title: Dental Students' Clinical Experience Across Three Successive Curricula at One U.S. Dental School.
abstract: As dental schools continue to seek the most effective ways to provide clinical education for students, it is important to track the effects innovations have on students' clinical experience to allow for quantitative comparisons of various curricula. The aim of this study was to compare the impact of three successive clinical curricula on students' experience at one U.S. dental school. The three were a discipline-based curriculum (DBC), a comprehensive care curriculum (CCC), and a procedural requirement curriculum plus externships (PRCE). Students' clinic experience data from 1992 to 2013 were analyzed for total experience and in five discipline areas. Clinic experience metrics analyzed were patient visits (PVs), relative value units (RVUs), and equivalent amounts (EQAs). A minimum experience threshold (MET) and a high experience threshold (HET) were set at one standard deviation above and below the mean for the DBC years. Students below the MET were designated as low achievers; students above the HET were designated as high achievers. The results showed significant differences among the three curricula in almost all areas of comparison: total PVs, total EQAs, total RVUs, RVUs by discipline, and number of high and low achievers in total clinical experience and by discipline. The comprehensive care approach to clinical education did not negatively impact students' clinical experience and in many cases enhanced it. The addition of externships also enhanced student total clinical experience although more study is needed to determine their effectiveness. The insights provided by this study suggest that the methodology used including the metrics of PVs, EQAs, and RVUs may be helpful for other dental schools in assessing students' clinical experience.
authors.affiliation: Dr. White is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Jenson is former Health Sciences Clinical Professor, University of California, San Francisco School of Dentistry; Dr. Gansky is Professor and Lee Hysan Chair of Oral Epidemiology, Division of Oral Epidemiology and Dental Public Health, and Vice-Chair for Research, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Mr. Walsh is a fourth-year dental student, University of California, San Francisco School of Dentistry; Dr. Accurso is with Oral Pathology Consultants, Grosse Pointe Woods, MI; Dr. Vaderhobli is Associate Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Kalenderian is Professor and Gladys and Leland Barber Chair of Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Walji is Professor and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; and Dr. Cheng is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry. whitej@dentistry.ucsf.edu.
authors.forename: Joel M
authors.initials: JM
authors.lastname: White
authors.affiliation: Dr. White is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Jenson is former Health Sciences Clinical Professor, University of California, San Francisco School of Dentistry; Dr. Gansky is Professor and Lee Hysan Chair of Oral Epidemiology, Division of Oral Epidemiology and Dental Public Health, and Vice-Chair for Research, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Mr. Walsh is a fourth-year dental student, University of California, San Francisco School of Dentistry; Dr. Accurso is with Oral Pathology Consultants, Grosse Pointe Woods, MI; Dr. Vaderhobli is Associate Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Kalenderian is Professor and Gladys and Leland Barber Chair of Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Walji is Professor and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; and Dr. Cheng is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry.
authors.forename: Larry E
authors.initials: LE
authors.lastname: Jenson
authors.affiliation: Dr. White is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Jenson is former Health Sciences Clinical Professor, University of California, San Francisco School of Dentistry; Dr. Gansky is Professor and Lee Hysan Chair of Oral Epidemiology, Division of Oral Epidemiology and Dental Public Health, and Vice-Chair for Research, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Mr. Walsh is a fourth-year dental student, University of California, San Francisco School of Dentistry; Dr. Accurso is with Oral Pathology Consultants, Grosse Pointe Woods, MI; Dr. Vaderhobli is Associate Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Kalenderian is Professor and Gladys and Leland Barber Chair of Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Walji is Professor and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; and Dr. Cheng is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Gansky
authors.affiliation: Dr. White is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Jenson is former Health Sciences Clinical Professor, University of California, San Francisco School of Dentistry; Dr. Gansky is Professor and Lee Hysan Chair of Oral Epidemiology, Division of Oral Epidemiology and Dental Public Health, and Vice-Chair for Research, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Mr. Walsh is a fourth-year dental student, University of California, San Francisco School of Dentistry; Dr. Accurso is with Oral Pathology Consultants, Grosse Pointe Woods, MI; Dr. Vaderhobli is Associate Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Kalenderian is Professor and Gladys and Leland Barber Chair of Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Walji is Professor and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; and Dr. Cheng is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry.
