Problem-based learning at the Harvard School of Dental Medicine: self-assessment of performance in postdoctoral training.

Problem-based learning (PBL) was implemented into the dental curriculum at the Harvard School of Dental Medicine (HSDM) in 1994 with an expectation that this pedagogy would enhance students' critical thinking and communication skills as well as general professional competencies. Previous studies have described several aspects of the outcome of PBL curricula at the predoctoral level. However, there is no information available on the perceptions and performance of PBL graduates during their postdoctoral training in dentistry. The purpose of this study was to evaluate the effect of PBL methodology on the performance of HSDM graduates during their postdoctoral training in comparison with their non-HSDM (traditional) co-residents. Surveys containing traditional knowledge-based criteria, preclinical and clinical criteria, and PBL criteria were sent to HSDM graduates from the classes of 2002 through 2004 who were in postgraduate training programs. The HSDM and traditional graduates were asked to evaluate and compare their performance in selected areas with those of their co-residents from either a PBL curriculum or a traditional curriculum. The directors of each program were also asked to assess HSDM graduates relative to other graduates in the program based on the same aspects. Overall, HSDM graduates rated themselves more highly than non-HSDM graduates on all competencies. No significant difference between HSDM and non-HSDM responses was found in general dental knowledge, specialty specific knowledge, preclinical skills, clinical skills, communication with staff, and patient education, whereas significant differences (p<0.05) were found for communication with patients, critical thinking, independent learning, performance in small group settings, self-assessment, and teamwork. The data obtained from the program directors revealed corresponding results. The HSDM graduates' capacity for independent learning was rated as "excellent" by 65.31 percent of the directors and 80.95 percent of the HSDM graduates themselves. These findings suggest that the performance of HSDM graduates during their postdoctoral training met expectations and were similar to non-HSDM graduates for traditional residency program competencies. However, the PBL training appears to provide HSDM graduates with enhanced abilities in independent learning, communication, and cooperation skills.