bluuebunny/crossref_metadata_2025 huggingface dataset:
Issues in the economic evaluation of community water fluoridation
Authors: White BA , Antczak‐Bouckoms AA , Weinstein MC
Published: June 2020

Community water fluoridation has long been recognized as an effective public health intervention in the prevention of dental caries. The recently documented secular decline in dental caries, however, presents for policy makers the challenge of appropriately allocating limited health care resources between a variety of health care programs. Appropriate economic assessment of these alternatives becomes critical for rational distribution of such resources. Cost‐benefit and cost‐effectiveness analyses are techniques that, when used correctly, can guide policy makers facing such decisions. This paper reviews and critiques the published literature assessing the cost effectiveness and cost benefit of community water fluoridation using criteria developed for economic evaluation. Eight papers met the criteria for inclusion in the present study. In general, the articles failed to incorporate the declining prevalence of dental caries into their analyses and to fully document costs associated with water fluoridation. Treatment savings from dental care averted secondary to water fluoridation were not appropriately incorporated into the cost‐effectiveness analyses, thereby overestimating the marginal cost associated with fluoridation. Specification of outcome measures to assess the consequences of water fluoridation failed to incorporate the dynamic nature of dental disease. Suggestions for improving the generalizability and usefulness of future cost‐benefit and cost‐effectiveness analyses are made.
Dental education 1989: how are we adapting to change?
Authors: Wotman S
Published: June 2020

Multiple pressures on the nation's dental schools have come in the form of a declining applicant pool, new university expectations of scholarship, and a changed professional environment for the dentist. The declining applicant pool led to a first‐step response: declining enrollments. Schools are now moving to a new phase in which they must cope with severe fiscal pressures simultaneously with developing new programs to equip the dentist for the changed professional environment. Factors in the new environment for dentistry are discussed, including changing demography and distribution of disease, new technology, and the changed marketplace. Fiscal survival options are reviewed, as are emerging differences between public and private schools. The recent experience of five schools seeking to adapt to fiscal and environmental pressures is described, and six criteria are suggested as useful in measuring the success of these (and other) schools. Crucial issues are discussed from the perspective of the dental school and the university. The value of the dental school as a major resource for the university is stressed, as is the important role of university administrators in providing the necessary conditions for schools that must change.
Perceptions of stress among third‐year dental students
Authors: Grandy TG , Westerman GH , Combs CE , Turner CH
Published: June 2020

The purpose of this study was to identify the perceived stress of third‐year dental students using a large sample (four classes). The dental environmental stress (DES) questionnaire was administered to 263 (87.7 percent) third‐year students from 1984 to 1988. The top six stress items, as perceived by third‐year students, included examinations and grades, graduation requirements, inconsistency of professor's feedback, patient tardiness or no show, atmosphere created by clinical faculty, and financial responsibilities. In addition, 15 of the 38 DES questionnaire items were considered moderately stressful or very stressful by at least 34.0 percent of the students.
Construct and predictive validities of the Perceptual Ability Test
Authors: Kramer GA , Kubiak AT , Smith RM
Published: June 2020

The construct and predictive validities of the Perceptual Ability Test (PAT) were examined. The results indicate that the PAT is a multidimensional test of spatial abilities, with each of the PAT subtests exhibiting different predictive validity. Furthermore, a linear combination of the PAT subtest scores was found to be more predictive of first‐year dental school technique performance than the total PAT score.
Infection control in dental school radiology
Authors: Katz JO , Cottone JA , Hardman PK , Taylor TS
Published: June 2020

U.S. and Canadian dental schools were surveyed concerning infection control practices in dental radiology. The majority of respondents reported surface disinfection of intraoral projection operatories (55 percent) and panoramic operatories (61 percent) before or after each patient. The most frequently used surface disinfectant was iodophor. Most schools routinely disinfected the x‐ray cone (89 percent) and tubehead (87 percent) of intraoral x‐ray machines; however, many did not disinfect the control panel (44 percent) or the exposure button (27 percent). Although 100 percent of respondents reported student use of disposable latex gloves when exposing intraoral radiographs, 27 percent did not use gloves when processing radiographs. Fifty‐six percent did not routinely disinfect countertops in the darkroom.
A theory of motor performance and its applications to preclinical dental skill acquisition
Authors: Feil PH
Published: June 2020

This article reviews one theory of motor performance that was derived from a large body of research findings. The validity of any theory depends on the extent to which it can generate testable hypotheses. Based on a number of applied investigations in the preclinical setting, several predictions developed from this theory have been supported. These, as well as other, potential applications are discussed and a model of preclinical instruction derived from the theory is presented.
Comparing learning logs and note summaries in a dental research methods course
Authors: Knoff E , Rugh JD , Littlefield JH
Published: June 2020

