4.1 Web-based interactive learning programmes - KSU Faculty ...

Eur J Dent Educ; 6 (Suppl. 3): 127–137 Printed in Denmark. All rights reserved

4.1 Web-based interactive learning programmes Anders Nattestad1, Rolf Attstrom2, Nikos Mattheos2y, Christoph Ramseier3y, Lorenza Canegallo4z, Ken Eaton5z, Luke Feeney6z, Guy Goffin7z, Neda Markovska8z, William Maixner9z, Rutger Persson10z, Patricia Reynolds11z, Juha Ruotoistenmaki12z, Martin Schittek2z, Eric Spohn13z and Mike Sudzina14z 1

University of Copenhagen, Denmark; 2University of Malmo¨, Sweden; 3University of Berne, Switzerland; 4University of Milan, Italy; 5Eastman Dental Hospital, London, UK; 6Trinity College, Dublin, Ireland; 7Procter & Gamble, Brussels, Belgium; 8University of Kosice, Slovakia; 9University of North Carolina, USA; 10University of Washington USA; 11Kings College Hospital, London, UK; 12University of Helsinki, Finland; 13 University of Kentucky, USA; 14Procter & Gamble, Cincinnati, USA

In the future, the training of competent dentists will need to take advantage of up-to-date digital technologies and learning practices. In order to accomplish this, the following goals should be considered: i) the design of ‘customizable’ web-based curriculum matrices that accommodate the training philosophies and resources of individual dental schools; ii) the development of digital instructional modules that can be incorporated or downloaded into specific parts of a curriculum; iii) the establishment of an e-consortium, which provides peer view and guidance in the design of teaching modules, and which is responsible for the storage, maintenance, and distribution of teaching modules within the consortium; iv) the development of central human and physical resources at each dental school to enable the seamless delivery of instructional modules in a variety of learning environments; and v) the assessment and provision of ICT training to students and faculty with respect to the use of computers and related digital technologies and educational software programmes. These goals should lead to the creation of a ‘virtual dental school’. Within this project summative and formative evaluations should be performed during both the production

and development of teaching material (e-learning material) and the learning process. During the learning process the following aspects should be measured and evaluated: i) students’ behaviour; and ii) effectiveness, retention and the transfer of e-learned material into the clinical situation. To obtain evidence of the efficacy of e-learning material a certain amount of research has to be done in the near future. It is suggested that all parameters currently known have to be implemented during the development of a learning programme. Previous workers have evaluated the following elements with e-learning: i) planning, ii) programming and technical development, iii) learning behaviours, iv) learning outcomes of both the programme and the student, v) the acquisition of knowledge, skills and attitude and vi) the transfer of e-learned skills into clinical situations.

Introduction

bilities that are available in networked environments. Initially, this new technology dominated the process and took the focus away from the educational content and learning. It has now reached a more mature state and the focus is now placed increasingly on content, learning and outcome. A prerequisite for a rational learning process is that knowledge is easily accessible, searchable and retrievable. In this respect electronic technology is a necessary tool in modern learning (1). It has enabled informed decision making through the use of database-stored information that can be retrieved by electronic interfaces. At present the consequence of new technology is an overload of information, which in turn requires access to different technology in order to organize the information for any specific clinical issue. A clinician who is unable to access or handle new electronic technology is

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education should be based on scientific evidence combined with accumulated clinical experience. Currently, there is a paradigm shift in dental education. Didactic teaching is being supplemented and replaced by a learner-centred approach, in which the individual student is made more responsible for his/her own learning. The speed of this change in learning style varies between institutions as well as between individual academics and countries. The change in pedagogy relates partly to the development of electronic media and communication possi-

Chairperson. yRapporteur. zGroup member.

Key words: e-consortium; e-learning material; ICT; virtual

dental school. ß Blackwell Munksgaard, 2002

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therefore left with the significant risk of being unable to provide optimal evidence-based care. Electronic technology is still young and under development. New facilities, knowledge and possibilities for electronic information handling are developing continuously and rapidly in a competitive open market. Thus, it offers several exciting options for interactive learning (2). However, at present, the use of information and communication technology (ICT) in dental education has been sporadic and no guidelines for its utilization or quality exist.

