“ New Dental Schools ” What Are They Doing Out There? (And Do We Really Need Them?)

1. “New Dental Schools”What Are They Doing Out There?(And Do We Really Need Them?)

2. 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

3. 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

4. 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

5. 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?”

6. 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?

7. 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

8. UNE - Mission University • 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.

9. 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

10. Hallmarks • Prevention-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

11. UNE CDM Graduates • Will 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;

12. UNE CDM Graduates • Will 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;

13. CDMI • Behaviorally 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

14. 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

15. CDMI (continued) • Interprofessional Learning and Practice • Core inter-professional course attended by all first year students from nine professional programs • Second 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

16. Active and Collaborative Learning Contemporary Classroom Complex Block System USN Educational Model – Mastery Education Assessment/ Outcomes-Based Education

17. USN • Block system for didactic courses • 36 hr course = six 6 hr. days • Supported by contiguous breakout room configuration to allow for small group, PBL, and active collaboration • Immediate exploration and clarification of core concepts with faculty

18. USN • Mastery Education Model • Criterion Referenced and Competency Based • Pass/No Pass • 90% passing grade • Assessments occur within block on Friday with remediation the following Monday • Additional 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

19. 1 Individual Course Block System / USN

20. Block System:Advantages • Focused Learning / 1 Topic • Mastery of Topic • Increase Active Learning • Rapid Instructor Assessment/Feedback • Peer Teaching • Remediation

21. Contemporary Classroom Complex • Classroom “in the round”; • No one more than 4 rows away from teacher; • 5 Breakout rooms – small-group teaching/discussion; USN’s Classroom Complex

22. Typical Teaching Day • 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

23. 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.

24. 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.

25. Guiding Principles • Critical Thinking • Self Assessment • Lifelong Learning • Science Based Curriculum • Integration of basic/behavioral/clinical sciences • Focus on Overall Health/Oral Health Connections • Early entry into clinic • Use of appropriate technology • Professionalism/Ethics/Values • Leadership/Communication/Management Skills

26. Curriculum Highlights • Basic/Behavioral Sciences • Systems based approached to basic sciences • Challenges with simply taking med school curriculum • Evolving 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

27. Curriculum Highlights • Comprehensive Patient Care • Group Practice Model • Evidence-Based • Patient Centered • Competency Driven • Community-Based Education • Real Life Experiences • Practice Management • Service 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

28. Inter-Professional Patient Care Center

29. Interprofessional Clinic

30. Western University • Evidence-Based Decision Making and Clinical Research – First Year Course • Course Topics and Objectives: • Introduction to Epidemiology • Introduction to Clinical Trials • Introduction to Biostatistics • Ethical and Regulatory Issues in Clinical Investigation • Introduction to evidence-based practice • Developing a precise question

31. 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.

32. 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.

33. Other Initiatives • University owned remote clinics • Community Service Learning Centers • Located in Rural, Underserved areas • Faculty, residents, dental students, staff practicing together • Expose students to patients with more complex medical and oral health needs • One goal is to have the dental graduates go back to those rural areas to practice

34. 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?

35. 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

36. Questions?Discussion