Because of You

Because of You

From the Dentists*:

Town and Gown
When the special stratum of private practice dentists teaching part-time at the University of Minnesota School of Dentistry became a subject Northwest Dentistry decided to explore, we invited both teachers and students to participate. What we found was a realm of real-world possibility for dentists, in active practice or retired, and for their students. All concerned feel strongly that this is an opportunity well worth considering, and an experience not to be missed.




From the Dentists On Teaching
While academic degrees are essential to teaching at every level, practical experience gained at chairside is perhaps the foremost qualification for teaching as a part-timer in a dental school. Dr. David Dvorak had always been fascinated by teaching, and in 1969 began that journey, leading to a program in higher education and an M.A.

“As an undergraduate I had trembled in the presence of my instructors, some of whom gave the impression they really ‘knew all the answers!’ On the contrary, being a teacher is very humbling. One soon realizes ‘knowing all the answers’ is an impossibility, and the key lesson is learning to say ‘I don’t know.’ As a teacher, you prioritize, organize, and present the lessons of experience in thought-provoking ways. Someone has aptly said that teaching is, in a sense, a performing art: Get the message across in an interesting and captivating manner, leading others to the truth and impressing them with it.

“Returning to school as faculty is a dual role, the dentist becoming both teacher and student. Dedicated practitioners are perpetual learners, and in a university setting they will be exposed to research which may call for compromise in established thinking. For the most part, however, the teaching experience will reinforce the basic principles which were introduced in dental school. The principles are rarely discarded, but occasionally modified and updated, requiring adjustment of your system for problem solving.”

What is it like, and why do they do it? Dr. Eric Stafne told us, “Except for running a small business, I enjoyed my practice, patients, and office team, but I was ready switch gears. I wanted to continue to be involved with students, so part-time teaching was the perfect solution.” Others who have made the choice told us, “Teaching at the dental school has turned into one of the most enjoyable and rewarding experiences of my dental career. What impresses me most is the faculty - their hard work, concern for the students, and camaraderie, an attitude that is passed on to the students in their relationships with each other and their patients. It is gratifying to see recent graduates turning their attention to the underserved.”

“There is rarely any stress involved working in the clinic, as opposed to private practice. This is important in the life of a retired (read ‘older’) dentist. The result is that I very much look forward to my day in the clinic.”

“I learn when the students learn. One setting complements the other, and I am a more well-rounded teacher from my experiences in clinical practice.”

 

Dr. Teresa Fong and dental student consult the record.

How Teaching Occurs
“At the end of class, put everything away properly and clean up your area! Good habits begin here, and what you do is a reflection on me!” My instructions to my pre-clinic freshmen students on their first day of class were specific. It was my first day too, and I thought I did a great job! Imagine my surprise when on day two we returned to find the top of a cabinet and adjoining cubicle burned and charred because one of my students put away her alcohol torch lit!” Steve Wolff

On the subject of how teaching happens, our contributors agreed that “Teaching occurs at unexpected moments, often in the most challenging clinical situations.” But, continued Judy Danielson, “The clinic is where I can see a student demonstrate knowledge, analyze data, and synthesize it to form a treatment plan. It’s fun to see student success and to see them realize a positive change in their patients’ dental health.” Eric Stafne concurred. “Currently I lecture and consult on tobacco cessation interventions, but the latter is where I learn not only about a student’s intervention skills, but about his or her struggles and accomplishments and plans for the future. I love that part!”

Dr. Dvorak summed up what all our doctors felt when he said, “Any dental student will come in touch with many different instructors, some more adept, but all bringing a wealth of knowledge and experience. The student will find that instructors are likely to have differing approaches to a particular problem; the lesson being that there may well be varying solutions to a problem, and each practitioner has developed skills in meeting special needs. Students should not miss the opportunities offered by different instructors, but rather evaluate their methods and ultimately develop their own.

“Most part-time instructors are general practitioners. Few are skilled in every discipline, but all possess strengths and differing levels of interest. An instructor of mine admonished us to “Keep your percentage of successes high” - i.e., don’t subject yourself to cases that go beyond your skill or comfort level. For instance, specialists are highly trained and experienced in advanced problem solving. By using their expertise, the referring dentist demonstrates strength, not weakness; shows respect and concern for the patient; and experiences greater peace of mind and confidence the needs are adequately met.”

 

Dr. David Dvorak at chairside with dental student Amber Bartel and patient.

Nuts and Bolts
So what are the qualifications for becoming a part-time instructor? The short list goes like this:
• Enthusiasm for dentistry and its dissemination to aspiring students.
• Communication skills; being a good listener.
• Sensitivity to individual learning differences.
• Awareness of what it’s like to be a student.
• Being personable and encouraging, yet objective and approachable.
• Willingness to prepare, demonstrate, and articulate the lesson.
• Evidence of relentless pursuit of excellence in dentistry.

And what are the parameters of employment?
Lewis Pierce summed up the requirements for part-time teaching succinctly: “If you have the passion, just do it. The experience that a dentist brings to the School is invaluable, and motivates both students and faculty with new ideas.”

