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The behavioural sciences curriculum in dental education is often fragmented and its clinical relevance is not always apparent to learners. Curriculum integration is vital to understand behavioural subjects that are interrelated but frequently delivered as separate issues in dental programmes. In this commentary, we discuss behavioural change as a curricular theme that can integrate behavioural sciences in dental programmes. Specifically, we discuss behavioural change in the context of dental education guidelines and describe four general phases of behavioural change (defining the target behaviour, identifying the behavioural determinants, applying appropriate behavioural change techniques and evaluating the behavioural intervention) to make the case for content that can be covered within this curricular theme, including its sequencing. This commentary is part of ongoing efforts to improve the behavioural sciences curriculum in dental education in order to ensure that dental students develop the behavioural competencies required for entry-level general dentists., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Dental schools must prepare future dentists to deliver culturally sensitive care to diverse patient populations, but there is little agreement on how best to teach these skills to students. This article examines this question by exploring the historical and theoretical foundations of this area of education in dentistry, analyzes what is needed for students to learn to provide culturally sensitive care in a dental setting, and identifies the discipline-specific skills students must master to develop this competence. The problems associated with single-discipline, lecture-based approaches to teaching culturally sensitive care are outlined, and the advantages of an interdisciplinary, patient-centered, skills-based approach to teaching culturally sensitive care are described. The authors advocate for an approach to teaching culturally sensitive care that builds upon learning in the behavioral sciences, ethics, and public health. Component skills and perspectives offered by each of these curriculum areas are identified, and their contributions to the teaching of culturally sensitive care are described. Finally, the need to consider the timing of this instruction in the dental curriculum is examined, along with instructional advantages associated with an approach that is shared by faculty across the curriculum.

This report describes the design, implementation, and function of integrated, learner-centered education at the Ostrow School of Dentistry of the University of Southern California. The 190 required courses of the previous curriculum have been condensed to forty-four courses. Four courses, presented for each of eleven trimesters of the four-year D.D.S. program, are entitled Human Structure, Human Function, Human Behavior, and Human Clinical Dentistry. An integrated biomedical sciences curriculum is supported by small-group, facilitator-based, problem-based learning (PBL) and an electronic PBL case library. Modules, rotations, and preclinical and clinical sessions make up remaining instructional units of the curriculum. Selected assessment outcomes measuring student knowledge, behavior, and skill development are discussed. As an external measure, first-attempt pass rates on the National Board Dental Examination (NBDE) Part I show a range of 87-96 percent over a ten-year period (for Classes 2005-14). First-attempt pass rates on the NBDE Part II for Classes 2005-12 ranged from 74 percent to 93 percent. Perceived barriers and opportunities for better performance on the NBDE Part II are addressed. Additionally, an exit survey, administered over the past four years, indicates a high level of student satisfaction with "depth and breadth" of their education (82-93 percent) and that graduates feel well prepared to enter the practice of dentistry (94-97 percent).

Communication skills have long been associated with practice success in dentistry. The Commission on Dental Accreditation's standards state that "Graduates must be competent in the application of the fundamental principles of behavioral sciences" and that "Graduates must be competent in managing a diverse patient population and have...interpersonal and communications skills." A recent survey of U.S. dentists found an underutilization of communication skills by general dentists. The University of Tennessee College of Dentistry strives for continuous improvement and has implemented an innovative behavioral science curriculum to improve students' communication skills, consistent with the College's "patient-centered, comprehensive care" philosophy. We describe the design and implementation of our "Patient-Centered Dentistry" course, in which third-year dental students practice communication skills with simulated patients in the Kaplan Clinical Skills Center on the UTHSC campus. The clinical simulations involve the following scenarios: The Initial Interview with a Patient, Presenting a Treatment Plan, Treating Patients with Fear and Anxiety, Interviewing Considerations for Difficult Patients, Delivering Distressing News to Patients, and Coping with a Drug-Seeking Patient. Student simulations were videotaped and assessed by course instructors as well as clinical faculty, and students received immediate feedback by instructors and clinical faculty after their simulations. Students were provided with the opportunity to view their simulation performance and to reflect on their performance in order to recognize their communication strengths as well as areas for improvement. The use of simulation experiences is becoming a widespread and expected practice in health care education. The Patient-Centered Dentistry course provides students with the opportunity to experience the kinds of real-life situations that they would experience in dental practice, without risks to patients. It provides students with the opportunity to assess their communication skills, make mistakes and improve.

