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Some implications of education and sociology for dental education

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Theses

U n p u b l i s h e d t h e s e s s u b m i t t e d for the M a s t e r ' s and D o c t o r ’ s d e g r e e s and d e p o s i t e d in the N o r t h w e s t e r n U n i v e r s i t y L i b r a r y are o p e n for i n s p e c t i o n , but are to be u s e d o nly with due r e g a r d to the r i g h t s of the authors. Bibliographical r e f e r e n c e s m a y be noted, but p a s s a g e s m a y be c o p i e d onl y with the p e r m i s s i o n of the author, and p r o p e r credit must be g i ven in s u b s e q u e n t w r i t t e n or p u b l i s h e d work. E x t e n s i v e c o p y i n g or p u b l i c a t i o n of the theses in w h o l e or in part r e q u i r e s also the c o n s e n t of the D e a n of the G r a d u a t e Scho o l of N o r t h w e s t e r n University. T h i s t h e s i s by ....... has b e e n u s e d by the f o l l o w i n ^ p e r s o n s , w h o s e s i g n a t u r e s a t t e s t t h e i r a c c e p t a n c e of the a b ove r e s t r i c t i o n s .

patrons

A L i b r a r y w h ich b o r r o w s is e x p e c t e d to secure the

NAME AND ADDRESS

this thesis for use by its s i g n a t u r e of each user.

DATE

NORTHWESTERN UNIVERSITY

SOME IMPLICATIOKS OP EDUCATION AND SOCIOLOGY POE DENTAL EDUCATION

A DISSERTATION SUBMITTED TO THE GRADUATE SCHOOL IN PARTIAL FULFILLMENT OF THE REQUIREMENTS for the degree DOCTOR OF PHILOSOPHY

SCHOOL OF EDUCATION

D3T GEORGE W. TEUSCHER

EYANSTON, ILLINOIS JUNE, 1942

ProQuest Number: 10102037

All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is d e p e n d e n t u p o n th e quality o f th e c o p y subm itted. In th e unlikely e v e n t th a t th e author did not sen d a c o m p le te m anuscript a n d th e re a re missing p a g e s , th e s e will b e n o te d . Also, if m aterial h a d to b e rem o v ed , a n o te will in d icate th e deletion.

uest. ProQ uest 10102037 Published by ProQ uest LLC (2016). Copyright of th e Dissertation is held by th e Author. All rights reserved. This work is p ro te c te d a g ain st unauthorized copying u nder Title 17, United States C o d e Microform Edition © ProQ uest LLC. ProQ uest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106 - 1346

ii

TABLET OP CONTENTS

.Chapter I

II

Page THE P R O B L E M ..........................................

1

Procedure Used in Making the Study................ Limitations of the S t u d y .......................... Method of Presentation ..................... ......

g

2 4

DENTAL EDUCATION IN THE UNITED S T A T E S ...............

5

Early Schools ..................................... 5 Dental School Organizations........ *......... g g Admission Requirements ........................... Objectives of Dental E d u c a t i o n ....................... 1 1 III

CURRENT THOUGHT IN DENTAL EDUCATION

...............

The Nature of the Individual ...................... Socio-dental Relationships ................... Learning ........................... The Role of the T e a c h e r ...... ................... The Content of the Curriculum ., .......... ....... Miethod............................................ Summary .......................... IT

THE NATURE OF THE EDUCATIONAL PROCESS

...........

12 13 13

gg 29 3$ 44 5g 55

The Nature of the Individual ....................... 57 The Relation of the Individual and S o c i e t y ....... 61 The Nature of Learning ...... gg 70 Nature of the Curriculum ••••..................... The Role of the Teacher ........................ 74 S u m m a r y ........................... 0^ T

SOCIO-ECONOMIC FACTORS AFFECTING DENTAL EDUCATION ... Health Care .......................... Population Trends ................................. Employment ............ ............ .......... ...!. Public Works P r o g r a m ..... Housing ....................................... Social P l a n n i n g ................................... S u m m a r y .......................... .................

85 85 90 9Q 106 211

^Ig

iii

CONTENTS (CONT.) Chapter VI

Page DENTAL EDUCATION' LOOKS AHEAD T e a c h i n g ......................... American Society «.............. The Univ e r s i t y ........ *...................

BIBLIOGRAPHY..................................

121 121 124 126 132

CHAPTER I

THE PROBLEM

The purpose of this dissertation is to discover shat implications can he found in education and in sociology for the growth and development of dental education.

It is the opinion of the writer that a study of these

fields will reveal pertinent material which may he used in the solution of the many problems of dental education. The dental school is an educational institution; and the profession which it supplies with young men and women is responsible for serving the dental needs of society.

For these reasons it should he clear at the out­

set that dental education is closely related to general education and sociology.

Because of this relationship, it was felt that a study discuss­

ing it, and drawing implications for dental education from it would he of value. A group which remains unaware of related groups and of their grow­ ing importance runs the danger of becoming isolated.

It should not he

inferred that dental education is in such danger at the present time; hut an occasional thorough examination of these relationships will do much to avert the danger as well as to move the whole field more quickly toward fuller cooperation with those groups. More specifically, the purpose of this thesis is (1 ) to review the literature of the fields of education, sociology, and dental education; (2 ) to draw implications of education and sociology for dental education; (5 ) to point out what would result if dental education were to adopt those - implications for its own educational program.

2

To the reflective dental teacher there mast arise from time to time some important questions dealing with the educational and social responsi­ bilities of the dental school*

Can the latter assume the responsibility

for training the student only in the technical skills of dentistry?

Or

must it recognize the fact that the dental student must know also about the general health problems of his patients; that he must know how to deal with disease, how to prevent it entirely, or at least to control it in its early stages, and how to deal with the many different kinds of personalities that he will encounter in his professional relationships?

Must it be

recognised that dental students probably l e a m in the same way that others do, and that they present as many individual differences as would be found In any group of students?

Does general education have any important

implications for dental education? pose it is to serve society?

la dentistry a profession whose pur­

In order to serve society well, must the

dental profession be familiar with the political, economic, and sociological foundations of American life?

These are some of the questions which need

to be answered by dental educators today.

