Fazal Ghani 1 PhD, FDSRCPSGlasg, FRSM, MSc , BDS, BSc
These days everyone loudly speaks that dental education needs a shakeup. Many also cite gaps between how dental students are trained and how dental healthcare is delivered1. In response much investment has been made by all stakeholders. To a great extent, this effort has facilitated the creative ways for better preparing dental practitioners for their careers2. However much is still needed to be done by the dental schools to reduce the apparent gap between training of dental graduates and the way they are required to deliver the dental healthcare.
In the past, the training and education of dental students was traditionally structured to do their basic science education in the so called pre-clinical years and then to move them into the clinical science years with very little focus in the science of dental healthcare delivery. Dental schools, now, must revise the way they teach fundamentals like basic medical and dental sciences. In fact, the three core elements in which dental students need grounding are “basic science”, “clinical science”, and the “science of dental healthcare delivery”, To achieve this objective, now rather than waiting until the “clinical years” to put students into clinical settings, they are to be placed into clinical environments starting from the very first year of induction in training3. This will require the adoption of a new curriculum having the “Trunk and Branch” architecture. The “Trunk” is about laying the core for all three mentioned sciences in the beginning years. All students will thus get a really important foundation in those, and then they will ‘Branch Off’ where they will differentiate themselves, based on their professional trajectory,” That trajectory may be a focus on managing patients with dental diseases, or it may be procedurally based specialized dental care, or a focus on hospital-based dental care.
In this proposed training approach, student will not mentored by the faculty. Thus they will have a very different orientation than the traditional beginning years in the classroom, the remaining last years in the clinical setting, and then figuring out what to specialize in.
When teaching them the basic medical and dental sciences, the dental schools should not try to cram everything in. Instead, students should be taught each basic science throughout their training years in the dental school in a clinically relevant context that is most meaningful to them. Students will begin their core clinical rotations in their early years, with the last years being the “immersion phase” during which they will have the chance to build a very individualized curriculum and figure out what they need more help with. For example, if a student needs help with chair-side presentation, he or she can ask for additional feedback to improve that particular skill. During their entire training, students are to be self-directed, self-motivated to become lifelong learners and empowered to be always analyzing what the gaps in their knowledge are” and thus seeking to fill them.
Dental schools should facilitate their students in learning the evolving and changing pattern of dental diseases and consequent changes in the dental healthcare delivery system. It is important that the “Tomorrow’s Dental Practitioners” are educated and informed how to make better use of oral and dental health data so they not only improve community-wide orodental health but to also make a difference for their individual patients. For this purpose, dental students should be informed how to access the health related data bases of the concerned international, regional and their own federal and local governments. Of specific importance in this context is to inculcate in them the skills of accessing the data about the healthcare delivered by dentists and dental care settings. With the changes happening in healthcare and the changing role of technology and data, teaching them data analysis skills seems more important than ever. It is very important for the “Tomorrow Dental Practitioner” to be knowledgeable about the trends of dental disease procedures and treatments provided as well as of the quality of care provided and variations in treatment charges and expenditures involved. It is very important for our dental practitioners to have good understanding
of what the data mean and how to improve quality of dental care as these are the critical skills for them even down to the practice level. As the healthcare system is rapidly evolving, the dental practitioner is required to know the latest trends. Knowledge and information obtained 5 or 10 years ago is surely different than what is available today. Thus in addition to the knowledge of basic science and clinical science, the knowledge of the “science of healthcare delivery” is also very important for them. Dental students must be trained in biostatistics and epidemiology and information technology as well as they are to be fully made aware of healthy disparities and social determinants of orodental health4 Contemporary dental practitioners are not just those who know everything clinically, but they are those who also know how to answer questions and find information that’s out there and are able to adeptly use that information and those skills to help their patients lead healthier living.
The primary responsibility of dental schools is to produce dental graduates who are capable of improving the orodental health of communities and reduce the burden of suffering from orodental diseases5. It is vital that our dental students upon graduation possess the important skills, competencies, and attitudes. They must be prepared to work with public health peers so as to design environments where people are less likely to get dental diseases of modern society through different strategies of prevention. This means that they will work in teams and across boundaries to advance the science governing dental health. They are also willing to measure the outcomes of their care. Dental student, during their education in the dental schools, need to be educated about, the safety, cost and quality of care, team-based care and leadership skills of a leading dental practitioner and a leading servant leader of the community. They are also trained to provide person-centered care so as to treat patients holistically rather than considering only disease management. The objective of dental education and training is to not only help students heal the sick and provide excellent patient care, but to also have the tools to heal the ailing healthcare system. They are trained to understand the journey that the patient takes through the dental healthcare system and they know the challenges they have and the things that work for them.
In conclusion, “Tomorrow’s Dentist” is a person who has been educated and trained in a dental school setting that follows an “Integrated Truck and Branch Model Curriculum”. He is well prepared for using and applying the basic medical and dental science and clinical dental science knowledge for preventing and managing orodental problems, He / she is also current in knowledge about dental health policy, dental health economics, the role of community agencies, the importance of electronic dental health information, the importance of teamwork, leadership, evidence-based dental care, dental healthcare financing and affordable dental care.
- Mossey P. The changing face of dental education. Birt Dent J. 197, 3 – 4 (2004). doi:10.1038/sj.bdj. 4811678.
- Ryder MI, Morio I. Current challenges for dental education in Japan and the United States. Japanese Dent Sci Rev2011; 47: 23-30. DOI: http://dx.doi.org/10. 1016/j.jdsr.2010.05.001.
- Frieden J. The Changing Face of Medical Education: Part I, II & III. MedPage Today series August 2015. http://www.medpagetoday.com/ accessed on 18-08-2015.
- Tedesco LA. Issues in dental curriculum development and change. J Dent Educ 1995;59:97-147.
- Vargas CM, Crall JJ, Schneider DA. Sociodemographic distribution of pediatric dental caries: NHANES III, 1988 1994. J Am Dent Assoc 1998;129:1229-38.
- Newacheck PW, Stoddard JJ, Hughes DC, Pearl M. Children’s access to health care: role of social and economic factors. In: Ruth E.K. Stein, ed. Health care for children. New York: United Hospital Fund, 1997:55-57.
Professor / Head of Department of Prosthodontics, Dean Postgraduate Dental Studies & Coordinator International, Peshawar Dental College , Warsak Road, Peshawar, Khyber Pakhtunkhwa (Pakistan).
Corresponding author: “Dr Fazal Ghani ” < email@example.com >