The American Dental Education Association,

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1 Critical Issues in Dental Education Mentoring Future Dental Educators Through an Apprentice Teaching Experience Carol A. Bibb, Ph.D., D.D.S.; Karen H. Lefever, Ph.D. Abstract: To address concerns about the growing shortage of dental educators, the UCLA School of Dentistry initiated an elective course to introduce fourth-year students to issues in academic dentistry and to provide an apprentice teaching experience. Participants in the elective (referred to as student teachers) developed a microcourse entitled Welcome to Dental Anatomy, presented to incoming first-year students during orientation week. Under the guidance of faculty mentors, the student teachers were responsible for development of course content, teaching aids, and evaluation methodology. Two cycles of the elective have been completed, reaching a total of twenty-one fourth-year students to date. The positive impact on student teachers and incoming first-year students indicates that this approach has great potential for encouraging more graduates to pursue careers in academic dentistry. In addition, the program has the potential to be expanded by adaptation to other foundational courses in the dental and dental hygiene curricula. Dr. Bibb is General Clinic Director and Adjunct Professor, Division of Oral Biology and Medicine, and Dr. Lefever is Director of Academic Programs, both at the UCLA School of Dentistry. Direct correspondence and reprint requests to: Dr. Carol A. Bibb, Division of Oral Biology and Medicine, UCLA School of Dentistry, Center for the Health Sciences, Los Angeles, CA ; phone; fax; carolb@dent.ucla.edu. Key words: dental education, professional development, faculty recruitment, academic careers, mentoring Submitted for publication 1/2/02; accepted 5/1/02 The American Dental Education Association, the American Dental Association, and other professional groups have expressed continuing concern that the academic community will find it increasingly difficult to fill the substantial number of faculty vacancies predicted for the foreseeable future. 1-6 In 1999, for example, an American Association of Dental Schools (AADS; now American Dental Education Association, ADEA) task force noted that between 1980 and 1999 the percentage of fourth-year dental school students indicating an interest in careers in academic dentistry fluctuated between 0.5 percent and 1.3 percent. 1 These same statistics were used to predict that, with an average of 4,000 D.D.S. graduates per year, the number considering academic careers (twenty to fifty-two) would be far below the estimated 200 needed yearly just for faculty replacement. 2 There are a number of reasons why students do not choose to follow an academic path, many of them financial. However, another important reason may be an education culture that does not foster interest in an academic career. 1,3 In fact, one of the recommendations of the 1999 AADS task force was the implementation of culture-changing programs to mentor, prepare, and recruit future faculty. 1 A 1999 AADS survey of dental school deans found that when schools did have formal programs directed toward promoting academic careers, these programs were predominantly focused on developing student research efforts. 4 In responding to these findings, Haden et al. recommended that predoctoral teaching assistant opportunities should be the primary means of educating students about the rewards of academic dentistry. 4 This teaching experience should provide the opportunity for students to develop a greater understanding of the theory and research that underlies practice in curriculum and pedagogy. In addition, student teachers should have opportunities to discuss and reflect on their experiences with faculty mentors and with peers who share their interest in teaching. These recommendations are supported by findings that an interest in teaching, mentorship, and role models were among the positive influences on the decision to choose a career in academic dentistry At the UCLA School of Dentistry, we responded to these concerns and recommendations by initiating an elective course designed to introduce fourth-year students to issues and scholarship in academic dentistry and to provide them with an appren- June 2002 Journal of Dental Education 703