Procedure Used in Making the Study First, the literature was read for facts pertaining to the history of dental education.

These have been recorded in rather complete form by

several writers and it was felt that only a sufficient number should be discussed in this dissertation to permit the reader to obtain some idea of the way that dental education has developed during its turbulent youth. Second, the dental literature was surveyed with the purpose of recording those things which best expressed the thinking of dental educators

s

today*

The areas chosen were those which appeared most prominently in the

literature*

They can he stated as follows, (a) the individual and his

relationship to society, (b) the learning process, (c) the curriculum, (d) the teacher, and (e) method*

Many quotations are used, hut it is felt

that this is necessary to express properly the opinions of the writers in the field* Third, the literature in the field of education was read to find those areas which occupied the major thinking of prominent American educators* The writer set these up as concepts of education and called them (a) the nature of the individual, (h) the relation of the individual to society, Co) the nature of the educational process, (d) the nature of the curriculum, and (e) the role of the teacher* Fourth, the literature referring to recent important social trends in the United States was read to discover those which seemed to have the greatest implications for dental education*

Those selected were (a) health

care, tb) population trends, (c) employment, (d) public works program, (e) housing, and (f) social planning*

Some of the implications of these

areas for dental education are direct; others, indirect.

Limitations of the Study The study is limited to the findings in the literature, and it should be recognized that actual practices may not conform to the literature* However, it can be assumed that when certain obstacles are removed, practices may gradually change until they coincide with the thinking of those educators who are responsible for the literature*

4

Method of Presentation 3?he study is presented in six chapters*

In Chapter II a brief

history of dental education is presented to acquaint the reader with some of the important facts in the growth of dental education* In Chapter III the thinking which pervades the literature of dental education is revealed*

Quotations from administrators, teachers, and con­

sultants are used to express this thinking*

Again it should be recognised

that actual practices may not conform to the written word, but it was believed that the latter is probably the best source of advanced thought in this area* In Chapter 17 five concepts of education are set forth.

It also

records the implications which can be drawn from them for dental education* In Chapter 7 several important social areas with which every pro­ fessional student should be acquainted are discussed.

It discusses these

trends as far as possible in the light of dental education, and draws implications from each of the areas* In Chapter 71 dental education looks ahead*

CHAPTER II

DENTAL EDUCATION IN THE UNITED STATES

This chapter serves to introduce the reader to some of the diffi­ culties which have beset the course of dental education in the United States during the last century*

To understand the present status of dental

education it is necessary to recognize some of the problems which it has faced and solved*

Dental schools today do not represent the results of

careful planning, but, like so many other American institutions, they have developed from the early needs of individual members of society with­ out any great amount of attention having been paid to the political, economic and sociological background of that society*

Early Schools In 1840 the first dental school in the world was founded in Baltimore, Maryland, and was known as the Baltimore College of Dental Surgery.3, The course of study leading to a degree was ei^it months in length. Previous to the establishment of the first school, a person who wished to become a dentist was trained by associating himself with a practicing dentist.

Looking upon such methods and comparing them with those

employed today brings to one the realization that in spite of the present need for improvement, dental education has made great strides in the last one hundred years*

Previous to 1840, dentistry had evolved slowly for

centuries as a part of medicine*^

But as the methods $f practice became

^ William J. dies, Dental Education in the United States and Canada (Boston: The Meryxnount Press; 1926) p* 40* 8

Ibid.

p. 38.

6

more extensile, dentistry developed into & craft which. 1he experienced practitioner taught to the beginner, The first organized courses of dentistry date hack to 1818 and 1819, Horace Hayden offered a course of lectures on odontology for the medical students of the university of Maryland,

from 1823-18S5 he offered a series

of lectures on dental physiology and pathology at the same school*

In 1887

John Harris gave a course of lectures to prospective students of medicine and dentistry** These two men were almost solely responsible for the founding of the Baltimore College of Dental Surgery in 1840*

It was the culmination of many

years of hard* trying effort to gain recognition for dentistry and dental education*

It represented the faith of two enthusiastic men who believed in

the future of a profession still in its embryonic stages*

The first faculty

consisted of Horace Hayden* Chapin Harris* Thomas E* Bond* Jr.* end H* Willis Baxley*

They all held the M*D. degree and the title of professor.

The

courses taught were dental pathology and physiology* practical dentistry, special dental pathology end therapeutics* and special dental anatomy and physiology* each —

The course of study occupied two sessions of four months

the same as medicine* As might be expected* in the early years dental education developed

slowly*

The records show that by 1865 only four dental schools had been

established*

Hone of them enjoyed a university connection*

The first

dental school in a university came into existence in 1867 with the

^ J* Ben Bobinson, Proceedings* Dental Centenary Celebration VTaverly Press; 1940} pp* 1012-1013,

(Baltimore:

7

1 establishment of the Harvard School of Dental Medicine.

Bat in spite of

these efforts to standardise and formalise dental education, there was a continual increase in the number of poorly prepared practitioners* Beginning about 1880, however, schools of dentistry were founded in rapid succession*

By 1902, sixty were in existence.

State laws, economic

difficulties, and growing demands for university associations have acted to reduce the number to thirty-nine at present* Many of the educational difficulties that dental education en­ countered were due to the copying of medicine in the establishment of proprietary schools*

The latter were indiscriminate in awarding degrees*

Profit was the major objective of those who owned and managed these s&ools; large enrollments were necessary to insure profit*

Low standards of scholar­

ship and easy courses insuring easy graduation were found to attract in large numbers those who wanted a degree to protect them from the law, give them some social standing and enable them to practice a profession*

Some

of them were nothing better than diploma mills, created under the sanction of indifferent state laws, and conducted with the collusion of unworthy dentists*

Protected by unfaithful practitioners in posts of public res­

ponsibility, they freely sold the degree of doctor of dental surgery at home and abroad to the disgrace of the profession and to the dishonor of dental education*

Such were some of the conditions which brought about

the organization of certain influential associations*

TJhder their leader­

ship, dental education has ceased to be a profitable business*

Strangely

enough, they were the most influential agencies for the promotion of dental X Gias, op* clt*, p* 41*

8

education in this country.