How to integrate ICT into the assessment of clinical proficiency and factual knowledge?

Parameters within which the section decided to work

Best practices and innovations

The section was subdivided to consider four different areas, addressing the following questions.

Tools for learning and communications What tools are available for videoconferencing, web-based learning, learning by CD-ROM and DVD? What is the added value of the web compared to stand-alone one-way resources? How to optimize the use of interactive resources? What communication tools are best suited for learning purposes?

Important content characteristics How can the subject and content drive the learning? Which best practices from the DentEd report should be used as background for the development of networked learning? How to overcome the ‘not-invented-here’ syndrome? How to indicate added value of networked resources? How to integrate clinical decision-making and networked resources? How to integrate patient administration and records with learning resources? What content is appropriate for interactive networked learning?

Development and implementation of networked learning What curricular changes are necessary for a rational use of networked resources? What level of computer literacy is needed between students and staff for the use of networked learning? What kind of ICT and educational expertise is necessary and how to integrate ICT competences into dental education?

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Evaluation of electronically sourced material and learning How might formative and summative evaluations of electronic learning material be undertaken? How might student behaviour and the effectiveness of learning be integrated into a course? How should electronically based educational material be quality assessed?

ICT offers one added value that cannot be obtained by any other means. It offers virtually unlimited use of image and video illustrations of clinical procedures and biological phenomena in a cost-effective manner. In addition, the option of interactivity with databases or resource-persons, more or less independent of time and place, is a unique feature of the technology.

Tools for learning and communications The application of ICT tools must enhance and enrich learning, not diminish it. It is essential that ICT tools be employed appropriately to meet learning objectives. It is essential that faculty staff learn how to use these tools and technologies. It is essential to ensure that ICT tools are used in an appropriate and coordinated fashion. It is important to identify personnel in each dental school charged with the responsibility of investigating and evaluating new tools as they become available. ICT tools should be made available to all faculty teachers and students along with appropriate instruction in their use.

Important content characteristics Database packages of images and texts must be linked to the evidence-based literature and to other similar databases of the same content. This principle will allow students to compare information provided from several sources. Each image in any database must meet certain standards, i.e. quality or image resolution. All images must describe defined conditions and include interactive options to guide and assist the learning process. A consistent layout of the descriptive text and the evidence base must be linked to the images. The level of interactivity between text and image should be relative to the skill level of the learner.

Web-based interactive learning programmes

In terms of access, a new search engine similar to National Library of Medicine, should be established. Pattern recognition from images must be studied further and used for the development of expert knowledge and communication technologies. An e-based learning model is not complete until a virtual reality simulation engine is available. This simulation engine should utilize available resources from image and evidence databases. The prerequisite for an e-based teaching format is that it complies with the seven principles for effective teaching in undergraduate education (3). These principles are as follows: Encourage student–faculty contact. Encourage cooperation between students. Encourage active learning. Give prompt feedback. Emphasize time on task. Communicate high expectations. Respect diverse talents and ways of learning.

Development and implementation of networked learning Some universities consider the use of a laptop computer mandatory upon entry into the dental school. Special software should be provided giving efficient access to the computer network in every school and password-protected electronic syllabus (http:// www.dent.unc.edu/). The electronic syllabus is a web-based matrix that organizes digital teaching materials and instructional modules in a searchable database that spans a full 4-year curriculum. Selected undergraduate dental students and dental hygiene students (18–20) should be provided with a 1-year duration fellowship to assist faculty/staff members with the development and implementation of ICT modules. Less computer-literate faculty/staff members could be paired with computer competent students as a means of supporting and mentoring faculty/staff in the use of ICT. Inexpensive high-speed connections to Internet from home for students should be made available.

Evaluation of the electronically provided material and learning Evidence-based quality criteria must be used in the development of educational programmes. All interactive learning resources should undergo both formative and summative evaluation as in integral part of the course.

