Student productivity under requirement and comprehensive care systems

Abstract

This retrospective study reviews the educational and patient care effects of changing from a numerical requirements‐driven clinical curriculum to aa comprehensive care model driven by patient needs and led by faculty group leaders. In September 1994, the Columbia University School of Dental and Oral Surgery implemented a program in which all patient care shifted to a patient care completion model. Core assumptions included creating an educational setting where students were assigned to groups with continuously assigned faculty as group leaders, with intensive case discussion and monitoring of students' progress. All patient care took lace under the direction of the group leaders with involvement of other attending interdisciplinary faculty and auxiliary staff. Data suggest that, over the period of this study (1994–97), a significant increase occurred in the number of treatment plans completed by students with no compromise in the number of specific procedures completed by individual students. We concluded that a carefully structured and monitored comprehensive care/group leader‐driven model is beneficial for both student education and patient care.

In their own words: investigating the preparedness of final year dental students in the UK for independent general dental practice

“…Educators have expressed concern that students may put their own needs ahead of the patients as a result (34). Those working without requirements having been shown to be less stressed and equally as productive (35)(36)(37)(38)(39)(40). Holmes et al suggest that students may even be more productive in the absence of requirements (41).…”

Impact of teaching requirements for students on the activity of a university dental hospital

“…Studies have been undertaken previously to describe the effect of the removal of the minimum requirement on student productivity (3, 4) and competence (5, 6). These investigations were all undertaken over 1 year, generally with one group of students required to undertake a minimum number of acts, and one group taking part in a ‘comprehensive care’ programme.…”

“…These investigations were all undertaken over 1 year, generally with one group of students required to undertake a minimum number of acts, and one group taking part in a ‘comprehensive care’ programme. In three of these studies, the performance of the students was found to improve in the comprehensive care group (3–5). In particular it has been shown that the students were more likely to complete full treatment plans drawn up at the beginning of the year and in addition, undertook an equivalent number of acts to their colleagues in the minimum requirement group (3).…”

“…In three of these studies, the performance of the students was found to improve in the comprehensive care group (3–5). In particular it has been shown that the students were more likely to complete full treatment plans drawn up at the beginning of the year and in addition, undertook an equivalent number of acts to their colleagues in the minimum requirement group (3). Students in the comprehensive care group were also reported to manage their time better (5).…”

“…This theory was confirmed by the present study, as the needs of the student seem to have greater influence on their clinical activity than the needs of the patient. The minimum requirement system also gives a false perspective of care in that the patient is not considered as a whole, but as a series of ‘acts’ that are undertaken in different, apparently unrelated, disciplines (3). The possibility for holistic patient care should be one of the advantages of students working in the hospital public health system as opposed to in a clinic solely attached to a faculty (13).…”