An Evolving Dental Grand Rounds

To meet the goals for curriculum reform established by the American Dental Education Association Commission on Change and Innovation in Dental Education, LSUSD introduced Dental Grand Rounds into the curriculum in 2009. This new course was intended to further evidence-based treatment and critical thinking skills through the integration of basic sciences with clinical sciences. Continual modifications to the course, derived from feedback from students and faculty members, have resulted in an enhanced educational experience.

In the original conception of Dental Grand Rounds, third- and fourth-year dental students were organized into six groups with a basic scientist and a clinician serving as co-course directors. Every Thursday morning, in concurrent sessions, a student from each of the six groups presented a case to an audience of students and faculty members. Before the presentations, course directors approved the students' outlines, making sure that the basic science foundation of the case was included. After each presentation, members of the audience followed up with questions. Modifications in the early years included expanding to seven presentations, assigning clinic bay team leaders as mentors and adding a group literature review component. Paul Fidel, PhD, and Larry Bates, DDS, were the original co-course directors. In the 2015-2016 academic year, Nicholas Miniotis, DDS, became co-director with Dr. Fidel.

In 2013 all four years of dental students became involved in the case presentation with each class responsible for a different segment: D1, basic science information; D2, pharmacologic material; D3, medical concepts; D4, dental treatment. To develop leadership skills, fourth-year dental students were assigned the responsibility of mentoring and guiding their student team.

After 2013 the frequency of presentations was reduced to every second week so that student groups had time to meet with faculty mentors to review the presentations in depth. "What-If" questions were placed throughout the presentation to foster critical thinking and discussion. Senior dental students were graded on two competencies: using critical thinking and problem-solving in the comprehensive care of patients, and applying biomedical sciences for the ultimate delivery of patient care.

An enhancement in 2016 was the introduction of Dental Grand Rounds Day, in which students whose presentation had been judged most significant or unique presented their case to an audience of all four dental classes. Cases included in this first event, held on May 5, are listed in the box below.

Dental Grand Rounds Day presenters:  Meredith Patton, Jake O'Brien, Vincent DiCarlo, and Zach Scogin

In a survey sent to students last year, one fourth-year student commented, "This course helped me to consider alternate view points and other possible treatment routes." A first-year student suggested, “"Devote a class to teach D1's about Dental Grand Rounds and show examples of presentations."

Among the changes planned for the upcoming academic year are the addition of interactive assessment software technology (ResponseWare) for the "What-If" questions; increased group discussion; increased student self-reflection via cumulative teaching points, lessons learned, and factors for case selection; and improved clarification of objectives, grading, and competency assessment.

Long-term goals include incorporating interprofessional education experiences and integrating cases into portfolio-based learning, a new tool in the curriculum. As faculty members continuously strive to improve the Dental Grand Rounds course, it remains a crucial component of the curriculum for the development of critically thinking health professionals.