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Evidence-based Dentistry

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CUSPID Image 01In 2008, Texas A&M University Baylor College of Dentistry received a $633,343 Oral Health Research Education grant from the National Institute for Dental and Craniofacial Research. The purpose of the grant was to help the college implement a series of curriculum initiatives that would instruct students how to incorporate evidence (clinical research outcomes) into their patient-related decision-making. The grant funding for these activities has continued through 2012.

“This R25 grant will be an excellent tool for enhancing our clinical research capability in several fundamental ways,” commented Dr. James S. Cole, HSC-BCD dean, when the grant was received. “In addition, our students will be empowered throughout their professional careers by exposure to new critical thinking and scientific inquiry skills. I expect the benefits of this initiative to greatly impact BCD’s overall effectiveness.”

The series of curricular changes are collectively designated as “CUSPID,” Clinicians Using Science to Produce Inspired Dentists.  CUSPID has proposed multipronged strategies for the early imprinting of clinicians-in-training with the key skills required for the filtering, appraisal and synthesis of information needed for clinical decisions.

Specifically, CUSPID has sought to create a curricular theme throughout all four years of dental school centered on the knowledge, principles and skills of scientific inquiry necessary for the dentist to critically evaluate new information and advances in treatment and to participate in dental practice research networks.  In each dental school year, courses and experiences are provided to teach students how to assess evidence and incorporate it into their decision-making matrix for treatment (schematic below).

CUSPID Image 02The program also supports enrichment activities through the Dental Scholars Program (schematic below), which provides a subset of dental students with additional curricular experiences in teaching and clinical and translational (lab bench to chairside) research.  It is hoped that some of these students will pursue careers in dental academics or clinical research.

A faculty development program enhances the ability of all faculty members to teach students sound scientific rationale for the incorporation of new information and technologies into oral health care.  One aspect of this effort is exemplified by the transformation of the annual Research Day from a basic science-dominated event to a more inclusive showcase for student and faculty efforts in clinical/translational research as well as case presentations and systematic reviews from the students’ evidence-based classes.

The collective impact of the initiatives on the practices of dental alumni, the career choices of graduates and the overall institutional culture has been systematically assessed through pre- and post-graduation surveys.

CUSPID Image 03The program also supports enrichment activities through the Dental Scholars Program (schematic below), which provides a subset of dental students with additional curricular experiences in teaching and clinical and translational (lab bench to chairside) research.  It is hoped that some of these students will pursue careers in dental academics or clinical research.

A faculty development program enhances the ability of all faculty members to teach students sound scientific rationale for the incorporation of new information and technologies into oral health care.  One aspect of this effort is exemplified by the transformation of the annual Research Day from a basic science-dominated event to a more inclusive showcase for student and faculty efforts in clinical/translational research as well as case presentations and systematic reviews from the students’ evidence-based classes.

The collective impact of the initiatives on the practices of dental alumni, the career choices of graduates and the overall institutional culture has been systematically assessed through pre- and post-graduation surveys. The program is jointly administered by a team of three principal investigators, each with a unique skill set and academic profile. Dr. Robert Hinton, professor in biomedical sciences, served as the original contact principal investigator, a post that has been taken over by Dr. Paul Dechow, professor and chair of biomedical sciences;  Dr. Daniel L. Jones, professor and chair of public health sciences, and Dr. Charles Berry, associate dean for academic affairs, serve as co-principal investigators.  A similarly broad-based steering committee directs the implementation of CUSPID’s objectives. Committee members include: Dr. Rena D’Souza, professor of biomedical sciences;  Dr. Peter Buschang, professor in orthodontics; Dr. Amp Miller, professor and former director of curriculum; Dr. Larry Bellinger, associate dean for research and graduate studies; Dr. Lavern Holyfield, director of faculty development; and Dr. Ann McCann, director of assessment.

“The R25 mechanism offers a unique opportunity for the integration of advances from recent local and NIH investments in scientific infrastructure at BCD with the strategic goals of the institution to improve competency-based exercises in building critical thinking skills for evidence-based dentistry,” says Hinton.

CUSPID Image 04CUSPID complements advances at HSC-BCD in the development of a strong and sustainable infrastructure for research in the oral health sciences, including formal collaboration with the University of Texas Southwestern Medical Center in Dallas on an NIH-sponsored K12 award for multidisciplinary training of Clinical Research Scholars and a Clinical and Translational Science Award to develop a strong infrastructure for clinical and translational sciences at UT Southwestern and HSC-BCD.  In addition, faculty members are optimistic that CUSPID will energize a subset of dental students to embark on careers in dental academics or research.

“The NIH awards Oral Health Research Education grants only to those dental schools that have the demonstrated capacity to provide students with an educational experience that combines the best of both clinical and scientific training, emphasizing what is now known as ‘evidence-based treatment,’” said Dr. David Carlson, vice president of research and graduate studies at the HSC. “The R25 award has provided yet another milestone for Baylor College of Dentistry with respect to recognition as one of the foremost dental schools in the U.S. that is advancing the frontiers of both dental education and scientific research.”

 

Grant group
L to R: P Dechow, R D’Souza, C Berry, A McCann, R Hinton, L Holyfield, D Jones, P Buschang, L Bellinger.  Not present: A Miller