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ment, and this improvement has been much more rapid in the past 10 years, especially in those subjects that are now taught in the undergraduate and medical departments of universities.
7. THE QUALITY OF INSTRUCTION
As already suggested in various connections, the attention of dental educators in endeavoring to secure concerted action in improving dental education has been directed almost exclusively to quantitative advance, that is, to extension of the number of years of preliminary education, to the number of weeks per session, and to the number of sessions required to attain the degree in dentistry. Practically no concerted action has been taken to improve the quality of teaching, nor has consideration been given to the requisite training of the teacher in dental schools. While those engaged in dental education have been ready at all times to insist that dentistry has long since risen to the dignity of a profession, they have not appreciated that education is not only an older but also a much broader profession, in which the education of the dentists is but one small corner.
Indeed, many of those in dental education have taken the opposite view and insisted that teachers in dental schools shall be dentists, but that their further qualifications along educational professional lines are secondary or merely incidental. This has brought two results; first, that the greater part of the teaching in dental schools in the past, and only in somewhat lesser degree at present, has been done by men to whom teaching is merely an incident. Men are chosen to professorships in dental schools not because of any experience or accomplishments in teaching either past or expected but because of success and prominence in the practice of dentistry. The second and sequential result has been that these men, busily occupierl in their practice, have themselves not done any considerable portion of the teaching, and so have delegated to demonstrators a large part of the intimate teaching and contact with the students.
The demonstratorships are ordinarily filled by very recent graduates. These men look upon such positions as merely temporary and serve but one year, or at best a very few years. During this time their relation to the school is an avocation, for they commonly have begun to practice immediately after graduation. These recent graduates, conventionally with no more than the minimum preliminary education and lacking pedagogical training or teaching experience in any line, have constituted the majority of the teachers in dental education throughout its history and have done the bulk of the teaching in the dental subjects, usually with mediocrity.
When, in the nineties, more emphasis began to be placed upon the medical subjects, the independent schools assigned these subjects either to dentists or to practicing physicians whose pedagogical efficiency was little, if any, better. With the advent of full-time teachers in the medical schools, the dental schools that were integral departments of universities participated in the improvement in educational procedure in the medical subjects. When, in 1917, the academic subjects were introduced into the dental curriculum those schools intimately associated with universities benefited by the stabilized pedagogical efficiency in these subjects in the undergraduate college of the university, but in independent schools the teaching of the academic subjects was not comprehended and much neglected.
Of the many noteworthy advances in dental education accomplished by the Dental Educational Council, none is more far-reaching than its insistence that the teaching should not be entirely by men to whom teaching is merely an incident, but that there should be on every teaching staff some men to whom teaching is at least a vocation, if not a profession; and to accomplish this there should be in every school some full-time teachers. In addition, there should be an additional number of men to whom teaching is at least an avocation rather than merely incidental, and who are giving at least half of their time to teaching. The initial number designated was small, but the more significant thing was that it was specified that some of them must be in dental subjects.
It is clear that dental education from now on must be a university function, and the greatest problem in university dental education of the immediate future is not preliminary education but improvement of the quality of teaching in the dental subjects. The academic subjects will be cared for in the predental year, and the medical subjects will come under the supervision of the university medical schools, which can be depended upon to conduct them acceptably, but an adequate quality of teaching in dental subjects must be worked out in the dental schools. This can be accomplished only when teaching dental subjects comes to be as dignified a career as practicing dentistry, and that end lies in the dental profession, and when, through public support, adequate salaries will attract capable graduates to a career in dental education.
The quality of teaching in dental schools showed only slight improvement for many years, but since 1917 there has been a great impetus, and we may look with confidence to a fruition of recent efforts in the next decade. As in all other phases of the dental educational problem, some schools, almost invariably those that were integral parts of universities, have led in the quality of teaching and at all times have been in advance of the general level. Now that all schools are to become of this type, we may expect effective results.
8. STANDARDS OF SCHOLARSHIP
No data are available as to what proportion of the aggregate dental student body year by year has been dropped for deficient scholarship. In the surveys by the Carnegie Foundation for the Advencement of Teaching one of the points upon which information was sought was the number or proportion of students that were dismissed for poor scholarship. The information thus secured showed a very sharp contrast between the procedure of the proprietary type of school and the real university school.
