Changes in educational methodologies in predoctoral dental education: finding the perfect intersection.

This article describes the evolution of thinking, primarily over the past fifteen years, within the academic dentistry community concerning teaching and learning strategies to facilitate students' acquisition of competence. Readers are encouraged to consider four issues. First, looking back to the time of the Institute of Medicine report Dental Education at the Crossroads: Challenges and Change fifteen years ago, in the mid-1990s, where did we think we would be now, in 2011, in regard to the structure of the predoctoral curriculum and use of specific educational methodologies, and to what extent have those predictions come true? The author's own crystal ball predictions from the 1990s are used to kick off a discussion of what connected and what did not among numerous advocated educational reforms, many of them transformative in nature. Second, what is the nature of the evidence supporting our ongoing search for educational best practices, and why are advocacy for educational best practices and prediction of down-the-road outcomes so treacherous? This section distinguishes types of evidence that provide limited guidance for dental educators from evidence that is more helpful for designing educational strategies that might make a difference in student learning, focusing on factors that provide a "perfect intersection" of student, teacher, educational method, and learning environment. Third, readers are asked to revisit four not-so-new teaching/learning methods that are still worthy of consideration in dental education in light of best evidence, upcoming events, and technology that has finally matched its potential. Fourth, a specific rate-limiting factor that hinders the best efforts of both teachers and students in virtually all U.S. dental schools is discussed, concluding with a plea to find a better way so that the good works of dental educators and their students can be more evident.