ISSUE
     
Educating Men and Women of Science
Educating Master Clinicians: The Cornerstone of a Progressive Oral Health Workforce
 


Martha J. Somerman, DDS, PhD
Dean, University of Washington School of Dentistry








I like to describe the kind of graduate that the University of Washington School of Dentistry seeks to educate as a “master clinician,” a term that has affinities with Dean Bertolami’s “men and women of science.” Both phrases reflect the goal of educating dentists who are creative thinkers, are grounded in a solid scientific foundation, and have superb clinical skills. These are dentists who continually seek and incorporate evidence-based philosophies into their patient care practices.

But more important than the words used to describe such dentists is the essential fact that they are lifelong learners, who embrace, rather than fear, new initiatives and the opportunities they provide to explore alternative treatment approaches. At the same time, they are scientifically savvy enough to evaluate new diagnostic and treatment technologies in order to determine if they are, in fact, better than existing products and therapies. You can tell if a dentist is a “master clinician/man or woman of science” by looking for the following characteristics:

  • An appreciation for research/discovery
  • The desire to help advance the state of preventive and treatment therapies by critically assessing new modalities
  • The ability to understand and critically evaluate published research findings
  • The habit of being an early adapter of new knowledge in practice, based on evidence supporting improved outcomes
  • A steady effort to advance clinical skills through continuing education courses and similar initiatives
  • A continuing engagement in dental education after graduation

In order to produce such dentists, dental schools must provide an environment that fosters innovation, discovery, and scholarly activity -- an environment that makes it possible to educate as well as to teach students. To some, these words may seem interchangeable, but I submit that there is a significant difference. To me, teaching implies the transfer of information from person to person -- from teacher to student. And while this will continue to be vital, the dynamic, rapidly changing environment in which we live demands that we do more than transfer information. In fact, information is rapidly becoming a commodity available through many channels. We must focus on knowledge, not information, and this demands that we create a “culture” of education that emphasizes the process of learning through interactions, engagement, discourse, and critical analysis.

To this end, the University of Washington School of Dentistry recently received a four-year NIDCR/NIH R25 evidence-based curriculum grant, which seeks to create a more supportive, knowledge-based environment by fostering increased research/scholarship and altering the attitudes of faculty/students. An example is our commitment to engage faculty in an array of activities designed to develop the skills they need to deliver integrated biomedical/clinical content; research-oriented, evidence-based approaches to dental education; and translational, case-based teaching methods emphasizing the application of new science/technologies to patient care. We understand that in order to develop “master clinicians,” we must undertake a comprehensive faculty development initiative to ensure that our students have models to follow who are themselves “master clinicians.”

We have also modified curricula to create greater interdisciplinary-focused opportunities, including having students and faculty review and critique scientific literature and/or engage in research across a variety of basic, translational clinical and public health topics. Such programs start at day one, with a modified, problem-based course in social issues designed to enable freshman to become rigorous thinkers. The course allows groups of students and faculty mentors to address community oral health needs and develop strategies to solve existing challenges to access to care. Each team presents its solution to a given problem to the entire class as a “final” project for the course. An added benefit of stimulating active, inquiring minds among students is that it can ultimately serve to attract more of them into academic careers.

The Challenges -- and Rewards -- of Curricular Reform

Most dental schools suffer from a densely packed, memory-based, test-driven, prescribed curriculum, making it difficult to introduce educational reforms. Fortunately, there are many innovations and opportunities available to assist us in identifying ways to overcome this difficulty. Indeed, our leading dental organizations (ADEA, ADA, IADR/AADR) and schools have been addressing the issue of information overload. We need to continually update our curriculum as new information is developed and to discard older, less effective practices. If we do not, and if we do not continue to respond to the explosion of new scientific information, do not innovate, do not address issues adequately, including new technologies, disparities in oral health, the economic and policy environment for dental schools, and dentistry’s relative isolation from the rest of health professional education, our profession risks becoming marginalized -- relegated to producing “technicians” trained at “trade schools.”

If we succeed -- and we must -- we will lay the foundation for an educational environment that is flexible, innovative, and capable of creating a progressive oral health workforce appropriate to the expectations and demands of the 21st century. This will be a workforce that supports diversity in thinking and in human resources; one that encourages innovative, alternative approaches to issues; one that approaches oral health care with a superb set of skills and an unmatched commitment to excellence; one that is eager to take on new challenges; and one that is committed to social responsibility.

I’d like to say a word about the role of “technology transfer” in the development of a progressive oral health workforce. One aspect of a progressive workforce is its ability to adopt new paradigms for treatment when the evidence is presented. Indeed, the adoption of research findings into practice is the ultimate goal. Accordingly, a key challenge is how, within the university setting, to best interact with industry to transfer “new” knowledge into practice for the betterment of society. We need to ask ourselves: “Are current models best for the transfer of science and technology to public use, or might there be spinoffs that can mitigate problems while retaining benefits?”

One possibility might be a closer, more intimate relationship between discovery and product development. Perhaps universities and industry should become more interconnected in the whole transfer process. Examples that are already occurring include incubator facilities sponsored by universities to house private companies that utilize research developed within the university. Other new models provide opportunities for students to intern and work with companies. Such arrangements may assist in retention of faculty, provide job opportunities for students, and generate greater financial rewards to the university because of ownership interests retained in these companies.

Going forward, I believe that all dental schools must address these issues, just as they must address the challenge of educating students who are capable of serving not only the oral healthcare needs of the nation, but also as primary healthcare resources for screening/risk assessment of a wide variety of diseases that may be detectable within the oral-dental craniofacial region. The fact that more people visit dentists annually than visit other primary healthcare providers will be the basis for achieving this important health-gatekeeper role. Dental schools therefore need to provide much stronger programs in the health sciences, in the basic-translational sciences, in psychology, and in health technology. As a result, the demands on student time will be greater than ever.

An Invitation to NYUCD

As a graduate of the NYU College of Dentistry, I am proud of the huge strides that my alma mater has made in recent years in becoming one of the leading dental schools in the United States. I would welcome the opportunity to join forces with NYUCD to see if, together, we could develop a program that would set a new standard in dental education by addressing the challenges I’ve outlined. I believe that the result would be increased attention to basic-translational-clinical science that would stimulate student interest in dentistry -- and in academic career paths -- to a greater extent than ever before, as well as increased interest among graduates in maintaining involvement with the clinical programs at their alma mater.