This paper reports a study that examines how two types of writing influenced dental students' performance in critical thinking and recall in a graduate research methods course. Forty‐five students in this five‐week, lecture‐based course were stratified by dental specialty and randomly assigned to one of two groups. The treatment group kept learning logs, expressing personal understanding of lecture material; a second group wrote note summaries, entailing the reorganization of key lecture points. Each student was asked to write for a ten‐minute interval during each class meeting. Mean scores for the log writers were higher on a post‐course essay measure of critical analysis; note summarizers performed better on recall; while in the direction predicted, differences did not reach statistical significance. Note summarizers' attitude toward future use of their activity in other classrooms was more positive and they complied more highly with their activity than did the log writers. This preference for the note summary method suggests that students may find the structured nature of the summary more useful when being introduced to a dental concept.
The Pew National Dental Education Program at the University of Florida College of Dentistry
Authors: McNeal DR , Mackenzie RS , Leo AL , Legler DW
Published: June 2020

The University of Florida College of Dentistry is located in a dynamic environment. Socially, economically, and demographically, the state of Florida manifests changes reflective of the entire nation, i.e., increasing numbers of elderly and minorities, a fluctuating, diversified economy, and altered cultural values. The explosive growth unique to this state has both positive and negative implications for all aspects of its culture and economy. The college resides in a maturing, research‐oriented university facing vigorous competition from other major universities in the state. Within the Health Science Center, the college was occupied during the first decade of its existence with development of an innovative curriculum, and now it must turn its attention to a new emphasis on research and service. A process of strategic planning was conducted at the University of Florida College of Dentistry from January 1986 through June 1987. Four consultant groups representing the college, the university, organized dentistry in Florida, and outside consultants, were guided by a steering committee in a thorough evaluation of the external and internal environment of the institution.(ABSTRACT TRUNCATED AT 250 WORDS)
Dentistry's future at the University of Southern California
Authors: Crawford WH
Published: June 2020

Participation in the National Dental Education Program has been a most important activity. It has had great impact on the future well‐being of the USC School of Dentistry. Success in Phases 1 and 2 was, of course, important. However, the involvement in training sessions, where ideas were exchanged and new skills learned, was probably of more importance. Communication with university officials suddenly became easier–we now spoke a common language and could respond more effectively than before. While the outcomes will be important in changing the school's course, the process leading to the outcomes will also produce significant change. Planning took on new meaning at USC. We are now able to respond to opportunities that come knocking at our door. We are able to see relationships previously invisible. We are beginning to recognize that what each does, in whatever activity, matters a great deal. We–faculty, students, staff, and alumni–are interdependent to a larger degree than previously thought. Challenging years are in store for the USC School of Dentistry. Much needs to be done to ensure dentistry's future at USC into the 21st century. The school is located at the right place at the right time. The external environment beckons for increased involvement by the School of Dentistry. If the school can address the challenges posed by the changed internal environment, it is well positioned to become the most important resource in dental education, in dental care, and in dental information in the Southwest.
Faculty status in a climate of change
Authors: Kennedy JE
Published: June 2020

Schools of dentistry that continue to conduct predoctoral dental education programs were surveyed to determine the status of full‐time faculty and permit a comparison to responses made in 1980 to the identical survey. The response rate was 72.7 percent and included a representative distribution of schools. Since 1980, there has been a decrease in the number of full‐time clinical faculty while at the same time the proportion of clinical faculty with tenure has increased. The development of dual tracks and the appointment of full‐time, nontenure‐trackfaculty forecasted in 1980 has come to fruition. Such appointments represent an increasing proportion of clinical faculty. The mean age of faculty has not changed appreciably due primarily to early retirement, and the five‐year turnover rate remains relatively constant at 33 percent. Dental schools, at least as reflected in the tenure review process, would appear to be imposing more stringent expectations for scholarship. This finding, coupled with the growing concern that in the future there will be a shortage of adequately trained clinical faculty capable of entering the mainstream of biomedical or behavioral research within academic health centers poses a challenge for all concerned with the viability of dental faculties.
Incidence of measurement disturbances in the Dental Admission Quantitative Reasoning Test
Authors: Smith RM , Kramer GA , Kubiak AT
Published: June 2020