Dental School Organizations *£o assist the schools in methods of administration and in principles of instruction, various organisations were formed; namely, the National Association of Dental Faculties {1884}, the American Institute of Dental Teachers (1893), and the Dental Faculties Association of American Univ­ ersities (1908)*

These organizations and the Canadian Faculties Association

(founded in 1920} continued their separate existences until 1923, each attempting earnestly to influence the progress of dental education.*

They

nere amalgamated in 1923 to form the American Association of Dental Schools. The latter has contributed much to the elevation of the dental schools in scholarship rating, and has been largely responsible for changes in curric­ ulum content and in methods of teaching.

Admission Requirements It is interesting to observe the change that has taken place in admission requirements.

2

From 1840 to 1897 the "rudiments of an English

education" vere necessary for admission.

In 1899 one finds that the

requirement was one year of high school; by 1902, two years of high school were demanded;

from 1907

show that from

1910 to 1917, graduationfrom hi^ischoolwas irregularly

required.

to 1910,threeyearswerenecessary.

Becords

After 1917 and until 1924, graduation from four years of high

school constituted the minimum admission requirement.

*

Gies, op,

8

m a „

clt., pp« 47-54.

p. 55.

Beginning in 1924

9

a minimum of one year of work in an accredited academic college was required. By 1937 two years of college were required as the minimum. Conjointly, the dental course and its contents have heen increased. From 1891 to 1917 it was three years in length; beginning in 1917 it con­ sisted of four.

'Che trend has been to crowd more courses of study into

the curriculum as they seemed necessary to assure the student of a broad foundation for the practice of dentistry. Prior to the organization of the National Association of Dental

y

Faculties, in 1844, there were no general academic standards affecting

y/

admission to dental schools, and practically all candidates were accepted without special regard for their intellectual qualifications.

By 1935

four states required two pre-dental years of the candidate before per­ mission to take the state board examination was granted. New York, New Jersey, and Ohio. courses those years represented.

They were Delaware,

They were also very specific as to what Their laws stated that six semester hours

of English, chemistry, physics, and biology were necessary . 1

One sees a

mutual influence of state on school, and school on state, in efforts to raise the standards of dental education.

In 1935 sixteen schools required

two years of pre-dental work for admission.

The American Association of

Dental Schools has stipulated that by the fall of 1941 all schools must require at least two years for admission. The question, "Will admission requirements continue to increase?** is asked occasionally.

But the tendency to raise pre-professional education

above the first two years of college is based on at least three considerations: ^ L. E. Blauch, A Course of Study In Dentistry, Beport of the Curriculum Committee of the American Association of Dental Schools, 1935, p. 361.

10

first, the need for a broad education on the part of men and women who practice the professions; second, the need for maturity in selecting and pursuing a professional course; third, the tendency to expand secondary education to include the work of the freshman and sophomore years of college* Further, every increase of educational requirements makes it more expensive for students to study dentistry*

The dental course can become

so expensive that only the sons of the wealthy will be able to undertake it, or some kind of subsidisation will be necessary to insure equal opportunity to all*

Bather than to increase the educational requirements

in terms of college credits, it can be expected that the caliber of the individual will play a greater role in the future* In 1840 there was one dentist to every 10,000 persons; in 1940 there was one for every 8,000*

It has grown from one school, teaching a

course that required eight months, to thirty-nine schools, teaching courses in dentistry that require four years of dentistry and two years of preprofessional education*

In addition, graduate education and research have

a fairly good start in our dental schools*

Today the schools are banded

together in one organization known as the American Association of Dental Schools, whose purpose is to consider and solve mutual problems; without fear or jealousy of one another*

With two exceptions, all members of the

Association are part of a university*

Between 1840 and 1866, a total of

1065 graduated from thirteen dental schools*

Today, thirty-nine schools

graduate annually, approximately 1700 dentists*

11

Objectives of Dental Education While the requirements for entrance into dental schools have become stricter, the objectives of dental education have been expanded* change is to be expected*

This

One hundred years ago, a dentist did little more

than extract painful teeth, make an occasional filling or a crude denture, and attempt tooth implantation for wealthy people*

He was completely un­

concerned with the dental needs of the American masses and considered dentistry almost solely as mechanics* But today undergraduate dental education strives to furnish the undergraduate dental student with an adequate foundation of knowledge and skill to enable him to serve his patients well*

It is considered important,

too, that his undergraduate education be of such a nature that he will continue his professional study after graduation by reading books and periodicals, by attending study classes and society meetings, and by post-graduate and graduate education*

It is doing little, however, to

awaken the student to the dental needs of American society*

ISor has it

drawn as heavily as it should from the field of education in order to improve its teaching of dental students*

Chapter III discusses some of

the more important problems of dental education; in it can he recognized the growth that has occurred during the period dating from the establish­ ment of the first dental school in 1840*

CHAPTER III

CURRENT THOUGHT IN DENTAL EDUCATION

The purpose of this chapter is to determine the thinking which pervades dental education today.

The literature pertaining to dental education

was read to determine (l) what areas occupied the most attention of dental educators, and (2) what were the thoughts and ideas of dental educators.

The

areas selected were influenced by the reading which was done more or less simultaneously in professional education.

Those chosen are (l) the nature of

the individual, (2) socio-dental relationships, (3) learning, (4) the teacher, (5) the content of the curriculum and, (6) method.

It is quickly admitted

that one must differentiate between actual practices and the literature, but the latter does represent the foreground of progress and should be regarded with a great deal of importance. Y/hile dental education has so far left unsolved many important problems, it has also made much progress during its evolutionary period. The reader will be impressed with the thinking of many of the leaders of dental education.

In general it takes the same direction that is taken

by the professional field of education.

This situation is a healthy one

and indicates a progressive element within dental education. There is a basis for all action; but it may consist largely of 1

emotion directed by the individual’s experiential organization.

The latter

may prove either an aid or a drawback in the advancement of education.

In

dealing with a student it is necessary to be acquainted with and constantly aware of the basic organization of his experience.

His actions will be

The literature of dental education contains some articles by men who are not dental educators, but who have from time to time been invited by dental educators to present ideas that might be applicable to the field of dental education. ^ D. A. Prescott, Emotions and the Educative Process, (Washington, D. C.: American Council on Education; 1938) p. 45.

