ISSUE
               
Research in Focus
A PEARL Network Interview with Dean Bertolami Asks: "Can Practice-based Research Broaden the Impact of Dental Education?"

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.