Description |Aims | Process | Assessment | Evaluation |Resources | Contact

Description

During their sessions in Oral Diagnosis, fourth-year dental students treat patients in a clinic within the Primary Care Unit of the Adelaide Dental Hospital. Teaching sessions consist of two hours of clinical work with patients followed by a one hour discussion in an adjacent seminar room. Each student attends one session per week, in groups of twelve or thirteen, for the whole academic year. At the start of the year, two one-hour lectures set the scene for the coming program.

The teaching program is designed using experiential and problem-based learning principles, with 80 per cent of the final grade derived from two self-assessments.

Aims

The first lecture encourages a sense of ownership and control of the course amongst students. It is they who develop both their learning aims and the teaching aims of the tutors by answering the following questions:

• `What things would you like to be able to do at the end of the year that you can't do now?'
• `A good teacher is . . .?'
  
  

In answer to the first question, students have nominated objectives such as the following:

• To have the ability to make a correct diagnosis
• To acquire a holistic approach to treatment
• To have patience with patients
• To act on constructive criticism

Guidelines for the tutors are compiled from answers to the second question, `A good teacher is . . .?' Qualities nominated have included:

• One who can empathise with students and communicate on the same level
• One who keeps an open mind and will listen to alternative viewpoints
• One who is accessible out-of-hours for advice
• One who allows you to determine your own level of knowledge and skill
  
  

Process

To create a productive learning environment, an `umbrella' of trust must be set up early in the course, so that students feel free to express themselves, to question, to make errors and not be judged beyond redemption. the first meeting of the group is solely committed to this task, with students and staff introducing themselves and their interests to each other, and the staff demonstrating the friendly and respectful attitude cardinal to the success of the course. an open, constructive working environment is essential for problem-based learning, otherwise students will not feel free to question and disagree with their teachers. The two main theories underpinning learning in Oral Diagnosis are problem-based learning and experiential learning. In problem-based learning students are learning from their involvement in problem solving, both in the clinic and seminar settings. This is achieved by tutors guiding students through problem solving with appropriate questioning, for example: `What do you know about this problem?', `Do you need more information?', `Are you sure of the facts?', and so on.

In the complementary experiential learning process, the students are encouraged to involve themselves fully, openly and without bias in the new experiences that are presented to them. They then reflect on these experiences from several perspectives. Following this critical reflection they are then in a position to create abstract models, and solve problems with these models by active experimentation.

The crucial reflection period is facilitated firstly by the seminar period which follows the clinical session, and later through the use of a `journal of reflection'. This journal serves to integrate and expand the knowledge gained from the clinical work, and enables knowledge to be created through the transformation of experience. A journal review is conducted once a term, at about the time the students are assessed. For students experiencing problems, a frank and open discussion ensues with the journal used as a focus for the appraisal. The aim is for students to realise what they need to do to improve the situation, and thereby accept responsibility for their improvement. Students then document their plans for improvement in their journals.

Assessment

At the end of the first and second semester, students are asked to self-assess and justify their grade by reflecting on the semester's achievements. The objectives students set at the beginning of the year act as guides in their decision-making. In their assessments they discuss their strengths and weaknesses, concluding with a negotiated grade. These assessments account for 80 per cent of their final mark, the additional 20 per cent coming from an end of year problem centred clinical test.

Evaluation

The components of the course have been evaluated separately. In a study of the appropriate conditions for journal use* the vast majority of students considered the journals a valuable tool for reflection and feedback that provided an insight into the learning process. At the end of Semester 1, 1995, 4th and 5th year students were surveyed to determine their views on the effectiveness of the assessment processes and, in particular, self-assessment**. The overall assessment process was seen by both groups of students as reflecting the objectives of the course (84% of the total sample agreed that this was so), and as being implemented in a fair way (81% agreed). Seventy percent said that they had a 'positive' or 'very positive' attitude to self-assessment, with only 7.5% having a 'negative' attitude.

Resources

References

*Wetherell J, and Mullins G. The Use of Student Journals in Problem Based Learning. Medical Education, 1996 (in press).

**Wetherell J, and Mullins G. Self-assessment in Dentistry; the first steps in lifelong learning. Research and Development in Problem Based Learning, 1995 Vol. 3.

Other Sources

This page is largely based on the more detailed paper;

Wetherell J, and Mullins G. A problem-based approach to a course in oral diagnosis. Australian Dental Journal, 1994, 39(3) 190-2.

The experiential learning model used in the course is based on;

Kolb DA. Experiential learning experience as the source of learning and development. Englewood Cliffs: Prentice-Hall, 1984.

The reflective journals take their inspiration from;

Boud D, Keough R, Walker D. Reflection: Turning experience into learning. London: Kogan Page, 1985.

Contact

last update 01/05/99