“New Dental Schools”What Are They Doing Out

There?

(And Do We Really Need Them?)

Overview

1986 – 2001: 7 Dental Schools Closed

1997 – 2009: 5 Dental Schools Opened

2011-2014: 7 new schools

Future: 8 new schools being considered

There are still many in the profession who remember the last time the system was expanded

Influence of practicing profession on applicant pool

Perspective

1980 – 6,000 graduates; 227 million = 1:38,000

1990 – 4,000 graduates; 250 million = 1:62,500

2000 – 4,200 graduates: 281 million = 1:67,000

2010 – 4,800 graduates: 308 million = 1:64,000

2020 – 5,600 graduates: 335 million = 1:60,000

Why Connected to Osteopathic Medicine?

• The Osteopathic Philosophy• Health is more than the absence of

disease• Health involves the whole person

(body, mind and spirit) and the person’s relationship to others and the world

• Oral Health is essential to Overall Health

Framing the Debate

“Do We Need New Dental Schools?

Vs

“If We Are Going to Have New Schools, How Can We Take Advantage of the

Opportunity?”

Opportunities for New Dental Schools

Many reports/articles/discussions about the need to reinvent dental education

Similar documentation of the slowness of real change

Dozens of presentations over the years about new ways of doing things but progress seems slow

Don’t new schools have an obligation to help move the profession forward?

Are these really “New Models?”

Or, is it that the new schools have a better chance?

Opportunities for New Dental Schools

A “Blank Slate”

Responsibility to the Profession to Lead Change

Innovative Curriculum models

Efficient/Effective Patient Care models

Community-Based Education models

Inter-Professional Education

Oral – Systemic Connection

UNE - MissionUniversity

The University of New England provides students with a highly integrated learning experience that promotes excellence through interdisciplinary collaboration and innovation in education, research and service.

College of Dental Medicine

The mission of the University of New England College of Dental Medicine is to improve the health of northern New England and shape the future of dentistry through excellence in education, discovery and service.

Hallmarks• Holistic Admissions Criteria

• Humanistic Environment: student and patient friendly

• Strong Foundation in Science

• Curriculum built around patient care

• Integrated teaching and learning model that is innovative and evidence-based (use of varied methods)

• Appropriate use of modern technology and Realistic Simulation

• Early and Extensive Clinical Experiences

• Comprehensive Care in Group Practice Model

HallmarksPrevention-Oriented Teaching and Practice

Promotion of community and dental public health

Significant community-based education experience

Development of strategic partnerships to help achieve mission and goals

Research and critical inquiry, inter-professional practice, life-long learning

Professionalism, Ethics, Leadership, Communication, Business Management Skills

UNE CDM GraduatesWill be ethical, caring people;

Will be life-long learners;

Will be capable clinical practitioners who will have the ability to provide complex, high-quality care in an inter-professional health care delivery system;

Will embrace scientific and technological advances ;

Will understand the connections between oral health and general health;

UNE CDM GraduatesWill be partners in the inter-professional health

care delivery systems of the future;

Will be leaders of their own oral health care teams, as they enhance and extend the quality of life in their communities.

Will collectively engage in clinical oral health care, public health practice, biomedical and health services research, education and administration;

Will fulfill their professional obligation to improve the oral health of all members of society;

CDMIBehaviorally oriented Whole File Admissions Reviews

Use of Multiple Mini Interview (MMI) protocol

“Single Pillar” Organizational Structure No departments or divisions Generalist model of education and practice Competency based

Integration of Pre-Clinical Curriculum Hi-tech Simulation based on clinical case scenarios

Integrated Oral Health Science Curriculum General Dentistry based supported by specialists Patient Centered, Group Practice, Grand Rounds

Approach

CDMI (Continued)Use of varied teaching learning methodologies

Small groups Case-based Problem based

Biomedical Sciences integrated and system based Connected to Oral Health Sciences where facilitated by

timing and scheduling Spiral model of curriculum progression in which basic

concepts are revisited throughout curriculum

Capstone, team-taught course in Yr. 2, 2nd Sem Review and reinforce prior learning in B.S. Motivate critical thinking through use of cases Provide better preparation for NBDE

CDMI (continued)

Interprofessional Learning and PracticeCore inter-professional course attended by all first

year students from nine professional programsSecond year course in Head and Neck Diagnosis

co-directed by Osteopathic Medicine and Dental Medicine

Inter-professional health care facility with dentistry as “anchor tenant” but with all other professional programs included

USN Educational Model – Mastery Education

ContemporaryContemporaryClassroomClassroomComplexComplex

Block SystemBlock System

Active andActive and CollaborativeCollaborative

LearningLearning

Assessment/Assessment/Outcomes-Outcomes-Based Based EducationEducation

USN

Block system for didactic courses36 hr course = six 6 hr. daysSupported by contiguous breakout room

configuration to allow for small group, PBL, and active collaboration

Immediate exploration and clarification of core concepts with faculty

USNMastery Education Model

Criterion Referenced and Competency BasedPass/No Pass90% passing gradeAssessments occur within block on Friday with

remediation the following MondayAdditional remediation opportunity in summer for

those with three or more “no pass”