This paper describes the incidence of inconsistent person‐response patterns in the Quantitative Reasoning Test (QRT), which is part of the Dental Admission Test (DAT) battery. using the Rasch person analysis approach to estimate the likelihood of a response pattern resulting from only two factors (the difficulty of the items and the ability of the person), a statistical profile of inconsistent response patterns was developed for a sample of students taking the DAT. The results of two test dates, April 1987 and October 1988, were included in this study. A random sample of 1,000 persons was drawn from each of these two test administrations. For the Fall 1988 sample, the person analysis was supplemented by a questionnaire designed to check the correspondence between a student's self‐reported response behavior and the statistical profile provided by the person analysis. The analysis of the two samples of response patterns indicates a high incidence (50 percent+) of atypical response patterns on the test. This has serious implications for the admissions procedure since many of the atypical response patterns invalidate the standard scores reported for those students.
Nutrition in the curriculum: medical experience
Authors: Shils ME
Published: June 2020

Nutrition in the Curriculum–Medical experience, current practices, and educational status in U.S. medical schools are briefly reviewed. There continues to be a need for more adequate instruction of clinical nutrition to physicians in training and in practice. A major problem is the failure to provide patient oriented, case‐related, nutrition teaching in the clinical years to all clinical clerks. Desirable changes are listed to help achieve better training in this field.
A theoretical model for understanding dentists' behavior in treating patients with AIDS
Authors: Chen MS
Published: June 2020

This paper attempts to expand on a model from the theory of reasoned action to help us identify and better understand the reasons dentists do or do not treat dental patients with, or at risk for, AIDS. We propose in the model that the dentist's actual behavior in treating dental patients with, or at risk for, AIDS, in his or her practice is a function of both his or her intention to treat such patients and his or her nonvolitional factors relevant to the behavior. The dentist's intention to treat patients with AIDS or HIV infection, or those belonging to high risk groups, is influenced by two belief components: (1) attitudinal variables, which are the dentist's beliefs about the consequences of treating such patients and the value that these consequences have for him or her; and (2) normative variables, which indicate the dentist's perceptions of how his or her reference groups view the treatment of such patients in his or her practice and his or her motivation to comply with those views. Finally, both the two belief components and the nonvolitional factors are affected by the personal characteristics and the environmental variables.
Accreditation of predoctoral dental education: clinical outcomes assessment
Authors: Boyd MA , Bennett IC , Bentley KC
Published: June 2020

The Curriculum Outcomes Review and Evaluation (CORE) system of outcomes assessment used in the accreditation of Canadian Dental Faculties by the Commission on Dental Accreditation of the Canadian Dental Association is described. The CORE system, which has become an integral part of the regular accreditation site visit of Canadian dental predoctoral programs consists of (a) two methods of chart review, (b) assessment of the performance of a random sample of final year students in both diagnosis and treatment planning and in case presentation, (c) a structured observation in the clinical setting, (d) the application of a detailed and focused survey instrument prior to the site visit, and (e) the solicitation of feedback from involved students, faculty members, school administrators and accreditation site visitors. The overall response to the CORE program was favorable and plans to expand the program to dental hygiene accreditation are described.
North Carolina AEGD model
Authors: Brantley F
Published: June 2020

The financial resource and expense management experience of the University of North Carolina Advanced Education in General Dentistry program has been presented. The program relies heavily on clinic productivity and effective financial management to counter challenges imposed by a diminishing state budget appropriation to the School of Dentistry and the lack of financial flexibility within the state university system. The School of Dentistry is firmly established and highly regarded within the university; administrative support for the program from within the school has been substantial and is ongoing. The program continues to actively pursue external funding applications; nonetheless, resource augmentation to date has been a largely internal matter through maximal and efficient use of existing means.
An experimental evaluation of the effectiveness and efficiency of the leadup activity
Authors: Feil P , Reed TR , McMillen SD , Killip JW , Purk JH
Published: June 2020

The positive effects of a leadup activity on the production of intracoronal operative preparations have been documented in earlier studies. However, an absence of certain controls may have jeopardized the validity of the earlier study, and an adequate test of the innovation's efficiency was not undertaken. The purpose of this investigation was to evaluate the effects of a leadup activity implemented as part of the scheduled laboratory course, when the amount of supervision provided to the experimental subjects during the entire course was reduced significantly, and when subjects were assigned randomly to the two conditions. Calibrated raters, blind to group affiliation of products, graded all preparations. Mean scores for the experimental group (n = 35) were superior to those of the control group (n = 29) for all five preparations, and were statistically significantly (p less than .05) higher on three. Self‐evaluations were equivalent to rater evaluations for subjects in the experimental group but not for those in the control group. Self‐reports suggest that students receiving leadup training used fewer teeth to practice each of the preparation styles. Anecdotal data indicate that instructors in the experimental group may have found their job no more difficult than it had been in the past. It is concluded that the leadup activity improves performance and increases efficiency as measured by the faculty‐student ratio and amount of practice required by students.
Determinants of dentists' geographic distribution
Authors: Beazoglou TJ , Crakes GM , Doherty NJ , Heffley DR
Published: June 2020

