|Year : 2018 | Volume
| Issue : 1 | Page : 41-46
|Methods of teaching and adequacy of the undergraduate orthodontic curriculum: Perception of Nigerian orthodontic faculty
Elfleda A Aikins1, Ikenna G Isiekwe2, Oluwatosin O Sanu3
1 Department of Child Dental Health, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt Teaching Hospital, University of Port Harcourt, Port Harcourt, Nigeria
2 Department of Child Dental Health, Faculty of Dental Sciences, College of Medicine, Lagos University Teaching Hospital, University of Lagos, Lagos, Nigeria
3 Department of Child Dental Health, College of Medicine, Lagos University Teaching Hospital, University of Lagos, Lagos, Nigeria
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|Date of Submission||24-Oct-2019|
|Date of Decision||25-Jun-2020|
|Date of Acceptance||21-Sep-2020|
|Date of Web Publication||19-Feb-2021|
| Abstract|| |
Background: It is crucially important that undergraduate studies prepare students to be internationally relevant and employable. Thus, the curriculum must be constantly reviewed to ensure this.
Aim: The aim of this study was to assess the perceptions of orthodontic faculty in Nigeria about the adequacy and global relevance of the undergraduate orthodontic curriculum in Nigerian dental schools and the most effective methods of lecture delivery to undergraduate students.
Materials and Methods: Data were collected from orthodontic lecturers using anonymous structured self-administered questionnaires.
Results: About half of the respondents (47.1%) believed that the curriculum used in their dental schools was adequate, while majority (70.1%) reported that it was globally relevant. Majority (88.2%) of the respondents believed that oral lectures with Microsoft PowerPoint presentations were the most effective method of lecture delivery. The use of whiteboard (29.4%), projector with transparencies (17.6%), and blackboard (11.8%) were considered the least effective methods by participants.
Conclusion: Orthodontic faculty members in Nigeria believe that the current undergraduate curriculum, though adequate, can be improved upon. Oral lectures with Microsoft PowerPoint presentations were considered as the most effective method of lecture delivery by Nigerian undergraduate orthodontic lecturers.
Keywords: Nigeria, orthodontic lecturers, orthodontic undergraduate curriculum, teaching methods
|How to cite this article:|
Aikins EA, Isiekwe IG, Sanu OO. Methods of teaching and adequacy of the undergraduate orthodontic curriculum: Perception of Nigerian orthodontic faculty. J Educ Ethics Dent 2018;8:41-6
|How to cite this URL:|
Aikins EA, Isiekwe IG, Sanu OO. Methods of teaching and adequacy of the undergraduate orthodontic curriculum: Perception of Nigerian orthodontic faculty. J Educ Ethics Dent [serial online] 2018 [cited 2021 Oct 19];8:41-6. Available from: https://www.jeed.in/text.asp?2018/8/1/41/309748
| Introduction|| |
Lecturing is the most common way of teaching undergraduate students worldwide. Various methods of teaching have evolved over the years spanning from the use of chalk and the blackboard, through visual aids to the current era of electronic information dissipation. These methods of teaching are also applicable to dentistry and undergraduate dental training in particular. The various constraints faced in the undergraduate training of dental students in Nigeria have previously been reported, which include infrastructural challenges such as inadequate dental chairs and dental materials, poor electricity supply, and the quality of training received., These constraints may also have an impact on the methods of teaching used in Nigerian dental schools.
Undergraduate orthodontic training in Nigeria commenced in the early eighties at the University of Lagos Dental School. Over the years, it has gradually evolved from a group of concentrated lectures to a more practical/clinical program. This has been facilitated by an increasing number of orthodontists going into academia and the increasing number of dental schools in the country. Orthodontic teaching, especially to undergraduate dental students in their clinical years, has been found to be the most challenging in dental education, not only in the aspect of theoretical teaching covering a wide range of disciplines in limited teaching hours, but also its application in clinical practice. Orthodontic practice in Nigeria requires additional specialist training, as is the practice globally, resulting in limited acquisition of knowledge by undergraduate dental students in their clinical years., However, orthodontics is an evolving specialty, with new systems and techniques of treatment being developed on an almost daily basis. Thus, it is important that dental students are well grounded in the basic principles of orthodontics and orthodontic treatment planning, as this will be of great relevance to them in their future practice as dentists. This fact reinforces the importance of a well-structured undergraduate orthodontic curriculum for Nigerian dental schools.