Some research has been done in the field of design of software but there remains a lack of knowledge (e.g. thumbnail size of histological images compared with X-rays).

Impact of information and communication technology In general terms, the impact of the ICT tools and services for learning will mature over the coming years. The enhancement of their impact will depend on the availability of high-quality resources and the access to the necessary communication tools for both teachers and learners.

How to converge towards higher global standards One of the major issues in convergence and collaborative use of learning resources is the so-called ‘notinvented-here’ syndrome. This phrase means a reluctance to incorporate teaching material or ideas into one’s own teaching material when they originate from outside sources. In addition, there are few existing educational standards or frameworks for design and electronic delivery of learning material and little, if any, work in this area specific to dental education. The competence level between teachers and learners with regard to the use of information and communication technologies varies between countries and institutions. In future a basic knowledge of and skills for the effective use of ICT for learning must be a part of the requirements to enter dental school for all new students and staff. The rights of patients must be respected and informed consent acquired for the use of content providing background documents, i.e. intraoral photos, pathology images and medical/dental history. This should be consistent with guidelines of institutional review boards (IRB) prior to publication of information on the world wide web. All web published documents should carry a statement to this effect. The following rules should be applied. Principles of design and standards should be developed to facilitate students and faculty in the use of Internet based educational material. Commonly defined thesaurus and parameters should be used to record textual and visual data. The name, credentials and address of the responsible ‘editor/site producer’ should be visible on all websites. The expected time required to read the material in any section of a web site should be displayed at the beginning of all sections (pages).

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The objectives, aims, and target audience should be defined clearly. All documents should carry their date of website publication. Specific comments from each of the four subgroups were as follows. Tools for learning and communications Establish realistic global standards for the use of ICT tools in dental education bearing in mind existing standards. Standards should be designed to allow development to keep pace with the ongoing dynamic evolution of information and communication technology. Consensus of all informed and interested parties is a primary requirement. A truly global group should be created, mindful of cultural differences and focused on enhancing communication, to oversee the standards devised for global convergence. The members of this group should not be confined to dental educators, but should encompass members from other related disciplines such as general educators, information technology, ISO, etc. Important content characteristics The cornerstones described above will lead automatically to a higher and a global standard of education and student knowledge. Quality assurance cannot be controlled by e-based systems but the general access to information will most probably assure certain levels of quality standards. In Table 1 there is a suggestion for criteria for this quality assurance. Development and implementation of networked learning Ideal dental school resources: it is recognized that there is great variance between dental schools with respect to their ability to support the development and delivery of web-based instructional modules and curricula. In order to develop and implement fully a modular matrix design several resource issues will need to be developed. These resources fall into two basic categories: physical resources and human resources. a) Physical resources: IT hardware and either a fully wired or digital wireless teaching and clinical environment. A standard laptop program. Digital classrooms and seminar rooms with videoconferencing capabilities. Computers, digital cameras, scanners and AD/DA converters, which are dedicated to the development of digital materials. b) Human resources:

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TABLE 1. What should be evaluated standards for quality assurance? 1a. Design I.

Colours A. Are the colours according to accepted colour diagrams? II. Text A. Are the fonts and size of the text adapted to accepted standards (e.g. Times New Roman)? III. Images A. Correctly adapted to size? B. Compression level and type? C. Fulfil its purpose? D. Not have images where technique or programming can compensate the image? IV. Animations A. No unnecessary animations B. Do the animations fulfil its purpose? V. Video VI. 3D VII. VR VIII. Sound A. Is it possible to turn off the sound (if, e.g. the computer is reading the text)? IX. Navigation X. Glossary

TABLE 1b. Technique I.

Automatic reading of screen resolution – which in turn changes the fonts and image size accordingly II. Automatic reading of where the CD/DVD is (if the CD/DVD is not in the D: drive) III. Automatic reading of what browser you use IV. Automatic reading of connection speed V. Possibilities to a low speed version VI. What database is used? VII. Search possibilities

TABLE 1c. Content. I. Is the content checked by a referee? II. The use of PVD technique (page visit documentation)

TABLE 1d. Pedagogy I. II. III. IV. V. VI. VII. VIII. IX. X.