Practice location may have greater economic importance today for dental students and dentists who are considering relocation and/or expansion to new sites than in the past. Yet, a literature review easily leads to the inference that practice location decisions are far too complicated and individualistic for there to be any systematic pattern of dentists' geographic distribution. This paper specifies and estimates an economic model that attempts to explain the distribution of dentists in particular market areas in the state of Connecticut and to test the hypothesis that the distribution, rather than exhibiting randomness, adheres to the prediction of theory. The findings show that the geographic distribution of dentists is significantly related to a few key variables. Given these results, and because this model can be applied to other areas and uses data that are readily available for any market area, it may be useful for educators involved in helping dental students with their practice location decisions.
Decision analysis for periodontal therapy
Authors: Holtzman S , Kornman KS
Published: June 2020

Current decision‐making approaches in clinical medicine and dentistry are based on principles developed when diagnostic and therapeutic options were few. The rapid pace of new technology development and the role of third‐party payment systems are increasingly requiring that health‐care providers and patients confront very complex decisions. These decisions typically involve significant uncertainty (e.g., How will a specific patient respond to each possible treatment?) and difficult tradeoffs (e.g., How much are patients willing to pay in money, time, and treatment effectiveness to avoid pain and discomfort?). This paper discusses high‐quality decision‐making. High‐quality diagnostic and therapeutic decisions result from a well‐developed decision basis that represents the alternatives, information, and preferences pertaining to the decision at hand. An effective decision basis is framed to address patients' and clinicians' key concerns. The resulting recommendation for action is based on an understanding of what factors are most sensitive in determining the best course of action. Moreover, the value of additional information‐gathering efforts (e.g., further diagnosis) can be measured before the information is obtained to determine whether it is worth more than it costs. The paper illustrates the need for better decision‐making methods with a sample patient case, discusses key decision analysis principles and methods, identifies specific areas where periodontal decision‐making can be improved by decision analysis, and presents a periodontal decision analysis case. It then discusses how intelligent decision system technology can make decision analysis widely available in a clinical setting and concludes by exploring how a future dental office might use this technology on a routine basis.
The oral health burden in the United States: a summary of recent epidemiologic studies
Authors: Caplan DJ , Weintraub JA
Published: June 2020

The nation's health care system is currently under scrutiny. A topic of great interest to the dental community is whether dentistry should be included in a plan for national health reform, and if so, what procedures should be covered. To answer this question, 1) the current oral disease burden in the United States should be assessed, and 2) factors associated with this burden should be described. This paper reviews several recent large‐scale epidemiologic surveys of oral health in the United States, summarizes their major findings, outlines important risk factors for oral disease, and makes recommendations regarding future oral epidemiologic surveys. The discussion is limited to the following conditions: dental caries, periodontal diseases, tooth loss, edentulism, oral cancer, and orofacial clefts. Five out of six 17‐year‐olds have at least one decayed, missing, or filled tooth surface (DMFS), with a mean of eight DMFS per 17‐year‐old. However, 25 percent of the country's children have 75 percent of the dental caries; minority children, rural dwellers, those with minimal exposure to fluoride, and those from less educated or poorer families tend to have a greater caries experience. Root caries, gingivitis, periodontal pockets, and loss of periodontal attachment are more common among older individuals. Whites have more teeth than do Blacks of similar ages, and edentulism is more common among those with less education and income. Of those age 65+, over 40 percent are edentulous and only 2 percent have all 28 teeth. An estimated 30,000 new cases and 8,000 deaths were attributed to oral cancer in 1991, with Black males having higher incidence and mortality rates than other subgroups. Oral clefts occur in about one in 700 total births, with Native Americans having the highest incidence.
The primary dental care workforce
Authors: Neenan ME , Paunovich E , Solomon ES , Watkins RT
Published: June 2020

With health care reform at the forefront of our nation's policy agenda, an assessment of the current status of the dental primary care workforce is required as an essential reform component. There has been much written in the literature about manpower but relatively little about the primary dental care workforce. The purpose of this paper is three‐fold: 1) to describe the current primary dental care workforce; 2) to identify the distribution of this workforce; and 3) to describe the current delivery system. Characteristics, distribution, and delivery systems of the primary dental care workforce in the private and public sectors are described, and workforce issues relevant to health care reform are identified for future discussion.
Perceived sources of stress in the dental school environment
Authors: Westerman GH , Grandy TG , Ocanto RA , Erskine CG
Published: June 2020

