Weintraub G S, Weintraub A M
Department of Restorative Dentistry, University of Pennsylvania School of Dental Medicine, Philadelphia 19104-6003, USA.
J Prosthodont. 1997 Sep;6(3):197-203. doi: 10.1111/j.1532-849x.1997.tb00091.x.
In 1977, a survey of American and Canadian dental schools was conducted by Weintraub to determine the delegation of laboratory procedures in preclinical and clinical complete and removable partial denture programs. This was performed in light of challenges raised to the value of requiring dental students, rather than laboratory technicians, to perform the various laboratory procedures involved in the fabrication of complete and removable partial dentures. Since 1977, the rate of edentulism has declined in the United States, and fewer edentulous patients have sought regular dental care. In addition, approximately 20% fewer curriculum hours have been spent in dental schools in removable prosthodontic instruction; a declining number of graduating dental students have felt comfortable with their level of knowledge of removable prosthodontics, especially complete dentures, and have performed fewer removable prosthodontic procedures in practice because of a perceived lack of treatment cost-effectiveness. The present study, an 18-year follow-up to the 1977 survey, was designed to determine if such trends toward a de-emphasis on removable prosthodontic treatment have affected the mechanisms of instruction in and the extent to which dental schools instruct students about removable-prosthodontics laboratory procedures. The 1995 survey was mailed to 53 American dental schools. Forty-six schools returned the completed survey, for a response rate of 87%. Results showed that the relative amount of material presented to students in clinical removable prosthodontics programs increased, primarily through the enhancement of laboratory technician support, both in-house and commercial, of student clinical removable prosthodontic laboratory procedures. The increase was greater than in preclinical removable prosthodontic programs, which were described in a companion article. The conflict between these outcomes and the call by the dental community, as well as that of the 1995 Institute of Medicine Study, for a reduced emphasis on teaching students about the technical details involved in removable prosthesis fabrication is recognized and explored.
1977年，温特劳布对美国和加拿大的牙科学院进行了一项调查，以确定在临床前和临床全口及可摘局部义齿课程中实验室操作的分配情况。此次调查是鉴于有人对要求牙科学生而非实验室技术人员执行全口及可摘局部义齿制作中涉及的各种实验室操作的价值提出了质疑而开展的。自1977年以来，美国无牙颌率有所下降，寻求常规牙科护理的无牙患者减少。此外，牙科学院在可摘义齿修复教学上花费的课程时间减少了约20%；由于认为可摘义齿修复缺乏治疗成本效益，越来越少的牙科毕业生对自己可摘义齿修复的知识水平感到满意，并且在实践中进行的可摘义齿修复操作也减少了。本研究是对1977年调查的18年随访，旨在确定这种对可摘义齿修复治疗重视程度降低的趋势是否影响了牙科学院教授学生可摘义齿修复实验室操作的教学机制及程度。1995年的调查问卷被邮寄给了53所美国牙科学院。46所学校返还了完整的调查问卷，回复率为87%。结果显示，在临床可摘义齿修复课程中向学生讲授的材料相对量有所增加，主要是通过加强校内和商业实验室技术人员对学生临床可摘义齿修复实验室操作的支持来实现的。这种增加幅度大于临床前可摘义齿修复课程，临床前课程情况在另一篇相关文章中有所描述。认识到并探讨了这些结果与牙科界以及1995年医学研究所研究报告中要求减少对学生讲授可摘义齿制作技术细节的呼声之间的矛盾。
