A. R . Baralt, Jr.,* D D S , Detroit
W hen a dental student is graduated, his
Continuing education A R IS T O C R A C Y O F T H E E DU CA TE D
education must be considered a mini mum. Because he is a professional person, he is obligated to continue his education throughout his professional life. Continu ing educational opportunities are abun dant,
newly graduated dentist, is urged not only to take advantage of technical short courses but also to make an effort to in crease his liberal education.
O n e can almost imagine the brand-new dentist heaving a sigh o f relief as he steps o ff the com m encem ent platform . In his hand, he grasps a parchm ent diplom a bearing the great seal o f his university attesting to the fact that he has learned almost everything there is to learn about dentistry. H e is once and forever through with the anguish o f sweating out clinic checks by unreasonably dem anding in structors. H e is once and forever through with school. H e is educated . . . at least that’s what his diplom a says. But is he? Is he really and truly edu cated? A t a recent conference on contin uing education, L. R . M ain observed succinctly that the man w h o was gradu ated yesterday and stops learning today is uneducated tomorrow.
In mid-twentieth century Am erica, there is an urgent desire to achieve status, and academic degrees have becom e the cur rency o f the marketplace. T h e extent one succeeds in achieving the “ g ood life,” it seems, is directly proportional to the number o f academ ic degrees on e may hang on his wall. T h e aristocracy of birth has been superseded by an aris tocracy o f the educated. O f this new aristocracy, E. M . Forster has written in his book, T w o Cheers for Democracy:
I believe in aristocracy . . . if that is the right word, and if a dem ocrat may use it. N ot an aristocracy o f power, based upon rank and influence, but an aristocracy o f the sensitive, the considerate and the plucky. Its m em bers are to be fou n d in all nations and classes, and all through the ages, and there is a secret understanding be tween them when they meet. T hey represent the real human tradition, the one permanent victory o f ou r queer race over cruelty and o f chaos. T h o u sands o f them perish in obscurity, a few are great names. T h ey are sensitive for others as well as themselves, they are considerate w ithout being fussy,
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their pluck is not swankiness but the power to endure, and they can take a joke. Privilege and responsibility have al ways been the characteristics of the aris tocracy, but today they receive a little different emphasis than in former times. The liberally educated have the privilege of helping identify the problems con fronting the world and the responsibility to work for their solution. Consider for a moment the educational heritage o f our newly graduated dentist. In the culture o f the Western civiliza tion, liberal education is and has been the epicenter of all formal learning, even that of the great professions. The ulti mate goal o f all liberal education is intel lectual independence or, to put it an other way, the goal of liberal education is to teach students to think. The “why” and “ when” place the “ what” and “ how” in proper focus. True liberal education is a great deal more than collecting infor mation and memorizing facts, and it is a great deal more than learning to do many intricate and difficult technical procedures skillfully and with dispatch. Facts, information and skills are the stuff, certainly, from which education is made, but being in possession of these raw ma terials does not ensure that the holder is or ever will be educated. Perhaps more than anything else edu cation is a state of mind. It is out of the humanities that the dental profession and, for that matter, all other professions have developed their codes of ethics and formulated their standards of excellence. Thus, these callings, which could have prospered as little more than highly skilled trades, have evolved into the great and honorable professions of today. TO EDUCATE A DENTIST
The new graduate may have been dreaming o f a career in dentistry since he was a small child, but his first positive act aimed at making his dream come
true was his review of the entrance re quirements for dental school. This marked the real beginning of the chain of events leading to admission to and ul timately graduation from dental school. These requirements are minimums, and it is understood that an applicant will not even be considered for admission un less he can prove that he meets these basic requirements. If he surpasses these minimums, he has all the better chance of being chosen over less-qualified appli cants. It is not so apparent, however, that the requirements for remaining in dental school and for graduation are also mini mum requirements. A gifted student may be required to do no more than make passing grades and keep out of trouble for the four years he is in dental school, and he will be graduated. It is well known that grades and class standing are not posted on the diploma received from the hands of the president of the university. The foregoing suffers the weakness of all dramatic oversimplifications. Dental educators recognize the handicaps under which they operate. There are altogether too few hours available in the day to teach students everything they would like for them to know. And the students rec ognize in dental school that, at best, they receive a fleeting, kaleidoscopic glimpse into the wonderful world of dentistry. Together, the students and their teachers realistically undertake the seemingly for midable task of covering the minimum essential principles of dentistry in the time allotted to formal dental education. There is no question that the new den tist is capable of conducting himself pro fessionally and ethically while he sets about establishing a practice, but he does not believe for one minute that he has learned everything he needs to know. He must continue to learn. o b l ig a t e d t o c o n t i n u e t o l e a r n
