Objective: The purpose of this paper is to provide a theoretical rationale for the implementation of the Four Component Instructional Design Model for Complex Learning (4C/ID-model) at the University of Pretoria with the aim of systematically developing the clinical reasoning of undergraduate dental students in a classroom setting. Methods:Recent literature provides a rationale for the use of the 4C/ID-model to teach clinical reasoning in terms of four strategic teaching and learning needs: (i) the need for authenticity in the learning process; (ii) the need to manage cognitive load during the learning process; (iii) the need for repeated practise; as well as a need for (iv) valid assessment, feedback and reflection. 2Results and discussion: The literature review indicated that the 4C/ID-model makes provision for teaching and learning in an authentic context and proposes systematically structured methods that could be practically applied to manage cognitive load during repetitive exercises. The model also makes provision for cognitive feedback following assessment in order to eliminate misconceptions about content and to develop the cognitive strategies of the learner. Conclusion:On the basis of the literature review above it is recommended that the 4C/IDmodel be considered as a basis for classroom teaching and learning to develop competence in clinical reasoning in undergraduate dental students, even at pre-clinical level. The model may also have an application in medical education.

The scaffolded case-based learning appears to contribute to accurate clinical decisions when compared to lecture-based teaching. It is suggested that the development of integrated reasoning competencies starts as early as possible in a dental curriculum, perhaps even in the preclinical year of study. Treatment-planning should receive particular attention.

Dental students should realise early in their careers -in dental school -the importance of developing and mastering sound relational communication skills with patients. As a result, the aim of this study was to develop and implement a curriculum in relational communication skills for third year dental students.The methodology employed in the study comprised the following three phases:Phase I: (i) Evidence from the literature.(ii) Macro analysis of the South African dental market.Phase II: (i) Identification of specific and sub-outcomes essential for the dentist to be competitive in the emerging South African dental market.(ii) Develop a curriculum according to the South African Qualifications Authority format (Purpose, Embedded knowledge, Assessment criteria).Phase III: (i) Implementation of the curriculum.Implementation of the curriculum involved a pilot study followed by a pre-and post training cycle. The subjects were 67 third year dental students. The following instruments were employed: A study guide; a case study; an assessment rubric; two questionnaires, namely "Patient's" feedback and "Dentist's" feedback; a standardised patient. 3Quantitative and qualitative results were obtained. (i)Quantitative results: The class as a whole scored significantly higher during training cycle 2 compared to training cycle 1 (p < 0.0001). Both male and female students rated the importance of the respective topics addressed in the curriculum, as rather important -average scores for male and female students were 4.27 and 4.25, respectively.(ii) Qualitative results: The important roles of trust, empathy and active listening in establishing a meaningful relationship with a patient, which was conveyed by means of the curriculum, were emphasised by the majority of students.

Since 1995 the Department of Community Dentistry of the University of Pretoria has been involved in the rendering of mobile primary oral health care services to children in the Hammanskraal area of Gauteng, South Africa, as part of their students' community-based training. Mokonyama Primary School was identified as the first school where a primary oral health care service could be rendered. The objective of this study was to evaluate the impact (outcomes) of a fissure sealant program on the dentition status of the school children. Seven years after the implementation of the program, the dentition status of children at Mokonyama was compared with that of a comparable group of children from the same area who were not exposed to the program. The results showed that the decayed, missing, and filled teeth in the primary dentition (dmft) in the six-year-old group in Mokonyama (1.74) did not differ significantly from the dmft (1.43) of the control group (p=0.49). The decayed, missing, and filled teeth in the permanent dentition (DMFT) of 0.59 for the fifteen-year-old group in Mokonyama, however, differed significantly (p=0.0001) from the DMFT of the control group (2.38). Fifteen-year-old children in Mokonyama had 75.2 percent fewer caries than their counterparts in the control group.