Delivering bad news has traditionally been associated with life-threatening illness, the imminence of death, or communicating about the death of a loved one to a family member. The delivery of bad news in dentistry is rarely about life-threatening circumstances. However, the impact of the bad news such as the loss of an anterior tooth can be devastating for the patient. This article outlines the S-P-I-K-E-S protocol and discusses the teaching aims and methodology in applying the model in an undergraduate dental program in Ireland.

There is increasing pressure on recent dental school graduates to understand and successfully utilize patient management and business management strategies to run a productive dental office. Dental schools are faced with the dilemma to either add more credit hours in their already crowded curriculum or adjust predental school requirements. All fifty-nine U.S. dental schools were assessed online to determine admission requirements in the areas of behavioral science and business education. Results show that only 11.9 percent of the schools require prerequisite course work in behavioral science and no school requires prerequisite course work in business. However, 64.4 percent and 30.5 percent of schools encouraged or recommended prerequisite course work in behavioral science and business, respectively. We suggest that the dental education community involve key stakeholders to discuss the incorporation of prerequisite course work in behavioral science and business. Additional courses in these disciplines would provide dental students better backgrounds from which the dental curriculum could build a more advanced and applied perspective to better prepare students for practice.

The goals of this exploratory study were to determine students' assessment of portable digital video instruction (using the Apple iPod) and to compare examination performance among groups of predoctoral dental students who did and did not utilize portable digital video instruction as a supplement to a conventional pediatric behavior management lecture. Dental students received a one-hour lecture on communication with the parent and child patient as part of their regular sophomore pediatric dentistry curriculum. Digital audio and digital video versions of this lecture were made available to all 113 students in the class. Eleven student volunteers were loaned portable digital video players (the iPod) containing the lecture for a two-week period. Upon completion of the study period, the entire class participated in an anonymous fifteen-minute post-intervention written assessment including a thirteen-item examination covering lecture material. Students who had used the iPod to review the digital video lecture material favored this medium as a pedagogical instrument and as a group performed significantly better on the examination than those who had not reviewed the digital material (p=0.034). In conclusion, portable digital instructional videos may be a useful educational methodology to help predoctoral dental students acquire knowledge in pediatric behavior management.

Dental schools are increasingly incorporating behavioral management strategies into the curriculum; however, little is known about the efficacy of this instruction. The purposes of this study were to evaluate student exposure to several categories of behavioral management techniques, assess student opportunity to observe faculty use of these techniques, and determine the extent of students' personal use of various behavioral management techniques. Third-year dental students (n=98, X age=26.52; s=4.05) were administered a survey assessing their exposure to and willingness to use behavioral management strategies. Results indicated differences between the techniques students recalled being taught and what they indicated they plan to use in their own future clinical practices. Student technique endorsement also varied as a function of student age, gender, ethnicity, and patient age. Despite increasing concerns regarding the use of these techniques, a significant minority of students stated that they were taught to use hand-over-mouth, verbal intimidation, and various forms of active and passive restraint/immobilization. While appreciation for behavioral management strategies within the dental school curriculum was demonstrated by the amount of didactic exposure students received, the need for increased experiential training is evident. Furthermore, student endorsement of controversial techniques appears to reflect the changing view of these techniques within the professional dental community.

This investigation explored whether teaching a case-based seminar influenced dental students' perceptions of the importance of various factors for diagnosis and treatment planning. In addition, the effects of an interdisciplinary approach to case-based teaching were analyzed. During the winter semesters 2004 and 2005, 204 second-year dental students participated in a case-based comprehensive care seminar. The students were randomly assigned either to a section with a behavioral science instructor present or to a section without a behavioral science instructor. At the beginning and end of each semester, the students evaluated the importance of various factors for diagnosis and treatment planning in self-administered questionnaires. This seminar increased students' importance ratings of subjective oral health-related factors (such as dental fear) and diversity-related factors (such as the patient's ethnicity/race) from the beginning to the end of the semester. Students in the section with a behavioral science instructor rated the importance of behavioral and diversity-related factors higher than students in the section without the behavioral science instructor. These findings suggest that interdisciplinary, case-based teaching increased students' appreciation of the complexity of patient care and of a patient-centered, culturally sensitive approach to diagnosis and treatment planning.