In the proprietary school dismissal for deficient scholastic attainment is almost unknown. Some men voluntarily withdraw from conviction of inability to carry the course or distaste for the work and some students are delayed in graduation, but there is resort to dismissal only in case of serious moral turpitude or for failure to pay tuition. Now, that dental schools are all to be under control of universities, the elimination of the unfit student can be confidently expected in the dental schools as well as in all other departments of the university. Elimination of the unfit is a cardinal principle of efficient professional education, and now that dental education is becoming more educational and less dental the application of this principle seems assured.
While graduation in dentistry carried the right to practice, the dental school became careless of the fitness of its graduates. With the advent of the procedure that graduates must appear before the State boards of examination and licensure there was a check upon this carelessness which had a salutary influence upon the quality of the dental teaching and the rigor of school examinations. When, about 1905, the National Association of Dental Examiners inaugurated a tabulation committee and issued public reports of results in licensing examinations, there came a further tightening in the requirements for graduation, for a record of many failures to obtain license by the graduates of any school diverted prospective students to other places for their dental course.
The licensing boards, in their examinations, have properly put the emphasis upon knowledge of and ability in practical dentistry, and their standards on the fundamental sciences and medical subjects have been much lower than on the dental subjects. The teaching efforts in the dental schools have responded to this differentiation.
State boards of examination therefore should have credit for aiding in improving the preparation for entrance to the practice, but have not been equally helpful in stimulating a broadening of dental education; in fact, they are at times deterrent to this effort by
imposing rules that hamper educational forces in the educational experimentation necessary to find the most desirable procedures in the education of the student.
9. UNIVERSITY CONTROL
Frequent reference has been made in the foregoing pages to the conflict between the proprietary thesis of dental education as compared to real educational principles. Beginning with a single university dental school in 1867, but overwhelmed in numbers for decades by the independent schools, the university dental school has been in the minority until very recently. In the past two decades gradually appeared an appreciation that education for the dental profession is a public service that rests in the universities, both State and private, and the number of university schools has slowly increased. In recent years many independent schools have either become university departments or have effected affiliations that are educationally advantageous.
The independent dental school, with rare exceptions, did not comprehend the needs of dental education, or if it did, was unwilling and unable to provide for their fulfillment. With the extinction of the independent school there comes a distinct need for the extension of university participation in dental education. Dentistry being now recognized as a part of the health service, its correlation with medicine becomes closer and closer, and each university that feels its public duty to carry on medical education should see that there is a similar duty regarding dental education.
The curriculum is similar in the first two years except for dental technology, and even those medical schools that provide only two years of the medical curriculum could well similarly provide the first two years of the dental curriculum, the students in their later years to go to schools where more clinical material is available. However, the question of clinical teaching material in dentistry does not involve availability of hospitals, and so can well be carried on in university towns where the teaching of the clinical years in medicine is not feasible. It is to be hoped that we may see the rise in the next decade of several dental schools in connection with university medical schools at places where there is yet no dental education.
CONCLUSION Any effort to trace the progress of dental education is one of difficulty, because of lack of records of accurate detail, although some general summaries have appeared from time to time, but what has been attempted here is to give to one, interested in education in general, a broad view of the problems and progress of this one field. With that purpose in view, detailed statistics have not been included, nor discussion of the curriculum in detail or of technicalities peculiar to dental education, since this is not written solely for dental readers but as well for those not familiar with dental terminology.
At the present time we are in the midst of the most active period of progress in the entire history of this field of education. The publication in 1925 of the report on the Study of Dental Education made during the past four years under the auspices of the Carnegie Foundation for the Advancement of Teaching will make that year an epochal year in dental education, equal to 1810, 1884, 1893, 1908–9, and 1917. There can be no doubt that progress will continue. The next few years will see in dental education great advancement and a probable stabilization, and a decade hence, better than now, can be written a judicial appreciation of the results of the activities in the past 10 years.