The oral ecosystem: implications for education

What can dental education gain by understanding student experience of the curriculum?

INTRODUCTION

Within higher education, there is increasing recognition that understanding the ways students experience the educational environment is critical to developing programmes that can educate our future professionals. There is a small body of literature about how students experience the dental educational environment; however, none that adopts a qualitative phenomenographic approach. This study aims to contribute to our understanding by asking what is the variation in the ways dental students experience their curriculum?

METHODS

This study uses a phenomenographic methodology. Phenomenography investigates the variation in the way a group of people experience a situation, and how they ascribe meaning to it. Interviews were conducted with 14 senior dental students at the University of Sydney. Transcripts were analysed using a phenomenographic approach.

RESULTS

Six increasingly sophisticated, qualitatively distinct categories of description were identified from the collective of transcripts: surviving the education system; following a guide or manual, learning how to treat teeth, learning how to meet patient treatment needs, learning how to relate with patients and understanding the complexities of dental practice. The outcome space consists of ways the categories of description are related; considering interactions with teachers, ways of coping with multiple opinions and integration of disciplinary learning.

CONCLUSION

This study provides new insights into the multifaceted and relational ways that dental students experience their educational environment. It could point curriculum designers towards strategies that assist students develop sophisticated understandings about themselves as practitioners, patients and the complexities of dental practice. Suggestions about the practical implications of the findings of this research are given.

Are dental students ready for supercomplex dental practice?

Contemporary dental practice requires practitioners who are able to draw upon varying interconnected knowledge and skills, in order to make judgments and take action when faced with multiple, often contradictory, ways of interpreting a situation. However, the curricula that prepare students for dental practice are traditionally based on the theoretical knowledge and technical skills to be gained by students. This is despite evidence in the dental literature of a collective desire for graduates to have more range and depth in their repertoire. Examination of contemporary dental practice through the lens of supercomplexity (Higher Education, 40, 409 and 2000) provides contextual understanding and a platform to explore the types of learning and curriculum approaches that can best prepare students for professional practice. From the insights offered by examples from other professional fields, we, as dental educators, can begin to conceptualise learning dentistry as much more than competency frameworks or descriptions of what students need to know and be able to do. Rather, to equip graduates for contemporary dental practice, the dental curriculum needs to become a vehicle for students to develop personally and professionally as well as teaching the theoretical and technical aspects of dentistry.

Dynamic Systems (Complexity) theory as a new conceptual model for researching PBL in dental education

Although problem-based learning (PBL) was introduced into dental education some 20 years ago, there have been relatively few well-designed studies carried out to clarify whether, how or why it works in a dental context. This paper introduces the Dynamic Systems (Complexity) theory as a new and potentially productive theoretical framework for researching PBL in dental education. This framework emphasises the importance of emergent self-organisation, perception and brain plasticity in learning. In this paper, a brief overview of the history of PBL in dentistry is presented and then the fundamentals of a Dynamic Systems Approach (DSA) are explained, drawing on two recently published papers advocating the DSA in medical education and teacher education. We focus on three key points related to this new approach: emergent self-organisation rather than simple construction of knowledge; the notion that perception drives the learning process; and the brain as the substrate of all learning. The paper also suggests how the DSA can help us move forward, both in terms of the future application of PBL in dental education and also in relation to posing new types of research questions.

A patient-centred approach to teaching and learning in dental student clinical practice

A patient-centred clinical teaching profile in the undergraduate dental curriculum at The University of Tromsø is described. This teaching profile implies that treatment planning is primarily based on the patients' perceived needs and the students are trained to retrieve information from the patients in this context. The role of the clinical instructor is primarily as a facilitator rather than an expert. The 'best interest of the patient' is not always easy to disclose and consequences related to the patients' levels of understanding, students competence, educational challenges and professional ethics are topics for discussion through the clinical education programme.