Psychosomatic and behavioural medicine have a long tradition in Hungary. In this paper, we highlight the possibilities of teaching behavioural medicine and behavioural science in the medical and dental curricula, particularly in the field of health promotion and prevention. There are a number of possibilities for dentists in the fields of behavioural science in both research and health policy. There is a need for closer integration of teaching, research and health policy in both general medicine and dentistry, and both doctors and dentists must approach their patients in a holistic way.

This paper outlines several aspects of the integration of basic sciences into the predoctoral dental curriculum. It addresses a number of the points or questions posed by the organizers of the Third Educational Conference to Develop the Curriculum in Temporomandibular Disorders and Orofacial Pain. The importance of the basic sciences for a comprehensive overview of knowledge bearing on temporomandibular disorders and orofacial pain is first emphasized, followed by considerations of what material should be taught and by whom. The paper concludes by considering at what stage of the curriculum this material should be included, how the pertinent basics sciences should be taught, and under what circumstances. Under the term "basic sciences" are included not only relevant biomedical or biologic sciences such as physiology and anatomy, but also the behavioral sciences such as psychology and cognitive science.

A new vision for dental education is being shaped by (1) future dentists' need to keep pace with rapid developments in medicine and biomedical science, and changing health-care delivery mechanisms that will transform dentistry; (2) dissatisfaction with unintended, undesirable consequences of traditional approaches to dental education that do not integrate biomedical/clinical, behavioral, ethical, and population perspectives in clinical practice, and fail to cultivate the skills and values which support lifelong learning; (3) new developments in cognitive science demonstrating learning environments' need to be more student-centered, to emphasize active learning strategies, and teach students to use the scientific method to resolve clinical problems. These changes will require efforts in faculty development, and have implications for the administration and function of dental schools.

From 1990, Behavioural Sciences have become a requisite subject of dental undergraduate curricula across the UK (2). However, subject matter taught varies from school to school (4). The aim of this study was to determine the views and experiences of senior dental undergraduates in applying their behavioural sciences teaching across a range of clinical situations. A questionnaire survey was designed in which 5 UK Dental Schools were included to provide a countrywide geographic distribution and where >75% of senior students in each Dental School participated. The questions required the students to evaluate their psychosocial skills in 4 main areas: dentist/patient interactions; enhancing preventive behaviour; anxiety management; coping with personal stress. 252 students participated, 43% were male. In general, students valued their behavioural sciences teaching and 84% rated its inclusion in the curriculum as important. Some patient management situations had been infrequently encountered in their clinical experience and their confidence in dealing with these situations was low. The data was entered into a stepwise logistic regression to determine which factors explained the variation in reported confidence. In relation to dentist-patient interactions and preventive aspects (9 aspects), significant variables were how well students felt they were taught and how often they encountered the situations. Gender contributed to explaining variation in 4 of these aspects. In dealing with patient aggression, men were over 7x more confident than women (Odd's ratio 7.32), but in changing patients' attitudes to oral health, women were more than 2x as confident as men (Odd's ratio 2.08). In anxiety management and dealing with personal stress, additional variables entered the model and these were age, gender and Dental School. For most aspects of confidence in anxiety management, the quality of teaching to manage these situations was the key variable. In conclusion, this survey has provided an evaluation of UK students' perceived psychosocial skills in a range of clinical settings. This should encourage educators to improve curricular content to support the development of clinical competency in this area.

In 1990, the GDC published its recommendations on the teaching of behavioural sciences. A study of sociological and psychological teaching in the dental undergraduate curriculum has shown a great deal of variation between the 14 dental schools in the United Kingdom. Most of this teaching was also theoretical and at a pre-clinical level. Should skills and applied psychology be given an increased emphasis in the core clinical content of the undergraduate curriculum?

