Dental education is incorporating computer‐assisted design/computer‐assisted manufacturing (CAD/CAM) into patient care delivery. The aim of this study was to determine if lean production methods applied to the preclinical phase of dental education would reduce the students’ time (efficiency) to complete CAD/CAM indirect restorations (CAD/CAM IR) without compromising the desired quality of the CAD/CAM tooth preparations (effectiveness). In 2016, all third‐year students at one U.S. dental school were randomly assigned to control and research groups (approximately 33 per group). The control group was taught using existing methods, while the course was redesigned to incorporate lean methods for the research group. Cycle times of the CAD/CAM IR process for both groups were collected and statistically analyzed to compare the effectiveness of the redesign. Standardized grading forms and tools were used to assess the quality of the CAD/CAM tooth preparations. The research group demonstrated significantly faster preparation times with both crowns and onlays (p<0.05) than the control group. The research group also produced CAD/CAM crown and onlay designs at a significantly faster pace than the control group (p<0.05). There was no significant difference between the control and research groups associated with the scanning process times (p>0.05) nor in the quality of the CAD/CAM tooth preparations (p>0.05). This study demonstrated that lean methods applied to pedagogy significantly decreased preparation and design times in a CAD/CAM restorative dentistry course without compromising the quality of the CAD/CAM tooth preparations.
PurposeThis research compared the efficacy of process outcomes leveraging lean methods versus traditional pedagogy applied to dental education dependent on emerging technology. The pedagogical objective was to improve system efficiency without compromising traditional outcomes of effectiveness (quality).Design/methodology/approachThe research team tested the efficacy of a lean A3 framework to identify, remove waste and redesign a technology-dependent simulation laboratory course (CAD/CAM/IR Restorative Dentistry). Students were also sensitized to time-in-chair to introduce a stronger patient focus. Baseline data collected from a control group were statistically compared to the research group's data after the course redesign. In addition, course time allocations were measured and then compared.FindingsThe results showed the interventions significantly reduced procedure cycle times without compromising quality. Additionally, the course was more efficiently conducted as measured by course time allocations.Practical implicationsThis research demonstrated that the use of the A3 framework enhanced learning through process documentation, reengineering and systems optimization resolving issues of inefficiency associated with the CAD/CAM/IR pedagogy. This work is significant because it demonstrates the practice of using lean interventions to redesign and improve a technology-based healthcare course to maximize benefits.Originality/valueThis research is the first to examine how to leverage lean methods in a healthcare simulation laboratory, dependent on innovative technology, to educate and train future practitioners. This research applied statistical rigor in a controlled experiment to maximize its applicability and generalizability.
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