THE ART OF DENTISTRY - School of Dental Medicine - Case ...

Ultimately, these thoughts helped to shape
not one, but two curricula at CWRU.
One curriculum focuses on restructuring
the predoctoral program (our primary
program) to ensure not only technical
excellence—which remains the foundation
on which all else is built—but also to
foster a culture of inquiry. To this end,
we are using a new pedagogy called the
REAL curriculum, a set of core principles
which promote communication skills,
independent learning, leadership, the use
of technology, lifelong learning, and
careful evaluation of science and practice to
nurture practitioners who are appropriately
educated not only for what they do, but
for what they might do. At CWRU we
believe that what they might do is to
evolve into a different kind of primary
healthcare provider, one with a broader
scope than currently exists.
The other curriculum supports a five-year,
combined degree program (for between
two and six students) that offers both a
dental and a medical degree. The combined
DMD/MD program shares all of the goals
and methods of the REAL curriculum
and, in addition, aims to create a cadre of
new healthcare professionals who, by
virtue of their dual training, transcend
traditional categories, allowing them to
think more expansively about the care
they provide, especially in the areas of
behavior modification and compliance
with treatment for chronic conditions,
two of the most important challenges in
health care today.
REAL is an acronym for Relevant,
Experiential, Active Learning. Because
we at CWRU believe that dental education
should be Relevant, we have deleted
unnecessary information and replaced
it with new information and emerging
technologies. Dental education should
also be Experiential, a focus derived from
our extensive, health promoting, first-year
experience in which students travel to
almost 100 elementary schools to provide
care, including the placement of sealants,
three months after entering dental school.
Students tell us that their ability to learn
concepts such as infection control, materials,
child management, etc., is sharpened by
the fact that they will so quickly be
challenged to provide care. The REAL
curriculum builds on this approach by
including four similar experiences during
the first two years so that students are
continually challenged to prepare for
something that is “just around the corner.”
The REAL curriculum also emphasizes
small group, Active Learning methods
(problem-based, case-based, and teamlearning).
In addition, subject material
has been reorganized according to themes
that cut across traditional disciplines;
namely, health and well-being, maintenance
of health disease processes, and restoration
of health. The curriculum also emphasizes
comprehensive care in a multi-doctor office
setting, the ability to apply management
principles, and vertical integration of clinical
experiences over four years.
It is very difficult to paint a picture of the
future, but I am convinced that these
concepts point the way to dentistry’s
potential and, indeed, obligation, to
demonstrate increased professionalism
and value to the public. A basic tenet of
leadership is that you spend time doing the
things that only you can do and delegate
the rest to others. In this way of thinking,
dentists learn to share responsibility and
to delegate so that they can involve themselves
more with evaluation, diagnosis, treatment
planning, office management, continuous
learning, and communicating with
patients and other healthcare providers.
Another core principle that emerged from
our deliberations is the value and importance
of students in different healthcare professional
training programs working together to
solve patient problems. This principle
is reflected in CWRU’s new DMD/MD
program, which will begin in fall 2008.
The DMD/MD curriculum is fully
integrated between the dental school and
the medical school so that the educational
objectives of both programs are met and
merged, rather than being presented as
discrete entities, one followed by the
other. The students in the DMD/MD
program are required to achieve all the
outcomes of the REAL curriculum, but
they are also expected to develop an
expanded ability to diagnose, treat, and
prevent a much broader array of health
problems. For many years, the Institute
of Medicine (IOM) has called for health
professional schools to stop educating
students in “silos” when patients expect
them to work in collaborative teams in
clinical practice. We feel that the DMD/
MD program is a step in that direction.
Importantly, it allows students to work
together in the clinic, as well as the classroom.
Equally important, it places CWRU
in an excellent position to continue to
research the many evolving links between
oral health and general health.
Another benefit is that students in the
DMD/MD program are exposed to an
additional group of professional role
models. It is our hope that from this
non-traditional education and experience
will come a new kind of healthcare
provider, one who synthesizes the best
of both dentistry and medicine.
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