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Colleges of continuing education
OPINION CLEARINGHOUSE The issues facing dentistry today are numerous. So are the number of opinions on any given issue. In this section of t h e j o u r n a l , we encourage responsible and well-written expression of opinion. Articles are chosen on a competitive basis. As in other parts of t h e j o u r n a l , opinions expressed or implied are strictly those of the authors and do not necessarily reflect the opinion or official policies or position of the American Dental Association.
Colleges of continuing education ■ ■ ■ ■ ■ ■ ■ ■ ■ Thaddeus
V.
Weciew,
C o n tin u in g ed u catio n is considered a necessity in m ost professions to day. M any disciplines favor this m etho d of u p d atin g th e g ra d u a te ’s ca p a b ilitie s and d isag ree w ith the notion th at a d e g re e represents the fin a lizin g of an ed u catio n. T h e em erg in g consensus is th at the tre m end o us sum s of m oney spent fo r u n d e rg ra d u a te and g ra d u a te ed u catio n m ust b e au g m en ted to keep th e p rofessional up to date. H o w ever, th e m ann er in w hich co n tin u in g ed u catio n courses in « a ll disciplines are presented leaves ^m uch to be desired and th erefore, th e estab lish m en t of colleges of c o n tin u in g e d u ca tio n , fo un ded and p ro m o ted by th e den tal profession, is h erein p ro po sed.
Background of continuing education H ealth
profession
societies
and
so m e universities have long held m e etin g s and sem in ars from w hich p rac titio n e rs could absorb current ideas. H o w ever, th e great m ajority
D D S, C h icag o ■ ■ ■ ■ ■ ■
of p rofessionals w ere not m otivated to attend and th eir new techn iqu es w ere fre q u en tly introduced to them by va rio u s co m m ercial purveyors. In 1949, w ith th e estab lishm en t of th e A c ad em y of G eneral P ractice in th e m edical profession, a nom inal fo rm al p ro gram of co n tin u in g ed u catio n beg an . T h e a c a d e m y ’s main o b je c tiv e w as to represen t the inter ests of g en eral m edical p rac titio n ers w ho w ere den ied hospital privi leges by so m e of th e num erous m edical specialties. T h e co n tin u in g e d u ca tio n re q u ire m en t fo r m em bership w as attain ed by atten d an ce at th e a c a d e m y ’s m eetings. O ver th e past th ree decades, co n tin u in g den tal e d u ca tio n has b u r geoned and taken m any fo rm s at universities, scien tific m eetings, and sem in ars and w ithin other gro up s in dentistry. F or exam ple, co n tin u in g ed u catio n is th e m ain o b jec tiv e of th e A cad em y of G en eral Dentistry, fo u n d e d in 1951. As o ne of th e fo u n d e rs of th at group, I can say th at it was org an ized to en h a n c e th e status of th e general
den tal p rac titio n e r and to rew ard his effo rts in keep ing ab reast of the d yn am ic ch an g es in dentistry. A lth ou gh th e d esirab ility of co n tin u in g e d u ca tio n is reco gn ized by th e professions, no overall fo rm a t fo r th e p resen tatio n of courses has evolved, n or has any m e as u rem e n t o f th e s tu d e n t’s ab so rp tion of th e co u rse c o n ten t— o th e r than by e x a m in a tio n — been d evised. F urther, it w as d ecried at one university se m in ar th at th ere is no know n way to d e te rm in e if th e kn o w led g e and tec h n iq u es offered at co n tin u in g e d u ca tio n courses a re fin a lly d eliv ered to th e p atien t or client.
