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become effective beginning with the session of 1917–18. In this decision the council had a large influence and here first gave promise that it was to become the leading dental educational force of the next decade.
In 1916 the council, having in part overcome the mistrust and lack of financial support which had nearly throttled it, really began to function, for it announced that, having in the past three years inspected all the dental schools, it proposed to publish at once a “ model” curriculum, and also the specifications of a class A school, and that after a year it planned to reinspect all schools and make an initial classification in 1918.
The specifications for a class A school and a suggested outline of a curriculum were published late in 1916. Those specifications were very general and liberal, referring chiefly to quantitative specifications. No direct attempt was made to standardize any conditions to obtain a betterment of quality of teaching, partly because no measure of determination had been devised, and partly because dental educators, as a class, had not yet come to appreciate the importance of quality in instruction in addition to quantity. Indeed, the whole history of dental education has been based on quantity; that is, elapsed time and number of weeks, days, and hours in the course. This is only one of the major factors of efficiency in education. There was nothing in these first specifications to keep commercially conducted schools from the highest rating. The proposed reinspection of schools in 1917 was not carried out.
In 1918 came the great opportunity for the Dental Educational Council. Among the congressional war measures late in 1917 was one providing that an enlisted reserve corps be established to which should be eligible, among others, the students of " well recognized," dental schools. Such reservists were to continue in the schools in preparation for professional service in the Army. Being already enlisted, these reservists were not subject to draft.
It became the duty of the Surgeons General to determine which were 5 well-recognized” dental schools, and in January, 1918, they informally asked the American Institute of Dental Teachers, which was considered the most representative body in dental education, what organization of dentists was best fitted to give this advice. By resolution of the teachers the Dental Educational Council was designated. Thereupon, by common consent, dental political opposition to the council was suspended for the period of the war. In March, 1918, the council made its first classification of dental schools for the use of the Surgeons General. This was not published until after minor revisions at a meeting in August, 1918.
At this August, 1918, meeting also was adopted a principle that a dental school conducted for profit to individuals or a corporation
does not meet the standard of fair educational ideals as interpreted by the council. This was soon after enlarged to state that such a condition would exclude a school from an A classification. Thus the council threw down the gauntlet and began the battle between the advance of dental education on the one hand and proprietary and commercial interests on the other. The war with Germany being over, the armistice with the various dental political interests was at an end, but the accomplishments of the council had already been so great that it was futile to attempt to destroy it.
The council carried out reinspections, revised its specifications for a class A school, revised its classification of schools, elaborated its suggestions of curriculum, devised some minimum specifications for facilities and equipment, and adopted as a principle that a school must have a minimum number of full-time teachers, thus definitely beginning a program for the improvement in the quality of dental teaching. In its classification it made some blunders in cases where it allowed political expediency to nullify its published principles in regard to schools conducted for profit.
In recent years the council and its officers have helpfully and whole-heartedly cooperated in the survey of dental education made by the Carnegie Foundation for the Advancement of Teaching, and the report of this survey promises to mark an epoch in dental education second to none of the epochs of the past. 1 In 1923 the council made one of its most far-reaching contributions to dental education when it announced that after January 1, 1926, no dental school may obtain or retain its highest commendatory A classification unless, as one of its requirements, it enforces for preliminary education one year of work in a college of arts and science in addition to completion of a four-year high-school course. In 1924 this requirement was extended to include schools of a B classification. In this the council only followed the more progressive schools, for already nearly half the dental schools had this requirement in operation, several since 1921.
The council has from time to time revised its classifications, but each classification has been only an approximation due to the ever persistant influence upon its decisions of interests other than educational.
For the past 10 years the council has been the outstanding dental educational agency. It has a history of far-reaching helpfulness to dental education, and the credit is largely due to two men of high capability and altruistic motive who served it as executive secretaries, the first through its period of early struggle, the last through the recent years of its greatest activities and trials. To these two men education and dentistry owe a great debt of gratitude. Its future usefulness must depend upon whether it can free itself from
those Machiavellian influences which still are existent in dental education, whether it can become a really judicial and constructive educational body, or must remain swayed by the winds of political and commercial expediency; whether in a word it can become more educational and less dental. Only the future can answer.
7. THE AMERICAN ASSOCIATION OF DENTAL SCHOOLS
In 1923, after various conferences, a consolidation of the three associations of dental schools in America and the one association of dental teachers was effected under the above title. Since the new association is purely advisory, there is little incentive for political machination.
This new association is for discussion of educational problems, particularly those that apply to dental education. The results of these discussions are not to be enforced upon any school but are open to use by any who wish. This association should attack the problems of improvement in the quality of teaching in dental schools, the neglect of such problems through all the years since 1840 being largely responsible for the present lack of any concerted opinions and actions in the field of pedagogy as applied to dental education.