The purpose of this study was to identify the perceived stress of dental students across the entire curriculum (D1–D4 years). The dental environmental stress (DES) questionnaire was administered to 244 (90.4 percent) dental students during 1990. Significant differences were found for 12 questionnaire items across four classes. For male‐female comparisons, significant differences were found for 17 questionnaire items, all perceived as more stressful by females; and between classes, significant differences were accounted for by three questionnaire items. Comparisons with previous dental students (1980s) on the identical questionnaire were noted.
Pre‐admission credentials and dental school performance of dental hygienists
Authors: Mauriello SM , George JM , May KN
Published: June 2020

This study examined the effect of dental hygiene preparation prior to entering dental school on dental school performance. Study participants included 203 female students who entered a public dental school from 1980–1989. Groups 1 and 2 had completed dental school prerequisites and a dental hygiene curriculum in a community college setting (n = 19) or university setting (n = 22) respectively, and Group 3 (n = 162) were traditional students with no dental hygiene education. Preadmission variables were predental science and non‐science grade point averages (GPA) and Dental Admission Test (DAT) scores. Performance variables were GPA of years one and two of dental school and National Board scores (Part 1). Results showed that Group 2 hygienists had significantly lower predental science GPAs than Group 1 or 3 and significantly lower non‐science GPAs than Group 3 (p < 0). Both groups of hygienists had significantly lower DAT scores than Group 3 (p < 0). No difference was seen in first and second year GPAs or the National Board average. Adjusting performance scores to compensate for deficiencies in preadmission variables showed that Group 2 hygienists had significantly higher adjusted first‐year GPAs and National Board averages than Group 3 (p < 0). Thus, hygienists performed as well as non‐hygienists in spite of weaker admission credentials.
A time for change of tooth numbering systems
Authors: Peck S , Peck L
Published: June 2020

Tooth numbering provides dentists with an essential shortcut in clinical record‐keeping. Today, three systems are favored worldwide: the Zsigmondy/Palmer system, the universal system, and the FDI two‐digit system. Histories of these tooth numbering methods are traced, and the strengths and deficiencies of each are discussed. The FDI two‐digit system‐used throughout the world, but not in the USA‐is the only method that makes visual sense, cognitive sense, and computer sense. It deserves consideration by American dentists as our official tooth numbering system.
A quarter century of changes in oral health in the United States
Authors: White BA , Caplan DJ , Weintraub JA
Published: June 2020

This paper provides an overview of the oral health status of Americans since the 1960s. Data from seven national surveys, conducted between 1960 and 1987, have been presented. Estimates of coronal and root caries, periodontal diseases, and tooth loss were reviewed. In addition, data on edentulism and oral cavity and pharyngeal cancer were included. Although the purpose of this paper is descriptive rather than analytical, some important trends have been noted: The number of children who were free from dental caries increased dramatically between 1963 and 1987. By 1987, almost one‐half of school children between the ages of 5 and 17 were caries‐free. Among those children with dental decay, the number of teeth affected has also declined. The oral health of adults also improved during the 27‐year period included in this review. In particular, the mean number of missing teeth and the percentage of edentulous adults have declined substantially. Trends in periodontal diseases were difficult to determine due to changes in the measures of periodontal diseases utilized in the surveys. In the most recent survey of employed U.S. adults, approximately 44 percent were found to have gingivitis and slightly more than 13 percent had periodontal pockets 4–5 mm in depth. Approximately 30,000 new cases of oral cavity and pharyngeal cancer were diagnosed in 1993, resulting in approximately 8,000 deaths. African Americans have higher incidence and mortality rates than white Americans and also have a much lower five‐year survival rate.
Assessment of dental student studying strategies
Authors: Lindemann RA , Cabret ML
Published: June 2020

This study evaluated the studying strategies of second‐year and third‐year dental students as related to end‐quarter exam preparation. Focus groups were convened to elicit current student studying strategies that were incorporated into a three‐question survey and administered to second‐ and third‐year students. Strategic use of study resources was rank ordered in the first question; course characteristics influencing study prioritization were rank ordered in the second question; and a third question addressed strategic time management. Overall, both second‐ and third‐year students ranked the studying resource “notepool” first, although students of high academic standing ranked “texts and syllabi” first. Regarding course characteristics, both classes gave high ranking to “instructor expectations,” “performance on midterm,” and “course structure.” Second‐year students rated “performance on midterm” as significantly more important to prioritization than did third‐year students (p = 0.01, t‐test). As to time management, a statistically significant number of second‐year students (p < 0.01, chi‐square) ranked “studying for exams mid‐quarter” first while third‐year students (p = 0.05) ranked “studying the week before finals” first. Second‐ and third‐year students of high academic standing indicated that they began studying at the beginning of the quarter. The data suggest that studying strategies change as students progress in school and that students of high and low academic ranking differ in the strategies they employ.
Survey of clinic fees and clinic revenue–summary report, 1993–94
Authors: Solomon ES
Published: June 2020

