6. LOCALIZACIÓN
6.1. Localización y características del terreno
2.5.1 Odontology and Stomatology
The development of dentistry as an independent discipline began in 1782, when dentistry was separated from surgery (Bánóczy 1993). This situation forced dental education to develop along two different pathways; odontology (or dentistry as an independent discipline), and stomatology (or dentistry as one of many specialities of medicine).
With regard to the odontology pathway, its principles stemmed from two assumptions. Only those necessary medical sciences should be taught for dentistry; and there should be integration of teaching and learning among medicine, dentistry, and human biology, while dentistry should have its own autonomy (Bánóczy 1993). The characteristics of an odontology programme are that the curriculum is mainly dentally-oriented and it may have little linkage to medicine (Hobdell and Petersson 2001). Currently most European nations have already changed their UG dental curricula from stomatology to odontology through the European HE harmonisation process (Bánóczy 1999).
The question of the quality of a programme and the competence of graduates from both traditions is controversial. Dental graduates from stomatology programmes should have more competence in providing primary healthcare, which requires holistic approaches; while graduates from the odontology tradition (which has less medical content) might not be able to deal with
patients with complex medical issues. On the other hand, odontologists would definitely have high levels of dental-related skills and they should be more competent in providing general dental healthcare – while stomatologists may lack skills and competences in providing primary dental healthcare. Stomatologists themselves might be de-skilled in medicine when they do dental practice more than medical practice for a long period. According to this notion, it may not be possible to determine which tradition provides better educational quality, because dental education depends on the ethos or philosophy of an individual school or university.
2.5.2 Higher Education and Dental Education in Europe
The European Union (EU) was established in 1993 with an important aim to strengthen its economic market and global competitiveness (Pechar 2007). Regarding Higher Education (HE), in 1999 29 European countries signed and committed to the ‘Bologna Declaration’, which is generally recognised as a major change in European HE. The Bologna Declaration states that it is “an agreement among the education ministries of all participating countries to create the EHEA by 2010” (Pechar 2007, p. 112). The purposes of the EHEA are to strengthen the international competitiveness of HE in Europe, and to increase the mobility and employability of European citizens. The
implementation of the Bologna Declaration is defined as the “Bologna Process” (Oliver and Sanz 2007, p. 309).
Concerning the dental profession, a landmark in the history of dental education development in Europe was in 1978 when the EU Council Directive launched the Directive 78/687/EEC, which describes a list of subjects which provide a dentist with the necessary skills for dental practice (Bánóczy 1999). Although it does not provide the exact number of teaching hours for each subject, the directive enabled dental schools to develop common rules, requirements, and educational contents for their UG dental curricula (Anneroth 1989; Bánóczy 1999). Since the 1980s, most
stomatology schools have gradually switched their curricula to odontology in order to align themselves with the Western tradition, and so achieve the common goal of the EU (Scott 2003a). However, these developments have not yet fully affirmed EU policies (gaining mobility, improving employability, developing a comparable degree), as there are several divergences in dental education among European countries, especially in assessment and
examination methods (Shanley et al. 1997; Albino et al. 2008; Manogue et al. 2011).
Since 1999, the Bologna Process has enabled progressive improvements in dental education in Europe through the DentEd project – whose major aim was
“to facilitate and assist dental schools achieve higher standards in UG- DentalEduc, science and scholarship through pooling intellectual resource, sharing experiences, exchanging and promoting better understanding of education and training in the context of regional priorities and resources” (Shanley et al. 2002, p. 187).
The DentEd project assisted dental curricula in Europe to gradually converge towards European standards (Shanley, 2007). The results were the
establishment of a curriculum model, characteristics of a European dental graduate, an educational quality improvement system, and other educational issues relevant to the principle of Bologna Process (Murtomaa 2009). This project was merged into the Association for Dental Education in Europe (ADEE) in 2007. ADEE played a major role in supporting the DentEd project during its implementation, by acting as a representative of European dental schools and reflecting the European view of dental education at a global level (Hobson 2009; Cowpe et al. 2010).
2.5.3 Implications for Dental Educators
Regardless of the extensive development of HE and dental education in Europe, the issue of dental educators and their development has not yet been fully recognised. However, the dental education conference in Dublin (1984) and the workshop in Moscow (1988) mentioned dental curricula and the characteristics of desirable dentists, which may be relevant to dental educators (Oliver and Sanz 2007). These events implied that the roles and responsibilities of dental educators in the development of dental education were considered as an integral part of the whole curriculum development process.
The Directive 78/687/EEC and other relevant documents may indirectly relate to dental educators. However, the characteristics and roles of dental
educators on European dental education development were not recognised. Similarly, several dental education developments have been conducted since the Bologna Process. It is notable that many issues (e.g. profile and
competences of dental graduates, curriculum structure, and QA system) have received much consideration in order to improve dental education to meet the European standards. However, the issue of dental educators is yet to be fully considered.
It is highly possible that educational strategies between odontology and stomatology traditions are different because they are based on completely different curriculum structures. It possibly infers that dental educators in both schools should have different profiles and educational skills in order to support the particular characteristics of each tradition. Dental schools in many countries still have stomatology-based resources and systems. It is questionable whether knowledge and competences (both in dentistry and education) based on a stomatological approach can be fully adapted to odontology. However, an aim of dental education (for both traditions) is to develop dentists who are able to provide the best oral healthcare to the
population (Bánóczy 1999). If the educational goals of both programmes are similar, then dental educators in both schools should have shared common characteristics, in order to educate dental students. A common educational training programme that is applicable to dental educators in both traditions is essential.
Dental educators have several important roles in the UG-DentalEduc. They have responsibilities in providing appropriate educational strategies which allow students to develop essential competences. They are key people who develop new knowledge and implement research into practice. They are an important part of curriculum development, educational management, and educational quality improvement. If these roles lack attention and are not included in any policy or development, then it follows that the quality of European dental education may be compromised and the development of dental educational systems might not be fully achieved. In the next two
chapters, the roles and competences of dental educators will be discussed in order to help to develop a training framework for dental educators in Europe.