Dental students often express difficulty in relating the theoretical knowledge obtained in the classroom with the practical skills needed to diagnose orthodontic problems in the clinic. The orthodontic lecturer is thus expected to provide a solution to this situation using appropriate lecture methods. This quest has occasioned many different and new methods of teaching to evolve over the years., These methods supplement the traditional method of oral lectures alone and include online recorded lectures, multimedia lectures, computer-aided learning, and information technology.,
Various factors have been found to be necessary for adequate orthodontic training at all levels which include adequacy of funding, numbers of orthodontic teachers, availability of equipment, number of training centers, numbers of orthodontists, availability of books, journals, and information technology. These important factors have been found variously to be lacking in orthodontic education in some European countries. The global relevance of the orthodontic undergraduate curriculum is also important because it will ensure that Nigerian trained dentists are globally competitive and employable internationally, bearing in mind the fact that the world is now a global village.
The aim of this study was to assess the opinions of orthodontic faculty on the relevance and adequacy of the orthodontic curriculum in Nigeria as well as their preferred methods of teaching.
| Materials and Methods|| |
This was a cross-sectional descriptive study. Anonymous structured self-administered questionnaires were distributed to lecturers who taught orthodontics at various training institutions in Nigeria that attended the Annual Conference of the Nigerian Association of Orthodontists which took place in Lagos. Compliance in filling in the questionnaire by respondents was taken as implied consent, while refusal to fill the questionnaire was taken as consent not given. Furthermore, to ensure confidentiality, names and other personally identifiable information were omitted from the questionnaire.
The questionnaire was divided into three sections: Section A provided information on sociodemographics of participants, Section B asked questions concerning the adequacy of the undergraduate orthodontic curriculum, methods of lecturing employed by respondents, and the effectiveness of methods used, whilst Section C inquired about the global relevance of the Nigerian orthodontic curriculum and the challenges that the lecturers face in carrying out their duty.
Data were entered into the computer, and statistical analyses were performed with the Statistical Package for the Social Sciences (SPSS) software (version 20.0; SPSS, Chicago, IL, USA). Frequency tables of variables were generated. Associations were tested using Chi-square tests, with the level of statistical significance (P) set at P < 0.05.
| Results|| |
A total of 17 respondents participated in this study, with ages ranging from 31 to 57 years and a mean age of 44.35 ± 7.1 years. Majority were female (12, 70.6%) and only about 30% were male. The sociodemographic characteristics of participants are shown in [Table 1].
About half of the respondents (8, 47.1%) felt that the Nigerian orthodontic curriculum was adequate, while one-third (5, 29.4%) considered it inadequate. Majority (12, 70.6%) felt that the curriculum was globally relevant [Table 2].
|Table 2: Respondents' opinions of the adequacy and global relevance of the undergraduate orthodontic curriculum|
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[Table 3] highlights the recommendations proffered by consultants to make the orthodontic curriculum more relevant globally. These include continuous education to update the lecturers, collaboration with other dental schools outside Africa, and international exchange programs for students. Other recommendations include availability of materials that make teaching more practical, provision of teaching aids, and better funding.
|Table 3: Recommendations by orthodontic faculty for improvement of the curriculum|
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[Table 4] depicts the perception of effectiveness of different methods of lecture delivery by the respondents. The methods of lecture delivery considered to be the most effective based on the responses received were oral lectures with Microsoft PowerPoint presentations (15, 88.2%) and oral lectures with or without dictation (9, 52.9%). Conversely, the use of transparencies (3, 17.6%) and blackboards (2, 11.8%) were considered the least effective methods of lecture delivery. With respect to the actual methods of lecture delivery employed [Table 5], only one consultant (5.9%) used transparencies as a method of lecture delivery, while majority used PowerPoint presentations (9, 52.9%) and oral lectures only (7, 41.7%).