General Dentistry Group Practice Teams

Community-based education for most of 4th year

Focused approach to research

1 Individual Course

Focused Learning / 1 Topic

Mastery of Topic

Increase Active Learning

Rapid Instructor Assessment/Feedback

Peer Teaching

Remediation

Block System:Advantages

Classroom “in the round”;

No one more than 4 rows away from teacher;

5 Breakout rooms – small-group teaching/discussion;

Contemporary Classroom Complex

USN’s Classroom USN’s Classroom ComplexComplex

8-9 am: Formative Assessment / Prior Day

9-10 am: New Material (lecture)

10-11 am: Team Activities + Feedback

11-Noon: Lunch

12 – 1 pm: New Material

1-2:30 pm: Team Activities

2:30-3:00 pm: Feedback, Wrap-up, Loose Ends

Typical Teaching Day

Western University of Health Sciences College of Dental Medicine

Vision

Western University College of Dental Medicine will be a premier center for integrative educational innovation; basic and translational research; and high quality, patient-centered, interprofessional health care, all conducted in a setting that utilizes advanced technology and promotes individual dignity and potential for personal and professional growth.

The WesternU College of Dental Medicine will realize this vision by educating and training highly competent, diverse groups of clinical practitioners who have the ability to provide complex, integrative, high-quality, evidence-based care for patients, families and communities.

Western University of Health Sciences College of Dental Medicine

Mission

WesternU College of Dental Medicine will produce graduates who will be ethical, caring life-long learners; who will collectively engage in clinical oral health care, public health practice, biomedical and health services research, education and administration; and who will fulfill their professional obligation to improve the oral health of all members of society, especially those most in need. They will embrace scientific and technological advances and understand the connections between oral health and general health. They will be partners in the interprofessional health care delivery systems of the future, as well as leaders of their own oral health care teams, as they enhance and extend the quality of life in their communities.

Guiding PrinciplesCritical ThinkingSelf AssessmentLifelong LearningScience Based CurriculumIntegration of basic/behavioral/clinical

sciencesFocus on Overall Health/Oral Health

ConnectionsEarly entry into clinicUse of appropriate technologyProfessionalism/Ethics/ValuesLeadership/Communication/Management

Skills

Curriculum HighlightsBasic/Behavioral Sciences

Systems based approached to basic sciencesChallenges with simply taking med school curriculumEvolving into dental school ownership of biomedical

sciences with integrated case based approach

Interprofessional Experiences Case-base instruction, didactic coursework, community education as well as clinical training and rotations

Integrated Dental Sciences Essentials of Clinical Dentistry

“Bucket approach” based upon patient care Close juxtaposition of didactic material with simulated exercises and patient care Learn procedure, practice to competency, apply in patient care

Curriculum Highlights

Comprehensive Patient Care Group Practice ModelEvidence-BasedPatient CenteredCompetency Driven

Community-Based EducationReal Life ExperiencesPractice ManagementService to Community

Faculty Coming from private practice or directly from residency

programs Possibly contributing to a net gain in faculty? Will require well planned faculty development programs

Inter-Professional Patient Care Center

Interprofessional Clinic

Western University

Evidence-Based Decision Making and Clinical Research – First Year Course

Course Topics and Objectives: Introduction to EpidemiologyIntroduction to Clinical TrialsIntroduction to BiostatisticsEthical and Regulatory Issues in Clinical

InvestigationIntroduction to evidence-based practiceDeveloping a precise question

Western University Introduce students to clinical research methods as well

as basic and advanced concepts of evidence-based practice in the health professions.

Train students to appropriately utilize and evaluate the biomedical literature across health professions.

Prepare students to engage in evidence-based decision making, providing the skills needed to locate relevant online scientific/medical information as well as to evaluate the quality of the research methodologies and statistical analyses reported in the clinical research literature.

Focus is from a clinical practitioner/researcher standpoint rather than that of a basic sciences researcher. This is an introduction to several key concepts, and students are not expected to have a deep mastery of statistics, research methodology, or online bibliographic databases prior to taking the course.

Western University

Develop and utilize effective evidence-based practice search strategies

Critically appraise the evidence for its validity and importance regarding diagnosis and screening, prognosis, therapy and etiology/harm

Apply the results to practice 

Instill in the student an approach to health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence in the context of patient treatment needs and preferences.

Other Initiatives

University owned remote clinicsCommunity Service Learning CentersLocated in Rural, Underserved areasFaculty, residents, dental students, staff practicing

togetherExpose students to patients with more complex

medical and oral health needsOne goal is to have the dental graduates go back

to those rural areas to practice

General Thoughts The more I learn, the less I’m sure of

This is simply an overview

CCI principles do form the basis for much of what is happening

“New” schools, like existing schools, are unique, with individual missions and goals

Doing “new” things or doing “old” things differently will require paradigm shifts, risk taking, extreme flexibility, and willingness to “fail”

Possible to create a different culture, but can it be maintained?

When the going gets tough, will we revert back to what we know?

Special Thanks To:Dr. Lex MacNeil, Midwestern University-Illinois

Dr. Rick Buchanan, University of Southern Nevada

Dr. Steve Friedrichsen, Western University of Health Sciences

Dr. Rick Valachovic, ADEA

The thousands of people who have taught me over the years, both formally and informally

Questions?

Discussion