13

colored by it and will receive a large degree of direction from it*

If

dental educators wish to help dental education along the road to greater achievement and effectiveness, therefore, they mast first see clearly what has been the basis of dental educational thought to date*

Eventually a

sound and intelligent philosophy of education will evolve to give direction to a sound educational process in dentistry*

The Nature of the Individual Dental educators do not consider all dental students alike in ability, capacity, and interest*

They would agree, with few exceptions,

with the following quotation from Boas: The genetic lines composing a race are so varied that the assumption that all members are by heredity endowed with the same physiological and mental characteristics is as absurd as to claim that they are all physically alike *1 Merely to agree, however, that such a statement seems reasonable means little*

The important thing is whether or not it has any effect on the

way that the school practice is conducted*

If one is to judge from the

expressed thought of dental educators, one must come to the conclusion that little or nothing that is part of the school is fundamentally con­ cerned with individual differences*

This will become more clear as the

chapter is developed* The Selection of Students*

To say that no dental educators are

thinking about the nature of the individual and its relation to the school program, however, would be to discredit those who are striving to improve teaching in this field*

That aspect of the nature of the individual which

1 Frans Boas, "The Relation Between Physical and Mental Development,* Science, Vol* 93, No* 2415, p. 342*

14

has attracted the greatest discussion deals with the very point made by Boas, namely, the difference in individuals, and its relation to selection of students*

Banzhaf

points out the need for greater attention to the

quality of students selected by dental schools; he criticizes the latter for their Interest only in quantitative requirements* the student’s habits, attitudes, and personality*

By quality he means

Hinds in discussing the

selection of students, says, His habits must be good and his morals above reproach* We all know that habits formed in youth are rather difficult to change, consequently if the applicant enters dental college with badly formed habits, we find him a very difficult student to train** Another shaft of light, somewhat stronger than the previous, shows in the following quotation from Hinds, We are also aware that individuals who fail in one endeavor quite often become highly successful in another field of work*® Ho educator could fail to agree with the latter statement*

But what are

dental educators doing about it? It is certainly conceivable that some of the men whose concern Is that of student selection think in terms of the applicant as a total personality*

But as far as the literature goes, there is little to warrant

the assumption.

The fact that circumstances may not permit the practical

application of the thought must also be recognized*

For instanoe, Smith

* H* L* Banzhaf, '’Qualitative Entrance Bequirements for Dental Freshmen,1’ Journal of Dental Education, Feb. 1939, pp* 156-58. 2 F* W. Hinds, "Aptitudes for the Study of Dentistry,** Journal of Dental Education, Feb* 1939, p. 171, 3

Itiid., p. 167.

15

points out, But as long as our state dental qolieges remain under­ populated there seems to he little reason for 'believing that any practice of denying admittance will take place* For this reason, the point that should he stressed, for the present at least, is that the test results should he used for providing careful surveillance in regard to the had risks among those t&o do enroll* 1 Some might readily use such a situation to excuse their lack of interest and lack of action in regard to student selection, and, in fact, for failure to make an intelligent attempt to see the student not necessarily as a dental student, hut as a young man or woman eager to find his proper place in the world*

One would suspect that Insufficient effort has been

made to interest young men in studying dentistiy hy directing their attention to the advantages — Human ffature*

and disadvantages —

of a dental career*

One often hears the remark made hy dental teachers

that human nature cannot be changed, that the student is what he is and there is nothing that education can do about it* support in their assertion*

They are not without

For instance, H o m e r says,

The true professional man is horn not made, and our constant effort should be to find him and direct him into the study of dentistry* 2 The assumption, however, carries some contradictions*

First, many will

agree that the person who graduates from dental school is not the same person who entered it, four years earlier*

The graduate has acquired certain

skills and at least accumulated a number of facts which supposedly help him in using those skills intelligently*

In the same sense his reactions are

E* TT* Smith and H* J* Freeman, "Educational Significance of the Iowa Dental Qualifying Examination," Journal of Dental Education, Feb* 1959, p* 210* & H* H* H o m e r , "Inventory on ISehtal E d u c a t i o n , Journal of Dental Education, April, 19dl, p* 25d«

16

modified; his attitude toward dentistry has changed* for hotter or for worse, hut it has changed; his attitude toward people is different —

if

his dental education has been thorough, he has had realistic contact with human suffering*

No man can hare that and not come away from it with a

greater sympathy for ailing human beings* the great practitioners of history*

fhat sympathy has characterized

H o m e r fails to state what should be

looked for when one sets out to find the true professional man; nor is one enlightened as to how to determine whether a young imm possesses those qualities, even if they were known* In writing about administrative officers and others that hare anything to do with the selection of students for a dental school, Miner says, but they are exhibiting a refreshingly new concern about the fitness of the beginning student, whioh is indicated by the term ^selection*. This concern goes far beyond time spent, credits recorded and rituals followed, and inquires about rank attained, range of general study pursued, and disposition to engage in rigorous scientific endeavor* More, the process of selection is frequently elaborated by mental and manual aptitude tests to discover, if possible, adaptability to dental study and practice* In many instances, also, officers of selection are scrutinizing the human side of the ledger the applicant brings with him, in order to determine that his character is above reproach, that his ideals and motives are such as to make him a worthy member of a profession engaged in a great public health service, and that he gives promise of understanding and of living up to the inevitable dis­ tinctions between a trade and a profession.! Obviously, if dental educators make use of the criteria mentioned by Dr* Miner, they are giving serious consideration to the nature of the individual, at least as far as his selection for the study of dentistry

* L. M* S* Miner, ^Trends in Dental Education,* Journal of the American College of Dentist a, Dec. 1940, p. 329*

17

Is concerned*

But one has more reason to suspect that the economic

conditions of our universities, rather than the educational ideals of a few dental educators, determine the present policy of student selection. Classification of Students.

It can he said that dental educators

recognise the differences in abilities that exist among dental students, hut it cannot he said with equal certainty that very much is done about it as far as actual school practices are concerned.