|Table 4: Respondents perceived effectiveness of methods of lecture delivery|
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[Table 6] highlights the challenges in teaching recorded by respondents. The greatest challenges reported were lack of orthodontic materials for teaching (8, 47.1%) and poor electricity supply (7, 41.2%).
| Discussion|| |
Undergraduate orthodontic education in Nigeria has evolved, and many of the dental schools now have resident orthodontic faculty members, compared to the past when there were very few orthodontic academics in the country., There are currently about 25 orthodontists involved in undergraduate training across the 11 dental schools in the country. Thus, the sample size of 17 for this study represents about 70% of the current study population and is, therefore, representative of the overall population of orthodontic faculty in Nigerian dental schools.
There are constant changes in the profession of dentistry, and orthodontics as a specialty is particularly affected by change. The adequacy of any curriculum must take this fact into consideration. The undergraduate orthodontic curriculum currently employed in Nigerian dental schools is an adaption of the British undergraduate orthodontic curriculum. In our study, the fact that only half of the respondents reported that the curriculum was adequate, although majority of the respondents reported that it was globally relevant, implies that a lot can still be done to improve on the curriculum. Thus, although the current curriculum may be perceived as globally relevant, there is still a need for improvement in its content and implementation. The present curriculum is based on the prescribed template by the regulatory institutions for undergraduate dental training in Nigeria, namely the National Universities Commission and the Medical and Dental Council of Nigeria. Thus, while the curricula may not be exactly the same in all Nigerian dental schools, they are all similar in the basic knowledge and clinical competencies in orthodontics expected from a dental graduate in Nigeria.
The suggestions made by the lecturers to improve the adequacy and relevance of the Nigerian undergraduate orthodontic curriculum included involvement of students in orthodontic research, teaching on current trends in orthodontics by lecturers, more funding which will make more materials available, continual education for the lecturers' added exposure of students to orthodontic trends in other parts of the world in the form of exchange programs, and collaboration with other dental schools outside of Africa. Some of these recommendations are easy to implement and have already been adapted by a few dental schools in the country such as the involvement of students in research and the teaching of current trends in orthodontics. However, other recommendations such as funding will require increased advocacy on the need for allocation for more resources to orthodontic training in the various dental schools. This is further hampered by the limited resources available to dental schools in the country, which are all government funded. The findings from this study highlight the need for tuition fees to be paid by dental students in Nigeria, no matter how small, in order to increase the funds available for training and thus ultimately improve the quality of training provided. The government may then provide loans, scholarships, and subsidies to students unable to afford the fees that are charged. This will ultimately ensure access to undergraduate dental training for qualified students without compromising the quality of training provided in Nigerian dental schools.
The success of tertiary education largely depends on teachers and particularly on how a teacher delivers lectures in the classroom. The effectiveness of different methods of lecturing the orthodontic undergraduate curriculum has been tested, with the use of multimedia being found to be as effective as standard lecturing methods.
Microsoft PowerPoint presentations provide an audiovisual method of presenting information to an audience. In this study, this was the preferred mode of orthodontic lecture delivery. This method is an improvement on the traditional mode of lecture delivery which involved oral lectures alone or the use of a blackboard or whiteboard as ways of providing additional visuals to the lecture audio. Students have also been found to prefer this method of teaching. This is comparable to what obtains in another developing nation (Bangladesh) where the use of multimedia, PowerPoint presentations, and interactive whiteboard were encouraged in order to increase the students' attentiveness in the classroom. PowerPoint presentations are modern and relatively easy to create which may be the reason for the choice by the studied population of lecturers.
