STOMATOLOGIYA
УДК: 614.23:616.314-001.18-
FOSTERING FUTURE DENTISTS WITH
LIFE-LONG LEARNING COMPETENCY
Jihyun LEE
Seoul National University,
South Korea
Dentistry is a profession with continual changes and explosion of
knowledge a nd technology. Consequently, dental treatment and
care are unceasingly advancing. Some medical educators contrast
medical education to running a bakery (Shaughnessy & Slawson,
1999). Professors have students stock their empty shelves with new
loaves of knowledge. We tell our students what bread to stock and
what to do with it. It is we, professors, who do all the heavy lifting, i.e.
the actual learning. As a result, students become good at stocking
already-made-knowledge on the designated shelves. These students
can perform well on tests at school. However in their professional
pathways, they may neither produce bread by themselves, nor stock
it by themselves any more without spoon-feeding instructions. These
pitfalls would threaten patients'safety. It is thus imperative for dental
professionals to be life-long learners.
Lifelong learning is one of the key components of
professionalism. In other words, ongoing commitment to lifelong
learning is a professional responsibility, and it can be the firm source
of public trust of dentists. Accreditation and regulation bodies across
globe such as General Dental Council (GDC), Commission on Dental
Accreditation (CODA) and other organizations in each countries all
require graduating dentists to equip with lifelong learning
competency and dental educational institutions to educate them the
competency. It is also related to evidence-based dentistry since
lifelong learning can bridge between practice and research, and allow
dental practitioners to provide high quality dental care by staying
updated with scientific evidence for their treatment.
However, the current situation is not that ideal. Students are
overly assessment-driven and dependent on faculty direction rather
than initiate their own learning. Busy dentists are hunting for answers
to questions arisen from practice instead of developing self-direction
for learning, in a way of reading professional journals, attending
academic meetings or courses, or undertaking retraining courses.
They are not familiar with reliable methods for foraging through the
jungle of overflowing information to keep up with newfindings, and
do not have a proper filter to discern relevant information.
According to medical education researchers, a selfdirected
lifelong learners should have following features (Miflin, Campbell, &
Price, 2000, p. 300):
-
Be conscious of the need and accept responsibility for
evaluation of practice in the light ofchanging understanding;
-
Be able to identify deficiencies in their own knowledge, skills
and attitudes;
-
Be motivated to generate a learning program to address
deficiencies, including finding and using the best evidence;
-
Have the skills to identify access and use resources wisely and
efficiently;
-
Be able to evaluate learning efforts, including resources used,
and the effects on practice, and
-
Be committed to repeating the cycle with each patient and
clinical situation.
Then how to foster dental graduates with such features? Dental
and medical schools have exerted various efforts to prepare future
dentists and doctors with self-directed lifelong learning competency.
Interventions have been implemented from program level,
instructional method level, and professors' guide level. What is
evident is that traditional curriculum, instructional method, and
professors'role cannot ensure that we train future doctors with
lifelong learning competency. Lecture and test only equip learners
with plenty of information but not the skills to actively and
responsibly update it. Starting from mid-1980's medical schools
started to in novae their curriculum for fostering lifelong learners. In
1985, Harvard Medical School initiated the New Pathway program
(NP), a preclinical curriculum aiming at promote positive attitudes
toward self-directed lifelong learning integrating psychosocial and
humanistic concepts with biologic principles in patient care. In 1992,
the University of Toronto medical school integrated PBL and Self-
Directed Learning (SDL) into its conventional lecture-based medical
curriculum. Currently, most dental schools are trying to develop
students' lifelong learning capacity with diverse forms of
interventions. The comparative effectiveness of the new programs to
conventional curricula was reported in several studies.
Such school-wide programs that sought to promote lifelong
learning attitude and competency often adopt Problem Based
Learning (PBL) due to its student-centered process structure. In PBL,
(1) students analyze a patient's case, (2) define the problem (3)
develop hypotheses, (4) identify learning issues (learning objectives)
to solve the patient's problems. Later, after (5) independent study (6)
students share what they have learned and apply their learning to
solve the patient's problems. Faculty facilitator guides the students
through the PBL process and provides feedback instead of providing
content information.Through the process students take responsibility
for directing their own learning by addressing learning objectives.
The presented cases facilitate motivation, which simulates lifelong
learning situation when the students graduate and practice.
Professors should
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В ПОМОЩЬ ПРАКТИКУЮЩЕМУ ВРАЧУ
ensure that the learning objectives students generate are appropriate
to a particular stage of learning planned as part of a progressive
development of knowledge and skills, and help transfer their learning
habits toward life-long learning when they become the practicing
dentist. However, there exists diverse constraints against successful
implementation of PBL in practice.
