Our indispensable, incomparable affiliate faculty
By STEVE STEINBERG
Dental Alumni News Editor
On this sunny summer day in the D-2 clinic, a third-year student who is just a few days into her Operative Dentistry clerkship is applying glass ionomer to a patient’s premolar.
Dr. Philip Anderson (’72), her instructor, is watching carefully. As she puts the finishing touches on the application, he leans in and tells her: “This is where you want your assistant to come in, like this.” He demonstrates with a quick, precise sweep of his hands. “It’ll make this faster and much more efficient.”
That’s the voice of experience – decades of it – delivering a real-world lesson in four-handed dentistry. And it helps show why affiliate faculty members play such a vital role at our School of Dentistry.
For virtually all of our School’s history, affiliate faculty members have been an essential part of the clinical teaching mission. Serving a half-day or more each week in our pre-doctoral and graduate programs, they’re a faculty force multiplier whose work has grown only more important in an era of declining state support.
In our Department of Restorative Dentistry alone, affiliate faculty members worked more than 1,200 half-day sessions from fall 2015 through spring 2016. If our School suddenly had to replace all affiliate faculty with regular full-time and part-time faculty, tuition might well reach six figures.
Yet these dentists, more than 600 of them at last count, take time away from busy practices or retirement fun and games to work with our students – all for about $13 to $25 per half-day session. That barely covers parking and a vending-machine snack.
“Affiliate faculty are an ideal and necessary ingredient to a modern dental education. They are critical to the smooth operation of this and every dental school,” says Dr. Sara Gordon, our Associate Dean of Academic Affairs. “Most importantly, students love to interact with affiliates, who bring the real world into the dental school experience.”
Like so many other students, Renelle Conner of the Class of 2017 heartily seconds that notion. The Air Force veteran and RIDE student also describes the powerful influence that affiliate faculty members exert on their students, recalling a day in clinic near the end of third year with Restorative affiliate Dr. James Newman Jr.
“He made a comment that was so simple yet so profound,” she says. “He stated, ‘It is important to make the patient feel like there is no place I would rather be than attending to their health care needs.’ This value strikes a chord within me, as it reflects my own values, and the values of many veterans: service before self.”
A two-way street
“Full-time faculty also love to work with their peers on the outside; it keeps us in touch with the business of full-time dental practice,” Dr. Gordon says. “But it’s a two-way street. I was an affiliate faculty member at my alma mater, Dalhousie [University in Nova Scotia], for nearly a decade when I had a full-time general practice. It was my favorite day of the week.
“It kept my memory fresh about the lessons I had learned in dental school. It kept my knowledge up to date. I also really enjoyed meeting and interacting with the dental students, as well as seeing colleagues.”
Says Dean Joel Berg: “Our students do get that voice of experience from our regular faculty as well, since many of them also practice, in some cases for many years. But having that kind of input from so many other teachers on our affiliate faculty is a tremendous benefit. You can’t have too much practical wisdom.”
Beyond teaching the nuts and bolts of dentistry, affiliates add another critical dimension, Dr. Gordon says.
“Affiliate faculty can and do share with the students the ethical and legal dilemmas that present every week in practice, and their wisdom can keep the students out of the weeds,” she says. During the summer, she notes, a group of affiliates conducts regular ethics seminars with the rising fourth-year students.
“It would be hard to imagine a more compelling way for the students to get a sense of the ethical and legal challenges of real-life dental practice,” Dr. Gordon says.
With the implementation of a new curriculum, our students are also receiving far more extensive exposure to practice management, and that’s where affiliates can be especially helpful.
“Our first-year students have been loving our new Tuesday morning course, Conversations On Dental Practice (a.k.a. Tuesday Morning Live), led by Dean Berg, in which a series of outside speakers including affiliates talk informally with the class about practice management issues, including dental insurance, financial planning, and so on,” Dr. Gordon says. “This course has expanded to include both first- and second-year classes this year, and it has been a huge success.”
As she observes, it’s not just the students who benefit from this relationship. Affiliates say that it is indeed a two-way street.