A suggestion for colleges of continuing education For the afo re m e n tio n e d reasons, it is proposed that co lle g e s of c o n tin u in g e d u ca tio n be established as th e fo urth level (after th e e le m e n tary, seco n dary, and u niversity lev els) in our e d u ca tio n system. T h e term co lleges of c o n tin u in g e d u c a tio n d en o te s a suggested type of JADA, Vol. 94, June 1977 ■ 1063
school of advanced or current learn ing wherein the professional can enhance his skill and knowledge under the aegis of the universities. The structure of colleges of con tinuing education would replace the present haphazard format and de livery of continuing education. The colleges, located in conjunction with our universities, would have the background to sift the many new ideas and methods and to for malize the presentation of the stud ies. With its current leadership in con tinuing education, the dental pro fession could conceivably initiate and promote such colleges. All den tal schools offer some continuing education courses, from a few courses to a full program of over 100. Some dental schools have a full-time head of the continuing ed ucation program, but in most, a fac ulty member heads the continuing education department on a parttime basis, along with other duties. Thus, the factors of experience and administration exist in the univer sity, and a foundation for a college of continuing education is already laid. Furthermore, dentists are ori ented to continuing education and many of the new graduates are par ticipating in refresher courses (con tinuing education) soon after re ceiving their diplomas. This large group would be the initial promot ers of the colleges of continuing education. Some ‘prerequisites’ Continuing education, as it is now presented, runs the gamut from the short one-hour lecture to a partly subsidized vacation (such as five days on a cruise ship) to two-week courses—all with various degrees of adequacy. Therefore, first, an indepth survey of the effectiveness of various methods of course delivery must be made. The most effective continuing dental education de livery pattern seems to involve courses that meet for several days or more, that include learner partic ipation, and whose content is rela ted sequentially. Participation
courses are thought to be the most efficacious in developing the skills related to manual dexterity. For col leges of continuing education, how ever, a determination should be made on the basis of universities’ past experiences in education, with the assistance of the ADA and other interested, knowledgeable parties, as to the most effective delivery methods. In a project of this nature, the think tank facilities of several universities might be utilized. When the delivery methods have been analyzed and conclusions reached, attention should next be focused on the development of a physical plant and faculty. The very existence of such a facility, with a dean at the head and a faculty ros ter including visiting lecturers and clinicians, would serve as a moti vational force for continuing edu cation to both the graduate and undergraduate. The establishment of a physical plant and the organization of a fac ulty need financing and approval of the universities’ boards of trustees. These two necessities would re quire an explanation of the value of such a college to those in authority. The state assemblies, those pro viding endowments, and other hold ers of the purse strings must be made aware of the great potential the public would lose if the grad uate—the product of their original investment—were not brought up to date regularly. If a professional practices with his skills and devel oped talents as he learned them in the past, instead of using currently accepted methods, the public is the loser. This is contrary to the estab lished doctrine of “the public weal," which is the basis for licensure. The cost of fully implemented col leges of continuing education with programs in all disciplines would be enormous. These costs, except for plant and facilities, should be borne by the college’s students. Facilities, faculty, and course content Present dental school facilities could be used until separate facili ties for a college of continuing edu
1064 ■ OPINIO N CLEA RING HO USE / JADA, Vol. 94, June 1977
cation could become a reality. At the start, dental school facilities that are not in use a night could be made available and would be ideal from the standpoint of scheduling, since most health professionals do not work in the evenings. Weekends would also be a favorable time. Dental school laboratories and lec ture halls could be used on a rotat ing basis with the other health pro fessions (for example, medicine, nursing, and pharmacy) for the con duct of their continuing education courses in the future. The content of courses offered by colleges of continuing education should meet the needs of the stu dents. The faculty members of the colleges and persons appointed to committees of the professions should be asked to cull the litera ture and audit professional meet ings to learn what is innovative and worth teaching in the various disci plines. This could be the basis for the year’s courses. For the older graduates and those who have not recently participated in continuing education courses, a review of the basics should be required or at least offered if the enrollee wants to refresh his knowledge. For the faculty, a list of visiting instructors, as well as members of the university’s staff, could be com piled, along with their areas of ex pertise. The specialists should be alert to the general practitioners’ clinical problems and urged to par ticipate in courses of a mutual na ture so that they might better un derstand these problems. In a college of continuing educa tion, after a course has been pre sented, the faculty instructor and the course should be evaluated by both the school and the students. Recognition of participation At this time, continuing education is not structured in a formal pat tern leading to a scholarly goal; in stead, a collection of courses has been offered randomly, with certifi cates as mementos. However, many serious students in continuing edu cation would desire recognition of their course participation in the