Figure 4 shows the mean unadjusted revenue‐per‐student by program type. Advanced Education General Dentistry programs had the highest revenue‐per‐student this year and in two of the three previous years. Oral and Maxillofacial Surgery programs generated the second highest mean amount of clinic revenue‐per‐student, followed by General Practice Residencies, Orthodontic programs, and Prosthodontic programs. Pediatric Dentistry, Endodontics, and Periodontics programs also had similar mean revenues‐per‐student. The smallest revenues‐per‐student were generated by D.D.S./D.M.D. and dental hygiene programs. These data should be interpreted with care. A review of the information for each program shows that there are significant variations in these data from school to school. These variations could be caused by different accounting procedures as well as differences in program size and location. Consequently, these data are best viewed in general terms.
Effectiveness of standardized patient instruction
Authors: Johnson JA , Kopp KC
Published: June 2020

To prepare freshmen dental students for clinical experiences, standardized patients (SPs) were used to teach basic skills in communication, examination, and record keeping. SPs allow students to practice and be assessed in a realistic, predetermined, and controlled setting. The SP cases integrated the clinical content from freshman “Preventive Periodontics” with the behavioral content taught in “Basic Patient Management.” Six SP cases were developed: two oral hygiene instruction cases, two medical and dental history cases, and two head and neck examination cases. One case of each type was used for instructing the students, and the others were used for assessing student competency at the end of the course. The SP methodology was evaluated by comparing the performance of freshmen, who had taken the course, with sophomores, who had only traditional clinical experiences. To make the comparison, sophomores participated in the same SP assessment as the freshmen. Scores for both groups were analyzed in three skill areas: interpersonal, technical, and record keeping. Freshmen scored higher in all three skill areas, with significant differences of 21% in technical skills and 31% in record keeping skills.
Dental health services research utilizing comprehensive clinical databases and information technology
Authors: Hayden WJ
Published: June 2020

Marketplace pressures for accountability in dentistry have made clear dental delivery systems' weaknesses in information generation, management, and analysis methods. Without this type of information, dentistry is unable to quantify and document the outcomes of the dental care services it provides. The Pew Health Professions Commission and the Institute of Medicine both suggest that dental schools should be among the leaders in the development and teaching of dental information capabilities, as well as the source of fundamental dental health services research. This paper argues that dental schools are the logical location for the development of valid, reliable, and acceptable health services research methods and databases. It describes the development of an insurance claims database to demonstrate the types of investigations possible, as well as the weaknesses and shortcomings of pure administrative data.
Using questions to facilitate motor skill acquisition
Authors: Knight GW , Guenzel PJ , Feil P
Published: June 2020

For the process of question‐guided problem‐solving to work successfully, several conditions must exist: 1) presence of valid and reliable criteria for evaluating product (DO) and performance (DP), 2) development of learning resources such as life‐sized examples, 3) training sessions in the application of criteria and use of the process for both faculty and students, and 4) faculty commitment to the process. The process helps to establish conditions in which learning occurs. Underlying its structure is the requirement for incorporation of discrimination tasks. Question‐guided problem‐solving structures the learner's approach to the task in a way that facilitates the refinement of independent learning strategies over time. Further, it promotes effective use of time in laboratory or clinic. Through repeated interactions, the faculty may better monitor student progress, diagnose student learning problems, suggest remedial strategies, and evaluate their outcomes. By providing instruction that includes opportunities to practice the subskills of problem‐solving in an interactive cooperative environment, students systematically monitor learning by asking good questions and, through questioning, are empowered to solve problems.
An assessment of the intellectual development of dental students
Authors: Gogan CM , Davis EL
Published: June 2020

William Perry proposed that students' underlying reasoning structures can be assessed by eliciting their perceptions of their educational experiences. His research demonstrated that cognitive development occurs in stages and that not all students at the same educational level display the same level of intellectual development. He suggested that curricular interventions are necessary to enable students at lower stages to develop the cognitive structures that facilitate such higher level tasks as making critical judgments and evaluating alternatives. The present study determined the level of intellectual development of first‐year, fourth‐year, and postdoctoral dental students using the Perry model. Scores on the Measure of Epistemological Reflection (MER), used to indicate Perry level, suggest that these students, on average, are in the early multiplicity stage of development. Comparison of mean scores indicated significantly different Perry levels only between first‐ and fourth‐year dental students.
Toward a competency analysis of operative dentistry technique skills
Authors: Chambers DW , Geissberger M
Published: June 2020

