EDHP 504 TEACHING PRACTICUM

Literature Review 12/1/2013

DR. ERNESTINE LACY

Dr. E Lacy, professor and executive director of Student Development and Multicultural Affairs at TAMBCD received the 2013 American Dental Education Associations prestigious William J. Gies award for Outstanding Achievement.

Recently in The Journal of the American Dental Association (JADA) an article which was a landmark article by Dr. Gies in February 1924 was spotlighted for having lasting impact on dental care and the dental profession. A subsequent article highlighting the contributions of Dr. Gies was done in 10/2013 and will be the article chosen for this literature review.

ARTICLE: THE CONTRIBUTIONS OF DR. GIES

PROMOTING STANDARDS OF DENTAL Author: Richard R. Ranney, DDS, MS EDUCATION, RESEARCH Journal: The Journal of the American Dental Association Vol.144 Journal credibility: High in the area of Dentistry: 2.195 and has been on a steady climb according to the ADA. This proves the quality and scientific acceptance of published articles in this journal as it is being cited more in other publications Dr. Richard Ranney is a professor emeritus and the former dean of the University of Maryland Dental School. Past president of American Association for Dental Research AADR

ARTICLE SUMMARY:
PRESENTATION

DR. GIES 1924

In Dr. Gies brief presentation in 1924 he addressed the origins of dental education, its relationship to medical education, proprietary dental schools, dental schools relationship to universities, the scientific background of practice, the function of research in dental schools, inter-professional relationships, dental auxiliaries and financing dental educationall of which are still serious issues of the present world of dental education

ARTICLE SUMMARY:
BELIEFS

DR. GIES

Dr. Gies strongly believed that dentistry should be an essential part of a total health service. He was disappointed after a failed attempt in 1839 to have dentistry integrated into the curriculum at the University of Maryland School of Medicine. After this failure, to appease Dr. Gies Dr. Horace H. Hayden and Dr. Chapin A. Harris formed the Baltimore College of Dental Surgery giving birth to dental education.

ARTICLE SUMMARY:

THE MERGER

Dr. Gies then approved the merger of the oldest dental school in the world BCDS with the University of Maryland in 1913. He stated that this was a new spirit in health-service education. It became the Dental School of the University of Maryland and with a status independent of the medical school. After Dr. Gies concluded that dentistry should remain an independent division of the health sciences and not a sub-specialty of medicine. He did however want to seek a closer working relationship with medical colleagues.

ARTICLE SUMMARY:
EDUCATION FOR PROFIT

DENTAL

In 1924 article Dr. Gies supported the assimilation of dental schools with university systems but denounced the independent dental school that were being established for the sole reason of gaining profit. He felt that these days were past but the author and maybe other feel as if it has re-surfaced. Today there is increasing pressure to become self-sustainable. There has been an increase in philanthropic fundraising, raising revenue through clinical programs and increase in tuition leaving students in substantial debt. Care must be taken not to undermine the educational excellence while attempting to maximize clinical revenue. The increasing debts of students has also have impact on career paths that may not be in the best interest of the profession in terms of its impact of dental education.

ARTICLE SUMMARY:
RESEARCH

DENTAL

Dr. Gies also called for dental research being an integral part of dental schools. Dental research has made many valuable contributions to the improvement of dental practice. Some of the most research intensive dental schools such as Washington University, Emory University and Georgetown University have closed creating the need for research intensive strides in ever institution. There is an increase in the number of dental schools. 12 new institutions have opened or will be opened by 2013. None of which are a part of research-intensive universities. Dr. Ranney is not seeking to denounce these institution but rather caution us to make sure that we are not moving away from Dr. Gies goal of finding a welcome home in research intensive universities. Most research intensive universities have declined the offer to start a predoctoral dental program for unknown reasons

ARTICLE SUMMARY:
EQUIVALENCE

SCHOLASTIC

Dr. Gies strongly urged that the dental education be scholarly equivalent of medical education in every way. His landmark report evaluation dental education for the Carnegie Foundation in 1926 stimulated advancements toward this goal. Curriculum was enhanced in the areas of basic science and relevant medical matters. Dentistry is still realizing Dr. Giess goal for intellectual pedagogical par with medicine

ARTICLE SUMMARY:

DENTAL EDUCATION REFORM AND CHALLENGES

Some believe that is time to reassess how to design educational efforts to prepare future dentists in the best manner. The idea of moving some of the standard curriculum to becoming prerequisites has been postulated. The biggest challenge with curriculum reform and maintenance of current excellence is the shortage of full time faculty for dental schools. Dr. Ranney states that it is disheartening to see how few dental students aspire to an academic career.

ARTICLE SUMMARY:
EDUCATION

POST-GRADUATE

Dr. Gies also expressed goals for post-graduate education in dentistry including advanced training and specialties. Some states have recognized a successful, accredited post-graduate year 1. There has been talk of making PGY-1 mandatory to obtain licensure, making dental school a total of 5 years. Advocates suggest that the pre-doctoral curriculum is too dense and leave very little time to to provide comprehensive knowledge and experience to dental students.

ARTICLE SUMMARY:
CARE

ACCESS TO

Dr. Gies also saw the problems with access-to-care issues. He stated that simply raising the number of dental schools and graduate would not meet this need because students are financially motivated to settle where the pay and lifestyles are what they want. Rural areas are rewarding and meet the need but no as rewarding financial. He stated that distribution of the students is the main way to improve this. When doing the application process, look at a students place of origin. There is evidence to suggest that students from rural areas will usually return back to their native towns to practice.

ARTICLE SUMMARY:
INFLUX AND CONSEQUENCES

DENTAL SCHOOL

Dr. Gies stated that the number of graduates and dental schools should always be controlled. During the Health Manpower Legislation in 1970s/1980s the number of dental schools and class sizes were increased drastically as a part of this initiative. This resulted in too many dentist in some urban areas and rural areas were still underserved. This caused applicants to dental schools to decline in latter years.

ARTICLE SUMMARY:
AUXILIARIES

DENTAL

Dr. Gies promoted the use of dental auxiliaries in regard to access to care issues. Dental Hygienist have now become a valued part of the dental practice but was met with opposition at first. There is talk of expanding the functions and training of hygienists and other dental auxiliaries to provide access to care to underserved communities. Many are concerned for safety of patients and the impact it will have on dentist. Alaska has already implemented an clinic of this type and has upset the community of dentistry. Dr. Gies urges us to look at how dental auxiliaries can used to improve access to care while also protecting against inappropriate treatment due to lack of education and training. In the end, everyone should benefitThe public and the profession.

CONCLUSION:
Dr. Gies has been an integral part of the development of dental education. In 1924 he spoke or areas of improvement that are still issues today. Attention is needed to solve these problem that have been longstanding in our profession. Our profession is only as great as those people who are a part of it. My personal opinion is that decisions of many of our colleagues to ignore the issues with dental education, access to care and research will negatively impact the longevity of our profession. A new Gies Report is needed and a new charge need to be excited in our students to improve the future of dental education.