UCLA School Of Dentistry - Curriculum Review

Student Perspectives on Instruction and Curriculum:

Recognizing and Appreciating

Effective Teaching Practices

By Shyam Indrakanti

TABLE OF CONTENTS

Please click on the Section, Sub-Section or Page Number to be automatically directed to it.

EXECUTIVE SUMMARY ____________________________________________________ 1

Abstract ____________________________________________________________________________________________ 1

Noteworthy Findings __________________________________________________________________________________ 1

Short-Term Recommendations __________________________________________________________________________ 3

Long-Term Recommendations __________________________________________________________________________ 3

INTRODUCTION _________________________________________________________ 5

METHODS _____________________________________________________________ 6

A qualitative Approach ________________________________________________________________________________ 6

Method of Data Collection _____________________________________________________________________________ 6

Method of Analysis ____________________________________________________________________________________ 8

Numerical Analysis ___________________________________________________________________________________ 9

Testing Validity and Reliability of Qualitative Data ________________________________________________________ 9

DATA AND ANALYSIS DIDACTIC CURRICULUM ________________________________ 11

Disclaimer__________________________________________________________________________________________ 11

Relevance __________________________________________________________________________________________ 11

Activities __________________________________________________________________________________________ 14

Organization ________________________________________________________________________________________ 16

Dissemination of Information __________________________________________________________________________ 18

Testing and Grading _________________________________________________________________________________ 21

DATA AND ANALYSIS PRE-CLINICAL CURRICULUM _____________________________ 24

Disclaimer__________________________________________________________________________________________ 24

Relevance __________________________________________________________________________________________ 24

Activities __________________________________________________________________________________________ 26

Organization ________________________________________________________________________________________ 29

Dissemination of Information __________________________________________________________________________ 32

Testing and Grading _________________________________________________________________________________ 34

CONCLUSION __________________________________________________________ 37

REFERENCES __________________________________________________________ 38

ACKNOWLEDGEMENTS __________________________________________________ 39

EXECUTIVE SUMMARY

Student Perspectives on Instruction and Curriculum Table of Contents

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EXECUTIVE SUMMARY

ABSTRACT

Perhaps the most pressing issue for instructors when considering updates or changes to curriculum is student feedback. Course-Evaluations help address changes to individual courses but feedback regarding the curriculum as a whole is sparse. With 74.4% participation, 117 unique responses and a clear model of analysis, this survey hopes to provide a preliminary look at how some students in the class of 2017 perceived the first year curriculum in UCLAs School of dentistry. Data was gathered through face to face interviews, focus group interviews and survey responses. Each of these gathering methods utilized an ice-breaker question, followed by several open ended questions attempting to keep bias to a minimum. For the interviews, questions had several levels of probes that were used by the surveyor to delve deeper into relevant topics. This data was then recorded by the surveyor and analyzed according to the precepts of grounded theory generating 5 themes, connecting them with each other and drawing recommendations out of this analysis. Provided here is data from students on both didactic and pre-clinical curriculum, explaining what aspects of these courses are well received and some recommendations to improve upon practices that arent as well received. Student response was overwhelming in quantity and overwhelmingly constructive in nature with a predominantly positive tone to their comments.

NOTEWORTHY FINDINGS

TABLE 1 THEMES AND NUMBER OF COMMENTS

THEME NUMBER OF COMMENTS

Didactic Relevance 171

Didactic Activities 73

Didactic Organization 154

Didactic Dissemination of Information 178

Didactic Testing and Grading 164

Pre-Clinical Relevance 84

Pre-Clinical Activities 219

Pre-Clinical Organization 143

Pre-Clinical Dissemination of Information 63

Pre-Clinical Testing and Grading 173

EXECUTIVE SUMMARY


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Didactic Courses Recommendations are mostly small requests, mainly surrounding lecture presentations, but effective improvements when implemented. These have been shown in certain courses but could be beneficial if incorporated in most.

o Creating and organizing information to make it conducive to learning o Making material available early and of the appropriate length for the allotted time o Use of concluding slides and highlighting in presentations to underscore

important material o Preventing fragmentation of data and facts presented in lecture by making them

consistent for the entire course especially in courses with multiple instructors lecturing

o Organization of courses by themes or blocks to group relevant topics together o Offer more learning experiences like case discussions which allow students to

apply the knowledge they learn in lecture. Preclinical Laboratory Courses Most suggestions for these courses revolve around

laboratory sessions. Some suggestions have been recommended for lectures in these classes regarding how best to convey material that has to be interactively experienced in the conventionally passive lecture format.

o Calibration of bench instructors, clear stating of guidelines for clinical competence

that are adhered to by all instructors, and standardization of grading o Use of videos or animations in lecture and in-person laboratory demonstrations

enhancing learning for audio and visual learners more directly. o Attributes effective bench instructors possess proactive in identifying areas

where students need help, supportive of students who struggle, encouraging more out of students who excel, impartial to all students at a bench, efficient with time when offering help to students, technically proficient and knowledgeable, unperturbed when needing to verify guidelines for laboratory procedures if unsure.

o Making reference materials, such as lectures from previous years, available to introduce armamentarium earlier. This would help foreshadow what is to come in current courses and helps students integrate techniques from various courses or quarters and learn cumulatively.

EXECUTIVE SUMMARY


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SHORT-TERM RECOMMENDATIONS

In the immediate future, some goals this survey outlined include:

o Didactic courses providing more opportunities to apply knowledge gained CBLs, Summary questions at the end of lectures, whenever possible

o Improve lecture presentation via proper pacing, offering more targeted highlighting, and explanatory notes as necessary.

o Assess the need and scope of current special guest lectures in both didactic and pre-clinical laboratory courses either to expand or curtail as needed

o Laboratory courses offering more standardized grading and clearer classification of errors for examination and clinical purposes

o More usage of visual elements in laboratory courses (videos and demonstrations) and better integration of available technology/equipment to enhance learning

Mostly these could be established and achieved through the Faculty Development committee, Curriculum Enhancement committee, and Curriculum committee.

LONG-TERM RECOMMENDATIONS

On a larger scale, these are some recommendations to enhance the already high

academic standards at UCLA and facilitate fruitful student-instructor interactions:

o Establish a forum for open discussions regarding curriculum with course chairs. This would hopefully create the tone of mutual respect that is absolutely necessary in student-instructor interactions

o Arrange for comprehensive student feedback to be gathered and analyzed such that it would be ready for curriculum enhancement purposes

o Work towards incorporating some of the suggestions and recommendations presented here into applicable courses per the discretion of course chairs and section chairs.

These goals are not however solely the responsibility of the faculty, students realize that

this is a combined effort if progress is to be achieved this report demonstrates that students are eager to offer their opinions just as faculty have always been receptive to it. Since we are all affected by it, we are all willing to contribute to the academic character of our school

EXECUTIVE SUMMARY


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This survey and the efforts put forth by participating members in the class of 2017 are to ensure there is some information about what this group of students would like to see addressed. This is an attempt to engage the faculty in a constructive and positive way and try to establish a forum for discussions of this sort. With the overwhelming amount of work, suggestions on making the workload more manageable or more productive will naturally arise on the student front. Similarly, multiple faculty members have expressed that they too would like to enhance curriculum yet they are left to simply guess what students would find agreeable. Bridging this gap could be very mutually beneficial to both the teachers and the learners.