The classification

is generally of the kind exemplified by the following quotation, I believe all students of the same class should be made to meet the same requirement, and as long as students can be classified as good, average, or poor the difficulty or ease with which the requirement is met will depend on the student's aptitude and ability But in the literature one can also find statements such as, Hu matter what kind of dentistry you teach them you have to have ability, interest, and industry to start with . 2 and, There is one outstanding fact about the history of mental measurements and that is that wherever mental measurements have been applied they disclose an enormous range of individual differences, regardless of the trait measured . 3 There is an awareness among dental educators that persons who study dentistry may have different interests, abilities, and capacities. It seems, however, that because of economic conditions in our schools, or because dental educators have not fully grasped the significance of 1

Doran S* T h o m , "To What Extent Should There be a Quantitative Clinical Requirement?" Proceedings of the American Association of Dental Schools, Vol* 14, p. ISTT o H. R. Douglas, "Aptitude Tests for Dental Students," Proceedings of the American Association of Dental Schools, Vol. 15, p. 111. g Donald G-, Paterson, "Mental Measurements," Proceedings of the American Association of Dental Schools, Vol. 15, p. 96.

18

individual differences, little attention is given this important concept of education*

Socio-dental Relationships The dentist, the dental profession, and society enjoy mutual obligations, educators.

Vexy little has been written on this point by dental

That which has been written is indicative, however, of a deep

understanding of those obligations.

For example, Miner* writes that the

dental schools do not exist for the benefit of dentists, but because they satisfy a public need, and that they will exist only so long as they fulfill that need.

Davis in speaking of professional men, says,

They must acquire an appreciation of their own personal relationships and responsibilities to society, and to the economic, legal, and political forces which are maintaining and are also progressively altering the social order*g An analysis of this statement reveals that the dentist cannot isolate himself from society and hope to meet the needs of that society. whole, dental educators realise this. fact.

On the

The latter was in part estab­

lished by a check list prepared and analyzed by Asgis . 3

This list

revealed that the profession {a) realises the need for making dental health services accessible to more people, (b) recognizes that its obligations to society include an active part in planning distribution of dental care to the masses, (c) realizes that the protection of the

1

Miner, op. cit., p. 327.

2

M. M. Davis, "The Social Outlook," Proceedings of the American Association of Dental Schools, Vol. 12, p# 84. 3 A. J. Asgis, "Principles Underlying the Social and Professional Background in the Education of Dentists and Teachers of Dentistry,* Journal of Dental Education, Oct. 1939, p. 3 ,

19

professional standards of service and of the economic status of dentists is a social necessity, (d) is opposed to health insurance and a taxsupported system of state dentistry#

To substantiate the same point

farther, Miner* says, that the evidence piling up from research (laboratory and clinical) shows the relationship of oral health to general health and physical disability#

He continues,

The pressure of this growing body of knowledge makes the dentistfs participation in the activities dealing with the general health of the community a necessity# STothing is said, however, of how the schools shall help the individual prepare himself for such activity.

It is hardly conceivable that the

majority of men in dental practice would be conscious of the part that they might play in the social aspects of health problems.

Still the

recognition that the dentist has such a role to play will eventually aid in bringing dental educators to the place where they will realize that perhaps dental students should think in terms of large health problems# There may be other solutions#

For example, Ford says,

So there falls upon all of us, upon you, upon physicians, upon lawyers, that obligation to so conduct your profession, so direct your education, so lift your thinking above the levels of your profession alone, that you can meet those problems in your own field that are posed for you by a new social and economic world# and his solution, In a certain sense there ought to be for every profession a kind of somebody outside, somebody in the conning tower, who looks about to see the drift of the tides and the clouds and the rise of the storms# There ought to be somebody who played the role of (Jaesar's friend, asked to stand beside him in the chariot at the triumphal procession and whisper in his

*

Miner, op# cit., pp# 524-325.

20

oar all the time that the crowds cheered: remember, you are only a man} remember you are only a man* Someone to say to any profession, any great organisation; remember, after all, that you justify yourself not by your success in an economic sense, but by the discharge of your obligations to your fellowmen *1 He is advocating thinking on the part of the individual professional man, but then seems to confess that perhaps the latter is not entirely capable of that job, and that it might be better if there was some one person who could direct the others in the broader aspects of their professional social relationships* It is probably true that the majority of dentists do not under­ stand the public very well.

As students they have been closely confined

to the immediate problems of becoming eligible for State Board examinations. Little or no effort was made to show the relationships of dentistry to public problems*

The early years of practice usually serve to enlighten

the young professional man on many economic issues related to the practice of dentistry, but they seldom do much to awaken him to the public needs. Articles and statistics setting forth the needs of the public do little to stir him*

He may figure that needs can be those of individuals only,

that there is no public problem involved; or that such things are for social workers to think about one person at a time*

his job is to practice dentistry for

0 9Brien says,

It is my impression that the average professional man does not understand the public very well* He imagines that in order to be impressive he must confuse* Another thing we have learned is that the public, generally speaking, does not know very much about what the scientific professions have

G* S. Ford, "Address,** Proceedings of the American Association of Dental Schools, ?ol* IS, p* TSIT"

21

to offer In the way of aid for his problems# We hare thought of ourselves as apart from him, going our own way, but still he is a very necessary part of any program that we wish to carry out #1 0 #Brien sees, then, the need that the professional man and the

public* understand each other* assumption* part

This seems, certainly, to be a reasonable

In any public problem, it requires continuous effort on the

of the professional group to bring: about, public enlightenment*

But

no major accomplishment is made until the public has understood what the profession has attempted to do for it*

Each is neoessaiy for the advance­

ment of the other* Ford stresses the importance of understanding public problems by professional groups and visualises a condition where the latter may ignore and resist those needs*

He says,

This professional interest and citizenship is a vivid thing that takes hold of us; mark it well, not only in dentistiy but in medicine and law. These groups thus formed and self-directing are surrounded by society as a whole and played upon it* lay concern for them, for here I am emphasizing something that 1 said last year in Chicago to the physicians — my concern for them is that they will become so absorbed in their own laws and procedures and activities that they will lose consciousness of the changing world around them and the new demands that are being made upon their profession by society* If they not only ignore them but as is true with some professions, defy them, and resist them, then society in the end will crash in upon them, and the liberties that they have been given as a responsibility to exercise within their own organization will be taken from them, and they will be told by society what their duties and their economic rewards are *2 Ford call* attention to a danger not at all remote in the relationship of * W» A* O'Brien, ’♦Social Economic Problems As They Pertain to Public Health,* Proceedings of the American Association of Bental Schools, Tol* 15, p ; 150. — — — — —

z

Ford, op* cit*, Tol. 15, p. 70.

zz

dentistry and society.