8. TIIE CARNEGIE FOUNDATION FOR THE ADVANCEMENT OF TEACHING
As already noted, as early as 1910 some dental educators advocated a survey of dental education by some agency outside of dentistry in order that a judicial rather than a biased view might be attained. Other dental educators opposed this vigorously, claiming that only dentists were competent to judge of dental education and that the dentists were entirely capable of cleaning their own house, if perchance, as many denied, any purgation was necessary or even desirable. It was upon this theory that the survey by the Dental Educational Council was proposed. Experience has shown that that survey, while of great value, is only approximately a reliable verdict.
In 1921 the Carnegie Foundation for the Advancement of Teaching determined upon a survey in character similar to that it had made in medical education, but with the experience gained in that former activity the survey of dental education aimed to be more exact and more constructive.
The two divergent views as to whether such a survey should be made by a dental agency or by a nondental agency were happily compromised by a cooperative survey. The dental agency selected as the best informed, most comprehensive, and least biased was the Dental Educational Council. The nondental agency was the Carnegie Foundation for the Advancement of Teaching, which created a division for the study of dental education and put in charge of this a gentleman of rare capability and tact, trained in science to know the high value of painstaking accuracy, ling experienced in teaching a fundamental science in a cognate profession, and in sympathy with dentistry through contact with members of the profession in cooperative research and publication along lines of dental science.
This study of dental education has been most thorough. No time or expense has been spared, and the published result soon to appear will give a reliable basis for dental, educational, and lay information and judgment. The publicity which this report will give the relations of dental education to public health and welfare, and the needs of the moral and substantial support of the lay public will undoubtedly furnish a stimulus to more rapid constructive advance than we have yet seen, and bring to dental education the financial support it must have to fulfill its public obligations.
It has been the privilege of the writer, in common with many others, to consult parts of the manuscript of the report in advance. This has been freely used in the writing of this chapter, and indebtedness is acknowledged for many facts as to time and place which are here incorporated.
II. ANALYSIS OF PROGRESS OF DENTAL EDUCATION
Having reviewed the more important agencies which have affected the progress of dental education, it is now logical to discuss the steps in this progress. It is impossible to ascribe these advances to any one agency, since it is the resultant of all of them. At times all have cooperated; again the policy of one agency has been opposed by other agencies, resulting in a compromise or a stalemate. Commercial interests, only ancillary to dentistry, have proven a very serious deterrent factor in the attempts at progress.
It seems best to separate the era of dental education into periods and then to consider seriatim the progress in some of the different factors that enter into this field of education.
(A) PERIODS OF PROGRESS
* The periods of progress may be roughly set down as follows: A first period from 1840 to 1883, the beginning marked by the establishment of the first dental school, the end by the formation of the National Association of Dental Examiners. This period is characterized by a lack of any coordinated educational effort, and by no great advance except the fact that in the latter third of the period six universities entered the field of dental education–Harvard in 1867, Michigan in 1875, Pennsylvania in 1878, Vanderbilt in 1879, California in 1881, and Iowa in 1882.
A second period from 1884 to 1908, the beginning marked by the formation of the National Association of Dental Faculties, the end by the organization of the Association of Dental Faculties of American Universities, the inauguration of an effective effort to enforce university ideals of dental education in contrast to the lack of educational ideals which pervaded the proprietary schools. This period is characterized by the organization of an association of teachers in 1893; by an advance to a three-session course with a partially successful attempt to establish a graded curriculum; by a gradual, but hesitant, advance of the requirement in preliminary education; and by the lengthening of the annual session.
A third period from 1909 to 1916, beginning with the organization of the Dental Educational Council, the first cooperative effort of different agencies, and ending with the adoption of a four-year high-school preliminary educational requirement and of a fouryear professional school curriculum. This period is marked by very moderate increase of the nominal entrance requirements and by the establishment of a graded curriculum.
A fourth period from 1917 to 1925, beginning with the actual enforcement, in practically all of the schools, of a four-year highschool preliminary education and of a four-year professional course and ending with the enforcement in all reputable schools of a predental year. This period is characterized by the introduction of the two basic sciences of biology and physics into the curriculum; by increased attention to the fundamental medical sciences; by the beginning of a policy of full-time teachers in dental schools; by extensive work of the Dental Educational Council in inspection and classification of schools; by the rapid disappearance of proprietary schools and the increase of real university schools; and finally by the publication of the Report of the Carnegie Foundation for the Advancement of Teaching, based on its study of dental education.
(B) PHASES OF PROGRESS
To consider all the aspects of the advance in dental education concomitantly would lead to confusion and a lack of appreciation of the relative weight of the different factors; therefore a comprehensive understanding will be facilitated by an analysis of this progress into several phases.
Of these phases there are two groups, one quantitative, the other qualitative. Progress of those phases which are quantitative can be followed readily because the records are reasonably clear. The qualitative phases, while fully as important, are more elusive and are not capable of as definite delineation. It will appear that throughout the progress has been more largely of a quantitative