Is the content linear or non-linear? Has the content a logic sequence? Is the content motivating? Does the software give feedback? Is the software interactive? Can the student determine pace Are there tests? Are there update possibilities? Is the content up to date? Are there: tutorials, simulations, problem-based cases/ tests, tests, evaluation and examinations?

TABLE 1e. Special software evaluation I. II. III. IV.

Chat Web boards Communication tools Etc


A central IT group that maintains the hardware and software of the digital environment. A small group of multimedia instructional design technologists who can generate digital media and content. A small group of individuals with database management skills who can prepare and post materials in a searchable web-based database. A multimedia technologist who maintains and prepares digital classrooms and seminar rooms that permit access to the Internet and video conferencing. Student fellowships to assist faculty/staff with the development and identification of novel digital teaching materials. In order to bring cohesion to the project, and to diminish redundancy and cost of implementation, it is recommended strongly that these resources be housed at a centre within each dental school, which permits full access to all members of the faculty/staff and students. Evaluation of the electronically provided material and learning After establishing further knowledge and evidence through evaluation and research, higher standards may be reached in electronic (networked) dental educational material (4).

Important regional and continental differences The DentEd report suggests that the addition of interactive computer-based educational programmes would facilitate learning and add strength to dental education while reducing unnecessary or unwanted differences in dental education, both in terms of content and quality. The balance between the theoretical and clinical elements, and the number of hours in dental school curricula varies significantly across European dental schools (5–7). Defined outcome assessment is often missing. The introduction of web-based learning programmes will not necessarily resolve these problems but may assist faculties in curriculum reorganization. The benefits of ICT in undergraduate dental education are becoming increasingly evident (8). However, the utilization of these tools requires a certain level of competence with computers between students, graduates and faculty members (9). Although most dental students have a very specific background in biological sciences, chemistry or physics upon entering dental school, their competence and attitude towards computers is extremely variable. This variation often remains

unaltered until graduation (9–15). Previous experience reported by the European Dental Students Association (EDSA: http://edsa.globaldent.com) and the DentEd Thematic Network Project (16) indicate extreme regional differences in the students’ competence, access and use of ICT and Internet in different European dental schools. Consequently, the ability and opportunity to take advantage of new technologies for the benefit of dental education and professional development is very varied between dental students and young graduates in Europe. This could increase the diversity between professionals in the borderless Europe of tomorrow, and as such constitutes both an educational and a political problem (16). The differences in competences and opportunities are important factors for a rational use of ICT in undergraduate and postgraduate oral health education. It is therefore necessary, as part of the DentEdEvolves project, to focus on identifying these differences and suggesting ways towards reducing the consequences of these differences. Within each of the four different areas, considered by this section’s subgroups, a number of issues were highlighted and recommendations made as follows:

Tools for learning and communications Dental schools should continue to use ICT tools to transcend regional and continental differences even though current software is unable to ‘regionalize’ successfully software-training products, i.e. language, hardware configurations, etc.

Important content characteristics Significant cultural, ethnic and skill differences as well language and technical barriers exist. E-based virtual resources will not limit these barriers but may over time result in reduced regional and continental differences.

Development and implementation of network learning Computer literacy between dental students and staff is a prerequisite for the development and implementation of ICT in the curriculum. Existing problems include: 1. Extreme differences are present between dental schools around the world regarding the competence of the students and staff to use and develop ICT. 2. ICT is not implemented in the planning and learning strategies of many dental schools. Dental students in North America receive structured ICT education during their secondary education and also during college years. In addition to basic ICT