Commenting on the need for continuing educational effort by the professional
B a ra lt: C O N T IN U IN G E D U C A T IO N • 43
man, Philip E. Blackerby, Jr., has writ ten, “ As a professional man, the dentist has both a need and an obligation to con tinue his education throughout his ca reer. With the continual expansion of knowledge brought about by research, the dental practitioner must strive con stantly to keep himself and his practice methods fully up to date, in order that his patients may receive the modem dental service to which they are entitled. For the professions, continuing educa tion should be spontaneous and volun tary, rather than mere conformance to regulation or tradition.” Conceivably a professor of freshman English composition might take excep tion to the construction of the phrase “ continuing education,” contending that it is redundant and semantically invalid. In the present context, however, the combination is not only valid but em phatic. Its redundancy underscores the urgency for all dentists to seek continu ously and consciously to attain the unat tainable— the state of being fully and completely educated. Continuing education, as it is presently understood, came into being with the de mobilization o f the armed forces at the close o f World War II. Dentists and other young professional men, whose lives and careers had been interrupted by the war, were impatient to return to productive civilian lives, but they realized that many new technics and materials had been developed during their absence, and they needed to learn about these de velopments as quickly as possible. In ad dition, they recognized that many of their older technics had grown rusty through disuse. As a result there was a tidal wave of demand for the dental schools to offer short refresher courses— short, intensive courses from which all extraneous material had been eliminated leaving only a hard core of solid, nononsense information. Spawned in an era of excitement and urgency, continuing education has contributed mightily to the fantastic progressive changes that are
now sweeping the profession. Recognizing the implications o f this burgeoning activity, the American Col lege of Dentists, in 1958, published a pamphlet entitled, An Outline for a Continuing Educational Program for the Dental Profession. The pamphlet was the outgrowth of a panel discussion held in Miami Beach, Fla, during N o vember, 1957. The purpose of both the discussions and the pamphlet was the identification o f the various phases of education in order that clear, concise guidelines could be formulated which would help reduce confusion and mis understanding to the minimum. In the preface o f the publication, Otto W . Brandhorst commented on certain of the several significant obligations basic to the proper practice of dentistry. Dr. Brandhorst emphasized the obligation of the dentist to keep abreast of develop ments in the field, and the obligation of the dentist to share his knowledge and experience with his conferees. Meeting these obligations suggests a planned ap proach to an orderly program of con tinuing educational effort to seek infor mation on new developments and, through sharing of knowledge and ex perience, to place proper evaluation on such developments. T he obligation o f the dentist to con tinue actively his educational endeavors is emphasized further in the first section o f The Principles of Ethics of the Ameri can Dental Association: The right of a dentist to professional status rests in the knowledge, skill and experience with which he serves his patients and society. Every dentist has the obligation o f keeping his knowl edge and skill freshened by continuing education through all his professional life. Thus, to meet its responsibility as a profession, dentistry has currently as sumed the tripartite obligation of be coming technically capable, biologically
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oriented and socially sensitive. Although the first two terms are understood by dentists everywhere, the third may re quire clarification. The obligation o f social sensitivity re fers to the obligation the dentist has for responsible citizenship. For the sake of brevity, social sensitivity may be charac terized as being aware of the problems existing in society and recognizing one’ s role in helping to resolve these problems in the best manner possible. For the most part, dentists have so limited their formal education to subjects bearing di rectly on dentistry that they may find themselves ill-equipped to cope with problems arising out of social changes. It is for these dentists that continuing edu cation may offer greatest benefit. In The Great Conversation, an intro ductory volume to the The Great Books of the Western World, the editor of the series, Robert M . Hutchins, had some cogent comments concerning liberal edu cation and social responsibility: “ The goal toward which Western society moves is . . . civilization. The spirit o f Western society is the spirit of inquiry. Nothing is to remain undiscussed. N o proposition is to be left unexamined. Th e exchange o f ideas is to be the path to the realiza tion of the potentialities o f the race.” The liberally educated man comprehends the ideas that are relevant to the basic problem, and he has a mind that can operate well in all fields. It is almost as though Doctor Hutch ins were writing directly to dentists when he points out that, although the person may be a specialist in one particular field, if he is liberally educated, he will be cap able of understanding anything impor tant that is said in another field and can see and use the light it sheds on his own specialty. He may even derive from his liberal education some conception of the difference between a bad world and a good one and some notion of the ways in which one may be turned into the other. Continuing education is effective be