Regardless of school-wide programs or methods, individual
faculty members can promote students' lifelong learning
competency in their courses. In the beginning such as the first year
of the dental school, students need support and guidance to foster
the development of self-directed lifelong learning. The completely
'hands-off' minimalist approach may frustrate students especially at
the beginning of a new course in an unfamiliar environment.
Professors should assist students over time to develop the capacities
by providing of well-structured resources for foundation knowledge,
coaching in accessing databases and literature review, formative
assessment, and modeling reasoning procedure. GraduaIly they can
get confidence and take greater responsibility for directing their own
learning. As students are learning clinical skills, professors should be
a lifelong learner model by contextualizing the PBL process in a real
practice situation. Dental schools should make efforts across all levels
of program, instructional method, and professors' guide. Especially,
in the time of proliferating amount of research and ever-advancing
technologies, schools need to provide technological infrastructure to
facilitate lifelong learning by preparing e-learning resources or other
electronic tools and making evidence-based knowledge available as
students' guestions arise.
As we conclude, we'd like to guote John Gardner's phrases.
"If we teach our students in an elaborate set offixed beliefs, we
are ensuring their early obsolescence. The alternative is to develop
skills, attitudes, habits of mind, and kinds of knowledge and
understanding that will be instruments of continuous change and
growth. Then we will build a system that provides for continuous
renewal." (p. 21).
For the continuous growth of our field of dentistry and
patients'safety, we truly need to recognize our responsibility to
graduate self-directed lifelong learning future dentists, not workers
who only follows directions where to stock bread.
References
1.
1. Gardner J.
IT
Self-renewal: The individual and the innovative society. - N. Y: Harper
&Row, 1963.
2.
2. Miflin B.M., Campbell CB, Price D.A. A conceptual framework to guide the development
of self-directed, lifelong learning in problem-based medical curricula//Med. Education. - 2000.-
Vol. 34, №4.-P. 299-306.
3.
3. Shaughnessy A.E, Slawson D.C Are we providing doctors with the training and tools for
lifelong learning?//Brit. Med. J. - 1999. - Vol. 319, №13.-P. 1-3.
УДК: 616.314-089.5-053.2]-07
ОБОСНОВАНИЕ ПРИМЕНЕНИЯ
АРТИКАИНОВЫХ АНЕСТЕТИКОВ В
ДЕТСКОЙ СТОМАТОЛОГИЧЕСКОЙ
ПРАКТИКЕ У ДЕТЕЙ МЛАДШЕ
ЧЕТЫРЕХ ЛЕТ
Касаткина А.Л.
1
,
Маслак Е.Е.
1
,
Мишарева Н.И.
2
,
Ставская СВ.
3
,
Филимонова Е.В.
2
,
Фоменко И.В.
1
,
Панченко М.Л.
2
1. ФГБОУ ВО «Волгоградский государственный
медицинский университет» Минздрава России 2.
ГАУЗ «Детская клиническая стоматологическая
поликлиника №2», Волгоград, Россия
3. ГАУЗ «Клиническая стоматологическая
поликлиника №12», Волгоград, Россия
Среди всех лекарственных препаратов, применяемых при
стоматологическом лечении детей, местные анестетики,
бесспорно, занимают первое место, а местная анестезия широко
используется не только для хирургических, но и для
терапевтических
стоматологических
манипуляций
[3,6].
Безболезненное лечение - одно из важных положений,
отмеченных в Порядке оказания медицинской помощи детям со
стоматологическими
заболеваниями,
которое
помогает
улучшить психоэмоциональное состояние и предотвратить
негативное поведение детей во время стоматологического
лечения [2,14,17]. Однако проведение местной анестезии в
детской стоматологической практике вызывает значительные
затруднения, так как многие дети анестезии боятся больше, чем
бормашины [6,11]. Нередко анестезия не только не приводит к
эффективному обезболиванию, но и вызывает целый ряд
побочных эффектов и осложнений. У детей это обусловлено
анатомо-физиологическими особенностями челюстно-лицевой
области,
незрелостью
иммунной
системы
организма,
спецификой психологической и эмоциональной сферы. Чем
младше ребенок, тем ярче проявляются вышеуказанные особен-
ности и выше вероятность неэффективности местной анестезии,
что необходимо учитывать при выборе способа обезболивания
[7].
У большинства детей наблюдается низкая активность
кариеса, поэтому при обращении ребенка в стоматологическое
учреждение нередко требуется лечение или удале
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