Unless dentistry, and that means dental education

too, begins to think seriously and generously in terms of the dental needs of the public, it is going to find itself striving to exist under conditions similar to those mentioned above*

Such conditions could become far more

serious than those which would prevail where no heed was given public needs* But the latter could not prevail unchanged for any significant period of time*

Control of Admissions,

Douglass hints of public control of

admission to the study of dentistry in the following, It costs the state a rather large sum of money to give advanced and professional education to these young people, and we ought to be reasonably certain that we do not permit these resources to be used in educating individuals who possess less in the way of potential contributions to society than others who have been denied admittance to our schools*^ This is a challenge to dental education and it can be met only when dental education becomes wholly conscious of the public needs and takes steps to meet them*

It does not seem that failure to do so has been in an effort

to block progress, but simply due to the fact that dentistry has grown up in an individualistic fashion* Prevention of Disease*

In the following statement Kelly discusses

cure and prevention: Professional men and women serve individuals but they also serve society* There is a distinction between the service which individuals expect from professional men and women and the service which society ejec t s from the professions as a whole **. •« The individual may want a dentist to straighten crooked teeth, but society wishes dentistry to bring about

* Harl R. Douglass, "Aptitude Tests for Dental Students," Proceedings of the American Association of Dental Schools, Tol* 15, p* 109•

23

conditions whereby crooked teeth will not occur.^ This seems to he a reasonable request on the part of society and at the same time should help to enlighten the profession on its place in the social order. Dental Students and Socio-dental Relationships.

Little has been

done to teach socio-dental relationships to dental students*

The latter

visualise themselves largely as individuals serving individuals.

They

have been educated to this* and they have many examples about them in the form of fellow practitioners*

Here and there will be seen large

scale mouth examinations and to a far lesser degree some dental care for indigent children*

But while mouth examination programs are fairly well

supported by the organized profession, programs which provide for actual care are not*

The latter are usually under the direct supervision of

public officers; a committee of dentists may or may not act in an advisory capacity*

This is said, not in criticism of such an organization, but

rather to indicate that more initiative is needed on the part of the dental profession in the solution of public problems as they are related to dentistry.

That will not happen until leaders in dental education see

that dental students are educated to ihink about the important issues which constitute the political, economic and sociological life of the American people* Learning Begardless of the field of subject matter involved, learning must be a major concern for all teachers*

How does learning take place, what

* F. J. Kelley, "The Professions in Our Society,* Proceedings of the American.Association of Dental Schools, Tol* 14, p* 386.

24

happens to the individual who learns, what are the conditions which aid learning and what are those which interfere with it?

These are some of

the questions which teachers will ask themselves if they are aware of the importance of learning in the educative process* Repetition,

An examination of the literature will show what

attention dental educators are paying to the efficiency of learning* One of the concepts of learning most frequently found is seen in the following quotation from Rogers, In the report of the Curriculum Survey Committee for Crown.and Bridgework, or fixed partial dentures, one of the fundamentals of Pedagogy has heen ignored, i*e*, repetition* By repetition, the doing of a thing several times, the student becomes more proficient by having the te&nical procedure drilled into him, not once but several times*! This same dependence on repetition is shown in the following statement by Godfrey, A pre-clinical student should be taught definite technical procedures by a limited repetition of technique that will teach him not only how to plan and construct replacements himself, but to be better able to demand a high standard of mechanical perfection in the finished restorations for his patients in his private practice when the actual construction is done by a technician*2 The author Is assuming that repetition of a mechanical procedure will not only improve the student's skill in that particular procedure, but will teach, the student how to plan replacements and to distinguish good mechanical work from poor*

It is difficult to understand how the

* £* J* Rogers, wDi scuss ion," Proceedings of the American Association of Dental Schools, Tol* 15, p* 56&* 2

R* J* Godfrey, "The Relation Between Instruction in Complete Denture Prosthesis and Instruction in Partial Denture Prosthesis," Proceedings of the American Association of Dental Schools, Tol* 14, p* 121*

25

repetition of a specific mechanical skill can aid very much in the planning of that sikill* In the following statement, experience and repetition are used synonymously*

Wilson says,

Some students require more extensive experience than others to develop proficiency in operating* One and some­ times several operations do not provide enough experience to meet conditions found in practice* learning is hased on experience as a first principle* The individual learns hy doing* More repetition of operations for learning is required of some than others* A reasonable quantitative requirement coupled with an exacting qualitative requirement, set in a program which, is flexible enough to permit more freedom for good students inculcates high standards of service not only while in school, hut also after graduation* This is the extent to which quantitative requirements Siould he expected of students *1 Wilson's conception of learning is not hased solely on repetition*

Be

probably understands the benefits of varied experiences when he writes about a flexible program, one which will allow more freedom for good students; it is assumed that by freedom he means opportunity for varied experience* fainter says, But, if a more intelligent class of students could be attracted into the profession, it is quiteprobable that much less drill on these technical subjects would be required, for the speed of learning would be significantly increased *£ The

author sees a relationship between ability and learning, but learning

is again a matter

of repetition*

One could eapect from fainter, however,

George W. Wilson, "To What Extent Should There Be Quantitative Requirements for Students?" Proceedings of the American Association of Rental Schools, Tol. 14, pp* 184-165* ® M* S* fainter, "Pharmacology in Rental Education and Method of Instruction," Proceedings of the American Association of Rental Schools, Tol, 15, p. 84