2 tice-type teaching experience under the guidance of faculty mentors. The elective, Hands-On Experience for Future Dental Educators, differs from traditional teaching assistantships and tutoring activities in laboratory courses by introducing the participants (referred to as student teachers) to learning theory, concept sequencing, test question writing, and outcomes assessment. In the process, the student teachers develop their own microcourse for presentation to incoming first-year students during orientation. We offer the elective to students at the beginning of their fourth year when they are primarily engaged in patient care, have sufficient time to focus on an elective, and are in the process of finalizing their future professional plans. We chose to frame the microcourse around dental anatomy because it is a foundational course and fourth-year students are sufficiently knowledgeable and comfortable with the content to be effective student teachers. In addition, one of the elective directors (C.B.) teaches the regularly scheduled dental anatomy course in the UCLA curriculum and serves as a national board test constructor in this discipline. The other elective director (K.L.) brings the perspective of research and experience in education to the elective. Two cycles of the elective have been completed, reaching a total of twenty-one fourth-year students to date. As a result, we are able to report on the impact of the elective on two groups of student teachers and first-year course recipients. In addition, we describe how student feedback and analysis of our first cycle experience were used to make significant modifications in selection of participants, scope of the microcourse, and use of visual aids during the second cycle. This article will describe the elective we offer, how it has evolved over the past two years, our roles as mentors, and the impact on both student teachers and course recipients. In addition, we will discuss the potential to adapt the program to other foundational courses in the dental and dental hygiene curricula. Program Description This teaching apprenticeship is offered as an elective during the summer (first) quarter of the fourth year. The student teachers attend eight weekly discussion sessions that integrate didactic material on learning theory, concept sequencing, and test question writing with the progressive development of their microteaching presentations (referred to as the Welcome to Dental Anatomy microcourse). During the microcourse development, the student teachers determine the objectives for their presentations, select and sequence the order of topics, create visual aids and handouts, and develop test questions and a course evaluation survey, all under the guidance of the faculty mentors. The last two sessions are devoted to practice teaching, during which each student teacher receives peer and instructor critiques of his or her presentation, visual aids, handout material, and test questions. A complete dress rehearsal is held two days prior to the microcourse, which is presented during orientation week (mid- September) for the incoming first-year students. The microcourse concludes with a fifteen-question multiple choice test and completion of a course evaluation form. Course Organization The major differences in organization between the 2000 and 2001 cycles are summarized in Figure 1. To accommodate a maximum number of participants and yet develop a microcourse that is realistic in length, the student teachers are divided into teams, with each team presenting to a subgroup of the firstyear class of eighty-eight students. In the 2000 cycle, the fifteen fourth-year students (eight women and seven men) who signed up for this teaching apprenticeship were divided into three teams of five student teachers, with each team presenting to one-third of the first-year class (approximately thirty students per group). During the 2001 cycle, we limited participation to six student teachers (four women and two men) by implementing the selection process described below. As a result we had two teams of three student teachers with each team presenting to half of the first-year class (forty-four students per group). Each member of the team presents a twentyminute mini-lecture followed by five minutes of discussion, so there were a total of five presentations per team in the first cycle and three in the second cycle. The topics covered, visual aids, handout material, and test questions are standardized across the teams to permit reliable comparisons. Modifications from First to Second Cycle Feedback from both student teachers and firstyear students after the first cycle of the elective indicated that the scope of the microcourse was overly 704 Journal of Dental Education Volume 66, No. 6

3 enthusiastic; specifically, too much material was covered and the overall program was too lengthy. We responded in two ways when constructing the second cycle (Figure 1). First, we reduced the number of student teachers from fifteen to six by instituting a selection process that required applicants to submit a brief statement about their interest in teaching and past experiences that might have influenced that interest. We then held informal interviews. This change reduced the length of the microcourse by one hour. Second, during the second cycle we included more material on learning theory and cognition to emphasize the need to focus on broad concepts and basic terminology in an introductory course. Another major change was selection of visual aids by the student teachers. During the first cycle, they used overhead transparencies that proved to be inexpensive, easily modified, and interactive. The second cycle of student teachers chose to develop PowerPoint presentations, so we instituted a training session that was conducted by the UCLA Media Services Director. Role of Faculty Mentors During the development of the microcourse, the student teachers grappled with practical issues of curriculum development and delivery, applying their new knowledge in a problem-solving situation. In our own role as mentors, we encouraged the students to consider the background an incoming firstyear student brings to the course, the difficulties they had experienced themselves in learning this material, and ways to explain and illustrate the concepts in order to minimize these difficulties. We took a non-directive approach during this process, relying on the student teachers personal reflection and peer review to modify and direct the eventual outcome. Obviously, we have intervened when we identified a serious omission or inconsistency in course content. In addition, we have found it valuable to share personal experiences with the student teachers, both positive and negative, in the development of our own teaching styles and expertise. Evaluation Methodology Our evaluation plan focused on two areas: the experiences of the fourth-year student teachers and how the incoming first-year students responded to the Welcome to Dental Anatomy microcourse. We recognized that the experiential nature of the elective would be best captured by qualitative methods. We chose to use quantitative measures to assess the effectiveness of the microcourse on the first-year students learning of dental anatomy. Qualitative Methods Surveys. The first-year students completed an evaluation form at the conclusion of the microcourse (Figure 2). Five weeks later, after the regularly scheduled dental anatomy course midterm exam, they responded to a survey asking how useful the microcourse was in preparing for the midterm, whether the microcourse should be offered again, whether it should be mandatory, and if they would be interested in taking the elective as a fourth-year student. Narrative evaluation. The student teachers provided narrative feedback on their experience during a verbal debriefing after the presentations and Volunteers without screening Selection process 15 student teachers 6 student teachers Division into 3 teams of 5 student teachers Division into 2 teams of 3 student teachers Topics covered: Topics covered: 1. Tooth anatomy, universal numbering system 1. Dentition periods, universal numbering system 2. Arch form, surfaces 2. Tooth anatomy, surfaces 3. Anterior teeth 3. Arch form 4. Posterior teeth 5. Primary dentition Choice of visual aids: transparencies Microcourse length: 3 hours Choice of visual aids: PowerPoint presentations Microcourse length: 2 hours Figure 1. Major differences between 2000 and 2001 cycles June 2002 Journal of Dental Education 705