form of an eventual degree, but the universities require residence, a time limit for achievement, and a specific program. A change in this pattern should be negotiable. A new degree for continuing edu cation participation (an associate, for example) might be awarded for 40 to 60 weeks of continuing edu cation without a fixed time limit for achievement. This might entail par ticipation in meaningful, two-week courses (80 clock hours) for 20 to 30 years. Colleges of continuing education could be geared to han dle such a program. The education process never ends, and the finalizing of an edu cation with a degree (BS, MS, or PhD) should be a thing of the past. No education should be static. The public has a great deal of money invested in each graduate, and the graduate has invested much time, money, and effort to achieve his professional status. The product of this investment must be brought up to date regularly. Sum m ary
Educators should now take over the haphazard pattern that has evolved in continuing education and formalize it in colleges of con tinuing education. Most dentists in America are now oriented to the concept of contin uing education, and this large group could be the nidus for the promo tion of colleges of continuing edu cation. Dentistry is the youngest of the health professions and has been the foremost advocate of continu ing education. The founding and promotion of colleges of continu ing education by the dental profes sion, as the fourth level in our edu cation system, would certainly con tribute to dentistry’s stature.
I th a n k Dr. A lb e rt W a sse rm an fo r his h elp in c o m p ilin g th is m a te ria l. Dr. W e clew is in p riv a te p ra c tic e a t 6007 N S a u g a n a sh Ave, C h ic a g o , 60646.
The general practitioner and continuing education ■ ■ ■ ■ ■ ■ ■ ■ John W. W ittrock, DDS, MA, Richmond, Va
Continuing education is a necessity for relicensure in several states, and this trend seems to be gaining approval as an accepted part of the practice of dentistry. Both the den tist and patient can gain from this form of advanced education, but it is not without problems. The solu tion of these problems, in my opin ion, requires a coordinated effort on the part of the educational insti tutions, the dental societies, and the boards of examiners. Problems are concerned with the availability, quality, and continuity of dental continuing education for the general practitioner if meaning ful objectives in the courses are to be achieved. The objective of den tal continuing education is to aid the practitioner in increasing his capabilities, resulting in better pa tient care. However, this urgent ob jective is not always attainable. If dental continuing education is mandatory, it follows that an ade quate number of courses should be available from which the practi tioner can choose. It is not motivat ing to require something that is of no interest or is perhaps of doubtful availability. Courses on a particular subject can be “nonavailable” if they are not in existence or if sched uling conflicts preclude attendance. However, the greatest cause of “nonavailability” may be the loca tion of the course. For example, if the issues of The Jo u rn a l (June and December) that contain notices of continuing education courses are examined, it can be seen that cours es are more available in some geo graphic areas than others. There fore, some practitioners may have to travel considerable distances to attend, and if the travel is excessive,
it can act as a deterrent to participa tion. I have seen many “heroic” ex amples of both the practitioners and teachers who have traveled great distances to participate in continuing education courses. All things being equal, good course availability is an incentive and not a deterrent. Quality involves setting objec tives, facilitating learning, and then evaluating whether learning oc curred and determining if it were worthwhile. Present continuing education can vary from a highquality education to entertainment with color slides. However, if con tinuing education is mandatory, the courses should be of high qual ity and allow both the teacher and practitioner to determine if any worthwhile changes in patient care have occurred as a result of partic ipation in the courses. Continuity in programs is probab ly the one factor that could improve continuing education most. Con tinuity—an interrelationship of courses—is achieved by structur ing each course so it proceeds from the simple to the complex, and structuring all courses so they relate to each other and are arranged in a sequence that will enhance learn ing. Continuity would permit the practitioner to choose a related ser ies of courses that would provide a greater cumulative learning effect than courses given in bits and piec es. At present, there is little or no continuity in continuing education courses and rarely is the practition er presented a related group of courses that would allow his sys tematic progress. If continuing edu cation is mandatory, the practition er should have the opportunity to
OPINION C LEARING HO USE/JADA, Vol. 94, June 1977 ■ 1065
Colleges of continuing education ■ ■ ■ ■ ■ ■ ■ ■ ■ Thaddeus
V.
