The PEARL (Practitioners Engaged in Applied Research and
Learning) Network recently asked Dean Bertolami about his
views on the impact of practice-based research networks on
dental education today, and in the years to come. The
interview appears below.
PEARL: What do you see as the impact of
practice-based research on dental education?
Dr. Bertolami: Practice-based research
networks (PBRNs) have the effect of encouraging dental
schools to educate a different kind of practitioner. For
example, the work that PBRNs are doing to develop
evidence-based resources for practitioners reinforces and
supports the increasing emphasis at NYU College of
Dentistry on developing men and women of science.
Put simply, a man or woman of science is a sophisticated
consumer of research. Not every graduate has to become a
scientist, in the sense of becoming a producer of new
knowledge; but a learned profession does require that every
graduate be able to think for herself or himself, be an
intelligent user of research, able to critique it, and
comfortable with the structure and syntax of modern
biomedical science. Only by becoming a person of science is
there any hope that the practitioner will be able to
acquire and assimilate new knowledge and adapt to the
changes in practice and in the profession that the future
requires.
Developing men and women of science is a pillar of
NYUCD's strategic plan. At NYUCD, our curriculum provides a
foundation of knowledge in epidemiology and epidemiological
methods that teaches the student how to read and analyze
articles by providing a rich and utilitarian set of
"professional literature analysis skills," and a grasp of
the context for use of these critical thinking skills
within the challenges of providing "best patient care" in
their future dental practices.
When you implement an evidence-based curriculum in a
dental school, and teach the value of implementing these
standards in real-world clinical practice, then in
principle you begin to diminish the distinction between
being in school and being in practice.
PEARL: Can PBRN members play a role in
preparing students to become men and women of science?
Dr. Bertolami: Yes. The
practitioner-investigators can be role models who help
students understand the connection between doing well in
evidence-based classes and succeeding in future clinical
practice. Schools should consider creating opportunities
for interaction between students and the
practitioner-investigators (P-Is) in the school's clinics
or in the practitioners' offices.
PEARL: So you see a role for PBRN
practitioner-investigators on the faculty?
Dr. Bertolami: Yes. Through the PBRNs,
we are creating a cohort of practitioners who now have both
the confidence and the interest in going back to a dental
school to teach. Part of the reason for the shortage of
faculty in dental schools is the lack of ability of
practitioners to return seamlessly into the academic
environment because they've been out of it for so long.
They might have an interest in teaching, but they don't
often have the skills that are needed.
People who are fully engaged intellectually in a PBRN
will not have the problem of integrating into the academic
environment, and will recognize that they have skills and
interests that are valued by academia. A person who has
been in practice for 20 years and can articulate problems
and issues through practice-based research has talents that
would be valued in an academic environment.
If you can conceptualize a project, articulate your
ideas, and convince others within the PBRN system that
these are worthwhile questions, propose possible solutions
and a methodology for evaluating them, and then see this
through to an outcome that results in a change in clinical
practice, you can have an energizing impact on the
educational process.
The question is, what kind of dentists are we going to
present to our students as role models? A thinking dentist
who has had the exhilaration of conceiving an idea and
taking it to fruition can be an immensely inspiring role
model.
PEARL: How can PBRNs and dental
educators work more closely to further each other's
goals?
Dr. Bertolami: Dental schools want to
conduct research leading to advances in patient care and
treatment, and then teach their students about these new
concepts. Practice-based research networks want to test new
ideas in a real-world environment. The two can work
together to further these goals through a continual cycling
of ideas. For example, research faculty develop a solution
for a clinical problem, feed the concept into a PBRN for
testing, and the PBRN subsequently sends its findings back
to the school for additional evaluation, and, if
appropriate, for incorporation into the school's
curriculum.
The PBRN capitalizes on the notion that you can't keep
ideas within the academic center, where they may die or not
be adequately elaborated. With a PBRN, these ideas are put
into the hands of talented people with a scientific
orientation. What comes back are applications that could
never have been imagined.
Practice-based research represents a departure from the
traditional, NIH-funded research model, in which studies
are performed in isolation in an academic center based on
the particular idiosyncrasies of an investigator, who must
publish that work and send it out into the ether, where
somebody someplace might pick it up and reduce it to
practical application.
PBRNs have an important role to play in the process of
advancing research from basic science to clinical
application. While bright ideas are common, taking those
ideas and developing them is of central importance. The
PBRN helps to reconcile the differences between what a
bench lab scientist and a practicing dentist consider
important.
The NYU PEARL Network, for instance, can evaluate
practical applications for ideas that originated in the
College of Dentistry's basic science laboratories and were
further developed in the NYU College of Dentistry's
Bluestone Center for Clinical Research or in the NIH-funded
NYU Clinical and Translational Science Institute.
PEARL: Looking to the future, how do
you see the relationship between PBRNs and dental schools
evolving?
Dr. Bertolami: Educators at
universities like NYU take a broad view of dental
education. We see it as much more than a transaction in
which a student has to learn this in order to do that. When
they graduate, we want students to feel that they have
acquired a way of thinking about clinical problems and a
certain level of expertise in assessing treatment
methodologies that is much deeper than "today I graduated
and I know these techniques." Tapping into the PBRN,
strengthening our ties to the PBRN, and encouraging
interaction between students and PBRN practitioners will
broaden the impact of dental education.