4 Figure 2. Microcourse student teacher and course evaluation subsequently in writing. At the end of their fourth year, the student teachers were asked whether they planned to incorporate teaching into their future plans and what impact the elective had on their interest in teaching. Quantitative Methods We used descriptive statistics to summarize and compare the results of the microcourse and student teacher evaluations during the first and second cycles. Student s t-test was used to identify significant differences between the two cycles and between before and after scores in each cycle. Results Impact on First-Year Students The results demonstrate that the Welcome to Dental Anatomy microcourse was viewed by the first-year students as a legitimate learning opportu- 706 Journal of Dental Education Volume 66, No. 6

5 nity and that the majority took their test taking and course evaluation responsibilities seriously. Performance on the fifteen-question post-test showed a range of scores (Table 1), and the evaluations of the student teachers showed considerable variation (Table 2). Table 3 shows that the first-year students perceived a significant increase in their knowledge of dental anatomy as well as their confidence and enthusiasm to begin studying the material. Improvements in test performance, course evaluations, and student knowledge, confidence, and enthusiasm were all significant from the first to second cycle. Written comments from the first-year students focused on the value of the microcourse as an Table 1. Performance of first-year students on microcourse post-test (15 questions total) (n=88) (n=87) Average Score* Range * Significant difference between 2000 and 2001 cycles at P=0.001 introduction to dental anatomy course content specifically and to the structure and expectations of a dental school curriculum overall. As shown in Table 4, a majority of the firstyear students considered the microcourse useful in preparing for the midterm exam in the regularly scheduled dental anatomy course, thought the microcourse should be offered again next year, and agreed that it should be mandatory. Twenty percent of the first-year students in the first cycle and 21 percent in the second cycle indicated a strong interest in taking this elective as a fourth-year student. Impact on Student Teachers The majority of the twenty-one student teachers reported a positive and rewarding experience. A total of three described the elective as one of their most positive experiences during four years of dental school. Narrative comments highlighted the personal fulfillment and growth they experienced: I really felt that I made a small difference in the performance of some first-year students and This course was a Table 2. Evaluation of microcourse and student teachers by first-year students (n=88) (n=87) Knowledge of Subject Mean Range Range of Means Organization of Presentation Mean Range of Means Clarity of Presentation Mean Range of Means Visual Aids Mean Range of Means Usefulness of Handout Mean Range of Means Relevance of Test to Presentation Mean Range Range of Means Overall Student Teacher Rating Mean Range of Means Overall Course Rating Mean Range Scale: 4 = Excellent, 3 = Good, 2 = Fair, 1 = Poor Note: There was a significant difference between 2000 and 2001 cycles at P=0.001 for each item measured. June 2002 Journal of Dental Education 707

6 Table 3. Impact of microcourse on first-year student knowledge, confidence, and enthusiasm for studying dental anatomy (n=88) (n=87) Knowledge of Dental Anatomy Before After Confidence to Begin the Study Before After Enthusiasm for Studying Dental Anatomy Before After Scale: 4 = Excellent, 3 = Good, 2 = Fair, 1 = Poor Note: There were significant differences between 2000 and 2001 cycles and between all before and after scores within each cycle at P= Table 4. Retrospective survey of value of microcourse to first-year students How useful was the welcome to Dental Anatomy course in preparing you for the dental anatomy midterm? (n=69) (n=78) Very useful 57% 74% Somewhat useful 43% 26% Not useful 0% 0% I recommend that the Welcome to Dental Anatomy course be offered again next year to the incoming firstyear class. Definitely agree 72% 76% Agree 25% 23% Disagree 3% 1% Participation in the Welcome to Dental Anatomy course should be: Mandatory 72% 71% Elective 28% 29% real confidence builder for me. Other comments emphasized the satisfaction of team teaching and that the reality of developing an effective presentation and writing good test questions was more challenging and time-consuming than expected. One said that she now understands why teachers get frustrated when students goof off in class. The second group of student teachers was unanimous in their opinion that the opportunity to learn to create effective PowerPoint presentations was well worth the extra effort. The significantly higher scores on the course evaluations, specifically in the areas of clarity of presentation and visual aids (Table 2), support this conclusion. All but one student teacher indicated a desire to incorporate teaching into his or her future plans, and all said that the elective had played a moderate to significant role in this decision. One said, for example, Now that I have had this experience, I would like to be part of the teaching world. Of note, the student teacher who decided, on the basis of participation in this elective, that teaching was not an activity he enjoyed had been evaluated by the first-year students and the faculty mentors as one of the weakest student teachers. Discussion This hands-on teaching elective is one of the first apprentice-type didactic teaching experiences offered to predoctoral dental students. The positive response we have received indicates that this type of program has great potential for recruiting and mentoring future academicians by giving students hands-on exposure to the rewards of teaching. The majority of the student teachers we have reached to date are excited about the prospect of including at least part-time teaching in their future plans, and a significant number of our current first- and secondyear students are looking forward to enrolling in this elective when they are fourth-year students. Conversely, giving students the opportunity to discover that they are not suited for a career in teaching is also considered a positive outcome. Response to Feedback We interpret the significant improvement in microcourse evaluations, student performance, and attitude toward the study of dental anatomy from the first to second cycles (Tables 1 4) to be the result of modifications we made in response to feedback from student teachers and first-year students. These modi- 708 Journal of Dental Education Volume 66, No. 6