INTRODUCTION


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INTRODUCTION

Rapid changes in the modes available for the delivery of information and incorporation of these changes into teaching strategies may create differences among generations in ways to enhance learning and teaching. Since students and faculty are receptive and motivated individuals who want to disseminate and accumulate information respectively, we continue to critically examine the best practices available in an effort to collectively address these differences. This survey is a student effort to provide commentary, acknowledgement and recognition of the range of our learning experiences during UCLA School of Dentistry's first year curriculum. The intent is to highlight some of the amazing techniques in teaching that faculty members have created, expanded and embraced while simultaneously providing students a sense of catharsis in discussing and reflecting upon an academically challenging and intellectually stimulating time in their lives.

This was a qualitative study that used student responses to probing questions, followed by an analysis that was both quantitative and qualitative in nature. Information has been organized into 5 major themes and then further divided into subthemes to provide targeted feedback for instructor review. Where necessary, context has been provided for any analysis done and the positive/negative comment system has been explained accordingly. These themes were then interconnected by similarities or types of comments made by students to draw recommendations and suggestions that could be passed on to faculty members. The goal is to provide usable student sourced data to faculty members regarding student perspectives on curriculum - both in the content and organizational domains.

Faculty members have expressed that they require honest feedback to alter their teaching if and when necessary. Course evaluations and other forms of feedback may provide information targeted to specific courses but they do not provide usable data that addresses the curriculum as a whole. There may also be charged, inflammatory or simply undiscernible remarks that detract from the general effort of enhancing curriculum in course evaluations. This survey hopes to provide instructors with feedback from a large proportion of students from one class. The data gathered was analyzed and organized to be accessible, then the entire document and all claims within were verified by students. The intent is to evaluate and respond to the question "What elements and practices employed by instructors in the academic year of 2013-2014 in the first year curriculum were most appreciated by students and why?" Ultimately, not only is it necessary to highlight the most liked teaching practices, but also the reason why. Hopefully, this facilitates more careful consideration of any information presented.

METHODS


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METHODS

A QUALITATIVE APPROACH

Since the main impetus for conducting focus group discussions is to understand student concerns regarding curriculum and provide genuine feedback from students, a qualitative approach was necessary. An inquiry such as this where the perceptions of individuals will heavily influence the data gathered, needs to be analyzed carefully and without bias. Therefore, this phenomenological approach was focused on understanding the lived experiences of participants involved (Denzin et al 2000). This was done to provide full, detailed descriptions of the phenomenon [Student-Instructor interactions] under study (Miles et al 1994)

The information gathered here was provided voluntarily, with the participants knowing fully well that there was no faculty oversight in acquiring this information in short, all who participated were being candid and all of the issues raised were done so in a constructive fashion.

METHOD OF DATA COLLECTION

In the 3 weeks that concluded the summer quarter of 2014, 7 meetings were conducted and a total of 57 students were present at the focus group interviews. At each of the meetings, food was provided to the participants, partially to thank them for their efforts in providing feedback and partially to incentivize others to come participate. Students who participated did so of their own volition, and contributed as little or as much to the discussion as they saw fit.

The data for this report was compiled from 2 main sources in person focus group interviews and questionnaire responses. A focus group for this exercise consisted of 5-12 students in a semi-structured 50 minute interview spending 25 minutes discussing didactic courses and 25 minutes discussing laboratory courses. The discussions were relatively open ended with questions that were followed up by more focused probes for important or crucial points of discussion. The surveyor noted key points of discussion, the frequency with which they were brought up along with verbatim quotes all of which would be incorporated into the analysis. (Merriam S. 1998)

Before the interviews, participants were sent a short questionnaire to fill out and return. This allowed the participants to come into the focus groups with a sense of what would be discussed and how best to express their ideas. It also allowed the surveyor to hold a directed discussion and obtain a higher proportion of usable data (Hesse-Biber et al 2006). The questionnaire has been reproduced below. Responses to these questions were used in order to

METHODS


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compile this report. Nearly all the questions were constructed to provide relevant data. (Maxwell J. 2005)

TABLE 2 QUESTIONNAIRE

# QUESTION

1. Pick 2 words to describe your experience during your first year in the school of dentistry.

2. In your Fall quarter classes, what elements made these classes particularly engaging or effective in learning the material?

3. How about Winter quarter and Spring quarter classes?

4. What was your experience like in your laboratory courses versus your didactic courses? Do you feel the lab courses and didactic courses complemented each other?

5. What were the least effective elements of classes (or teaching/instruction) that made it hard for you to learn or stay engaged?

6. Were there certain aspects of courses that were too easy? In what sense? How could you modify these courses to make it a more meaningful learning experience?

7. After your first quarter of lab instruction, how comfortable were you working with the hand-piece? How about hand instruments? Do you feel you began to develop dexterity?

8. Was the curriculum in spring relevant to your development as a student dentist?

9. How prepared did you feel entering the second year of dental school?

10. What are 3 things that you feel could be improved upon in UCLA SOD?

11. What are 3 things you feel UCLA SOD has done extremely well towards your personal enrichment?

12. How receptive do you think the faculty members are when it comes to listening to the students

A total of 64 students weighed in and 117 unique responses were collected. For reference, the class of 2017 had 86 students in the summer session thus 74.4% of the students participated in one form or another. Below is a tabulated summary of participation.

TABLE 3 PARTICIPATION SUMMARY

DESCRIPTION OF GROUPS TOTAL PER GROUP TOTAL PARTICIPANTS TOTAL RESPONSES

In-person interview participants 57 57 57

Questionnaire from interviewed participant

53 57 110

Questionnaire from

non-participant 7 64 117

Non-Participants 23 64 117

METHODS


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METHOD OF ANALYSIS

All data was gathered by September 15th and it was analyzed according to grounded theory and the 3 types of coding described within (Corbin and Strauss 2007). This is very similar to method of analysis Dr. Minh Tran and Genevieve Cedillo are using to analyze student course evaluations as presented at the Faculty Retreat 2014. The responses and comments are divided into 2 broad categories - Didactic and Pre-Clinical. The comments in each category are then organized into 5 major themes where they were then further broken into numerous sub themes for the sake of organizing the information. The intention is to allow faculty members to access the portion of the report most relevant to them without having to read this report in its entirety.

In table 4 below, the 5 themes have been listed along with brief descriptions. Also highlighted are which questionnaire questions provided the most data for a specific theme.

TABLE 4 THEMES AND QUESTIONS

THEME DESCRIPTION OF THEME RELEVANT QUESTIONS

Relevance

Students often ask "Why do I need to know _____?" or "I wish I had known ____." Subthemes here will deal exclusively with techniques that identify information as relevant or practices that have been successfully used to impress upon students how certain knowledge is pertains to their growth and career development

# 2,3,7,8,9

Activities

This theme and its subthemes are purely about certain activities that students found either beneficial or detrimental to their learning and which elements of these exercises contributed to this.

# 4,6,10,11

Organization

Subthemes within are points raised about how courses were organized and how lectures/presentations were structured. There is also discussion here about some wonderful practices certain course-chairs or lecturers used of which students were greatly appreciative.