26

Support for Wilson's recommendatf on, namely, that the educational program should he a flexible one* Again, one sees learning as something more than repetition in the following statement hy Cushman, Repetition of techniqties has its place in teaching; hut only to the extent that it reasserts the importance of attention to details, and continues to demonstrate, under varying circumstances, its adherence to basic principles ***** Our clinical failures are not primarily from lack of knowledge or skill as such, hut rather, from lack of understanding of their application to individual situations, or want of the firm inner conviction of their importance which drives the student to perfect himself * 1 There is present in this statement something of a philosophy of exper­ ience*

The author seems to see the importance of continuity of experience,

for to he able to apply knowledge and skill to a clinical case requires that the experiences previous to the clinical one shall be of the proper kind*

Repetition he sees as of importance in the learning of a complicated

motor skill* Motivation of Learning*

Cushman says that the solution of a

clinical problem is hased on the relating of fundamental common principles to that problem*

He writes,

The student will develop initiative and resourcefulness only as he at first is required to do so in order to solve his questions, and as he thinks of them in terms familiar from his past experience* As teachers, we must think less of getting specimens done, and more of how the student is being affected by our teachiig^ 2 Again one finds some attention to the importance of continuity of experience and a concern as to what happens to the student in a teaching situation*

Frank H* Cushman, "Correlation of Instruction in the Clinic With Instruction in the Pre-Clinieal Sciences," Proceedings of the American Association of Rental Schools, Tol* 14, p* 170. 2

Ibid., p* 169*

27

The latter is, so far, a novel one in the literature of dental education. Swenson has the following to say about learning, Interest is recognized as the great factor in learning. I have found a man's interest far keener when he did not have to repeat the .uninteresting monotonous elementary technic that taught him no new solution to problems. The instructor interest likewise greatly increased making him a "better thinker in the broader professional problems.l One finds here a hint that repetition may kill interest and, therefore, become a deterrent to learning rather than an aid. The Nature of Learning.

It Is generally recognized by dental

educators that it is impossible to equip a student with all the specific skills and knowledge that he will require in dental practice.

O'Rourke2

has said that it is impossible to organize the dental course so as to provide him with competency in all worthwhile fields of dental knowledge and technique.

He contemplates learning as something which affects the

student in such a way that he can solve his own problems.

He expects

the student to come out of school with something more than a collection of skills.

In proposing a solution for the fact that dental schools

cannot completely fit the student with skills and techniques, he writes, JBvidently the way out is the promotion of independent thought and of the spirit of inquiry. These are outcomes normally anticipated from dental education at the university level, and they can be achieved while at the same time giving complete recognition to the practical or vocational aspects of the dental course and to the need for training in basic skills and fundamental techniques.3 1

M. £. Swenson, "What Laboratory Procedures Should the Students be Kequired to do When Treatii^ Patients in the Dental School Clinic?" Proceedings of the American Association of Dental Schools, Tol, 14, p. 137. s

J. T. O ’Rourke, "Aims of Dental Education," Journal of Dental Education, Feb. 1941, p, 158. 3

Ibid., p. 164*

28

Learning to 0 ,Eourket might mean that which, enables the learner to use his knowledge and skills for the solution of new problems; it is something which regards the learner not'as a storehouse of information and techniques, but rather as an individual capable of reflective thought and constructive action, Learning in All Fields is Similar,

One of the hopeful things in

regard to learning as it is conceived by dental educators is found in the following quotation from Turner, Another factor which has assumed immense importance in directing our evolution, one no doubt attributable to university influence, has been the abandonment of the idea long prevalent that dental education was; sin)generis and that it had its own peculiar problems which were not like those to be found elsewhere, Such an isolationist and cloistered attitude has long retarded our progress, and now that we know that all educative processes have much in common and now that we have recognised the kinship of all learning and have sought to avail ourselves of the experience of educators in other fields, our efforts have acquired a new significance and wider vistas of the possibilities of the future have opened before us. While no hint is given as to the nature of learning in the above statement, it does indicate that the author recognizes that the learning process is similar regardless of the field of learning. Summary,

Some dental educators consider learning as consisting of

something more than repetition,

They recognize the need for flexibility

in the educational program to insure the greatest good for all students* It is pointed out that continuity of experience is important to the learning process, and that the student must be interested in the subject to be learned.

One author states that learning does not consist of stored

Charles E. Turner, "Presidential Address,"’ Proceedings of the American Association of Dental Schools, Tol. 16, p. 19.

29

knowledge, but is that which enables the learner to think reflectively and act creatively*

It is hoped that this thinking will prevail and that those

who do not believe so now will be won over to a fuller understanding of the learning process*

The Role of the teacher There is a growing realization on the part of several dental educators that the teacher is an important factor in the education of the student* today*

This has not always been true, and is not universally believed In some quarters he is still looked upon as one who is unable to

practice dentistry successfully*

One author, in 3 peaking about students

who fail to impress their patients, says, In the broadened field of dentistry such individuals will find a place in education or in re search * 1 No comment is made about the need of impressing students*

This point of

view has been one of the inhibitiig factors in the development of better dental teachers*

It is traditional and universal to such an extent that

unquestionably many brilliant men have avoided dental teaching as a career* Another factor, less vicious however, has been that which concerns itself with the ability of the teacher*

Turner mentions it and at the same time

renders an opinion in the following excerpt from his presidential address, While there are two opposing schools of thought on this subject, one being represented by the belief -that a teacher is b o m and not made, the other by the belief that even a good teacher may be improved by suitable training in educational methods, there are many activities in the field of general education which support the latter point of view.2 *

Hinds, op* clt*, pp* 170-171*

2

Turner, op* cit*, p* 23.

30

Ufa-9 Teacher.