7 fications included a selection process for student teachers, a reduction in the length and scope of the microcourse, and use of PowerPoint presentations. It is impossible to determine the relative contribution of these changes, but we suggest that all of these factors played a role in improving the microcourse. Our conclusion from these results is that the organization of the second cycle, specifically limiting participation to a maximum of six student teachers, is the model that we will use for the third cycle. Mentoring Future Educators One of the strengths of this program is the personal mentoring of students interested in becoming dental educators. The student teachers saw the opportunity to teach important subject matter to our incoming students as a vote of confidence, and they viewed their success in this endeavor as a major milestone in their professional development. In addition, we encouraged the 2001 student teachers to share their experiences by presenting posters at the 2002 ADEA meeting, and we included student participation in the Faculty Development Workshop we presented at that meeting. We anticipate that these opportunities will promote and reinforce the satisfaction of sharing knowledge with peers as well as students. Directions for Program Development In our opinion, this program has the potential to be adapted to other foundational courses in the dental and dental hygiene curricula. In addition, offering such a course to residents in postdoctoral training programs and students enrolled in M.S. and Ph.D. graduate programs would target individuals already committed to an academic career. Another possibility we are considering is to offer the elective earlier in the predoctoral curriculum for example, during the third year, so that more advanced teaching opportunities would be available during the fourth year. As professional educators, we are also interested in prediction of student performance and intervention for students with learning difficulties who could possibly be identified during the microcourse. Our preliminary attempts to correlate performance on the microcourse post-test with subsequent performance in the regularly scheduled dental anatomy course have produced equivocal results. This is an area that we will continue to explore. Conclusion The primary requirement for implementation of this program is identification of faculty mentors who, individually or in combination, have expertise in educational methodology and scholarship, as well as the content expertise to preserve the academic integrity of the material presented by the student teachers. Most importantly, the faculty mentors should be passionate about their own contributions as educators and willing to serve as role models for future teachers. REFERENCES 1. American Association of Dental Schools. Future of dental school faculty: report of the president s task force. Washington, DC: American Association of Dental Schools, Meskin LH. Those who can do. J Am Dent Assoc 2000;131: Valachovic RW, Weaver RG, Sinkford JC, Haden NK. Trends in dentistry and dental education. J Dent Educ 2001;65: Haden NK, Beemsterboer PL, Weaver RG, Valachovic RW. An update on future dental school faculty. J Dent Educ 2000;64: Institute of Medicine. Dental education at the crossroads: challenges and change. Field MJ, ed. Washington, DC: National Academy Press, Roberts MW, Slade GD, McIver FT. Pediatric dentistry faculty profile and plans to remain active. J Dent Educ 1997;61: Weaver RG, Haden NK, Valachovic RW. Annual ADEA survey of dental seniors: 2000 graduating class. J Dent Educ 2001;65: Kula K, Glaros A, Larson B, Tuncay O. Reasons that orthodontics faculty teach and consider leaving teaching. J Dent Educ 2000;64: Laskin DM. Factors influencing oral and maxillofacial surgeons to select or leave academic careers. J Oral Maxillofac Surg 1994;52: Schenkein HA, Best AM. Factors considered by new faculty in their decision to choose careers in academic dentistry. J Dent Educ 2001;65: Shepherd KR, Nihill P, Botto RW, McCarthy MW. Factors influencing pursuit and satisfaction of academic dentistry careers: perceptions of new dental educators. J Dent Educ 2001;65: June 2002 Journal of Dental Education 709