Faculty of Dentistry, Tokyo Medical and Dental University first introduced New Curriculum of Behavioral Dentistry in Japan. This curriculum has been established in consideration of the current social environments and dental clinical practice in our country, in addition to reference to Curriculum Guidelines in the USA. When students' impressions and assessments on the courses were researched and analyzed, the majority were found to be satisfied with this curriculum although several problems to be solved were also presented at the same time, such as timing of derivering lectures.

Critical issues that affect dental education and the connection between science and practice include the community, managed patient care, public skepticism and fiscal support, and shifting demography in patterns of oral disease as well as the background of students entering the dental profession. During the past several decades, there have been major shifts in the patterns of oral disease, most recently described in results of the NHANES III dental survey. The diversity and background of students entering the dental profession have changed dramatically as well, and present estimates of change in U.S. population are no less volatile. Funding for dental education in constant dollars is decreasing nationally, with declining support from state and federal sources and a much greater reliance on clinical and development income. Recent recommendations by the Institute of Medicine and Pew Health Commission and reactions to those recommendations by representative dental organizations-particularly the American Dental Association, American Association of Dental Schools, and the American Association of Dental Examiners-have significant implications for the structure of dental education. All of these factors are tempered by the emergence of managed patient care and the implications of that environment to increasing the level of academic excellence of students, improving the quality of care delivered to patients, and enhancing the scholarly contributions of faculty. These forces may represent an opportunity to maintain a well-documented national excellence in oral health care, expand the educational options to meet student demand and interest, increase the biological and behavioral background of our graduates, and explore new educational approaches to preclinical and clinical training.

The behavioural science course for the undergraduate dental curriculum at Liverpool university Dental School is designed to be integrated into the basic science and clinical teaching. The course is taught by a clinical psychologist and social anthropologist. The course has an input to each of the 5 years of the student's training. This paper presents three examples (community dental visits, communication skills training and special symposia) of how the course is being developed, illustrating the strengths and some shortcomings requiring further development.

Lessons from other places present several diverse suggestions for the dental curriculum's continuing improvement. Models from other professional education venues (medical schools), conceptual frameworks for self-reflection (ethos), and the scientific bases for learning and teaching (cognitive psychology) demonstrate that an interplay of factors must be addressed to advance the curriculum.

This study assesses the effect of the pre-doctoral and continuing behavioral education on dentists' efforts to treat fearful patients. A mail survey consisting of a booklet of 27 questions was sent to the 1988 and 1989 graduates of the Universities of Washington (UW), Kentucky (UK), and British Columbia (UBC). Graduates from UW and UK who received predoctoral instruction and some UBC graduates who received continuing education on the behavioral approach to caring for fearful patients were compared with UBC graduates who received only a primarily pharmacological oriented education. The overall response rate was 80.4 percent (164/204). Results indicate the average proportion of fearful patients seen was greater for those receiving behavioral instruction. Dentists who received behavioral instruction also reported greater effort addressing fear during patient's initial contact with the practice; however, they perceived the costs of the behavioral approach to be greater. No differences were found between groups for the remaining effort measures.

A case has been presented for strengthening the science-base of the future dentist. Such a development is essential and inevitable and we must plan the changes in the dental education continuum that will facilitate it. Transfer of advanced clinical training to mandatory post-doctoral education will control the economic impact of the change and improve the education of the dentist tomorrow.

An approach to effective integration of the basic, behavioral, and biomaterials sciences with the clinical curriculum is described. Teaching is accomplished by both scientists and clinicians on multidisciplinary teams. The instructional format is based on terminal objectives that are stated in behavioral terms. Examples of the objectives and the manner in which they are fulfilled are presented.

Two decades have passed since Blackerby's call to develop departments of social dentistry within dental schools. Recent events, having changed the climate for the delivery of health services, would seem to bear out the wisdom of such departments. A review of the development and present status of departments of social dentistry is provided with a discussion of evolving programs and need for a change in the relationship between departments of social dentistry and the general school teaching programs.

This paper explores the collaborative research relationships between clinical dentists and behavioral scientists in dental education. The emergence of behavioral sciences in dentistry is discussed and attention is given to the nature of professional roles in collaborative clinical research. Components for a model for collaborative clinical research are specified based on the research experiences of behavioral scientists with colleagues in prosthodontics and orthodontics.