# 2,3,4,5

Dissemination of Information

As the theme implies, topics of discussion are limited to how information is presented and what techniques really resonated with students.

# 2,4,7,8,12

Testing and Grading

The final theme may be the most contentious one, but it is also very important to students since it measures their performance. It is, presumably, equally important to instructors since it allows them to reaffirm or reassess their approach according to student performance. Subthemes in this category relate to how certain testing techniques have been received by students and what students have expressed about grading practices.

# 5,6,9,10,11

METHODS


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Within these themes, subthemes were generated via a second level of open coding (Corbin and Strauss 2007). In the data analysis section subthemes have quotes of varying lengths to explain what the subtheme pertains to. There is also commentary that is a composite of student responses presented in interviews or in questionnaire responses. To identify which comments pertained to a sub-theme, axial coding (Corbin and Strauss 2007) was used to label and group them. Lastly, selective coding (Corbin and Strauss 2007) was used to draw recommendations and suggestions that could be passed on to relevant committees and administrators to bring about enhancements to the curriculum as presented here.

NUMERICAL ANALYSIS

Since this was an endeavor in ascertaining subjective information that was analyzed qualitatively by a student author, there is an attempt to provide some numerical data to facilitate an objective approach in recognizing which points are the most important or pressing for students. Questionnaire responses and discussions were carefully reviewed and comments were classified as either positive or negative in relation to the commentary associated with each sub theme - if a different criterion was used to classify comments it has been explicitly stated. Context has also been provided if the positive and negative classification oversimplifies the responses. The numerical analysis may also facilitate in determining what action, if any, needs to be taken and which practices, if any, need to either be inculcated or avoided. Since this is pertaining to elements of effective teaching, names of individuals or courses have been eliminated - regardless of their mention being in a positive or negative light.

TESTING VALIDITY AND RELIABILITY OF QUALITATIVE DATA

Lastly, in order to test the veracity of the claims presented this report, data was triangulated by utilizing information from multiple sources student interviews, questionnaire responses and discussions with faculty members. Since the themes and subthemes were established based on converging several sources of data or perspective it adds to the validity of the study (Corbin and Strauss 2007).

Once a preliminary draft was compiled with completed data analysis, 7 students 6 participants and 1 upperclassman were selected to review the findings. The 6 participants were chosen because their questionnaire responses were extremely detailed and comprehensive, while the upperclassman was chosen due to his role as a representative of the entire student body. Their primary objective in doing so was to keep the contents of this report as free from author bias as possible and confirm the claims within were representative of those students made in the focus groups. Furthermore, some faculty members were also kind enough to review the preliminary draft once again with the intention to scrutinize the claims presented here and judge whether they are representative of those commonly made by the student body. Through this process most of the themes or subthemes were not altered in any

METHODS


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significant way. However, some subthemes were abridged in light of institutional changes and context provided by institutional history disclosed by faculty members. In other cases, more quotes or expanded commentary were implemented to clarify a specific point of discussion that was raised in the interviews or questionnaire responses. The use of member checking to determine the accuracy of the qualitative findings can also add to the validity of the findings.

DATA AND ANALYSIS DIDACTIC CURRICULUM


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TABLE 5 THEMES AND NUMBER OF COMMENTS (DIDACTIC ONLY)


Didactic Relevance 171

Didactic Activities 73

Didactic Organization 154

Didactic Dissemination of Information 178

Didactic Testing and Grading 164

DISCLAIMER

The data provided here has been acquired through student feedback. Direct quotes come

from responses while commentary is a composite of student responses provided. Some of the

recommended practices may seem familiar to instructors if their classes had certain elements

experience positively by surveyed individuals. Not all of the themes and subthemes may pertain

to every course. Some courses may already be incorporating some of the things suggested below.

The information is meant to cover a broad range of topics across the didactic curriculum it is

not targeted at any individuals, courses or tracks in particular.

RELEVANCE

a. Is material being repeated for a reason or is it simply redundancy? A couple pictures and tables have come up so many timesit's like deja-vu"

The most often brought up point under this theme was the concept of repetition. While some students used the word "redundant" to describe this, others simply stated repeating stuff tells me whats important. There were other concerns too regarding courses that present the same information in subsequent quarters - again a good number of students found this repetition as an indication of the importance, while others found it to be



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extraneous if the exact same material or research data is presented in consecutive quarters. The general consensus however is that all those problems can be allayed if, when presenting material multiple times, instructors could quickly comment on why there is repetition effectively providing some much needed context. It is perfectly understandable to revisit anatomy or histology before a lecture on physiology, just as it is perfectly feasible to revisit physiology before a lecture on pathology - a simple clarifying comment generally helps proceedings. This was done by certain instructors who knew that their lecture came in close proximity to another where the same topics were discussed and the prefaced their talks by underscoring the importance of the topic, or showing how their talk was related but different in scope. when Dr. X always starts her lectures with Have you discussed ______? before getting into it for real

Positive - 48 ; Negative - 9 Negative comments, in context, viewed comments which maintained that the practice of repetition is entirely unnecessary. Focus group mentions - 7

b. How are one-time guest lectures received by students? "sometimes I just didn't get what I was hearing"

Another hotly contested point was the introduction of special guest lectures on narrow topics presented by an expert in the field. While these are exciting opportunities to meet and interact with real scientific pioneers and their novel research ideas, students were generally expressing how the material presented was beyond the scope of the course and far beyond their current understanding. It was also brought up that these hours could be used towards other topics which were of more immediate application - there were times when such regular lecturers mentioned something to the effect of "if only I could get a little more time to cover topic X in more detail". If students are mistaken about the relative importance of some of these more abstruse topics, it might be prudent to have residents present such lectures. In a few cases, residents were given the chance to present advanced material, but since they are also in training, they could present the understandably inaccessible material in a more accessible fashion. Students responded positively to this practice. In general, this problem only really surfaced when we had guest lecturers who were pioneering researchers or well renowned clinicians who had a single lecture - not with all lectures by full time or part time faculty members.



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Positive - 32 ; Negative 4 Negative in this context is referring to students who were perfectly happy with these guest lectures or disagreed that such lecture time needs to be ceded to regular lecturers. They were not opposed to the other ideas above. Focus group mentions - 5

c. Does the use of themes or blocks or subdivisions enhance learning or detract from it? "having the blocks in (course 1) was greatkept things organized when there was so much material."

One of the most well received organizational cues was the use of themes or blocks to split relevant information into unified and manageable portions. This was especially important in voluminous classes with nearly an endless amount of crucial information, where each week was, ostensibly, a course in and of itself. It also helped when topics in an eclectic course could be disjointed or seemingly -unrelated. Some students found that these themes helped organize and retain information for use beyond the impending exam - as one student put it "If I have to remember all of this, I can't do itI can remember it exactly how it was taught and I could recall a good amount of it". Effectively combining all relevant information of each topic was placed together, the experience was more conducive to learning. Conversely, there was one course that students noted a set of topics that were rather disparate that could have benefited immensely from a block or themed organizational structure.

