Combining Technology and Ingenuity to Educate Tomorrow's Dentists
Innovations in Predoctoral Education


During the past decade, biomedical research, approaches to the treatment of disease, and the delivery of health care have all undergone profound changes, necessitating the introduction of innovations designed to improve the quality, efficiency, and relevance of dental education. One situation that comes immediately to mind is the challenge of facilitating students' ability to transition from didactic knowledge to practical, hands-on experience.

This is a challenge that has been with us from the earliest days of dentistry, when the mantra, "see one, do one, teach one," was the basis for an apprenticeship model of hands-on dental education. As dentistry became a learned profession incorporating basic science education and was integrated into a university teaching model, schools throughout the U.S. and Europe exchanged the apprenticeship model for an amphitheater approach that made it possible for a demonstration to be performed by an expert in front of a large class. But this approach, with large groups of students straining to view a limited operating field, had a built-in weakness. Later came the advent of small group demonstrations, but since the small group format requires many instructors per group, as opposed to a single lecturer in front of a large class, a new wrinkle occurred as the range and diversity of teaching styles tended to undermine consistency in the learning experience.

In today's new technologically driven environment, these problems are no longer insoluble. Video presentations, particularly digital online video presentations, provide students with a pragmatic and flexible approach to facilitating the transition from didactic to practical experience. Videos can be viewed on any computer; they can be projected in a classroom, or even viewed on an iPod® while exercising. They can also be uploaded to online sites such as Blackboard Learning Systems™ or iTunes U (both available to NYU dental students). Using this new technology, students acquire a new set of skills that focus on self-directed learning. They have great flexibility in designing the study methods that work best for them. They can access the training programs in advance of the laboratory session; use the programs during the laboratory session; and/or review them later at their leisure in preparation for treating a patient.

Given the advanced state of digital learning technology, it's ironic that very few viable digital video training products are available within dental education. This is not to say that dental schools do not use videos; on the contrary, many dental schools contract with private production companies to direct, edit, and produce teaching videos that can cost well over $50,000 per video. But once these are produced, they cannot be altered, which rapidly leads them to become extinct. Several years ago, my colleagues, Drs. Kumar Shanmugam and William F Skiba, and I got together and decided to utilize the skills we had acquired as videography and video editing hobbyists to produce a series of eight streaming videos featuring expert clinicians demonstrating and describing fixed prosthodontic preclinical and clinical procedures, step-by-step.

Over the past several years, the productions have become increasingly sophisticated. New high-definition cameras allow enhanced and enlarged unobstructed close-up views that can be shared with students, creating a net video effect that enables students to view the procedure from three synchronous views: from the side, in front of the operator, or as the operator, thus viewing the procedure as if they were present and moving around the patient.

The carefully scripted videos have an audio track that explains precisely "why" the procedure is performed as well as "how" it is being performed. The entire video is carefully edited to meet the standards of the course director using state-of-the-art digital editing software. Everything is done in-house, with our team having sole responsibility for filming, editing, and final formatting of all videos.

As our education program changes and adapts to reflect new advances in care, we are able to edit the production to reflect the latest developments, update our video library, and expand the library as needed. Student response to the videos has been extremely enthusiastic. In fact, after viewing the video production available in the D2 fixed prosthodontics course last year, the second-year students asked for videos in other areas. The latest NYU College of Dentistry training program video focuses on basic wax-up techniques for an anterior and a molar tooth.

Under the supervision of the department chair, Dr. Mark S. Wolff, and with the assistance of Dr. Barnett Bucklan, director of the dental anatomy and first-year operative dentistry courses, a talented dental student, Dr. Alberto Ambriz, Class of 2009, was videotaped performing the wax-up of an anterior and a posterior tooth. As a result, students are now able to view in great detail the technique of waxing the teeth for dental anatomy at their leisure. This allows a better understanding of the esthetics, form, and function of the tooth being reproduced. In addition, it liberates the faculty from the burden of performing demonstrations and allows considerably more time for students to self-evaluate and to be evaluated by their supervising faculty.

At the request of our students, a restorative dentistry video demonstrating Class I and II preparations for amalgam as well as the final restoration has also been produced. This unique video, filmed in high definition, allows an unmatched close-up view of the procedure using two camera angles. As a result, the rubber dam placement, securing the clamps with floss, the positioning of the handpiece and the related action of the cutting instrument now become visible on a large-scale image. Being able to follow the preparation and the placement of the restorative material, all in real time, provides an excellent, comprehensive guide to this core procedure. This video also allows students to view and review every aspect of the procedure at their leisure, as access to this visual aid is online. Plans are currently underway to produce a full series of restorative dentistry videos.

This in-house project, started in 2005, now consists of a library of 14 DVDs ranging from ergonomics in the simulation lab, to pouring of alginate impressions, to full coverage preparation and three-unit bridge preparation and construction of a provisional restoration. The video library, offering an outstanding opportunity to educate and to learn, is available to NYU dental students 24 hours a day.