This research seeks ways to distinguish beginners from competent students based on the manner in which they perform. Five “beginner” students who had passed preclinical operative dentistry technique and six “competent” students one month prior to graduation were videotaped performing an occlusal amalgam preparation on #19 on a typodont. The tapes were scored for time in cutting the preparation and observing it and for “unproductive work” (nonfluencies). The number of changes from one operation to another and the use of instruments as aids in measurement were also recorded. Three processes were identified in every student's performance: rough outline form, making walls parallel and cavosurfaces level, and refinement. All preparations were scored as being clinically acceptable and indistinguishable in quality between the two groups. Beginning students required over twice as long to complete the preparation and changed operations more than twice as often as their competent classmates. Most of these differences between groups occurred in the third, refinement, process. Compared to beginners, competent students showed more evidence of using powerful, internalized schema to guide their performance, were smoother, and seemed less rule‐driven.
Diversity and critical forces in dental education
Authors: Robertson PB
Published: June 2020

Critical issues that affect dental education and the connection between science and practice include the community, managed patient care, public skepticism and fiscal support, and shifting demography in patterns of oral disease as well as the background of students entering the dental profession. During the past several decades, there have been major shifts in the patterns of oral disease, most recently described in results of the NHANES III dental survey. The diversity and background of students entering the dental profession have changed dramatically as well, and present estimates of change in U.S. population are no less volatile. Funding for dental education in constant dollars is decreasing nationally, with declining support from state and federal sources and a much greater reliance on clinical and development income. Recent recommendations by the Institute of Medicine and Pew Health Commission and reactions to those recommendations by representative dental organizations‐particularly the American Dental Association, American Association of Dental Schools, and the American Association of Dental Examiners‐have significant implications for the structure of dental education. All of these factors are tempered by the emergence of managed patient care and the implications of that environment to increasing the level of academic excellence of students, improving the quality of care delivered to patients, and enhancing the scholarly contributions of faculty. These forces may represent an opportunity to maintain a well‐documented national excellence in oral health care, expand the educational options to meet student demand and interest, increase the biological and behavioral background of our graduates, and explore new educational approaches to preclinical and clinical training.
Alumni self‐perception of competence at time of dental school graduation
Authors: Holmes DC , Diaz‐Arnold AM , Williams VD
Published: June 2020

A survey instrument was administered to recent alumni to evaluate self‐perceived competency in twenty‐one selected areas at the time of graduation. The questionnaire was completed by 439 (62.8 percent) alumni who graduated between the years 1985 and 1994, inclusive. Graduates generally felt most competent in their ability to treat dental caries and its sequelae and least competent in their ability to recognize myofascial pain and temporomandibular joint disorders. Very little association was demonstrated between demographic characteristics of the respondents and their competency self‐ratings. The survey identified areas of strengths and weakness within the present comprehensive care curriculum as perceived by the graduating dentists.
Application of the diligence inventory in dental education
Authors: Jasinevicius TR , Bernard H , Schuttenberg EM
Published: June 2020

The fifty‐five‐item Diligence Inventory for Higher Education (DI‐HE) was applied to a new subject group–190 dental students. After item and factor analysis, a fifty‐item (four subscale) inventory best reflected this group. The DI‐HE's split half reliability was 0.81 (p < 0.001), the reliability coefficient for the pre‐ and post‐test was 0.68 (p < 0.01), and the correlation coefficient alpha was 0.90. The DI‐HE scores were high, with no statistical differences among the four classes. Overall, significant relationships were found between grade point averages (GPAs) and DI‐HE total and subscale scores, with r values as high as 0.44. While female students' DI‐HE scores were significantly higher (p = 0.023) than male students' scores, no correlations between DI‐HE scores and GPAs for females were found. The results suggest that DI‐HE may be useful for assessment purposes in professional education.
Review of current tenure policies and their relation to junior dental faculty
Authors: Mayhew RB , Van Stewart A
Published: June 2020

The nature of tenure eligibility requirements for faculty has changed in recent years. The purpose of this study was to review the current tenure policies among U.S. dental schools. A five‐page, sixteen‐item survey was mailed to fifty‐three U.S. dental schools. The survey produced thirty‐seven completed questionnaires for a response rate of 70 percent. Among the results of the survey were: a) the most prevalent probationary period was seven years; b) faculty were expected to have a minimum of six to 15 publications to obtain tenure; c) only 39 percent of schools were perceived to offer a financial guarantee along with the award of tenure; and d) 69 percent of the schools offered an alternative track for selected full‐time faculty.
An investigation of dental student practice preferences
Authors: Winter PA , Butters JM
Published: June 2020