Positive 31 ; Negative - 0 The only comments that weren't positive were neutral in nature - neither proclaiming the benefits of having themes nor vilifying any potential shortcomings of omitting them. Focus group mentions - 4

d. Do students perceive courses that are more dental technique or materials marginalized? "the first year of dental school seems like med school"

While the comment above was delivered deliberately in a humorous way, there is an associated concern that students expressed numerous times. The most challenging classes



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for the majority of the first year's curriculum were all-encompassing courses that provided a wealth of knowledge on a series of topics that were both broad and applicable to the field of dentistry. Yet the classes that are purely dental technique or cover the more commonly found phenomena in dentistry were not the focus for a majority of the students.

This point is presented not as advice regarding how to restructure existing curriculum - participants in this exercise were quick to recognize that though there are concerns, the curriculum is intentionally designed to give us the most exposure to the rudimentary information every competent clinician requires. This is intended to be shown more as a consideration when revisiting curriculum changes or reviewing the current curriculum by the entire faculty. There are always concerns about overshadowing one subject or another - as students we cannot establish the veracity of any of these claims or even know what information will be more relevant to us in our clinical careers. Given how ubiquitous this discussion was, a brief version of the concerns have been presented here .

Positive - 35 ; Negative - 12 Negative in this context refers to comments that argued dental classes should take preference over other didactic courses, positive comments were those requesting a more balanced approach to difficulty and exposure to information. Focus group mentions 6

ACTIVITIES

a. Are Case-Based-Learning exercises beneficial to student learning? The patient history, list of drugs, pictures and stuffit lets me think like a doctor and, you know, talk about it with a professor

A lot of students had positive comments about case based learning scenarios that were presented in certain courses. The most exciting aspect of this was the application of technical information from the class in differential diagnoses, requesting medical tests necessary to arrive at the correct cause of the patient's affliction and the proper approach to treatment. It helped students in organizing and applying information in a new way one that would also help students retain information for exam purposes and beyond. The process itself was well received too - as one student put it getting those



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cases in parts made it exciting while others used expressions such as solving a mystery. Having a few more of these, if possible, would be well received.

Positive - 34 ; Negative - 5 Some students were of the opinion that these sessions are superfluous, however the vast majority of students had positive comments about CBLs. These comprise the minority of "Negative" comments.

Focus group mentions - 4

b. What is the effect of using computer laboratory simulations? "In (course 1)those labs with the simulation programsthere were 2 of them first one was great but the second one was not clear"

In some of the courses we had special computer lab sessions which were occasionally brought up by students in the group discussions. Depending on the level of fidelity the simulation software offered, the number of instructors available to help and how closely the exercise let students apply knowledge learned in lecture, these exercises were either praised for being a creative way to enhance learning or found to be excessively long or complicated. The most favorable findings about these exercises are listed below i. Software that was working well without too many glitches was essential ii. Providing an answer key to the students a little before the exams is necessary if

these lab exercises had testable material. Students realize that providing an answer key immediately completely diminishes the learning from the exercise, however, when reviewing back the material, it was greatly appreciated when instructors posted the answer key a week before exams or something similar.

iii. For some of the more complicated concepts, addressing them in a step by step fashion either via software or by having instructors break these complicated concepts into elementary steps through their explanations

Positive - 19; Negative - 15 The tally above is referring to how many positive and negative comments were said about the Computer lab exercises, not in relation to the summary of all the comments above Focus group mentions 4



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ORGANIZATION

a. What methods for organizing lecture PPTs/PDFs did students find agreeable? "You remember Dr. Xs slides? [she] started with a list of things and got through all of it by the end... [It was] like a 'table of contents'"

One of the presentation techniques that was universally praised is the use of organizing slides. For instance, if there is a lecture encompassing multiple topics, lecturers will already split the presentation by topic, or even subtopics. However this can all be put together with a few well organized slides that shows a list of topics/subtopics in the order they are covered. In particular, the example most commonly brought up had the lecturer reuse this slide while highlighting the relevant topic or subtopic as we moved along through the lecture. A different approach to this is the use of specialized hyperlinked PowerPoint or PDF files which allow seamless navigation to the information as the student needs. Others chose to simply split their lecture files by topic and made their presentations based on topic rather than the allotted lecture time.

Some students were also mentioning how if updated or changed after the lecture, new files should be updated to Angel reflecting these changes a lack of this can truly detract from the learning experience.

Positive - 49 ; Negative - 0 Focus group mentions - 7

b. How can PowerPoint presentations be organized to convey technically difficult information in a more approachable way? "I am scared when all I see is [a single] picture on a slideno text or bullets just a picture"

Another very popular implementation of technology is diligent use of the notes section in PowerPoint. Some instructors who know certain slides of theirs are challenging or voluminous will place their notes so that students can revisit the slide later and still recall the main concepts from lecture. This is especially true when a slide is comprised of a single complicated graphic that depicts biochemical pathways, or a sequence of events. While nearly all students take notes, we all recognize that even our best notes, cannot be as thorough or lucid as someone's who has mastery over his or her subject.



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i. Some students found the notes section to be distracting or daunting if every slide had a large notes section in a presentation.

ii. Some students also realize not all professors and lecturers like PowerPoint software. However, they were equally favorable to lecturers who supplemented their presentation material with handouts that explained diagrams from their respective PPT or PDF lecture files. In particular the example of one lecturer came up often who labelled each diagram in his PPT files and explained them clearly in his handouts - a practice that was praised every time it was brought up in a group.


c. What were some ways course chairs showed themselves to be proactive in organizing the content of their course? "either Dr. X or Dr. Y were there for every lecturethey did their own review sessions" Students were in great appreciation of course chairs who attended a majority of the lectures in their course (if the course had numerous guest lecturer component). In some cases course chairs weren't able to physically be there, but kept up to date on the events in the course and provided announcements, updated slides and relevant tips along the way. One specific case which was brought up again and again was of 2 course chairs who attended every single guest lecture and provided a review session for students at the end where they covered all the topics of the course by themselves. Though this practice might not be replicable in by or applicable to every course, it was a practice that nearly all students appreciated - even though the course itself was seen undeniably labelled as One of the most difficult by most.


d. What constituted good pacing according to students? [We had] that 50 minute lecture in (course 1) that had [more than] 100 slidesthere [were]ww 40 slides left and time's almost up

The final concern students have with organization is pacing. While most lecturers know exactly how far along in their presentation they ought to be to finish on time and convey the full extent of their lecture material, there are instances when a large portion of the



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lecture is not covered. When this happens, it elicits a lot of anxiety from students and raises a lot of questions. This is especially true since it is not always clear whether or not these portions of a lecture are considered testable material in certain courses. Students did appreciate it when in certain courses, material that wasn't presented in class was not used for examination purposes.

Another side of this issue is when instructors rush through their material skipping over slides or content they deem irrelevant for dental students. This tended to cause anxiety in students for the exact opposite reason as the one above - anxiety over material being presented but feeling like not all of it was well understood or explored.


DISSEMINATION OF INFORMATION

a. When presenting information what can lecturers do to indicate the importance of a specific fact or concept? "I always pay special attention to Dr. X's slides that have yellow text"

As all professors will readily admit, each lecture has a lot of material for them to cover. While everyone recognizes that a presentation is already the bare minimum amount of information that the presenter needs to establish context and explain the topic of presentation, highlighting more important concepts or facts is always advisable and appreciated. Some instructors choose to physically highlight, change font color, or indicate importance via formatting use of bold and italicized fonts. Others do so via diagrams and repetition of certain slides, or simply pointing it out in lecture. In all cases, this is very important and helps students in identifying what parts of a lecture will need more attention due to relatively higher difficulty or importance. i. Some students did state that these highlights were at times distracting or simply not

what the instructor focuses on in lecture - leading to confusion about the purpose of highlighting. Even these students were able to provide more examples of where highlighting was helpful, but their comments offer a great suggestion - highlights should be reserved for noteworthy aspects or facts in a presentation.



