Leela S. Breitman, BA1, Aisha K. Ba, BS1, Emily J. Van Doren, BS1, and Jennifer E. Lee, BS1
1 Harvard School of Dental Medicine, Boston, MA 02115, USA
Correspondence concerning this article and requests for reprints should be addressed to Emily J. Van Doren (Emily_VanDoren@hsdm.harvard.edu)
The views expressed in this article are those of the authors and do not reflect the opinions of the Harvard School of Dental Medicine. The authors disclosed no conflicts of interest.
ABSTRACT
Dental students often feel underprepared for their clinical duties upon graduation. Educators must investigate the current state of predoctoral dental education to better understand this trend. Currently, PowerPoints and live demonstrations are the primary tools for teaching preclinical dentistry. Concerns with these modalities are that: two-dimensional PowerPoints cannot reliably explain concepts that require three-dimensional visualization; live demonstrations cannot be replayed and do not accommodate different learning paces; and live demonstrations occupy a large percentage of class time that could be otherwise allocated to practicing clinical skills. Having grown up during the technological revolution, modern students expect the integration of technology into all aspects of their lives. Beyond student expectations, the COVID-19 pandemic demands that dental education embrace online learning. Educational videos provide the opportunity to address the shortcomings of current teaching methods, satisfy students’ need for educational technology, and effectively communicate clinical skills in the context of social-distancing precautions. At present, few academically verified, online dental educational videos exist. To fill this void, dental educators should enlist their students to work as their co-educators and collaborators to create a library of academically verified videos. Beyond improving and modernizing dental education, the increased production and utilization of academically verified videos in preclinical dental education will help galvanize interest in dental academia among the next generation of dental clinicians. Work of this kind has the potential to dramatically improve dental education around the world, including in dentally-underserved areas.
INTRODUCTION
Effectively preparing dentists is critical to address the global oral health needs. Unfortunately, there is a worldwide shortage of dental educators. Among dentists graduating from predoctoral programs, many report feeling “unprepared” to meet the clinical needs of their patients [1]. To better understand why dental students feel underprepared, we must examine the current state of dental education and compare this to current educational trends in related disciplines. To date, related health care specialties have made use of online educational tools, including internet-based course content, online interactive learning modules, virtual communications, and evaluations [2]. At present, dental education has not explored these modalities to the same extent. We must consider solutions to the problems outlined above: namely, the global shortage of academic dentists, students’ feelings of unpreparedness, and the lack of online educational tools in clinical dentistry.
Figure 1. Video collaboration as a means of addressing the technological gap in predoctoral dental education. Original illustration by Leela Breitman.
SITUATION ANALYSIS
Current teaching modalities
The field of dentistry faces the unique challenge of preparing students to rapidly achieve proficiency in clinical techniques before practicing with patients. Currently, most dental schools accomplish this by presenting PowerPoint lectures that explain procedural steps, followed by live demonstrations in the preclinical laboratory. In the setting of the COVID-19 pandemic, students are able to receive lectures delivered through video-conferencing, but the use of live demonstrations in the preclinical laboratory is no longer possible. Additional concerns are: first, PowerPoints rely on two-dimensional imagery to explain concepts that require three-dimensional visualization. Second, live demonstrations cannot be replayed and therefore, do not accommodate students who learn at different paces. Lastly, live demonstrations occupy a large percentage of class time that could be otherwise allocated to more active forms of student learning.
Technology in education
The majority of current dental students grew up in the context of the technological revolution. As such, we have come to expect the integration of technology into all aspects of our lives, including in our education. We, as “digital natives,” gravitate toward video-based technologies over traditional teaching modalities such as PowerPoint lectures and textbooks. Rather than combing through slides and books for answers, modern students prefer searching for information online. Most dental students turn to electronic applications to learn anatomy, and to e-flashcards and websites to study for exams.
Beyond simple preference, the use of modern technologies such as video-recorded clinical techniques enhances student learning and procedural outcomes [3,4].Video-recorded clinical demonstrations communicate three-dimensional spatial information which is particularly crucial to dental learning. Further, students may pause, slow-down, replay, and easily navigate to different time points in videos, providing them with the necessary autonomy to learn at an individualized speed. Given the fast pace, vastness, and diversity of procedures that dental students must master, recorded video demonstrations allow students to refresh their memory of procedures at any time during their education.
Moreover, video demonstrations may be viewed and reviewed outside of academic settings. This is particularly pertinent during the COVID-19 pandemic, where the physical closure of schools has brought clinical learning to a grinding halt. Notably, continuous access to videos remains beneficial beyond the context of COVID-19, as pre-recorded videos may allow class time to be reallocated. For example, a video demonstration may be reviewed prior to class such that students are prepared to begin working upon arrival to the preclinical lab. Additionally, given the worldwide shortage of dental educators, video-recorded clinical techniques can act as a teaching force multiplier, delivering consistent and credible information to trainees with less reliance on the need for small faculty-to-student ratios. In sum, educational technologies — namely video-based technologies — have tremendous potential to enhance dental education and supplement the current teaching modalities both in the context of the COVID-19 pandemic and traditional academic circumstances.
