Dental School Post COVID-19

  • by AGD Staff
  • Sep 21, 2020
Dental schools and faculty members are navigating a new school year with a host of new challenges and protocols. Virtual courses, in-person classes, enhanced safety procedures in clinics and limits on social opportunities are aspects of this year that make it different. AGD reached out to some students and faculty and asked them to share their insights on how the year is coming together. 

Q: What changes has your school made this fall? Are students attending courses in person or online?

Miguel Solorzano (fourth-year student at the Universidad Iberoamericana (UNIBE) in the Dominican Republic):
My university is currently hosting classes virtually and is starting to begin the process of letting dental students come back to the clinic that’s on campus. They will be working in small groups with about 50% occupancy with the proper personal protective equipment (PPE) starting with the students who were not able to finish their requirements when all of the lockdowns and quarantines happened. 

The clinic plans to open sometime this semester in order to not only continue the studies of the students but to also address patient problems. For about five months, everything was just put on hold, so I know there’s a lot of patients desperate for the students to begin work again.

Jenna Hang (fourth-year student at A.T. Still University-Arizona School of Dentistry and Oral Health): Our school has opened in phases starting in June. D3s and D4s were back on campus, but they were practicing on manikins for a month before patient care started again. Meanwhile, the D1s and D2s were splitting their time between online didactic courses and pockets of time in the simulation clinic on campus. Currently, all courses that can be online are online, but, for those of us in clinic, there are designated non-aerosolized and aerosolized areas in an attempt to continue patient care. There is a check-in process before entering campus that involves answering a COVID-19 questionnaire and daily temperature checks.

The clinic is operating. We started with emergency and urgent care only. At first, only faculty members were performing dentistry, but, as more students got fitted for N95 ventilators, we have been able to see patients as well.

Annce Kadria and Alex Weinstein (third-year students at Boston University Henry M. Goldman School of Dental Medicine): This fall, our school transitioned to an in-person/remote hybrid model for didactic education, which allows an option for completely virtual. 

Currently the clinic is operating at 50% and in the near future will be increasing to 75% capacity. There have been significant changes in screenings, walk flow of the building and patient scheduling. Currently, the school is not accepting new patients at all and is booking appointments two weeks out. Patients are screened for symptoms a day before their appointment, the moment they arrive at the school and a day after their appointment. 

What are the biggest challenges with this year’s format?

Solorzano: Going to class online was a bit frustrating at first, but, over time, I have adapted to the circumstances and have made the best of it. I am ready to get back in the clinic and work on my patients. 

Hang: One of the biggest challenges is the constantly changing schedule. It is difficult to know exactly what the next week or month will look like as the school tries to open more chairs for patients. Continuity of care has been an issue as well, as patients are scheduled with whichever student is available at the time.

Kay Jordan, DDS, MAGD (general dentist and clinical associate professor, Department of Comprehensive Dentistry, Louisiana State University School of Dentistry): Students are still learning a great deal here at LSU, but the bonds that form, particularly the first year, and the special moments like the White Coast Ceremony for second year student have been limited. Lunch and learns and other opportunities to connect informally are very important to the overall experience. Unfortunately, that isn’t doable with the COVID-19 safety measures we have in place. 

LSU's AGD Chapter is looking forward to its first lunch and learn with our D1 students in mid-October, with social distancing in place to encourage membership and to highlight the importance of AGD membership as a student and beyond. 

We are committed to finding ways to help our students develop their hand skills, and that has been a challenge, but I am hopeful that we will be able to increase the amount of time they have in the clinic and with hands-on training in the future.

Connie L. White, DDS, FAGD (AGD president, associate professor, associate dean for clinical programs, University of Missouri-Kansas City School of Dentistry): One of the challenges of this year is that students don’t have the volume of experiences that is standard as part of dental school. Similarly, the environment we are working in is much different and can be difficult to train in. 

Ultimately, we know there will be gaps in training because students will see fewer patients. Our faculty and students are working together to help everyone be prepared. We know that it is tough to learn online. Dental students didn’t go to school to stare at computer screens. They value hands-on experiences, and that makes this situation so tough.  

