March 10, 2015

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David Johnsen, DDS, MS Darren Roesch

Dean, University of Iowa

Pauletta Gay Baughman University of Louisville

Baylor/Texas A&M University

March 10, 2015

!   Critical thinking is essential in patient care, research, institutional directions, planning for the future, etc. !   Critical thinking in education !   an evolving culture of inquiry, rigor and respect with substantive, engaged faculty !   strong background in critical thinking concepts !   specific outcomes, learning strategies, and assessments are elusive !   education literature has promise to take a step closer to what the student is to do – the outcome, skill set, learning framework, etc. !   the focus for today

Characteristics of a graduate:

Programs crossing disciplines or curriculum years or are not in one department (and for which there is no “point”). !  Treatment planning –coordination for students and patients !  Clerkship teaching, learning, and assessment coordination beyond technical !  Technology assimilation (eg, digital restorative dentistry) !  Technology incorporation !  PBL !  EBD !  Incorporation of ethics into clinic !  Self-assessment !  Prevention !  I-pads in the clinic !  Implants !  IPE !  Mapping of outcomes/competencies/courses/CODA !  Risk !  Caries !  Periodontal !  Geriatric

A little methodology – a lot of culture

Assessment of critical thinking !   Brennan book – Chapter on performance assessment for complex thought processes – no scales !   Lohman – scale of 1 to 10……… !   Critical thinking: the art of analyzing one’s thought process with the intent of improving it. !   A first step in meaningful assessment: Articulating what we want the student to DO – different from know. If we don’t know what we want the student to do, can we meaningfully assess the performance? If we can articulate it, assessment becomes more self-evident

Good news: we are doing a lot of things right. Analysis we don’t do as well.

Culture of Inquiry Processes Outcomes

Critical thinking –

some concepts from the education literature: The thought process (skill set) is the outcome !   Engage the student in multiple situations reflecting critical thinking – the more situations, the more likely to be able to adapt to new ones. !   For each exercise, emulate the intended activity for validity.

Critical thinking –

some concepts from the education literature: - cont.

!   Gain agreement of faculty on the content, application and assessment mechanism for reliability !   Use the same instrument to guide learning and assess performance. !   Include alternatives, biases and selfassessment

Notes on assessment of learning frameworks/skill sets: !   The more clearly and concisely the thought process is articulated, the more self-evident the assessment will be !   Steps in assessment !   Know the steps in the process – objective !   Systematically apply each step – objective !   Grasp the concepts of the exercise (eg, treatment planning) as applied to the case – subjective

Notes on assessment - continued: !   Conduct random second assessments for reliability !   Can assess performance to a level of performance (competency), but not precisely enough to rank students.

Patient progression/treatment planning:

Technology Decision-Making

Schematic showing components of the caries risk learning and assessment program.

D-3 Moral and Ethical Dilemmas in Dentistry, continued:

!   Progression map:

“Characteristics of a College of Dentistry Graduate”

“Characteristics of a College of Dentistry Graduate”

“Characteristics of a College of Dentistry Graduate”

“Characteristics of a College of Dentistry Graduate”

“Characteristics of a College of Dentistry Graduate”

“Characteristics of a College of Dentistry Graduate”

“Characteristics of a College of Dentistry Graduate”

“Characteristics of a College of Dentistry Graduate”

Matrix for Critical Thinking Programs and Exercises

Graphic representation of the learning progression summary

Closing thoughts: !   Thinking starts with doubt !   Reflection is at the heart of scholarship !   What do we want the student to do? !   More about the culture of inquiry. !   Ethics; more from feelings than reasoning !   Questions!

References: ! 

Johnsen DC, Finkelstein MW, Marshall TA, Chalkley YM. A model for critical thinking measurement of dental school performance. J Dent Educ 2009; 73(2): 177-183.

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Lipp MJ. A process for developing assessments and instruction in competency-based dental education. J Dent Educ 2010; 74(5): 499-509.

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Marshall TA, Finkelstein MW, Qian F. Improved student performance following instructional changes in a problem-based learning curriculum. J Dent Educ 2011; 75(4): 466-471.

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Marshall TA, Straub-Morarend CL, Handoo N, Solow CM, Cunningham-Ford MA, Finkelstein M. Integrating critical thinking and evidence-based dentistry across a four-year dental curriculum: A model for independent learning. J Dent Educ 2014; 78(3): 359-367.

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Johnsen DC, Lipp MJ, Finkelstein MW, Cunningham-Ford MA. Guiding dental student learning and assessing performance in critical thinking with analysis of emerging strategies. J Dent Educ 2012; 76(12): 1548-58.

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Johnsen DC. Critical thinking: Focal point for a culture of inquiry. In Student learning: Improving practice. Ed: Boyle C. Hauppauge, NY: Nova Science Pub 2013, 151-70

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Guzman-Armstrong S, Warren JJ, Cunningham-Ford MA, von Bergmann H, Johnsen DC. Concepts in critical thinking applied to caries risk assessment in dental education. J Dent Educ 2014; 78(6): 914-920