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training students may receive part of their college education through web-based or computer-based courses. This allows the dental faculty to make considerable use of ICT in teaching, and appears to positively affect the students’ attitudes and preference towards the media. The fact that most dental students in Europe enter the university without basic computer knowledge is probably a deficiency in the extant secondary education systems in many European countries, which is also one of the major reasons for the extreme regional variation. A recent EU report on the teaching of informatics in secondary education demonstrated major differences between European countries. Although the progress made is remarkable, the effort of promoting convergence in curricula between European countries still has far to go (17). The competence of the staff with regard to ICT presents less variation between the dental schools. Most of the faculties in Europe have not yet implemented ICT in their educational strategies and the development of learning material is still limited (16). In order to overcome these difficulties in the dental school environment the following actions are recommended: 1. Universities must act to ensure that young dentists will be able to utilize ICT. 2. Assessment of students’ ICT competence on entry to dental schools and remedial training for the less competent ones through self-study or distance learning courses. A detailed instrument has to be developed for this assessment, which could measure students’ competence objectively through detailed questions and tasks and not only through self-assessment (18). Building on this, the teaching of less competent students should be

supplemented with the proper teaching modules, so that the necessary competence between the students would be reached. The study modules could be carried out through distance learning by sharing resources within a consortium of universities, since several schools would probably lack the resources for such an educational task.

Evaluation of the electronically provided material and learning There are regional, continental, cultural but also personal differences in learning behaviours. The term ‘global standards’ should be understood in a wide perspective acknowledging and respecting local needs. If an educational programme is flexible in the design and in the presentation of the content, it may be more usable throughout different cultures for both teachers and students. This hypothesis remains to be proved.

Considerations not otherwise covered This section is related primarily to the various evaluations judged to be necessary with regard to electronic learning material and the evaluation of the learning effectiveness of these tools (14). The following basic elements of e-learning should be evaluated (see Fig. 1): 1. Planning, programming and technical development. 2. Learning behaviours and learning effects of both the programme and the student. 3. Attainment of knowledge, skills and attitude. 4. Transfer of e-learned content into clinical situations. Dental professionals may use e-learning to perform higher skills in their dental practice. Therefore the need

Fig. 1. Elements and principles of elearning evaluation. Figure 2 below has additional information on the A/B model.

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Fig. 2. A/B-evaluation model. The A/B-evaluation model described here includes pre-, post-test and questionnaire evaluation. Furthermore a retention-test is planned to evaluate the transfer of e-learned skills into clinical situations. A, e-learning (test); B, conventional learning (control).

for detailed evaluation in the field of e-learning is vital for its application (19–21). As a result Internet and networked computers will be focused as much as learning behaviours of dental professionals at undergraduate, predoctoral and postgraduate levels. The outcomes of these assessments may create a rich knowledge base of ideas for developers and producers of online dental educational material. Evaluation systems described and used so far may not be useful enough to assess new educational methodologies. Therefore other evaluation systems have to be created. This will be an empirical process. Evaluation should take place in a variety of forms. Initially, there should be basic evaluation based on the techniques and/or previous work of Rowntree (19), Meier (20) and Tergan (4). This initial evaluation should then be followed by formative and summative evaluations as described by Wottawa and Thielke (21).

Implications and potential for emerging countries In general, the maturity of e-learning is not yet sufficient for optimal use in countries with emerging economies. There is however, a significant possibility for the efficient use of the technologies especially in emerging countries when the e-learning is matured and the necessary infrastructure is in place. The previously mentioned ‘not-invented-here’ issue is probably not as significant in these emerging countries. When introducing e-learning in emerging countries, the following issues should be considered. A strategic ICT plan should be devised, implemented and monitored to ensure that determined objectives are attained in a structured and complete fashion. Constant local, national and international review should take place regularly.

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A suitable ICT infrastructure should be provided and suitably maintained to allow the integration of the ICT tools. Following the provision of a suitable infrastructure, initial training and education of the faculty and appropriate support staff is vital. Continuing education can then be carried out using the ICT tools and infrastructure. The current predominant primary teaching tools are based on faculty lectures, seminars, laboratory exercises that are re-invented at almost all dental schools worldwide. The cultural influence on learning should be respected and maintained.