Weciew,
C o n tin u in g ed u catio n is considered a necessity in m ost professions to day. M any disciplines favor this m etho d of u p d atin g th e g ra d u a te ’s ca p a b ilitie s and d isag ree w ith the notion th at a d e g re e represents the fin a lizin g of an ed u catio n. T h e em erg in g consensus is th at the tre m end o us sum s of m oney spent fo r u n d e rg ra d u a te and g ra d u a te ed u catio n m ust b e au g m en ted to keep th e p rofessional up to date. H o w ever, th e m ann er in w hich co n tin u in g ed u catio n courses in « a ll disciplines are presented leaves ^m uch to be desired and th erefore, th e estab lish m en t of colleges of c o n tin u in g e d u ca tio n , fo un ded and p ro m o ted by th e den tal profession, is h erein p ro po sed.
Background of continuing education H ealth
profession
societies
and
so m e universities have long held m e etin g s and sem in ars from w hich p rac titio n e rs could absorb current ideas. H o w ever, th e great m ajority
D D S, C h icag o ■ ■ ■ ■ ■ ■
of p rofessionals w ere not m otivated to attend and th eir new techn iqu es w ere fre q u en tly introduced to them by va rio u s co m m ercial purveyors. In 1949, w ith th e estab lishm en t of th e A c ad em y of G eneral P ractice in th e m edical profession, a nom inal fo rm al p ro gram of co n tin u in g ed u catio n beg an . T h e a c a d e m y ’s main o b je c tiv e w as to represen t the inter ests of g en eral m edical p rac titio n ers w ho w ere den ied hospital privi leges by so m e of th e num erous m edical specialties. T h e co n tin u in g e d u ca tio n re q u ire m en t fo r m em bership w as attain ed by atten d an ce at th e a c a d e m y ’s m eetings. O ver th e past th ree decades, co n tin u in g den tal e d u ca tio n has b u r geoned and taken m any fo rm s at universities, scien tific m eetings, and sem in ars and w ithin other gro up s in dentistry. F or exam ple, co n tin u in g ed u catio n is th e m ain o b jec tiv e of th e A cad em y of G en eral Dentistry, fo u n d e d in 1951. As o ne of th e fo u n d e rs of th at group, I can say th at it was org an ized to en h a n c e th e status of th e general
den tal p rac titio n e r and to rew ard his effo rts in keep ing ab reast of the d yn am ic ch an g es in dentistry. A lth ou gh th e d esirab ility of co n tin u in g e d u ca tio n is reco gn ized by th e professions, no overall fo rm a t fo r th e p resen tatio n of courses has evolved, n or has any m e as u rem e n t o f th e s tu d e n t’s ab so rp tion of th e co u rse c o n ten t— o th e r than by e x a m in a tio n — been d evised. F urther, it w as d ecried at one university se m in ar th at th ere is no know n way to d e te rm in e if th e kn o w led g e and tec h n iq u es offered at co n tin u in g e d u ca tio n courses a re fin a lly d eliv ered to th e p atien t or client.
