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Critical thinking and problem-solving are two of the most frequently desired goals for dental student learning, but greater understanding is needed of how students' critical thinking skills develop from the beginning to the end of the curriculum. The aim of this study was to use students' performance on critical thinking assessments at five time points from the first to the fourth years to longitudinally assess their critical thinking development across the curriculum. In 2014-16, the performance of students in two successive graduating classes at one U.S. dental school was collected from five assignments designed to, among other things, assess critical thinking. Those assignments ranged from a case study in the Cariology I course in fall of the first year to an OSCE completed before graduation. Students were divided into four quartiles from lowest- to highest-achieving based on the first (baseline) assessment, and those quartiles were tracked to determine each student's progress over the four years. The results showed that, for both cohorts, students who ranked in the top quartile remained in the top of the class for all subsequent assessments. Also in both cohorts, the students who had the lowest scores on the initial assessment of critical thinking skills showed statistically significant improvements over time, increasing their scores by 9.4% (cohort 1, p0.001) and 4.6% (cohort 2, p=0.003) in each consecutive assessment. These results suggest that implementing critical thinking assessments early in the curriculum can assist in predicting students' future performance on critical thinking assessments. Furthermore, a dental curriculum intentionally designed to promote critical thinking capacities can help students improve these skills over time, whatever their level at the beginning.

OBJECTIVE The purpose of this study was to determine the effect of a relatively modest session of exercise on insulin sensitivity and fatty acid uptake the next day in obese adults. RESEARCH DESIGN AND METHODS Eleven sedentary obese adults (male/female: 3/8; BMI 37 ± 1 kg/m2; peak oxygen uptake [VO2peak] 20 ± 1 mL/kg/min) completed three experimental trials. On two of these occasions, subjects exercised to expend 350 kcal in the afternoon. These two exercise trials were identical except for the exercise intensity (50% VO2peak [EX50] and 65% VO2peak [EX65]) and the duration of exercise necessary to expend 350 kcal (EX50 = ∼70 min; EX65 = ∼55 min). Subjects also completed a control trial (CON), without exercise. The next morning, we measured insulin sensitivity (hyperinsulinemic-euglycemic clamp) and whole-body fatty acid uptake (palmitate rate of disappearance from plasma [Rd]). RESULTS Exercise increased insulin sensitivity the next day, but whereas the 35% improvement after EX50 compared with CON was statistically significant (P = 0.01), the 20% improvement after EX65 was not (P = 0.17). Despite nearly identical values between CON and EX65 (P = 0.88), systemic fatty acid uptake was lower after EX50 compared with EX65 (P = 0.02), but not quite significant compared with CON (P = 0.07). Importantly, the change in fatty acid uptake after exercise compared with CON was negatively correlated with the change in insulin sensitivity for all trials (r = −0.60, P = 0.003). CONCLUSIONS A relatively modest single session of exercise in obese adults improved insulin sensitivity the next day, and a reduction in systemic fatty acid uptake in the several hours after exercise may be important for this effect.