Core values applicable to all The use of ICT tools in dental education should above all aim at ensuring the provision of high-quality oral health-care for all members of the community. The following criteria will contribute to this aim: reliability; cost-effectiveness; educational effectiveness; ease of use; quality assurance for educational, technological and scientific applications; and security of use when applicable. Furthermore, the learning must be based upon: an evidence-based foundation; standards of care principles; free access with no restriction; all information obtained from patients must be consistent with informed consent; academic freedom; respect of copyright rules; and feedback and evaluation.

Conclusions A major indicator of the success of any ICT tool is the point at which the tool ceases to be a novelty and becomes the norm. Recent examples of this include e-mail, Internet connectivity and CD-ROM access. Reliable standards, decreasing system costs, ISDN and robust networking infrastructures are creating stable environments for the use of all available ICT tools. Sophisticated learning environments can enable and co-ordinate the use of such tools. It is important to note that even the pioneers and early adopters of ICT tools do not expect them to replace person-to-person com-

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munication or interaction completely. Indeed in many situations the ability to interact remotely with peers and students has the inherent value of improving communication through the reduction of tiresome travel and costs (22–24). The recommendations in this report are aimed at trying to ensure that ICT tools are and will become an integral part of teaching or learning rather than a specialized mode of information delivery. Finally, it is unlikely that any or all of these ICT tools will work seamlessly and smoothly, application and patience are advised to ensure long-term gain and, perhaps more importantly, ‘holding this gain’. It is concluded that a customizable web-based curriculum matrix should enable each school to implement ICT teaching modules in their curriculum. Digital instructional modules must be developed in each university and then shared with other institutions within a consortium. This e-consortium will provide peer view and guidance in the design of teaching modules. This unit will also be responsible for sharing of resources and expertise, storage, maintenance, and distribution of teaching modules to its members. The development of central human and physical ICT resources at each dental school is necessary. This will allow the seamless delivery of instructional modules in a variety of learning environments. Lack of competence with ICT between dental students and faculty is a major handicap towards development and implementation of ICT teaching modules. In addition it constitutes a major political issue, as it presents extreme regional variations. Assessment and if needed, supplementary ICT training to students and faculty will enhance the potential of new media in dental education.

Building and growing a thematic network It is proposed to establish a database of images and other teaching resources which can be used in any dental school or teaching establishment.

Recommendations, realistic goals and a time-frame The key recommendations of this section have been subdivided as follows:

Tools for learning and communications Within DentEdEvolves a representative working group should be established as soon as possible to formulate a


ICT strategic plan which should meet the following characteristics: specific; measurable; achievable; realistic; and time-based.

Important content characteristics An umbrella Internet organization of leading dental educational institutions should be established to set standards and produce content for undergraduate dental education provided on the Internet. This organization should develop guidelines and recommendations for the design, content, and search engines for dental educational web-based material. It should include representatives from all interested educational and professional institutions. There is an urgent need to initiate this work immediately.

Development and implementation of networked learning General recommendations Develop a consortium that coordinates the design of teaching modules and which will adapt and maintain individual instructional modules for distribution to the participating dental schools. Develop an infrastructure (human and physical) within dental schools that supports the delivery of a digital curriculum. Develop training standards for the use of ICT by both students and faculty. Detailed recommendations A ‘customizable’ matrix design is needed in each dental school which will permit the organization of curriculum materials into a searchable web-based database. The matrix should accommodate differences in teaching and learning philosophies, curriculum needs, faculty/staff and facility resources. In order to facilitate the use by faculty and students, the matrix development process should assist faculty/staff and minimize the amount of time and effort needed to generate digital teaching materials. In addition, the process should be organized in a manner that maximizes student utilization and access to these materials. To accomplish this, a collection of teaching modules will need to be developed that can be organized into customisable matrices which address world class standards or ‘best practices’ for dental education (Theme 4.1, areas a, b). Each module and matrix must be created using sound instructional design standards and in consideration of

