Comparing Comprehensive Care and Departmental Clinical Education Models: Students’ Perceptions at the University of Tennessee College of Dentistry

Abstract

In summer 2012, the University of Tennessee Health Science Center College of Dentistry transitioned from a departmental clinical education model to a comprehensive care/group leader model. The aim of this study was to investigate the perspectives of the fourth-year class of dental students who, because the transition took place during their training, had experienced treating patients under both educational models. To achieve this objective, a questionnaire was designed to assess the students' opinions on the eficiency of their effort, availability of specialty faculty, stress, collaboration with classmates, and availability of exposure to different practice styles and techniques under the two systems. The students were also given an opportunity to provide open-ended feedback on the shortcomings and advantages of the systems. The Class of 2013 had 81 students, 55 of whom participated in the survey for a response rate of 67.9%. The majority (86%) of the respondents preferred the comprehensive care model and reported feeling that, in it, they were able to accomplish more comprehensive dentistry with greater consistency of supervision from faculty in a more patient-centered environment than in the departmental model. However, 56 percent considered having the same group leader for two years a disadvantage and recommended rotation of at least one group leader every six months. The results of this survey can help this college and other dental schools that are seeking to optimize their educational model to best serve students' educational experience and the dental needs of their patient population.

Dental Students’ Clinical Experience Across Three Successive Curricula at One U.S. Dental School

“…Like many U.S. dental schools over the last 25 years, the University of California, San Francisco (UCSF) School of Dentistry has employed various clinical curricula to ensure students obtain adequate clinical experience and attain required competencies for graduation. Dental schools have introduced such innovative curriculum and assessment formats as comprehensive care, 1 – 6 case completion, 7 , 8 competency examinations, 9 – 12 portfolios, 13 , 14 and community‐based, off‐campus externships 15 – 17 . UCSF has had three major clinical curricular changes since 1992, moving from a discipline‐based curriculum to a comprehensive care curriculum to a procedural requirement curriculum plus externships.…”

Thinking ecologically about clinical education in dentistry

“…The student‐centred approach places a great deal of emphasis on students' educational needs, especially the completion of discipline‐specific procedural requirements . This approach has largely informed the traditional departmental, discipline‐based system of delivering CE . In this system, patients are assigned to students based on the students' educational needs and readiness to provide care .…”

“…Research shows that traditional approaches do not properly respond to the interplay of needs and interests of the stakeholders involved in CE . For instance, Dehghan et al found that whilst students valued the opportunity to provide more comprehensive care under the group practice system, they were concerned about not being exposed to the experiences of instructors and students outside of their group, which they recognised as an advantage of the student‐centred, discipline‐based system . Similarly, Park & Howell found that fourth‐year students favoured a case‐completion system informed by the patient‐centred approach over the traditional procedure‐based system; however, they recognised the insufficient exposure to some procedures as a limitation of the former system .…”

“…Dental education researchers can also play a pivotal role in the development of an ecologically informed system. Although individual studies have reported pros and cons of traditional CE systems, these experiences need to be synthesised. For example, a scoping review on CE systems could systematically identify all the systems developed to date, describe their main characteristics, specify how they have been evaluated, highlight their impact on stakeholders, and identify, at least preliminarily, the conditions under which existing systems may or may not work.…”

Dental Student Perspectives of a Comprehensive-Based Teaching Methodology: A Confidence, Effectiveness, and Challenge Report

“…From one view, it enables students to look upon the greater image of treating patients and not to focus on one precise problem. Furthermore, patients' needs are met, and health care is provided in a proper sequential manner which is not applicable when a “student-centered approach” is practiced [ 9 – 11 ].…”