PowerPoint presentations have been found to be an effective lecture method, provided that irrelevant pictures are not included which may serve as distractions, may reduce recall by the students, and may even be harmful to the learning process. PowerPoint-based custom software was also found to be most effective in the teaching of undergraduate cephalometry in particular when compared with commercially available software and traditional tracing methods., However, students have also been found to retain less verbal information during these presentations. In another study which compared the effectiveness of visually aided lectures and videotape slides, both methods were equally effective, with video achieving slightly better results. Furthermore, a significantly greater knowledge gain using computer-assisted learning (CAL) is evident in some studies when applied for teaching orthodontic topics related to diagnosis and treatment planning. CAL has also been seen to be as effective as conventional modes of orthodontic learning and adds a significant gain in student knowledge acquisition. CAL programs in orthodontics elicit mostly positive responses and attitudes from students toward learning and can be used as an adjunct to traditional education or as a means of self-instruction. In other studies, a blend of both traditional and electronic methods of teaching was found to be more effective and acceptable to students than either traditional or electronic methods alone when teaching orthodontic undergraduates.
However, in developing nations like Nigeria, the absence of a constant supply of electricity needed to power laptops and projectors is a huge challenge, as expressed by respondents in our study. This negative impact of poor electricity supply has also been reported in previous studies which looked at students' perceptions on the factors affecting the quality of training received in Nigerian dental schools., This challenge means that the lecturers may prefer to use electronic methods to teach but, due to these adverse circumstances, may not have a choice other than to employ other methods of passing information to their students that do not require electricity such as oral lectures alone and/or the use of blackboard and whiteboard to illustrate or emphasize a point. This may explain why even though majority of the respondents indicated that lecturing with Microsoft Powerpoint was the most effective method due to constraints they preferred to give their lectures without it.
Lack of adequate materials and constraint of finances were also major challenges expressed by the lecturers, which is comparable to the lack of funding for orthodontic undergraduate education reported in 13 European countries. Thus, cheaper methods of teaching were definitely more acceptable to the respondents where pictures of orthodontic instruments and appliances can be shown to the students on slides using PowerPoint presentations. This also bridges the gap between such disadvantaged students and those in other parts of the world who are privileged to sight and handle the same.
Suggestions made by respondents to increase the effectiveness of the methods of teaching presently being employed in our country emphasized the need for more practical “hands-on” and interactive lecture sessions. Others were the need for more seminars and tutorials, increased feedback from students, and the employing of problem-based learning methods. This is corroborated by the fact that there has been a shift recently from teacher-centered traditional didactic lecture-based teaching to student-centered methods of learning, examples of which include problem-based learning, case-based learning, and outcome-based learning.
In developed nations, educational technology plays a dominant role in medical education, and modern curriculum incorporates the use of facilities such as the Internet. Online orthodontic e-courses have also been proposed as a revision to the orthodontic curriculum. It was reported in a study that about 50% of the students felt that an orthodontic e-course should be an integrated component of the undergraduate orthodontic course and should be used to supplement traditional methods of learning.
The findings from this study emphasize the importance of obtaining feedback from undergraduate dental teachers about the adequacy of the dental curriculum as well as the perceived quality of dental training being provided. This feedback serves as a good guide for curriculum update and review.
| Conclusion|| |
Although the present curriculum was considered to be adequate and globally relevant, there is room for improvement with a quest for both students and lecturers to be more exposed to global trends in orthodontics. Oral lectures with Microsoft PowerPoint presentations were considered as the most effective method of lecture delivery by Nigerian undergraduate orthodontic lecturers.
There is a need for a review of the orthodontic undergraduate curriculum currently being used by dental schools in Nigeria. We recommend the use of more student-centered methods of learning in the training of undergraduates in orthodontics, which would greatly enhance student participation in the learning process. These methods include problem-based learning, case-based learning, and outcome-based learning, among others. In addition, the use of online media in teaching and encouraging clinical elective rotations in well-established orthodontic clinics outside the dental school environment are also ways of achieving this. We also strongly recommend the need for additional funding for the adequate teaching of undergraduate orthodontics.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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Dr. Elfleda A Aikins
Department of Child Dental Health, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt Teaching Hospital, University of Port Harcourt, Port Harcourt
Source of Support: None, Conflict of Interest: None
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]
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