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b. How should the bigger picture be explained and presented to students? "I learn the details better when I know why [I] cant be expected to just memorize"

Students claimed that knowing the bigger picture or "how things fit" into the overall course objectives helps them come to terms with the minutia and details presented in certain lectures and courses. As can be expected, testing questions are generally from smaller but essential details and presenting a bigger picture either at the beginning or at the end reinforces why certain facts must simply be known and committed to memory. Students appreciated a lecturer stating the reason a certain lecture was being given in the context of the course Dr. X in (course 1) gave a lecture on ______ after Dr. Y... Dr. Y explained how the class of those diseases worked and Dr. X explained specifics of _____ i. This especially applies to lectures where histological sections are present. While the

lecturer has expertise over such information, students generally need to get the context first before they can fully decipher what these complicated images are trying to convey. Some lecturers use the "normal vs. abnormal" comparison to really emphasize how cellular structure or tissue structure changes with disease. Once again, students claim to learn most effectively when they understand what the effects of these microscopic changes are at a macroscopic level (i.e. disease state or consequences of tissue dysfunction helps in the understanding of histological findings)


c. What is the biggest drawback to having multiple lecturers for each topic? "Dr. X says this and Dr. Y says that"

Students fully realize and understand that the world of science is never static. As such information doesn't stagnate or remain unchanging for an appreciable amount of time - especially the cutting edge information that is regularly presented to students by pioneers in their fields. Old paradigms are replaced with newer ones and different fields learn of and utilize this information differently. This is especially the case when a course is integrative in nature and has a myriad accomplished scientists, researchers and clinicians



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lecture on the intricacies of their fields. However, from a student perspective, when conflicting information is presented by faculty members, there is no way to truly decipher which information ought to be adhered to more closely.

This applies not simply to testable material but also to knowledge students must routinely utilize and apply as future clinicians. In general the technical information presented in most courses is far beyond facts that can simply be checked in a textbook. Therefore when such instances of fragmentation arise, students can notify course chairs or individual lecturers and request clarification on these points. However anticipatory efforts from course chairs were kindly appreciated. Preemptively clarifying an instance where the confusion arose in prior years was something nearly everyone was thankful of - Dr. Xs answer about the age of maximum bone deposition was cool. He told us what Dr. Y would say and [what] number [he wanted us] to remember

Positive - 31 ; Negative - 4

Negative in this context is regarding comments stating there is no way to avoid conflicting information from being presented or that it has no impact on the course or associated exams.


d. Does the use of anecdotes have any effect on student learning? "I love Dr. X's stories"

This is yet another topic that was heavily discussed in the proceedings. Undoubtedly, instructors use anecdotes and stories to really impress upon students how certain real life situations they faced underscore what is being taught. Students generally liked this approach because it associates technical details with a tangible story allowing better understanding and retention of information.

A few of the more expeditious students did claim that at times such asides would slow down the lecture, break the flow, or lead to issues in pacing. In (course 1), Dr. Xs stories made that lecture so long[we] didnt finish on time




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TESTING AND GRADING

a. Is the use of the TLC or computer labs preferred by students as a test taking medium?

"It's not that I don't like computers but"

While taking a test at TLC seems like an ideal solution to a standard paper test, there are some severe limitations that students commented on. Positive comments included the ease of use of the software, fairness in time allotted, significantly more detailed pictures when applicable and the possibility of instantly getting ones score. Negative comments were far more numerous and included the following

i. TLC computer system crash was anxiety inducing for those who faced this crisis. After that it was anxiety inducing for all of us who had exams in TLC subsequently

ii. Splitting the class into 2 groups and forcing one to stay the entire time doesn't mitigate all of the concerns about academic integrity

iii. Difficulty in proctoring since the students are spaced so far apart and proctors cannot maintain line of sight effectively.

iv. Software issues such as scrolling via a mouse leading to an unintentional answer choice change. This also includes the few glitches where the system would display scores immediately after the exam - something that brought equal amounts of exhilaration and anxiety based on the score and the student who this happened to.

In general, if at all possible, avoiding administration of tests in the TLC would be preferred by the majority of students consulted for this exercise. Students generally preferred the older and more predictable, paper test format. With the change from Angel to Gryphon, it seems the TLC is no longer viable. However, should the use of computer labs for test taking arise, the aforementioned points may be worth consideration.

Positive - 29 ; Negative - 3 Focus group mentions 4

b. What would be the best way to end a powerpoint presentation/lecture in most classes?

"I think every lecture could have board-style review questions at the end"

Some lecturers chose to have review questions at the end of their presentations. Others posted review questions in the form of Self-Assessment assignments or had other handouts on Angel. While all of these are appreciated and provide great insights into what comprises



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"testable material" or "crucial concepts", having a closing slide with take home messages or a few short review questions was universally praised. These questions need not be multiple choice or in test form in some of the most memorable instances questions were presented and discussed. Do you remember Dr. Xs questions in (course 1)? They were super long and he told us the answers next lecture. One of the most popular method was the use of short answer questions which concluded a lecture, while the answers began the next one. The request posed here is similar to the policy certain courses adopted by requiring instructors to post handouts along with their PowerPoint or PDF lecture material. Though nothing draconian is being suggested, students really emphasized the importance of discussing essential concepts in a question and answer format to enhance learning


c. How is learning best achieved through online self-assessments?

"Quizzes that aren't so bad"

The model of having take-home online quizzes was by and large very well received. Most students liked that these were an integral part for some of the heavy didactic courses. It provided students with a way to keep up to date with the material while also allowing them to see where I stand a couple weeks before the test, as one student put it. Other students saw questions here as indicators of the most important concepts, similar to the point above regarding summary questions. However, this is being brought up here because students wanted to highlight some Self-assessment models which were looked upon more favorably than others. The self assessment model that students found the most beneficial had the following constraints:

i. No time limit for the self assessment ii. Generally 3-5 questions per hour of lecture being covered. This was a consensus as

explained in a focus group they cant be too short cause then they dont really helpthey cant be a hundred questions long either

iii. No credit for self-assessments. Or extra credit for self assessment if student scores more than 70% (set to 0.5-1 % extra per self assessment).

iv. Unlimited attempts at self assessment (even if only the first attempt is for credit or extra-credit). This is to allows students to reinforce their learning through repetition.

Each of these suggestions is currently used in one or more courses and it really emphasizes self assessments as a means to explore the material and test proficiency. In



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particular, even with self-assessments that are for credit or have short time limits, students were generally happy with self assessments if multiple attempts were allowed.

Positive - 33 ; Negative - 7 Negative in this context refers to comments that were in support of alternate models where self-assessments have short answer questions, stringent time limits etc. that certain courses use. The comments themselves were not negative regarding the practice of using self-assessments. Focus group mentions 5

d. What is the perception students have about the grading system?

