Promoting critical thinking during a pandemic – Sterlitz – 2021 – Journal of Dental Education



The ability to foster critical thinking and problem solving is a standard that dental schools must meet under the 2-10 standard of the Commission on Dental Accreditation (CODA).1 In an environment unrelated to coronavirus disease 2019 (COVID-19), this standard is met during direct patient care sessions. This requires undergraduate students to apply the information acquired during basic didactic courses to diagnosis and treatment planning in clinical dentistry, demonstrating both critical thinking and problem solving skills. Patient care has been restricted and deemed non-essential during the COVID-19 lockdown period. As a result, many dental schools have been forced to research creative ways to foster clinical critical thinking without directly involving patient care.


Many experienced dentists find considerable value in participating in study clubs organized after graduation from dental studies.2 This concept was exploited before graduation with 127 fourth year dental students. They were assigned to 14 small groups led by 23 faculties. Each small group consisted of 8-9 students and 1-2 faculties. Due to social distancing guidelines and restrictions with in-person meetings, study club meetings all ran synchronously using Zoom Health.

This new concept required several orientation meetings for students and teachers at the start of the semester. During the first few weeks of the semester, course directors met synchronously with faculty several times a week to answer questions and provide advice on how to organize and provide effective feedback during club sessions. study. As the semester progressed, fewer faculty-specific meetings were needed. However, weekly ‘class-wide caucuses’ were held throughout the semester with all faculty and students available to reinforce key points from previous sessions, provide just-in-time instruction, and emphasize concepts. critical clinics of the new missions.

The need to complete 6 credit hours of clinical content without direct patient contact was overwhelming. Three sources were centrally identified and assigned to small groups. Central identification of content provided a consistent experience for all students and reduced the burden on faculty members. The common content was:
  • Digitized and anonymized patient records, photographs and x-rays for standard patient treatment planning exercises.
  • A one-year paid subscription to Spear Online at a discounted college rate.3
  • Guest presentations by faculty specialists focused on young learners in patient care.


The small group study club model exceeded expectations for a successful educational outcome. The teachers enjoyed working with the same students several hours a week for a 14 week semester. Due to the close working relationships established with students in this recurring study club model, faculty were able to relate principles of clinical dentistry and reinforce critical dental concepts demonstrating facets of the integrative pedagogical approach.4 This level of application is something students crave as they move from didactic courses to preclinical and clinical courses. In this course, students had time not only to make sense of the learning process, but also to apply the learning to practical but hypothetical situations, eliciting more “aha moments” than ever before. The faculties were more available to create this type of environment and discuss in more detail with the students, even if they were not in the clinic. Faculty mentors agreed that this level of cognitive reinforcement of important dental principles is not always possible in direct patient care. Often the pre-COVID-19 patient treatment model where faculty work with multiple students and patients in a single clinical session, leaves no time to discuss key concepts essential to developing problem-solving skills. and in critical thinking.

The ability to continue this immersive study club model in a non-COVID-19 environment will be extremely difficult. The 8-10 hours spent reviewing assigned content, preparing for study club sessions, and attending synchronous weekly meetings would be impossible to coordinate during a semester already loaded with didactic and patient demands on students and faculty.

Clinical disciplines like dentistry benefit from a continuing clinical education model of partnership, learning and progress.5 Figure 1 shows a strong positive correlation with our cohort and how they perceive the development of critical thinking during small group dynamics. Both students and faculty appreciated the collegial nature of the study club format. Based on our experience, dental schools should explore methods of connecting young learners with experienced clinicians in a less immersive and regular study club setting as part of their curriculum to encourage clinical growth and promote critical thinking.

Development of critical thinking in small group dynamics


The authors declare no conflict of interest.


Comments are closed.