This study explored characteristics hypothesized to influence dental student long‐range practice preferences. Dental students (N = 264) for this study were selected at random from all dental students in one state who rated practice arrangements they most prefer to be in five years after graduation. The rating instrument was composed of two items measured on 5‐point Likert‐type scales. The independent variables were student gender, year of dental study, and practice arrangement. The research design was a 2 x 4 x 3 completely randomized, fixed‐factor, factorial analysis of variance (ANOVA). The ANOVA model explained 48 percent of the variance in student practice arrangement ratings. Both males and females rated solo ownership as the most favorable practice arrangement. Males rated the solo owner arrangement more favorably than did females, while females had a stronger preference for the employee practice arrangement than did males. Study results have implications for dental educators in their efforts to structure curricula to meet diverse student needs, to assess personnel needs and enhance the accuracy of projections, and to evaluate the effect of practice preferences on the health care system.
Using standardized patients to assess presentation of a dental treatment plan
Authors: Logan HL , Muller PJ , Edwards Y , Jakobsen
Published: June 2020

In this new era of relationship‐based care, involvement in treatment planning and goal setting is a high priority for patient satisfaction. This study reports on the use of standardized patients (SPs) in training third‐year dental students to gather dental, medical, and psychosocial information from patients and to involve the patient in the decision‐making process leading to the dental treatment plan. Among the skill areas measured, students were most successful in gathering dental information, with 94 percent of the students obtaining the complete set. Students were least successful in identifying the patient's goals for treatment (81 percent of the students identified the patients' goals). Students were most challenged by discussing sensitive topics with patients such as grief‐related depression (25 percent of the students recognized and discussed such topics). It is important that dental schools familiarize students with patient issues and teach them how to talk effectively to patients about personal issues and to incorporate those issues into a discussion of the treatment plan for the patient. Standardized patients can be used effectively toward this end.
Tobacco counseling practices of dentists compared to other health care providers in a midwestern region
Authors: Block DE , Block LE , Hutton SJ , Johnson KM
Published: June 2020

Tobacco counseling practices of dentists and other health care professionals in a predominantly rural region in the Upper Midwest were assessed to determine the need for professional education. A survey was mailed to all dentists, physicians, chiropractors, nurse practitioners, physician assistants, and public health nurses in a 16‐county region. Half (51.9 percent) of providers returned usable surveys (n = 614). While dentists were more likely than physicians and other health professionals to accurately estimate their patients' tobacco use, they were less consistent than other professions in tobacco assessment and intervention, less supportive of tobacco intervention, less likely to report having strong tobacco cessation skill/knowledge levels, and more likely to perceive barriers to tobacco intervention. Three out of five dentists (61.1 percent) reported desire for further tobacco education. For dentists to effectively counsel patients regarding tobacco use, it is essential to integrate tobacco intervention education into dental school curricula and to offer continuing education regarding tobacco use intervention to practicing dentists. Recent state settlements with tobacco companies could provide funding for such education.
Outcomes assessment in dental hygiene programs
Authors: Grimes EB
Published: June 2020

In 1996, the American Dental Association's Commission on Dental Accreditation instituted a revised accreditation standard for dental hygiene educational programs entitled Standard 12‐Outcomes Assessment. As a result of this standard, all dental hygiene programs were required to assess the attainment of goals through a formal outcomes assessment process. This study examined and analyzed the implementation process used by dental hygiene programs. Twenty‐two dental hygiene program directors were interviewed to collect information regarding their experiences. The directors indicated that their programs routinely and effectively assess student outcomes and use the acquired information to make needed program improvements and to demonstrate accountability to groups having a vested interest in the program. Several factors, such as the policy itself, as well as gaining faculty and administrative support, were viewed as important to implementation. Time constraints were identified as a major barrier. Outcomes assessment data have also been used by dental hygiene programs as leverage for funding requests that resulted in significant program enhancement.
Educational implications for copyright in a digital world
Authors: Spallek H , Schleyer TK
Published: June 2020

Statutory law and court cases currently leave fair use of copyrighted material poorly defined and fail to provide effective guidance for the use of others' work. Copyright legislation is undergoing significant change, accelerated by the evolution of computing and communication technologies. This paper reviews copyright issues, fair use guidelines, and applicable laws and statutes to help administrators and educators understand and comply with copyright regulations. The paper describes principles of copyright and ownership, the rights of copyright holders, and the conditions under which copyrighted material can be used by others. Recently introduced legislation, such as the 1998 Digital Millennium Copyright Act, may significantly affect how educators can use copyrighted material in the future. The integration of computer and communication technology into education raises a number of intellectual property issues for dental schools. This paper provides some general guidelines regarding copyright issues in academic environments.