the different curriculum philosophies and resources available to various dental schools (Theme 4.1, area b). It is recommended that most of these modules be ‘open source’ and freely available to faculty/staff and students to meet local educational needs. It is recommended further that these instructional modules be maintained and distributed by a consortium with representation and support from current and future dental educational organizations (e.g. ADEE, ADEA, SEAADE). This consortium should have representation from several universities and will be of great value in monitoring the development, storage and distribution of instructional modules. A consortium will also permit the sharing of the effort required to produce these modules. Finally, this unit will function to provide peer review and assessment of the learning efficacies associated with the various learning modules. Funding for the support of the consortium and affiliated institutional activities should be provided by governmental and local resources, as well as by grants from industry and private resources. In the event that a dental school has insufficient resources to participate in the development of teaching modules, it must have high-speed access to the Internet.

Evaluation of the electronically provided material and learning The following recommendations are made concerning realistic goals and timeframe for the design of learning programmes. By July 2002: find the evidence criteria for software development. By October 2002: identify the criteria to be evaluated. By December 2002: prioritize and order the defined criteria. By 2004: carry out research according to the decided priorities. The recommendations regarding facilities, competences for students and teachers, as well as use of ICT in teaching and learning from the previous Dented report 2000 are set out below. Facilities Internet access, e-mail accounts and homepages should be available to all students and teachers; adequate access to up-to-date computers should be available at all dental schools with the possibility for students to plug-in laptops to local networks and Internet in all relevant teaching facilities; All relevant teaching facilities should be equipped with computer projection and Internet access.

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Competences for students and teachers Common EU competence statements should be formulated with respect to skills in handling information and communication technologies. The overall aim should be that on graduation a dentist is able to use ICT in order to maintain lifelong learning. The teaching of ICT skills in the undergraduate curriculum should help to develop the above-mentioned competence. This teaching needs to be individualized to deal with the great variation in initial ICT competence of the students. A set of competence requirements for the dental educators should be developed. The overall aim of these competences is that the teacher should be able to integrate ICT into the teaching and learning process including Internet based information and the use of communication technologies. The teacher must also be able to maintain simple web pages with educational content, lecture plans and slide-presentations. It should be the responsibility of individual dental schools to offer the necessary infrastructure to develop such competence. Use in teaching and learning It should be accepted that it is unlikely that there will ever be sufficient resources to permit dental schools to employ non-academic staff to establish and maintain teaching and other material online for its teaching and research staff. Most teachers and researchers must therefore develop their own skills in this area. ICT should be integrated into the curriculum not only as an option for those who are particularly interested. Initially, there should be a focus on areas where the technologies are most appropriate, i.e. in oral medicine where there much ‘pattern recognition’ or in practical procedures that can be illustrated with digital video. Use of the web should be integrated into the daily administration of students and teachers affairs, such as examination results, announcements, etc. in order to familiarize these groups with the web. Students should be involved in the design and development of online teaching and other material. Wide international university consortia/collaborations should be developed which aim at sharing experience, technology, expertise and policies on the role of ICT in dental education. The ADEE ICT Committee, educating of staff members through open projects and continuous contact could coordinate such consortia. Leading dental schools would have the chance to disseminate their expertise and assist less experienced schools in the development and use of ICT applications.

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Schools should also consider building creative industrial partnerships with dual feedback systems to increase the usability of commercial software and hardware products within the academic environment. All dental schools should develop a creative environment in which faculty members feel that efforts in developing new concepts in teaching and learning are appreciated. Schools with a particular interest should consider allocation of academic personnel for full time teaching and research in the field of ICT as a tool for undergraduate, postgraduate and lifelong learning. These staff individuals should cooperate closely with psychologists and educationalists to make sure that the assessment of the effect of the new media is performed in a scientifically correct way. The role of ICT in enabling dental schools, to obtain easy and economical access to a wide range of scientific journals and other educational material needs to be emphasized. A checklist of questions relating to the use of ICT in all areas within dental schools should be produced as a matter of urgency and used during all future DentEd visits.

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