A suggestion for colleges of continuing education For the afo re m e n tio n e d reasons, it is proposed that co lle g e s of c o n tin u in g e d u ca tio n be established as th e fo urth level (after th e e le m e n tary, seco n dary, and u niversity lev els) in our e d u ca tio n system. T h e term co lleges of c o n tin u in g e d u c a tio n d en o te s a suggested type of JADA, Vol. 94, June 1977 ■ 1063
school of advanced or current learn ing wherein the professional can enhance his skill and knowledge under the aegis of the universities. The structure of colleges of con tinuing education would replace the present haphazard format and de livery of continuing education. The colleges, located in conjunction with our universities, would have the background to sift the many new ideas and methods and to for malize the presentation of the stud ies. With its current leadership in con tinuing education, the dental pro fession could conceivably initiate and promote such colleges. All den tal schools offer some continuing education courses, from a few courses to a full program of over 100. Some dental schools have a full-time head of the continuing ed ucation program, but in most, a fac ulty member heads the continuing education department on a parttime basis, along with other duties. Thus, the factors of experience and administration exist in the univer sity, and a foundation for a college of continuing education is already laid. Furthermore, dentists are ori ented to continuing education and many of the new graduates are par ticipating in refresher courses (con tinuing education) soon after re ceiving their diplomas. This large group would be the initial promot ers of the colleges of continuing education. Some ‘prerequisites’ Continuing education, as it is now presented, runs the gamut from the short one-hour lecture to a partly subsidized vacation (such as five days on a cruise ship) to two-week courses—all with various degrees of adequacy. Therefore, first, an indepth survey of the effectiveness of various methods of course delivery must be made. The most effective continuing dental education de livery pattern seems to involve courses that meet for several days or more, that include learner partic ipation, and whose content is rela ted sequentially. Participation
courses are thought to be the most efficacious in developing the skills related to manual dexterity. For col leges of continuing education, how ever, a determination should be made on the basis of universities’ past experiences in education, with the assistance of the ADA and other interested, knowledgeable parties, as to the most effective delivery methods. In a project of this nature, the think tank facilities of several universities might be utilized. When the delivery methods have been analyzed and conclusions reached, attention should next be focused on the development of a physical plant and faculty. The very existence of such a facility, with a dean at the head and a faculty ros ter including visiting lecturers and clinicians, would serve as a moti vational force for continuing edu cation to both the graduate and undergraduate. The establishment of a physical plant and the organization of a fac ulty need financing and approval of the universities’ boards of trustees. These two necessities would re quire an explanation of the value of such a college to those in authority. The state assemblies, those pro viding endowments, and other hold ers of the purse strings must be made aware of the great potential the public would lose if the grad uate—the product of their original investment—were not brought up to date regularly. If a professional practices with his skills and devel oped talents as he learned them in the past, instead of using currently accepted methods, the public is the loser. This is contrary to the estab lished doctrine of “the public weal," which is the basis for licensure. The cost of fully implemented col leges of continuing education with programs in all disciplines would be enormous. These costs, except for plant and facilities, should be borne by the college’s students. Facilities, faculty, and course content Present dental school facilities could be used until separate facili ties for a college of continuing edu
1064 ■ OPINIO N CLEA RING HO USE / JADA, Vol. 94, June 1977
cation could become a reality. At the start, dental school facilities that are not in use a night could be made available and would be ideal from the standpoint of scheduling, since most health professionals do not work in the evenings. Weekends would also be a favorable time. Dental school laboratories and lec ture halls could be used on a rotat ing basis with the other health pro fessions (for example, medicine, nursing, and pharmacy) for the con duct of their continuing education courses in the future. The content of courses offered by colleges of continuing education should meet the needs of the stu dents. The faculty members of the colleges and persons appointed to committees of the professions should be asked to cull the litera ture and audit professional meet ings to learn what is innovative and worth teaching in the various disci plines. This could be the basis for the year’s courses. For the older graduates and those who have not recently participated in continuing education courses, a review of the basics should be required or at least offered if the enrollee wants to refresh his knowledge. For the faculty, a list of visiting instructors, as well as members of the university’s staff, could be com piled, along with their areas of ex pertise. The specialists should be alert to the general practitioners’ clinical problems and urged to par ticipate in courses of a mutual na ture so that they might better un derstand these problems. In a college of continuing educa tion, after a course has been pre sented, the faculty instructor and the course should be evaluated by both the school and the students. Recognition of participation At this time, continuing education is not structured in a formal pat tern leading to a scholarly goal; in stead, a collection of courses has been offered randomly, with certifi cates as mementos. However, many serious students in continuing edu cation would desire recognition of their course participation in the
form of an eventual degree, but the universities require residence, a time limit for achievement, and a specific program. A change in this pattern should be negotiable. A new degree for continuing edu cation participation (an associate, for example) might be awarded for 40 to 60 weeks of continuing edu cation without a fixed time limit for achievement. This might entail par ticipation in meaningful, two-week courses (80 clock hours) for 20 to 30 years. Colleges of continuing education could be geared to han dle such a program. The education process never ends, and the finalizing of an edu cation with a degree (BS, MS, or PhD) should be a thing of the past. No education should be static. The public has a great deal of money invested in each graduate, and the graduate has invested much time, money, and effort to achieve his professional status. The product of this investment must be brought up to date regularly. Sum m ary
Educators should now take over the haphazard pattern that has evolved in continuing education and formalize it in colleges of con tinuing education. Most dentists in America are now oriented to the concept of contin uing education, and this large group could be the nidus for the promo tion of colleges of continuing edu cation. Dentistry is the youngest of the health professions and has been the foremost advocate of continu ing education. The founding and promotion of colleges of continu ing education by the dental profes sion, as the fourth level in our edu cation system, would certainly con tribute to dentistry’s stature.