"pass/fail/honors is like a grades system with A,C,F"

The current system of grading, with the use of an "Honors" designation has elicited ambivalence from students. Students agreed that the relatively stress free pass/fail portion of grading eases their mind and reverting to a proper grading system would decrease camaraderie. As one student put it it doesnt have to be super-competitive like undergrad.

However a lack of standardization in assigning honors was debated. All classes assign honors to a fixed percentage of students, though it seems the percentage of students attaining this designation is arbitrarily assigned. Rather than being the top 20% or up to the top 20% at the discretion of course chairs, some courses only assign honors to the top 10% or even the top 5% of students. In terms of quantity, this translates to 17, 9 or 5 students respectively. Students respect the academic freedom of course chairs. Students can also see that to maintain the exclusivity and prestige associated with the designation, it must be limited in some way. But is honors in (course 1) and (course 2) the same? They all show up as Hs on GSD right? asked and noted one individual. The point raised is that the experience and workload amongst courses is different but the grading system used is the same for all courses and the grading tiers are different.

If there is a possibility to rethink this system or standardize how many students receive honors in each course and the necessary criteria, it might benefit students, faculty and administration alike. As with the prior point about more dental courses - this is not an attempt by students to tread on the territory of instructors and administration in any way. It is, however, a collection of thoughts about a topic important to students.


DATA AND ANALYSIS PRE-CLINICAL CURRICULUM


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TABLE 1 THEMES AND NUMBER OF COMMENTS


Pre-Clinical Relevance 84

Pre-Clinical Activities 219

Pre-Clinical Organization 143

Pre-Clinical Dissemination of Information 63

Pre-Clinical Testing and Grading 173

DISCLAIMER

The data provided here has been acquired through student feedback. Direct quotes come

from responses while commentary is a composite of student responses provided. Some of the

recommended practices may seem familiar to instructors if their classes had certain elements

that were experienced positively by surveyed individuals. Not all of the themes and subthemes

may pertain to every course. Some courses may already be incorporating some of the things

suggested below. The information is meant to cover a broad range of topics across the pre-clinical

laboratory curriculum as they were brought up during the discussions students in the class of

2017 had. There is no intention here to targeted at any individuals, courses or tracks in particular.

RELEVANCE

a. What in the armamentarium can be used to achieve a given task in a laboratory assignment? "what did you use to make that and how do you use it?"

One of the most common concerns in this category is the introduction of instruments that would be ideal for certain situations. Given the vast ever growing armamentarium available to dentists, students know it is unfeasible for a course to present all possible options to students in the first hour of lecture. However, it would be infinitely



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appreciated to have some of the PPT files where these instruments are discussed, available from the beginning of a course. Students can refer to these extra files at their discretion, if they so choose. Furthermore, for the lecturers in these courses, they no longer have to field questions about why certain things were introduced at certain points in the course - having reference material available from the beginning effectively eliminates this line of questioning. Instructors in lab show a remarkable flexibility in allowing us to use methods we are most comfortable with - therefore, providing information to students about techniques or instruments used later could be beneficial to students and lab instructors alike. We have things in our cassette that we dont even usewait maybe we dont know how to use them sums up the concern presented here and brought up many times in the focus group discussion.

Positive - 36 ; Negative - 4 Negative comments were those stating this might lead to an overwhelming amount of information. Focus group mentions - 6

b. Why should the purpose of laboratory projects be explained? "I'll do it now but will I have to do it again, like later on? Is this useful in private practice?"

In all lab courses, there are times when we undertake assignments and lab projects which have a narrow scope of use, but are incredible learning opportunities to gain certain dexterous skills. When these projects commence, it helps greatly if the instructors explain the exact reason why it is being undertaken and frankly state that this may not be a commonplace procedure in the average dental practice. In one of the classes, there is a fairly lengthy multi-step project most of which may not be relevant to most students in subsequent years - however an eloquent explanation by the course chair of why this project is assigned made the proceedings in lab significantly more amiable. Effectively eliminating the questions such as "why do I have to do this?" If such projects are to be assigned for the sake of personal enrichment, it is also helpful to have a broad range of due dates and allow some flexibility in when they are required - again a practice employed by the aforementioned course chair for the project described above. However, what these projects offer students in skills gained could, perhaps, be reassessed periodically to see if there are other projects that could be assigned instead which will provide greater gains in learning.



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Positive - 23 ; Negative - 6 Negative in this context refers to students who were vehemently in opposition to projects of this sort. Positive in this context refers to students who would like to see changes but see value in these projects and what they offer to us. Focus group mentions - 5

c. How to effectively employ special lectures regarding materials? "I never knew ________ was so complicated"

Periodically, lab curriculum will go on hiatus to have a special lecture about the dental materials that are being used in that given time. While these lectures are essential for the Dental Boards and are generally a wonderful change of pace, given how these are not procedural lectures but rather didactic in nature, students mentioned how having review questions, a concluding "take home message" slide or other common practices in didactic lectures could be implemented into these. In at least one of the special lectures over the summer, the instructor did have these elements and it was a very well received lecture despite being very different than others presented in the same course.

Another well appreciated gesture was when a course chair would draw upon information presented in these special lectures and tie them to clinical implications on a fairly regular basis - the assertion being that information is best retained when commonly applied and used.

Positive 15 ; Negative - 0 Focus group mentions - 3

ACTIVITIES

a. What would be a good way to deal with transitions from one facility to the next? Student 1 : "going to A floor, then 4th floor in 10 minutes Student 2: Sometimes its a lot of time and sometimes it just isnt enough!

The transition time from lecture to laboratory is something that was often brought up by students. The concern is about how much valuable time is spent time that could give students more interaction time with their bench instructors. In one of the laboratory



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courses, the course chair ensured that materials needed for a particular day's lab exercise were published in an assembled manual. This helped make the transition very efficient since students could gather materials either before class or do so more efficiently in the short interim between lab and lecture. Another very well received practice in a laboratory course was the use of lab monitors for miniaturized lectures followed by short lab exercises. However, if these lectures were too long one student described the result [the students] just sit there for an hour not doing muchwe kinda should be allowed to do stuff. While the prior made the transition more efficient, the latter avoided the need for a transition time altogether. Both of these models were employed by some lab courses and students found them to be effective. These two practices were brought up by students in different focus groups and comments, therefore there is no meaningful data which shows which of the two is preferred more by students.

Positive - 34; Negative - 5 Negative remarks in this context were those stating that these lectures could be skipped entirely or posted as self learning modules. Focus group mentions - 5

b. What facets of bench instructor interaction are well received by students? Student #1: Dr. X just basically made my ________ last week Student #2: how much help is too much?

