contemporary if it were here in the states."
KSA currently estimates that it has an insufficient number of dentists. According to Ministry of Health records, the Kingdom has one dentist for every 2,900 residents, compared with a dentist-to-population ratio of one to 1,680 in the United States. The Saudi government has also
provided economic incentives to encourage the growth of a private health care sector, which accounts for almost 40% of hospitals and half of other clinical facilities according to government documents. This spurred the opening of 19 publically funded dental schools distributed throughout the country and another nine private
Although the Kingdom has one of the most generously funded health care systems in the region, Dr. Al-Harbi says most dental care is focused on curing disease rather than prevention. He’d like to see this change. Although statistics on disease rates are more than a decade
old, studies have shown that more than 90% of Saudi children in many age groups have dental caries.
“National, coordinated efforts are needed to bring down the prevalence and severity of the disease, especially in accessible groups such as school children,” says Dr. Al-Harbi. To accomplish this, he advocates systematic and ongoing collection of caries prevalence data, ideally
organized by the Ministry of Health with the academic sector in conjunction with the Saudi Dental Society. He would also like to see the implementation of population strategies such as health education, oral hygiene instruction and fluoride varnishes and sealants. The college has organized health education
campaigns and, in the last two years, revised its externship program so that students spend more time providing clinical care, much of it in community-based settings.
“This area is planned to expand even more since the pediatric dentistry teaching staff has doubled in the last two years,” he says, “and the general anesthesia facility for the treatment of children is being furnished in the new dental hospital that will be finished in less than one year.”