cause of its inherent flexibility. Both the newly graduated dentist and his not-sonewly graduated professional brother may acquire not only new technical skills and additional insight into the biological significance o f the dental structures but also a broader understanding of what is meant by soul, state, God, beauty and other terms basic to a discussion of fun damental issues. As early as 1916, educational philoso pher John Dewey urged that the central purpose of education was not to teach students how to earn a living. He looked on any kind o f training directed toward learning a trade, solely to make a living at it, as narrowing and illiberal. Accord ingly, a truly liberal and liberating edu cation would refuse to isolate vocational training on any level from a continuous education in the social, moral and sci entific contexts within which wisely ad ministered callings and professions must function. All of which brings one to a confron tation. The newly graduated dentist asks quite pointedly, “ H ow is it possible to en gage in a program of continuing educa tion while simultaneously building up a practice, paying off a mortgage, buying school clothes for the children and fight ing crab grass or shoveling snow, de pending on the season?” T he following outline was contained in the pamphlet, Continuing Education for the Dental Profession, under the heading, “ Ways and M eans:” In considering ways and means o f develop inga continuing educational program, thought should be given toconventional methods of educational effort that might be available or that might be developed. The fol lowing categories suggest themselves: 1. Formal educational methods a. Graduate studies b. Postgraduate training c. Extension courses d. Seminars 2. Informal courses a. Scientific meetings b. Scientific lectures c. Exhibits
B a ra lt: C O N T IN U IN G E D U C A T IO N -4 5
3. Study clubs a. Instructional b. Investigative 4. Research 5. Organized reading a. Reading clubs b. Reading hours 6. Dental literature a. Books b. Periodicals c. Libraries 7. Aids a. Films b. Recordings c. Exhibits
Continuing education is the term used to describe the informal courses usually of short duration such as one or two days to several weeks on either a full-time or intermittent basis, which are offered to provide practicing dentists with informa tion about new developments in technic and science. Continuing education may be offered under the supervision of an in dividual, a dental organization or an educational institution. (These courses are, academically, non-credit.) Postgraduate program is a planned se quence of courses that does not lead to a degree but one for which the student may be awarded a certificate. The level of instruction may or may not be similar to that of the programs leading to the advanced academic degrees. The opportunities for continuing edu cation have skyrocketed within the past few years, and there is every reason to
expect that the growth will continue una bated. It will be up to the busy practi tioner to select those programs that will best fit his needs and his schedule. It is not only his problem, but also his respon sibility. Local dental societies, the American Dental Association and its state com po nents, dental schools, universities and public health agencies are but a few of the groups and agencies sponsoring programs of continuing education. An nouncements of these offerings are pub lished in their periodicals and, in some instances, there is a direct mailing to po tential participants. T o meet our obligations to our pa tients, our communities, our profession and ourselves, we dentists cannot afford either mental stasis or passive “ idea stuff ing” masquerading as education. Active participation in programs of continuing education will enable each dental gradu ate to sustain his claim to membership to the democratic aristocracy of the liber ally educated by enabling him to meet his obligation, to conduct his practice in a manner which is consistent with the title of doctor, which has been conferred upon him and identifies him as an edu cated person.
*D ean, School of D entistry, U niversity of D etroit, 2985 East Jeffe rso n A ve n u e , D e tro it. This a rtic le represents the basis fo r one ch a p te r in the fo rthcom ing book, te n ta tiv e ly title d " A M anual on Entering P ra c tic e fo r Dental S tu d e n ts," scheduled to be pu blished late spring o f this y e a r.
Care of Tools • The craftsman is proud and careful of his tools. The surgeon does not operate with an old razor blade; the sportsman fusses happily and long over the choice of rod, gun, club or racquet. But the man who is working in words, unless he is a professional writer (and not always then), is singularly neglectful of his instruments. I. Brown. In Gowers, E. Plain Words. New York, Alfred A. Knopf, 1959.