Students were generally very appreciative of the efforts of their bench instructors. They also all recognize that when help is offered it is with the best of intentions. There is the implicit understanding that each instructor has an approach to teaching that is unique, however, certain students did raise a few valid concerns: i. Instructors that are hands off - some instructors encourage their students to be

more independent and find their own means to achieving the desired results on lab projects. Though this works for some students, others have mentioned that at times they felt lost. Students were very appreciative of such instructors if they were flexible and offered extra help to some students when necessary.

ii. Instructors who are extremely supportive - some instructors offer copious demonstrations, or comprehensive critiques and suggestions. Once again, students who prefer this approach appreciated the level of support they received, while others were concerned about efficiency during the laboratory time leading to delayed grading and incomplete assignments slowing down progress in the course. A few instructors, who use this approach and either allowed students to work



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independently during demos or they were able to offer more concise critiques, were spoken of very highly.

iii. Some students also noted that when instructors had a very personable way of communication, they were more appreciated. While they did concede that this doesn't change the instructors ability to teach and the fact that each instructor has a personality and tone they find most appropriate for teaching, they were truly thankful to have had thoughtful and amiable instructors.

iv. Students often noted that their instructors, when unsure of criteria for a specific lab project, would speak to other instructors or course chairs. Students realize that some of the bench instructors aren't familiar with the stringent requirements for certain lab projects and this was a practice that most students viewed positively one student also commented it shows the collaborative way dentists tackle problems

Positive - 49; Negative - 2 Positive in this context support 2 or more of the 4 points brought up. Negative refers to students who did not present even 1 of the 4 points above but did comment on poor instructor interactions in lab. Focus group mentions - 7

c. Is there a possibility to increase the number of bench instructors in pre-clinical lab? "it was great having like 3 people to help out the group. Only one person could sign you off but extra help made things so much faster and better!"

In some lab courses or lab modules, each bench had one designated bench instructor and several helpers who were either preceptors, residents, students from other schools, or upperclassmen. The bench instructors were the only ones who could grade projects and assign deadlines, but the others were offering their help to students. This model, if replicable in other lab courses, would be extremely appreciated. As mentioned in the point above, instructors have a myriad teaching styles; similarly students have varied learning styles. Additional instructors - including students or residents in training - help ease this need for varied teaching and provide an environment more conducive to learning. Those who brought up this point of discussion did acknowledge this simply might not be possible for all lab courses. However, they were also quick to praise the instances that this practice was employed.



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Positive - 29; Negative - 6 Negative in this context refers to students who were opposed to having too many instructors - some citing that they were receiving conflicting information. Focus group mentions - 4

d. How are instructional demonstrations viewed by students? "lectures can be hit or miss, but demos are radsometimes I just need to see it!"

With the visual and hands on nature of dentistry, students are eternally grateful to instructors who have helpful and thorough demonstrations. This also includes video demonstrations in lecture - an aspect that does appear sporadically in some courses. However, students were quick to note that not all instructors did these demos. While respecting the instructors and their ability to approach teaching in a way they deem to be the most fitting, students would like to request more instructors to offer demonstrations in lab. Some students voiced their desire to help with such projects if instructors need it. As with the entirety of this report, this is once again a desire that students have expressed - it is not a mandate or a demand and ought not to be perceived as such.

Positive - 40; Negative - 3 Negative comments were from individuals who claimed too many demonstrations may adversely affect learning since precious lab time is being ceded. Focus group mentions - 7

ORGANIZATION

a. How should pacing be established in laboratory courses? (course 1) has such stressful finals I spend 2 hours for the prep and an hour for the ________"

One of the most difficult aspects of a lab practical exam is time management. This is an essential skill for students to develop for clinic as well. Students raised two concerns about time management:



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i. Effective project planning Some instructors actively remind students where they should be with a given project during certain points in a lab session. For example some instructors would say finish the _____ first so that you can focus on ______ for the rest of the time. This is a practice that a lot of students found helpful. While there were some who found this overbearing at times, most appreciated the timely reminders. Some students mentioned how they had, at times, spent enormous amounts of time on fruitless pursuits, when they could have been more careful and allotted periods of time for each portion of a project.

ii. Instructor time management By far, the most common organizational concern for lab courses is how bench instructors handle their bench group. Some instructors are very brief with their comments and provide high yield tips in mere moments. Other instructors are very methodical and spend 20 minutes or more with each student. While both of these methods were viewed as equally viable, students often prefer the former since they generally want to see their bench instructor at multiple points during the project. It is worth noting that instructors who spend larger amounts of time with each student are noted for providing more comprehensive information. In the same vein, students also voiced concerns over how instructors chose which student to approach. In general, students vastly appreciated instructors who used a way to organize how they dispensed help to students - be it a list followed alphabetically, chronologically based on request or otherwise.

For the point about the order in which instructors assist students, most participants conceded that this needs to be a joint effort between students and instructors. While we are asking instructors to approach students in a logical or organized fashion, students ought to respect the same logic and organization equally - strictly adhering to whatever organizational rules a bench instructor employs. Positive - 55; Negative - 0 Focus group mentions - 7

b. Is there a possibility for establishing smaller modules or self-contained exercises for the 3 hour laboratory sessions? "learning each instrument as a little mini lesson was perfectbut so much time gets wasted in between"

Certain courses choose to split lab projects into small modules that would be introduced piece-wise throughout the lab period. This practice was viewed as an innovative and wonderful way of organizing the 3-4 hours allotted to lab exercises.



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Students claimed to have often forgotten the little tips and tricks shared by lecturers for challenging parts of a project by the time they got to it. With shorter lab modules either with bench instructors offering demonstrations or shorter lectures in the 4th floor lab, this problem could potentially be avoided - information that is essential for a critical juncture in a lab project would be provided mere moments before. This was noted by students in courses that used presentations in 4th floor lab or bench groups where demos were provided before each major part of a project

Positive - 31; Negative - 21 Positive comments concurred with the commentary above. Negative comments were those that found the model described above, or courses which used this model, unfavorable - 7 of the 21 cited inefficiency as the prime reason. Focus group mentions - 7

c. What constitutes appropriate interactions with bench instructors specifically assigned to a different students group? "Is it ok to approach another bench instructor?"

This is a contentious point where students were on both sides of the discussion. While variety in approach is what makes dentistry fascinating, perfecting one's technique is equally important. Some students were advocating for bench instructors to rotate more frequently (rather than quarterly). Others were firmly against this since they preferred learning from one instructor for each quarter.

Another important concern that arose from this discussion was regarding the appropriateness of referring to other bench instructors. In general, students concurred that it is unnecessary to limit who can or cannot be approached, if an instructor is busy with his or her own group, they will generally mention this to others seeking assistance. Similarly, if free, bench instructors are generally happy to help students.

As an aside, this is another instance that requires a joint effort - students must be more empathetic to the needs of their peers and bench instructors could alter their approach based on the needs of the students in their individual groups. Positive - 17; Negative - 19 Positive comments for this subtheme were those that requested more frequent changes. Negative comments for this subtheme were those which argued that instructors should be kept for an entire quarter. Focus group mentions - 4



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DISSEMINATION OF INFORMATION

a. How can concepts presented in lecture be actualized and comprehended very well? "what exactly is _________?"

The question above, unedited, was relating to concept taught in a lab course. In this particular case, the student was able to define a concept and apply it to quiz or exam questions, but unable to really explain it. In short, regurgitation of the information was possible but clear understanding had not been attained. While the onus of learning is on the student it requires a concerted efforts from both instructors and students. The discussion relating to this point was primarily centered on reinforcing concepts taught in lecture via pertinent lab exercises. Most lab courses do endeavor to have the lecture and lab components be synchronous, yet when the two are different students are certainly aware of it and adversely affected by it. Another possible explanation for this phenomenon is that certain concepts are difficult to grasp and will only fully be understood with repetition (i.e. repeated mistakes followed by repeated corrections). The salient point of these discussions was to implore instructors to see if lecture and lab components could be more integrated, such that important concepts tested in lecture quizzes and exams can directly be demonstrated in lab exercises. This also has the advantage of making theoretical concepts more practically accessible

Positive - 15; Negative - 2 Negative comments were made by students who dismissed these concerns and stated they don't mind lecture and lab being separate entities or felt they are well integrated. Focus group mentions - 3

b. What role can pre-prepared videos play in pre-clinical instruction? "I loved Dr. X and Dr. Y in that video about taking impressions!"

