Becoming a dentist: faculty perceptions of student experiences with threshold concepts in a Canadian dental program

Abstract

Background: In each discipline, there are moments where students “get stuck” in their education and/or training and are often unable to move forward. These moments may be caused by threshold concepts as they represent a portal that students must cross in order to become successful in their chosen profession. This study investigated the threshold concepts from the instructors’ perspective that students must navigate as they transform from learners to dentists within a dental program. Methods: Two focus groups with faculty members within the School of Dentistry, University of Alberta were completed in the fall of 2017. Focus groups explored the faculty’s perception of the students’ transition from learner to dentist, difficult moments in the program, and the students’ ability to navigate the program successfully.Results: A qualitative phenomenographic analysis of the faculty focus group transcripts identified four potential threshold concepts within the dental program: 1) dealing with the whole patient, 2) accountability, 3) that you may not know everything, and 4) problem solving and adapting during practice.Conclusion: This study demonstrates that there are concepts within a dental program that faculty believe students must navigate in order to transition from learner to dentist. These concepts may inform curriculum design as well as other disciplines in the health sciences.

Threshold concepts in health professions education research: a scoping review

“…Almost half of the articles tried to identify possible TCs in HPE (n = 26), both in undergraduate and postgraduate education. A vast majority of articles employed qualitative methods to identify TCs (Barradell & Peseta, 2016 ; Barron et al, 2020 ; Bhat et al, 2018 ; Blackburn & Nestel, 2014 ; Bowman, 2017 ; Evgeniou et al, 2015 ; Green & Rasmussen, 2018 ; Hill, 2017 ; Kolar & Janke, 2019 ; Moeller & Fawns, 2018 ; Morgan et al, 2019 ; Neve et al, 2017 ; Nicola-Richmond et al, 2016 ; O'Callaghan et al, 2020 ; Tanner, 2011 ) and a few used mixed methods (Khatri et al, 2020 ; Leidl, 2018 ; Neve et al, 2020 ). Six articles identified TCs from a theoretical perspective, arguing for the validity of TCs on the basis of previous research and educational or theoretical models (Clouder, 2005 ; Fortune & Kennedy-Jones, 2014 ; Howarth et al, 2018 ; Kempenaar & Shanmugam, 2018 ; Larson, 2020 ; Stacey & Stickley, 2012 ).…”

“…Other articles identified TCs in a specific area within professions, such as mental health within nursing (Leidl, 2018 ; Stacey & Stickley, 2012 ), professionalism among medical students (Neve et al, 2017 ), internal medicine for residents (Bhat et al, 2018 ), psychiatry (Khatri et al, 2020 ), paediatric surgical training (Blackburn & Nestel, 2014 ), practice education for occupational students (Tanner, 2011 ), or population health (Neve et al, 2020 ). Others identified TCs in an entire profession or educational programme, e.g., occupational therapy (Fortune & Kennedy-Jones, 2014 ; Howarth et al, 2018 ; Larson, 2020 ; Nicola-Richmond et al, 2016 ), physiotherapy (Barradell & Peseta, 2016 ), dentistry (Green & Rasmussen, 2018 ), nursing (Stacey & Stickley, 2012 ) and pharmacy (Kolar & Janke, 2019 ). Some argued for the existence of TCs in HPE more generally (Clouder, 2005 ; Kempenaar & Shanmugam, 2018 ; Wearn et al, 2020 ), while one focused on interprofessional education (Morgan et al, 2019 ).…”

“…In the empirical work, the articles went about identifying TC in a number of ways. A variety of informants were used, although many used learners such as students e.g., (Bowman, 2017 ; Green & Rasmussen, 2018 ) or trainees e.g., (Blackburn & Nestel, 2014 ; O'Callaghan et al, 2020 ). Others used clinical educators or educationalists e.g., (Barradell & Peseta, 2016 ; Tanner, 2011 ) and some combined several stakeholders as respondents, such as students, educationalists and professionals (Hill, 2017 ; Khatri et al, 2020 ) or students, educationalists, and professionals (Nicola-Richmond et al, 2016 ).…”

Threshold Concepts in Preclinical Medical Education: Students’ Perceptions

“…Another study conducted by Green et al was similar in format to our study and used focus groups to determine TCs among faculty members [19,21]. However, both the Green and Arnold studies relied on the faculty to identify the initial threshold concept, while our study shifts the focus to the students identifying the concepts [20,21].…”