Since our founding in 1897, innovative faculty at the School of Dentistry have engaged in education, learning, patient care, and service to our profession and community.

This month I wish to highlight the contributions of a faculty member who has made a major impact on dental education at USC—Associate Dean for Academic Affairs Charles Shuler.

 In 1995, the Institute of Medicine report Dental Education at the Crossroads was released.  The School of Dentistry was one of several sites the panel visited in preparing their report.  In it, they strongly recommended major, innovative revisions in dental education.

In May of that same year, Dean Howard Landesman—Howard served as dean of the School of Dentistry from 1991 to 1998— invited Chuck Shuler to lead a bold, fast-track effort to recruit 12 applicants from the doctoral dental alternate applicant list to participate in an new, problem-based curriculum. 

It was Howard's vision that USC should become innovative in the science of learning and that inquiry-based, learner-centered methods would become a new frontier in dental education.  He clearly anticipated the future and the significance of the problem-based learning pedagogy.

Chuck was an ideal leader for such an experiment.  He graduated from the Harvard School of Dental Medicine where he was exposed to a PBL-model education as a dental student.  In addition, he earned his Ph.D. in Experimental Pathology at the University of Chicago and was familiar with advances in the science of learning.

In the fall of 1995 Chuck and a very talented group of faculty—Alan Fincham, Mal Snead, and Maggie Zeichner-David in particular—quickly designed a model problem-based learning curriculum.  With their newly recruited students, they began an experimental education pilot program that ran from 1995 to 2001.

 Early Reforms in Dental Education

One hundred years ago, the Carnegie Foundation initiated reviews of medical and then dental education in America.  At that time, the foundation was particularly disturbed to learn of the enormous variations in admission requirements, selection criteria, curricula and advancement requirements at medical and dental schools in the United States.  In 1908 Abraham Flexner was selected by the foundation to report on the facilities, resources, and methods of instruction at America’s 150 medical schools.

Flexner and his team visited all of the U.S. and Canadian medical schools and issued their report in April 1910.  Flexner identified “best practices” at Johns Hopkins, the University of Pennsylvania and the University of Michigan and made recommendations accordingly.  Flexner’s report hastened the demise of the “for profit” medical schools and significantly strengthened the ties between universities and the medical profession.  

Eight years later, the Carnegie Foundation also initiated reviews of dental education in America.  William J. Gies, a professor of biochemistry at Columbia University, was recruited to report on the facilities, resources, and methods of instruction at America’s dental schools.  Gies and his team visited all of the U.S. and Canadian dental schools and issued The Gies Report on Dental Education in 1926. 

The 40 years that followed witnessed the implementation of many of Flexner’s and Gies’ recommendations.   The creation of the National Institutes of Health , the GI Bill (enabling millions of men and women to gain university education), Vannevar Bush's report Science: The Endless Frontier (a blueprint for federal investments in science and technology in the nation’s self-interest), the medical legislation of the 1960s (Medicare and General Medical Education), and the emergence of major pharmaceutical companies and medical/dental manufacturers all served to catapult medical and dental education in America. 

Dental Education as a Science 

During the last 30 years, there has been a renaissance of interest in the learning of science and in the science of learning.  Some recent publications highlight this renewed enthusiasm: National Science Education Standards published by the National Academy of Sciences in 1996, Scientific Research in Education published by the National Academy of Science in 2002, the IOM's Dental Education at the Crossroads published by the National Academy of Sciences in 1995, and How People Learn also published by the National Academy of Sciences in 1999.  Each of these assessments serve as excellent primers for modern considerations of dental education as a science (available at htpp://www.nas.org).

Importantly, Malcolm Knowles explored the field of adult learning and contrasted the teaching of adults (andragogy) with the teaching of children (pedagogy).  He asserted that as people mature, their self-concept shifts, so that their personality develops from a state of dependence to one of self-direction.  Learning is affected by each person’s individual experiences, social role, unique problems, and other internal rather than external forces. 

A very clear and well-written application of PBL to clinical dental education was contributed by Chuck Shuler and published in 2002 (see California Dental Association Journal 30:435-441, 2002). What is really remarkable are the measured outcomes from Chuck’s leadership of our academic programs: the 2001 accreditation by the Commission of Dental Education; the 2002 University Academic Review (UCAR); a three-fold increase in applicants for the D.D.S. program; a four-fold increase in the applicant pool for the ASPID program; remarkable improvements in student performance on National Dental Board Examinations Part I  (first quintile) and Part II (third quintile); and improved performance on regional dental board examinations as well as an increase in the number of graduates seeking advanced specialty training and graduate education.  

Dental Education as a Continuum 

A few years ago, Dom DePaola and I wrote a position paper that focused on the urgent need for major reforms in dental education (see “Reforming Dental Health Professions Education: A White Paper” in Journal of Dental Education 68:1139-1150, 2004). We envisioned dental education as a system and as a continuum, extending from college/university through formal predoctoral and residency-level education to life-long learning and continuing professional education over a lifetime.  We identified the many stakeholders and offered a number of recommendations designed to emphasize learning, the science of learning, and professionalism. 

Dental Education for Optimal Patient and Community Wellness

Beyond curriculum and sequencing of content is the environment within which we learn. At USC, Chuck Shuler and Nan Mulligan, associate dean for community health programs, and their teams have designed a sequence of clinical rotations and assignments that enhance learning and reinforce the process of learner-centered education.  Beyond what can be evaluated by National Dental Board Examinations Part I and II, these venues and experiences expose the student to patient care throughout the human lifespan, from prenatal to elderly.  Chuck and Nan have been enhancing and creating new opportunities—community-based dental clinics, hospital rotations, mobile clinics, school-based programs, health screening fairs, etc.—as well as dealing with all of the subsequent scheduling conflicts and complications.  This remains a work in progress. 

Transitions

Chuck Shuler has provided leadership for the PBL model pilot program since 1995 and, since August 2000, he has served as associate dean for academic affairs.  Since joining the faculty, Chuck has excelled at everything he does—education and learning, innovation and discovery, patient and community oral health, service to the profession, reviewer for journals and funding agencies such as the NIH, and practicing oral medicine in our faculty practice.  Within these segments of his professional life, he serves as the director of the Center for Craniofacial Molecular Biology, director of the Craniofacial Biology graduate program, principal investigator on NIH grant activities, international advocate for PBL dental education, and member on university committees that enhance learner-centered education.  He is also a regular participant in the Ayuda activities.  Among these many activities, Chuck has also found time to have five children with his wife Cindy and to sustain his passion for ice skating and playing hockey.  

As of June 30, he will step down as associate dean for academic affairs, having served for the last six years in that capacity. The next day, July 1, Mahvash Navazesh will become our next associate dean for academic affairs.  Chuck will embark upon a one-year sabbatical that begins with a superb opportunity at the NIH in Bethesda, Maryland.  At the NIH, Chuck will learn and work with Tom Hart and his group in craniofacial genetics at the National Institute of Dental and Craniofacial Research. Please join me in thanking Chuck for his enormous contributions to USC and wishing him success and joy during the coming year.  Of course, we already look forward to his return to USC in July 2007 and his continued contributions to our university.