Adapting to COVID-19 Pandemic, CDM Shifts to Remote Learning

May 5, 2020

As a safety measure to limit the spread of COVID-19, the Columbia University College of Dental Medicine (CDM) began conducting all instruction online as of March 11. In line with a University-wide mandate, CDM will teach courses remotely through the end of the spring semester.

According to Dana Wolf, DMD, associate dean for predoctoral academic affairs, the transition to online learning has been smooth for didactic courses: Course directors adapted quickly and have been developing strategies to make online sessions interactive and engaging. A number of other adjustments are helping to ensure that CDM students receive a quality education despite the disruptions brought about by the pandemic.

Revamping the schedule

With preclinical and clinical activities suspended, creating alternative educational opportunities for students has become critical. One of CDM’s strategies is adjusting the timing of curricular content delivery. Normally, said Wolf, “we would have been preparing the second-years for their entry into clinic in July. Since we don’t know when clinic operations will resume, we will likely shift some of the didactic content from third year earlier so the students will be able to focus on hands-on clinical skill development when they get back. Similarly, with the first-years, they’ve missed some of their preclinical exercises—manikin exercises—and lab components. To adapt, we’ve been moving content that’s more advanced, that would typically be covered later in the curriculum, forward to occupy that time, as well as giving them evidence-based dentistry assignments, and just being creative about the curricular delivery.”

Knocking out knowledge gaps

CDM has been implementing self-directed learning exercises, which are usually done only in the preclinical portion of the DDS program, to supplement the education of the clinical (third- and fourth-year) students. “This is where students are being trained to be lifelong learners,” said Wolf. “They are going through the process of self-assessing their knowledge base, identifying gaps, formulating a clinical question, and researching that question to learn something they can apply to patient care.”

Several times a week, group leaders—faculty members who head the four clinical group practices—have been meeting with their students for virtual huddles and for students to present their findings from these exercises. “We’ve gotten good feedback from the students. They enjoy the experience, and they want to be able to see each other’s work,” said Wolf.

Software steps in

Using the Prosthetic Design Centre, a suite of CAD clinical and educational software from Stoneglass Industries, students are solidifying their understanding of foundational prosthodontic concepts through exercises that simulate activities they normally would perform in a patient care setting. The software was provided to CDM students courtesy of the company’s owner, Georges Sara.

Dental prosthesis created by a CDM student using the Stoneglass software (image courtesy of Dr. Candice Zemnick)

Candice Zemnick, DMD, interim director of the Division of Prosthodontics and director of predoctoral prosthodontics, facilitated the addition of the Stoneglass software to the CDM curriculum. “We have been using this software for several years in both the predoctoral and postdoctoral classrooms and clinics to allow for the design of fixed and removable prostheses supported by teeth, implants, or soft tissue,” she said. “During this challenging time of remote learning, Stoneglass quickly stepped in to support education by allowing for the deployment of the software to almost 300 students who can now work on different clinical cases from the comfort and safety of their home. It has proved invaluable in building and assessing their skills.”

Telehealth on the horizon

“Another initiative we’re working hard to get in the works is involving students in telehealth,” said Wolf. To do this, CDM is advancing efforts to enroll patients in Connect, Columbia’s online patient portal, which is used for video encounters. Students will learn how to deliver oral health care remotely with the help of instruction materials developed by a CDM faculty member and by observing three-way telehealth sessions led by faculty. Students will also be involved in phone screening and triage of patients who call to request care.

Zooming in on student needs

Most lectures take place over the Zoom video-calling platform, but CDM is also using it to conduct regular meetings with each predoctoral class. “We get together with the students to check in and see how they are doing. This situation is very stressful, and we have to be mindful of the toll it may take on students’ emotional and mental well-being. We want to be accessible, available, and comforting to the students. We want to make sure they are aware of the University resources available to address the mental health challenges associated with COVID-19,” said Wolf.

It’s also an opportunity for students to express their academic worries about, for example, achieving competency without being able to treat patients, or whether they will graduate on schedule. “Those concerns are looming and, we don’t always have answers for all their questions. That’s a very frustrating place to be. But, to the extent possible, we meet with them and listen to their concerns, and we try to give them answers and tell them what we’re thinking about or how we are trying to help them. And that’s the best we can do right now.”

Instructors make efforts to accommodate students by being flexible about assignment deadlines for those who fall ill or experience other difficulties and by making lecture recordings available to students in different time zones who are unable to attend live lectures. Some postgraduate students also have one-on-one mentoring meetings with their program directors over Zoom.

Challenges ahead, and opportunities

The switch to remote learning has posed challenges for assessment and certification of students in the graduating predoctoral and postdoctoral classes. On April 3, Christian Stohler, DMD, DrMedDent, dean of CDM, announced the creation of the COVID-19 Taskforce on Dental Education to address these and related issues. The taskforce is working with the Commission on Dental Accreditation (CODA) and the New York State Department of Education (NYSDE) on ways to ensure competency of DDS students. Online OSCEs, or objective structured clinical examinations, are being developed to replace testing in several areas, including diagnosis and treatment planning. The Stoneglass software is a likely option for assessing competency in prosthodontics. The taskforce also is investigating how CDM’s simulation environment may be safely used to demonstrate knowledge and skill for situations that cannot be assessed sufficiently with other methods.

Disruptions aside, the plunge into fully remote teaching has had positive consequences, too, and may even prove transformative. “This entire experience has forced us to explore new ways of teaching that could very well become additional ways to deliver content, even after we get back to ‘in classroom’ instruction,” said Sandra Bernal-Garcia, associate dean for student affairs.

Wolf added that CODA and NYSDE have regulations about remote learning, and how these bodies view and define remote learning may dictate what is possible once the pandemic has eased. “They’re making allowances now because of the crisis. In some circumstances, you do need to get approval to do remote learning. So the question is, will this change their view of this process?”

“I think the upside has been fantastic, from my point of view on postgraduate education,” said James Fine, DMD, senior associate dean for postdoctoral academic affairs. “Seeing what our postdoc programs have done—they have content and they have knowledgeable people. And because of this, other institutions have reached out us to take our Zoom courses. It reinforces to our graduate students the quality of education that they receive here, and how knowledgeable their faculty are. The rapid ability of our faculty to adapt distance learning to provide high-quality content will allow us to partner with other institutions in the near future to deliver a large part of their didactic education.”