“Instructors in a professional institution assume a two-fold responsibility,” Dr. Dvorak offered, “to the student, and to the public whom they serve. Instructors are rightfully expected to be outstanding role models and leaders, be academically and clinically competent, and willing to make personal sacrifices and commitments. Ultimately they are responsible for the professional development of aspiring dental students, and monetary compensation should reflect the value of such service. It must be acknowledged that there are numerous intangible rewards for the part-time instructor, for example, being a member of the prestigious faculty of a major university, and specifically the School of Dentistry. Of course, there is no opportunity for tenure or benefits, although parking, in-house training, and limited CE are available. The common denominator is that as part-timers we love what we do and are gratified to play a role in the development of the dentists of tomorrow. These are promising young men and women, and the patient population will be in competent hands.”

Some things are different, and some things are tough. “In my student days (the Dark Ages),” Eric Stafne told us, “we were provided with as many patients as we wanted, and those patients needed a lot of dentistry. That is not the case today. Patients are hard to come by at the School.” “For me,” said Steve Wolff, “the most difficult aspect of instructing is grading. I can look at students’ work, what is wrong, but I want them to know what caused the problem and how to fix it. I insist on professionalism; I do not like slang; ‘wisdom teeth, baby teeth, fillings ...’” Hiwet Ephrem added that “[While] teaching has helped me grow a great deal and I have strengthened my skills as an instructor, advisor, and a communicator, the greatest challenge is managing my time and keeping up with both professional circles.”

Students are different and the same, too. “Despite the new simulation clinic and other advances in technology, materials, and technique, the experiences of the dental students are much like I remember: rigorous, challenging, and frustrating,” said Steve Wolff. “The debt load many carry weighs heavily on them, and I understand their concern.”

And the demands of teaching? Judy Danielson stated, “It’s fun to teach, and always a challenge to teach well.” To this Dr. Ken Erickson added, “I wish I would have had the opportunity of taking a few courses on teaching. It is not enough to know your subject; you need to be able to teach it.”

 

Dental hygiene instructor Judy Danielson watches over dental hygiene student Jill Sink.

Philosophy
Finally we asked our teachers to tell us about the philosophy which drives this level of professional activity. Dr. Dvorak gave us this picture:
“Case studies are a rich source of clinical information, and the experienced professional has many cases to draw upon which lend themselves to streamlining technique and improving the art of problem solving. Therefore a diverse faculty is very apt to make a significant contribution to the development of the learner. Each teacher, in a unique manner, creates a learning experience with far-reaching implications. This alone is incentive to share one’s knowledge and skill in the classroom. In an instructional setting, one inevitable outcome is that the teacher learns the most. Teaching is the best form of personal education, giving testimony to intellectual progress. Teaching focuses the mind, for the teacher considers the subject at hand with special intensity. Imparting knowledge requires in-depth comprehension of the subject as well as organization of the presentation so as to explain and clarify while at the same time encouraging inquiry. As has been suggested, the teacher is the predominant benefactor.”

“Many dentists don’t realize part-time teaching (and learning) is good for their health,” Eric Stafne said. “Although part-timers receive a small salary, there are many benefits - internet access including an e-mail address, free parking, reduced fees for CE courses, and most important of all, a feeling of giving something back to the School and the profession. This is almost a volunteer experience, and volunteers are happier people and they live longer.”

“For people to be interested in teaching at the School, it is important to invest in the resources, past and present, available to the institution,” said Hiwet Ephrem. “This certainly includes part-time teachers and alumni, of which I am both. Being able to bring real-life experiences to the classroom serves not only student and teacher, but the institution as a whole.”

“Most dentists will agree that office practice can often be quite stressful,” said Ken Erickson, “and spending a day or two teaching in the clinic is a welcome break. I have often thought that many retired dentists are missing out on a wonderful opportunity in not offering to teach part-time at the dental school. I suspect that it has probably never entered their minds to offer their services. I have never regretted the time I have spent there, and I can enthusiastically recommend it to our colleagues.”

 

Dr. Lewis Pierce brings an intense concentration to the task at hand.

From the Students
Amid tales of gleefully flying calculus, and supersonic retainers, we gleaned this perspective on the role our part-time instructors play not only in the education but in the lives of their students, including an understanding, and I quote, that “an ugly wax tooth is not the end of the world”.

Students agree that the experience is positive overall, with these instructors keeping them focused on goals while providing the latest technical and treatment planning advice. But more than that comes the continuing steadying and inspiration day after day. “Small words of encouragement on days when your brain says one thing and your hands do another make you want to keep getting better,” said Megan Bowers.
“The part-time faculty at the School have been some of my most inspirational and memorable educators,” concurred Naomi Lane. “Their real-world experience, including mission work, fresh attitude, dedication to teaching, and practical approach to clinical learning show they respect students and welcome them as future colleagues. Sharing the most beneficial experiences from their early practice with us, they are also interested in our plans, and they uniquely build upon my education outside the classroom. Several have invited me to shadow in their offices, introduced me to new techniques or materials they have brought in, and suggested strategies for improving efficiency and advice on becoming a better clinician in applied and realistic situations.”