‘Love that energy’
“I love that energy from the students – it’s almost like ‘Teach me more!’ ” says Dr. Anderson, who has been teaching for nearly a decade. “It forces me to keep on my toes, to read the journals. Sometimes I’ll go into the library on lunch hour to read up.”
Dr. Anderson, who was honored in 2015 with one of the first two Hungate Awards for affiliate faculty excellence, says, “I remember as a student how much we loved being with affiliate faculty, because they taught you about the real world.”
He tells students, “This is what works for me. You have to expose yourself to all these people teaching you, take it all in hand, then see what works for you.” He adds: “It’s all about science- and evidence-based instruction. You’re learning from someone who’s been doing this for 20 or 30 years.”
Dr. Anderson, who retired from private practice in 2005, teaches in Restorative Dentistry one full day a week and substitutes when needed. “The students who really want to get everything out of you – they’re the ones who inspire you as a teacher,” he says.
After 43 years as an affiliate, Dr. Ernest Barrett (’69) can recall a bounty of such inspiration. “The best teaching moment is when situations occur that you know will happen once or twice a year in the student’s clinical life, and you show them how to solve it. Then, later, after graduation and in private practice, they come up to you and say, ‘Remember that situation that you showed me in school? Well, it happened again and I remembered what you showed me, and I got through it.’ Their remembering it demonstrates to me that I actually taught them something. That’s very rewarding, because that’s why I’m here.”
While the plethora of affiliate faculty voices enriches the student experience, it also poses a special challenge: calibration. Teachers can impart different approaches, but when it comes to grading and clinical procedures, everyone ultimately needs to be on the same page. Dr. Gordon elaborates:
“Calibration of grading means that all faculty members would ideally apply grading guidelines in a uniform manner, every day, in every clinical situation, to every student. Clearly defined grading rubrics that describe excellent, acceptable, and unacceptable achievement can go a long way to ensure calibration of grading. This was already good at the School of Dentistry, but it has become even better in the past year. The clinical instructors, especially the clerkship directors, have worked hard this year to develop daily grading forms in axiUm that are easy to use and explicit. We’ve also developed and refined a new series of Competency Assessment forms that unambiguously describe competent performance.
“Secondly, calibration of clinical procedures is important so that all clinical instructors guide the students in treating their patients in an optimal manner that has been agreed upon by our expert faculty members and is supported by scientific evidence.
“Many procedures change over time; new technologies come along and new dental materials are developed. Evidence can show that there are better ways to provide patient care. This is one of the gems of being an affiliate faculty member. Every week in clinic is like a free continuing-education course.
“There are often alternate approaches to patient care. Sometimes they all get equal clinical results, but often each has its pros and cons. Young dentists face these difficult dilemmas immediately when they graduate, and it is preferable for them to have already learned and practiced sound decision-making skills.
“Affiliate dentists who offer alternate approaches can bring this to life for our students, especially the senior students. Of course, this is tied to the whole issue of clinical calibration. The students can learn how to approach these decisions while they are still within the safety of the dental school.”
While affiliate applicants often feel that the paperwork can be burdensome, Dean Berg says, “We’re trying to streamline the process as much as possible. At the end of the day, though, this represents a chance to give something meaningful back to your profession by taking a hand in shaping its future. I’d hope this would outweigh any concerns about paperwork.”
Dr. Cindy Folsom (’80), who retired after 36 years in practice and joined the affiliate faculty in spring 2016, puts it in perspective. She says: ““It is a bit of a lengthy process to be accepted as affiliate faculty, obtaining letters of recommendation, going through immunizations and health clearance, background checks, taking online education modules. … But in the end, I am excited to meet with students every week. I love sharing with the students not only pearls and ‘technique tricks’ that I have picked up over the decades, but also business and insurance perspectives in clinical care. I talk about the psychological aspect of patient care, as well as the importance of complete documentation.”
Dr. Jansen Richins, a Perio affiliate since 2011, sums it up: “I’ve always enjoyed teaching and the camaraderie that comes with it. Being a member of the affiliate faculty was a way to stay connected with a first-rate dental school and give back to a profession that has given me so much.”