We are praying we don’t have another shutdown. We know that dentistry is essential care, and our dean will fight to keep us open.

Kadria and Weinstein: The biggest challenge with this year’s format is staying connected with classmates and organizing meaningful events for student organizations. 

Toni Neumeier, DDS, MAGD (general dentist and adjunct faculty at University of Alabama at Birmingham (UAB) School of Dentistry): COVID-19 has created several challenges here. In terms of lectures, it has been hard for both students and faculty to only be able to access lectures virtually. It helps to see student faces during lectures so that both groups can ensure full understanding of the topics being covered. 

Our D3s have eight hours of clinic assignments daily plus an additional two hours of virtual lectures. They are exhausted by the long schedules. Their training last spring was cut short, so some of the preclinical training was shorter than what most classes receive.

We have extensive procedures in place to ensure safety in the clinic, but assuring faculty and patients that these systems can limit transmission can be difficult. Quite a few patients canceled their appointments, opting to go to local clinics instead.

Finally, getting adequate PPE continues to be a challenge. 

How are students and their professors staying connected during this time?

Solorzano: My classmates and I group chat using WhatsApp messenger. We use WhatsApp for everything, sometimes even for communicating with professors.

Hang: Luckily, we are able to still see some fellow classmates during our scheduled time on campus, but, off campus, we still have small, socially distant group gatherings.

White: While a great deal of the school experience is online, we are trying to provide opportunities to connect and celebrate milestones. This fall, the White Coat Ceremony, where first-year students are presented their lab coats and honored for the contributions they will make, is being held online. Students will be socially distanced, and family members will only be able to view the ceremony online. We felt this was important, and I’m grateful we can offer this under these circumstances. 

Jordan: Our students are very resilient and reach out to each other to find ways to get to know each other. Faculty is always available to students via email and during clinical and preclinical times. 

How has your opinion of your dental education changed in response to campus closures, remote learning, etc.?

Hang: I was not aware of it before, but the closures have made me appreciate the wonder of in-person, hands-on learning. Though I appreciated having the time to listen to more lectures online, it is difficult not being able to apply the new techniques we just learned.

Solorzano: It's made me think about all that goes into trying to make a program successful. Even with all the sudden obstacles my program faced, faculty and staff managed to come up with a plan and try different methods with virtual classes and the way those classes are taught.

If remote learning continues long term, do you see needing to bridge any skill gaps as students transition to clinical practice after graduation?

Hang: I would expect to see more and more new graduates apply to General Practice Residency (GPR) or Advanced Education in General Dentistry (AEGD) residency programs to get more experience.

Jordan: Our fourth-year students now see patients four days a week, but for fewer hours than they had in the past. We are assessing the amount of time students are getting in the clinic and with all of their training. We are doing our best to accommodate as much learning and hands-on training as possible during this situation. 

White: I think it is too soon to know where there may be gaps in learning. We continue to prepare and present a CODA-approved competency education, and we hope that this serves as structure for students’ experiences. 

You can’t negate the things you’d pick up in the clinic, and in today’s format, those experiences have decreased. We are surveying and monitoring this information to provide insights on how we can help our students be best prepared for the future.

Kadria and Weinstein: I think GPR and AEGD residencies will be extremely helpful in bridging any gaps as we transition to clinical practice after graduation. Also, I think CE credits will be critical in the future as clinical dentists.

Other thoughts? 

Solorzano: Even with all the chaos we have all experienced through this pandemic, my university managed to keep us on track as far as our curriculum goes, and, once we return to campus, it's just a matter of clinical work with our patients in the clinic. We got lots and lots of practice, and I'm very grateful for that. At UNIBE, I had the privilege of opening the first international AGD student chapter. Even through all the quarantines, we found a way to set up a couple of webinars and keep our members engaged and learning with different doctors. Where there is a will, there is a way. 

Neumeier: We have found that virtual lectures solve the problem of limited seating space in our school, and I believe they will continue even after the pandemic is over.