The word "change" frequently invokes a response that engenders those actions we all learned in undergraduate physiology: fright, flight, or fight. Our natural protective instinct guides us to first consider the negative impact on self before considering the positive global effect. It is not uncommon for this same response to occur when the paradigms that are the foundation of our professional careers are challenged. The key to dealing with these reactions, and more important, the challenge of change, is to better understand our paradigms in light of the rapidly changing environment. To achieve this important end, I can think of no more timely guide than the frequently referenced quote from Francis Bacon, "Knowledge is power." It is through knowledge, and the ability to access this knowledge, that we will be able to shape the future of our profession and the oral health-related quality of life of the public we serve.
At this time, when we are required to address a changing health care delivery system that directly affects how we provide patient care, we are also experiencing a scientific and technological explosion. The challenge to the practitioner has been frequently documented; however, the challenge to dental education is no less significant. We must meet these challenges by establishing an infrastructure that will provide students the requisite knowledge to keep pace with change, but do so while continuing to provide the opportunity to develop critical clinical skills.
It has been suggested that dental schools are addressing the knowledge issues at the expense of clinical skills. I want to assure you that we, the faculty, do not want this to occur, and, in fact, have increased time directed to patient care by 18 percent during the past five years. We are cognizant of the fact that as our patients' needs change and the foundation knowledge expands, the application to patient care will always require specific clinical skills.
Continued support of patient care service by students does not reduce the challenge for dental education to provide an academic environment that will result in life-long learning for our graduates. This requires change in both curriculum contentwhat we teachand educational technologieshow we teach it. To accomplish this, the role of both teacher and student must change. The new model requires the student becoming an active learner and the teacher becoming a facilitator.
According to Webster, to teach is to "impart knowledge," while learning is to "gain knowledge or understanding of, or skill in, by study, instruction or experience." Historically, most learning occurred when a faculty member "imparted knowledge" through lectures. The student was expected to absorb, store, and present this knowledge by rotethe use of memory with little intelligence. Clearly, the vast amount of information required by today's health professional can no longer be transferred in this manner. The alternative is, we must provide students with the technology and skills to become independent learners in addition to, and, in many instances, instead of, the traditional presentation of lectures.
This change to case-based seminars (CBS) and problem-based learning (PBL) has been perceived by some as high risk because not all information is presented formally. In reality, however, there is no way dental education can address the volume of information and skill development required in the time allotted. Instead, we must develop life-long learners who can ask the right questions, access and assimilate information, and make "evidence-based decisions" to support their patient care responsibilities.
The transition from empirical imparting of knowledge to evidence-based decision making derived from knowledge is not easy. Dental educators must not prematurely conclude that change is better. We must also be cautious when deciding what basic information is still best transferred through the traditional lecture format. Despite the acknowledged risks and reservations, change must occur. Just as we could not provide appropriate patient care today if we only applied the science and technology of two or three decades ago, we can no longer provide an appropriate dental education using the educational technologies of the past.
In subsequent issues of the Beacon, I will focus on important changes that influence the "what" and "how" as we provide a challenging and contemporary dental education at the pre-doctoral, post-doctoral, and continuing education levels. The topics will range from caries management and tissue engineering to distance learning and computers in the classroom and operatory.
Until the next issue of the Beacon, may I extend my best wishes for continued success and happiness in both your personal and professional lives. And please remember to visit whenever you have the opportunity.
Robert A. Saporito, Dean