Ferguson Michael B, Sobel Morton, Niederman Richard
Office of Dental Education, Restorative Department, Harvard School of Dental Medicine, Boston, MA 02115, USA.
J Dent Educ. 2002 Oct;66(10):1159-62.
In conjunction with its problem-based learning curriculum, Harvard School of Dental Medicine (HSDM) developed a shortened preclinical restorative training curriculum. This study compared our curriculum with those in other dental schools and examined student reaction to it. Twenty-nine U.S. dental schools responded to a survey regarding the length of their preclinical course in Operative Dentistry. Nationally, preclinical courses ranged from 179 hours to 280 hours (mean +/- SEM = 193 +/- 9 hours; n = 29). In marked contrast, the new seventy-five-hour preclinical curriculum at Harvard was the lowest of any school, and significantly lower than the U.S. average (p < 0.01). In Harvard's previous curriculum, students spent 232 curriculum hours. Reactions of Harvard students to this compact preclinical curriculum were surveyed using a three-topic, three-category survey instrument. Results indicated that, prior to beginning clinical patient care, approximately 80 percent of students felt that the course was too short and 20 percent just right. Conversely, and retrospectively, after completing their dental school training, only 35 percent felt it was too short, and 65 percent felt it was just right. Retrospectively, in terms of clinical preparedness, 55 percent felt adequately prepared and 35 percent felt well prepared to treat their patients. No significant change was noted between Part II National Board scores following the change to the reduced curricula time. The average National Board Part II scores prior to initiating the new curriculum was 86.3, and afterwards, it was 86.2. Further, for the North East Regional Board, HSDM students in the past four years demonstrated a 98 percent overall success rate with 100 percent primary pass in the operative dentistry part of the examination. These results suggest that an abbreviated preclinical training is not only possible, but may make time available for training opportunities in other areas, such as aesthetic dental procedures and new biomaterials.
哈佛牙医学院(HSDM)结合基于问题的学习课程,开发了一门缩短的临床前修复培训课程。本研究将我们的课程与其他牙科学院的课程进行了比较,并考察了学生对该课程的反应。29所美国牙科学院回应了一项关于其口腔手术学临床前课程时长的调查。在全国范围内,临床前课程时长从179小时到280小时不等(均值±标准误=193±9小时;n = 29)。与之形成显著对比的是,哈佛新的75小时临床前课程是所有学校中时长最短的,且显著低于美国平均水平(p < 0.01)。在哈佛之前的课程中,学生们要花费232个课程小时。使用一份包含三个主题、三类别的调查问卷对哈佛学生对这一紧凑临床前课程的反应进行了调查。结果表明,在开始临床患者护理之前,约80%的学生认为该课程太短,20%的学生认为刚刚好。相反,在完成牙科学院培训后进行回顾时,只有35%的学生认为课程太短了,65%的学生认为刚刚好。回顾来看,在临床准备方面,55%的学生觉得准备充分,35%的学生觉得为治疗患者做好了充分准备。在课程时长缩短后,第二部分国家委员会考试成绩没有显著变化。在启动新课程之前,国家委员会第二部分的平均成绩为86.3,之后为86.2。此外,在东北区域委员会的考试中,过去四年里哈佛牙医学院的学生在口腔手术学部分考试的总体成功率为98%,首次通过率为100%。这些结果表明,缩短临床前培训不仅是可行的,而且可能为其他领域的培训机会腾出时间,比如美容牙科手术和新型生物材料方面。