This was briefly mentioned in the demonstration of techniques in lab, and the quote above is about a technique video as well. However, this subtheme is regarding videos that explain concepts. A point that was initially very difficult to grasp for students in a variety of scenarios was occlusal convergence and divergence in a preparation - a concept that is essential for several laboratory classes. What those two words meant, how to attain these



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results in a lab project and how to assess if the results were properly attained, were explained mostly via excellent illustrations and static images. However, a brief video or live demonstration of this concept could have hastened this understanding. This was also brought up in discussions about instrumentation and proper usage of the vast arsenal at our disposal.

Positive - 22; Negative - 0 Focus group mentions - 3

c. Were there any suggestions regarding the lecture presentations for pre-clinical laboratory courses? the lecture had 20 types of _____ materials, how and what do we use for _______it makes sense when there is a recap of stuff at the end or a table"

The lecture components of laboratory courses are generally not the most demanding didactic courses, yet they are certainly didactic in nature. As such, students found organization of lecture material, using relevant in class interaction and other didactic elements in these lectures. Some lab courses did employ in-class questions, summary slides and other mainstays of didactic lectures. In short, students truly appreciated lectures that had clearly outlined themes or concepts and orthodox organization with an introductory portion outlining the objectives of the lecture and concluding with "take home message" or summary slide.

Another request students wanted to make was regarding the updating of lecture slides. In some cases the lecture slides were not uploaded to Angel or were updated the day of lecture. In very few of these instances, students were presented quizzes in lecture on material that was either updated or uploaded on the same day often just a few minutes before the quiz. Students would like to avoid such a situation, it at all possible. Conversely, students appreciate it immensely when lecture slides are posted well in advance, a practice followed most of the time. This facilitated a more careful look at the presented material prior to lecture.

Positive - 17; Negative - 7 Negative in context refers to the instance of lecture slides being posted late or changed drastically.




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TESTING AND GRADING

a. What are the effects of calibration and standardization of instructors? "sometimes I pass and sometimes I fail" The most common concern in laboratory grading was one of standardization, in particular with practical exams. The main issue is that while objective measurements and standards are announced in classes, not every instructor adheres to them as strictly. The students fully acknowledges that part of why dentistry is so special is the variety in techniques different operators use. There is appreciation for this especially when learning; not everyone will be equally adept at every approach. However, in terms of assessment, uniformity is almost necessary. In some courses, course chairs go over each student's typodont and reevaluate to ensure that the grading does adhere to the course guidelines. This is a practice that was universally praised since it is clear that the chairs care enough to keep things fair It is easy to recognize the extra time it would take to grade 87 preparations and 87 restorations!

In addition to this, standardization of teaching was another concern. Ultimately, subjective grading is unavoidable in dentistry, yet we can minimize subjective grading by standardizing the scores bench instructors assign. This sort of calibration of difficulty can be used to standardize scoring between instructors. This idea was presented in a focus group prior to us knowing of the second year laboratory courses where this practice is employed

Positive 51 ; Negative ; 0 Focus group mentions 7

b. How is the honors designation assigned in Pre-clinical courses with a laboratory component? "I see some Es and notes in GSD but I don't know what it means" As with the didactic portion, there were animated discussions about the honors designation and as with that discussion point, it is worth highlighting that students fully recognize that this is the domain of the course chairs; there is no intention of intruding on their territory. The following is a list of points that were discussed with regards to honors designation for laboratory course



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i. Have the terms of designation defined very clearly - something that has been done in some of the laboratory courses as a list of pre-requisites

ii. If the requirements for Honors are stringent and not being achieved by the established percentage, allowing a discretionary way for course chairs or bench instructors to recognize students whose performance was deserving of the designation - this is also a practice in one of the lab courses.

iii. Allowing Honors designations for the various different portions of a laboratory course. Effectively allowing Exemplary Performance Reports for didactic or Laboratory portions that a student earned to be reflected on their transcripts rather than being a note only available internally. This point was brought up often since the different portions of these courses are graded independently and even on GSD need to be entered independently.

iv. Combine all aspects of a lab course into a single percent based grade where most if not all projects are graded towards a final composite score - this is an approach that one of the first year lab courses uses while keeping lab and didactic portions separate but using percentages to establish grades. A second year lab course uses a similar model but one where a percentage grade encompasses every didactic and laboratory exercise.

Concerns about Honors arise because as explained in the similar subtheme in the didactic portion, students are concerned about how their performance is being evaluated. As has been stated several times, this is not an attempt to intrude upon the territory of course chairs or administration, but rather a reflection of the various points discussed. It is being presented here for faculty members who would like to know what students are concerned about in terms of grading. It is also something that students brought up several times.

Positive 29 ; Negative - 0 Focus group mentions 4

c. How do students feel about the IP grade and how it is assigned? "I don't want to get an IP, but its great!" Students are very appreciative of the IP designation certain lab classes use. It is very forgiving to those who are truly struggling and provides them with a chance to improve upon their skills without penalizing them too severely. Students also really appreciate that an IP has its consequences in the form of remediation, tutoring and extra assignments that are productive investments in time for those who are struggling and also encourage students to work hard throughout the quarter to



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avoid this if at all possible. On all fronts, this part of the grading system is very well received and students are truly appreciative.

Positive 58 ; Negative - 0 Focus group mentions 7

d. In terms of grading practical exams, what types of errors are considered minor? What types are considered critical? "Is this a critical error?" This could be a subtheme under dissemination of information, but students mainly brought this up as a point of discussion in relation to testing. Though all courses mention what are critical errors and what are simply suboptimal results, it would be very helpful if the grading sheets used could highlight critical errors (These sheets highlight all errors right now but don't designate what constitutes a critical error). One laboratory course does show examples of what constitute a passing lab project and what are some of the common failures or common features of a failing lab project prior to the final. This practice is both cathartic and helpful since it allows students to revisit mistakes they made in the past or those that their predecessors made. It helped refresh certain concepts right before the lab practical

Positive 32 ; Negative - 3 Positive comments agree that more explanations or demonstrations are helpful. Negative comments are those that state such discussions are anxiety causing or detrimental to them specifically.


CONCLUSION


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CONCLUSION

The question posed at the beginning of this analysis was "What elements and practices employed by instructors in the academic year of 2013-2014 in the first year curriculum were most appreciated by students and why?" As the data and analysis above shows, the most appreciated elements are both numerous and not universally applicable. By demystifying student perspectives and sharing their thoughts, participants from the class of 2017, have articulated the most pressing matters for themselves and hope this data will be considered when approaching curriculum enhancement.

Since curriculum is always changing, being reexamined and reevaluated, the aforementioned data could provide a student perspective in what aspects need to be addressed and how they might be handled. While student perspectives may not always concur with the goals of the curriculum change or course obj

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