Online learning in medical education
In the modern landscape of medical education, online platforms such as Osmosis, Sketchy Medical, and UpToDate have arisen to fulfill the demand for video-based e-learning. Medical students use these resources to learn and review content during their preclinical and clinical years. In fact, nearly 100% of medical students use supplemental online materials to revisit and reinforce traditional medical curricula [5]. These resources provide the academic backing that most Google searches lack, given that professors and physicians who represent medical and research institutions create and review the content on these platforms. Academic verification reassures students that the information they receive is accurate and up to date.
While similar educational products would enrich clinical dental learning, such resources do not currently exist. As few academically verified, online educational technologies exist for the modern dental learner, students, in search of information presented in a manner consistent with their fast-paced, tech-savvy lives, frequently turn to Google and YouTube [6,7]. While there is no shortage of healthcare information available on the internet, issues that arise with existing online dental educational materials include: (1) verification of the accuracy and quality; (2) control over the scope and modernity; and (3) discrepancies in standards of care. In the context of the COVID-19 pandemic where students have restricted access to their professors, lack of academic verification is of heightened risk. In order to curb the spread of misinformation and cater to the modern dental learner, we must develop academically verified, online, dental educational tools similar to those utilized by medical learners.
THE SOLUTION
Enlisting students to improve education
Fostering student-initiated projects is a proven method to encourage students to pursue academic careers. Beyond their affiliations with academic institutions, many of the aforementioned supplemental online medical education platforms were founded by medical students and residents. Through their collaborations with academic faculty, these students gained opportunities to share their visions for advancing medical education in the digital age. Many have gone on to pursue careers in medical education. With this framework in mind, engaging dental students in the ideation and creation of technologically-forward learning tools in dental education will encourage students interested in becoming dental educators.
To best prepare dental students to tackle the modern oral healthcare landscape, we need academically verified, online educational content for clinical dentistry. Current dental educators have a strong interest in creating innovative, online teaching materials, but often lack the time, resources, and expertise in the most up-to-date technology required for production of these resources. For these reasons, dental educators should enlist their tech savvy students to work as their co-educators and collaborators (see Figure 2). In doing so, dental educators will provide their students with increased opportunities to engage with dental academia, solidifying interest in dental education. This collaboration has the potential to blur the division between teacher and student, and ultimately to resolve the shortage of dental educators.
Figure 2. Guide to the production of successful, verified educational videos for first-time teams.
We believe that increased production and utilization of academically verified videos in dental education will help modern students feel more engaged with their clinical learning, increase the efficient use of class time, and ultimately help students feel more prepared to enter the dental workforce after graduation. Importantly, should students be physically separated from their faculty and academic institutions in the future — as during the COVID-19 pandemic — an existing video library would facilitate continuation of clinical learning. With support from academic and research-based dental educational institutions, we can tackle the weaknesses associated with traditional teaching modalities, provide the verification that online sources such as YouTube lack, and meet the educational demands of the modern dental student.
Impact of verified, online learning tools
We live in an increasingly globalized society where the vast majority of dental students have access to the internet. This level of interconnectivity presents opportunities to disseminate high quality information to communities across the world. Improved access to information has the potential to bridge dental educational gaps across geographic and language barriers. For instance, a library of verified clinical video demonstrations might be used in dentally underserved areas. These videos may teach providers standard of care techniques and level disparities in dental education. Moreover, the migration of educational content to digitized platforms offers potential to increase the standardization of care.
CONCLUSION
Online educational tools not only cater to the learning style of modern dental students, but also solve many of the issues associated with traditional learning tools. Students enjoy learning from online and computer-based learning tools, and therefore often look to Google and YouTube to meet their learning preferences [6,7]. However, Google and YouTube do not, for the most part, contain academically-verified resources on clinical dentistry. The recent COVID-19 pandemic has further reinforced the urgency of developing academically verified, online learning technologies for dental education. While lectures can be recorded or conducted over video chat, high-quality online clinical learning platforms with trustworthy content are hard to create on short notice. We propose that dental students and dental educators work together to increase the body of online, academically-verified dental educational tools such as clinical educational videos. Through this work, dental students can learn about careers in academic dentistry — a field in need of dentists. Finally, online learning tools have the capacity to help dental students all around the world, including in dentally underserved areas and during times of crisis, such as the COVID-19 pandemic.
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