“By observing one such instructor,’ said Kami Wallner, “I realize I too wanted to develop a high level of composure, logic, and patient-centered care when suggesting treatment options.”

So what is a good teacher? Patient, kind, good sense of humor; shares special knowledge and interests, and tells great stories as leavening for all those type A personalities. Someone who makes sure you leave on a positive note no matter what. Said Teo Platinakova, “A good teacher is punctual, precise, accurate, confident, consistent, intellectually and professionally developed, can easily manage both difficult patients and needy students at the same time, effectively communicate with both, is encouraging but has high expectations, and will take time after an appointment to recap and review.”

Said Paige Christiansen, “A good teacher is the one who remembers that I am a student and a professional, but that I’m not perfect yet.”

What’s not? Someone angry, frustrated by or rude to students or patients. Someone who is not there to be a teacher. Someone who is not quick to help. “Our biggest fear,” all agreed, “is being embarrassed in front of a patient.”

Speaking for all of the students we queried, Megan Bowers told us, “The part-time faculty is an invaluable resource to the School and students. I hope they know how much we appreciate them!”

 

Our Contributors
1. Ms. Judy Danielson is an adjunct part-time faculty member and clinical instructor in the dental hygiene and D.D.S. periodontal clinics at the School of Dentistry three days per week. She serves as course co-director for the periodontal technique course for second-year dental students. A clinical dental hygienist at Bassett Creek Dental in Golden Valley for 18 years, she now practices there one and a half days per week.

2. Dr. David Dvorak is semi-retired from private general practice and currently teaches Operative Dentistry (pre-clinic and patient clinic), Oral Anatomy, Expanded Functions for Auxiliaries, and formerly Biomaterials, DAU and PCG (Patient Care Group). He holds a D.D.S. and M.A. (Higher Education) from the University of Minnesota.

3. Ms. Hiwet Ephrem became a part-time clinical instructor for the Dental Hygiene Program at the School of Dentistry following 15 years of dental hygiene practice.

4. Dr. Kenneth Erickson was a practicing pediatric dentist until 1990, and a part-time instructor at the School of Dentistry from 1952-1970, and from 1975 to the present.

5. Dr. Teresa Fong is a pediatric dentist in private practice in Fridley, Minnesota, and a member of the part-time faculty at the University of Minnesota School of Dentistry.

6. Dr. Lewis Pierce was a high school teacher before entering dental school. Following a general dentistry private practice of several years, he became a specialist in prosthodontics. Retiring in 2004, he joined the dental school faculty. An inveterate volunteer, he has participated in and directed activities in 22 countries worldwide.

7. Dr. Eric Stafne had a private practice limited to periodontics for 25 years as well as teaching part-time in the periodontal clinic at the School of Dentistry during that time, then accepted a full time clinical position at the school for ten years. Retiring from that, he returned as a part-time faculty member to continue to direct the tobacco cessation program.

8. Dr. Steven Wolff practiced for 33 years before neck surgery made full-time private practice unrealistic. Not ready to retire, he changed to teaching.

9. Megan Bowers is a third-year dental student and serves as her class president on the School’s Council of Students.

10. Paige Christiansen is a senior dental hygiene student at the School of Dentistry.

11. Naomi Lane is a fourth-year dental student at the School of Dentistry.

12. Teo Platikanova is a fourth-year dental student at the School of Dentistry.

13. Kami Wallner is a fourth-year dental student from northern Minnesota.

Epilogue: A Story We Just Couldn’t Do Without
A recent graduate dutifully saw an 85-year-old woman in the clinic every three months for perio recall. The first time I saw them together he was very slowly walking her into the clinic for an appointment, she hanging on his arm for support. Engaged in conversation, they were a study in contrasts, he very tall, she small and bent. He treated her with the utmost dignity and respect during the recall. Later I learned that he had given her a Sonicare for home oral hygiene, and asked him about it. Well, he said, it was the right thing to do for a woman who had literally gotten him through dental school by fulfilling so many of the requirements and competencies!

 

“Equal Time”
My best experience with a teacher? Long before bonding became an accepted form of restorative dentistry, a new patient presented with a maxillary RPD. When asked to remove the appliance, he gave a startled look and confided that he never removed it. An equally startled D3 student promptly observed that the RPD was firmly “bonded” to the teeth with massive deposits of calculus and was more like a FPD. Not having been indoctrinated to this form of retention, I felt compelled to call upon a very sympathetic instructor who, after much effort with various instruments, managed to dislodge the appliance. The status of the oral tissues is best left to the imagination of the reader, but the lesson became apparent from the start, i.e., the dentist must never assume anything when delivering an appliance or any form of therapy. To this day I am grateful to the instructor who stood beside me and saw me through the dilemma.

My worst experience with a teacher? During a difficult procedure, an instructor came to check my results and promptly proceeded to verbally berate and embarrass me in the presence of the patient, certainly not the most diplomatic means of establishing confidence and trust in the mind of the patient. It was an honest mistake and would have best been handled with softly spoken advice and counsel. But I determined to make it a positive experience, and am pleased to say I have never addressed a student in like manner. Besides, the case was resolved to both the patient’s and my satisfaction and with mutual respect.