I th a n k Dr. A lb e rt W a sse rm an fo r his h elp in c o m p ilin g th is m a te ria l. Dr. W e clew is in p riv a te p ra c tic e a t 6007 N S a u g a n a sh Ave, C h ic a g o , 60646.
The general practitioner and continuing education ■ ■ ■ ■ ■ ■ ■ ■ John W. W ittrock, DDS, MA, Richmond, Va
Continuing education is a necessity for relicensure in several states, and this trend seems to be gaining approval as an accepted part of the practice of dentistry. Both the den tist and patient can gain from this form of advanced education, but it is not without problems. The solu tion of these problems, in my opin ion, requires a coordinated effort on the part of the educational insti tutions, the dental societies, and the boards of examiners. Problems are concerned with the availability, quality, and continuity of dental continuing education for the general practitioner if meaning ful objectives in the courses are to be achieved. The objective of den tal continuing education is to aid the practitioner in increasing his capabilities, resulting in better pa tient care. However, this urgent ob jective is not always attainable. If dental continuing education is mandatory, it follows that an ade quate number of courses should be available from which the practi tioner can choose. It is not motivat ing to require something that is of no interest or is perhaps of doubtful availability. Courses on a particular subject can be “nonavailable” if they are not in existence or if sched uling conflicts preclude attendance. However, the greatest cause of “nonavailability” may be the loca tion of the course. For example, if the issues of The Jo u rn a l (June and December) that contain notices of continuing education courses are examined, it can be seen that cours es are more available in some geo graphic areas than others. There fore, some practitioners may have to travel considerable distances to attend, and if the travel is excessive,
it can act as a deterrent to participa tion. I have seen many “heroic” ex amples of both the practitioners and teachers who have traveled great distances to participate in continuing education courses. All things being equal, good course availability is an incentive and not a deterrent. Quality involves setting objec tives, facilitating learning, and then evaluating whether learning oc curred and determining if it were worthwhile. Present continuing education can vary from a highquality education to entertainment with color slides. However, if con tinuing education is mandatory, the courses should be of high qual ity and allow both the teacher and practitioner to determine if any worthwhile changes in patient care have occurred as a result of partic ipation in the courses. Continuity in programs is probab ly the one factor that could improve continuing education most. Con tinuity—an interrelationship of courses—is achieved by structur ing each course so it proceeds from the simple to the complex, and structuring all courses so they relate to each other and are arranged in a sequence that will enhance learn ing. Continuity would permit the practitioner to choose a related ser ies of courses that would provide a greater cumulative learning effect than courses given in bits and piec es. At present, there is little or no continuity in continuing education courses and rarely is the practition er presented a related group of courses that would allow his sys tematic progress. If continuing edu cation is mandatory, the practition er should have the opportunity to
OPINION C LEARING HO USE/JADA, Vol. 94, June 1977 ■ 1065