authors.forename: Cameron J
authors.initials: CJ
authors.lastname: Walsh
authors.affiliation: Dr. White is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Jenson is former Health Sciences Clinical Professor, University of California, San Francisco School of Dentistry; Dr. Gansky is Professor and Lee Hysan Chair of Oral Epidemiology, Division of Oral Epidemiology and Dental Public Health, and Vice-Chair for Research, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Mr. Walsh is a fourth-year dental student, University of California, San Francisco School of Dentistry; Dr. Accurso is with Oral Pathology Consultants, Grosse Pointe Woods, MI; Dr. Vaderhobli is Associate Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Kalenderian is Professor and Gladys and Leland Barber Chair of Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Walji is Professor and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; and Dr. Cheng is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry.
authors.forename: Brent T
authors.initials: BT
authors.lastname: Accurso
authors.affiliation: Dr. White is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Jenson is former Health Sciences Clinical Professor, University of California, San Francisco School of Dentistry; Dr. Gansky is Professor and Lee Hysan Chair of Oral Epidemiology, Division of Oral Epidemiology and Dental Public Health, and Vice-Chair for Research, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Mr. Walsh is a fourth-year dental student, University of California, San Francisco School of Dentistry; Dr. Accurso is with Oral Pathology Consultants, Grosse Pointe Woods, MI; Dr. Vaderhobli is Associate Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Kalenderian is Professor and Gladys and Leland Barber Chair of Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Walji is Professor and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; and Dr. Cheng is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry.
authors.forename: Ram M
authors.initials: RM
authors.lastname: Vaderhobli
authors.affiliation: Dr. White is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Jenson is former Health Sciences Clinical Professor, University of California, San Francisco School of Dentistry; Dr. Gansky is Professor and Lee Hysan Chair of Oral Epidemiology, Division of Oral Epidemiology and Dental Public Health, and Vice-Chair for Research, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Mr. Walsh is a fourth-year dental student, University of California, San Francisco School of Dentistry; Dr. Accurso is with Oral Pathology Consultants, Grosse Pointe Woods, MI; Dr. Vaderhobli is Associate Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Kalenderian is Professor and Gladys and Leland Barber Chair of Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Walji is Professor and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; and Dr. Cheng is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry.
authors.forename: Elsbeth
authors.initials: E
authors.lastname: Kalenderian
authors.affiliation: Dr. White is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Jenson is former Health Sciences Clinical Professor, University of California, San Francisco School of Dentistry; Dr. Gansky is Professor and Lee Hysan Chair of Oral Epidemiology, Division of Oral Epidemiology and Dental Public Health, and Vice-Chair for Research, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Mr. Walsh is a fourth-year dental student, University of California, San Francisco School of Dentistry; Dr. Accurso is with Oral Pathology Consultants, Grosse Pointe Woods, MI; Dr. Vaderhobli is Associate Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Kalenderian is Professor and Gladys and Leland Barber Chair of Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Walji is Professor and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; and Dr. Cheng is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry.
authors.forename: Muhammad F
authors.initials: MF
authors.lastname: Walji
authors.affiliation: Dr. White is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Jenson is former Health Sciences Clinical Professor, University of California, San Francisco School of Dentistry; Dr. Gansky is Professor and Lee Hysan Chair of Oral Epidemiology, Division of Oral Epidemiology and Dental Public Health, and Vice-Chair for Research, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Mr. Walsh is a fourth-year dental student, University of California, San Francisco School of Dentistry; Dr. Accurso is with Oral Pathology Consultants, Grosse Pointe Woods, MI; Dr. Vaderhobli is Associate Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Kalenderian is Professor and Gladys and Leland Barber Chair of Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry; Dr. Walji is Professor and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; and Dr. Cheng is Professor, Department of Preventive and Restorative Dentistry, University of California, San Francisco School of Dentistry.
authors.forename: Jing
authors.initials: J
authors.lastname: Cheng
mesh_terms: D002983:Clinical Competence; D003479:Curriculum / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D012575:Schools, Dental / Q000592:standards / Q000706:statistics & numerical data; D013335:Students, Dental / Q000706:statistics & numerical data; D014481:United States
keywords: clinical competence; clinical curriculum; clinical education; clinical skills; comprehensive care; dental education; externships; instructional models; teaching methods