Moat of those who write about the teacher in dental

education, write of him not as one endowed with the abilities, capacities, and interests of the great teacher, hut rather as one who must he con­ stantly striving to improve himself in many related fields*

They see

him not as a narrow individual, hut as one who has a broad background of experience and is capable of relating it to his teaching*

Blauch writes,

But there are evidences that a better day is at hand for teaching* On all sides we see a clear tendency to professionalize this function, to regard it as a most essential social service wfttich can be performed only by men and women of intellectual capacity and sound learning* Where formerly it was thought that anyone could instruct, today one meets generally the idea that the skilled teacher is engaged in an art which demands unusual ability*^ The Development of the teacher*

A few write of the need for

education of teachers in education itself and the need for encouraging and developing teaching*

The latter viewpoint is expressed in a quotation

from Marjerison, All that dentistry now offers to brilliant minds which it sadly needs is the practice of dentistry. Attractive opportunities in teaching and research are not open to young men in the field of dentistry, except in isolated instances* The traditional point of view did not encourage this phase of the problem* To the contrary, teaching positions were looked upon as stepping stones to practice. Research was sporadic and accidental ••••• As a result dentistry must start from the bottom to encourage and develop teaching and research as a career *2 Education of teachers is sponsored in a statement by Cushman*

He

writes, * L. E, Blauch, "Teachers and Dental Teaching," Proceedings of the American Association of Dental Schools, Vol. 14, p. 245* Z

H. M* Marjerison, "To Maintain Dental Education in Pull Accord with the Highest Requirements of Professional Education in the Public Service," Proceedings of the American Asaociation of Dental Schools, Yol* 15, p* 63.

31

Along with the education of our teachers to apply science to practice, we should enhance their capacities as teachers* Rot all teachers know intuitively how to impart their enthusiasm and knew ledge of the subject to others* In successful teaching it is essential to analyze the process of education itself, the pupil *3 individual capacities, the specific contributions each course should make to the student, devices by which this can be success­ fully done, and measures for determining how well it has been done* Better use of our allied Schools of Education, faculty discussions of problems of education, and the will to experiment, will do much in this field* Blauch also calls our attention to the importance of improving the teacher, when he writes, Surely it is impossible for one to instruct his pupils adequately unless he himself has first become a master of what the pupils are called upon to learn* But it is not enough that one shall know only the subject matter he teaches; he must have gone far beyond this point* He must have proceeded to the place where he has acquired a large perspective, where he sees what he teaches in its various relationships*2 In another passage Blauch^ describes two kinds of teachers:

the

first is the one with the warehouse mind —

he simply accumulates a lot of

information and hands it out in packages —

the second has the factory

mind —

this one takes information and does something with it*

have the student, the scholar, the creative artist*

Here we

For Blauch, teaching

is creative work which calls for broad and profound scholarship* Toung writes, The time is hard upon us when teachers in dentistry should take their rightful place with teachers in other phases of

Chiahman, op* pit*, p* 168* 2

Blauch, op. Pit*, p. 246*

3

Ibid*, pp* 246-247*

32

higher education* ETo longer is it enough to know one subject well, to he able to demonstrate a procedure in it or impart some information respecting it* The problems of viewing dentistry in its changing relation to medicine and society and the necessity for knowing the present dey principles, psychologies and trends in general education axe increasing ones for the dental teachers, as dentistry leads on to its destined place in the health professions* There is growing evidence that dental teachers are aware of this responsibility*^If the recommendations of Young were to be followed completely, the dental teacher would be a leader in the dental field; he would be a teacher with the proper educational background for teaching; and he would be sensitive to medical and social trends*

Obviously, this casts the teacher of

dentistxy in an exceptionally important role*

Semens says,

The time has come when dental teachers moat be better trained both in subject matter and in educational methods, if they are to be expected to measure up to the demands of a rapidly expanding dental education. It is common knew ledge that a reform is long overdue in the teaching methods employed in dental schools* The demands for economy of time and more effective teaching make it essential that the future teachers of dentistxy have a substantial amount of graduate training. 2 Demands are made of dental teachers for scholarship of the highest type, for thorough knowledge of the dental field, for acquaintance with the newest trends in medicine and social studies, and for thorough background preparation in the field of education. The Importance of the Teacher* element in the educational process*

The teacher is a very important

In dentistry, he is something more

* A* P* Young, "The Problems of Teaching in Dentistxy,** Proceedings of the American Association of Dental Schools, Tol* 14, p. 273. ^ S* M. Semans, "President*s Address," Proceedings of the American Association of Dental Schools, Yol* 15# p. 20.

33

than an excellent technician.

He must he a scholar with a broad and

profound background of experience; he is a scientist* well versed in his major interests* dentistry and education* and acquainted with medical and social trends*

Some dental educators recognize the importance of the teacher

in dental education*

For example* Horner says*

Baring the hundred years that dental education has been slowly and painfully coming to its present status, a relatively new science has been discovered and organized and an accompany* ing art has been developed to a high state of perfection* I refer to the science of education and to the art of teaching.* And TanKirk writes* The essential factor in the final success of the new dental educational program is the teacher* Increases in his interest* his skill* and his knowledge are the final and most important achievements* Success or failure of the entire program is in the hands of the teacher.2 The effect that faulty teaching may have on good student material is discussed by O'Bourke*

He says*

Although it Is admitted that as far as is possible admission should be limited to highly qualified applicants* there Is no magic in admission requirements alone* It should be considered that good material may be ruined by faulty educational practices* that initiative may be destroyed* and that the development of resourcefulness* Judgment and proper habits and methods of study may be inhibited *3 Criticism of Teaching* into two groups:

Dental educators divide the teaching corps

the first one is referred to as the basic science teachers*

the second as the clinical teachers*

Their major concern seems to be an

attempt to correlate the basic science teaching with olinical teaching* I

Home r , op* cit** p. 265*

a

L* E* TanKirk, *The Teacher and the Hew Curriculum,* Journal of the American College of Dentists, Dec* 1935, p. 365* ®

0 #Kourke,

op. cit*, p. 162*

54

Occasionally one finds a reference to stimulation of student interest, attention to those hahita, attitudes* and characteristics of the individual which are generally recognized as important in the practice of dentistry, hut which receive little attention from educators.

'This is true not so

much because they do not believe them important, but because they do not believe it a function of the school to concern itself with them.

One

finds in this expression an educational philosophy which says that the subject, rather than the student, should be taught and that the business of the school is the transfer of specific knew ledge from institution to student. Cushman writes, The responsibility of the basic science teachers in bringing about increasing emphasis in their subjects should include more clearly differentiating for the student the specific from the background material and placing added accent upon the broad principles involved* 1 This author wants basic science teachers to put more attention on basic principles and to direct their teaching in such a way that specific references will be seen always based on those principles.

About the

clinical teachers of dentistry, he has the folloi&ng to say, ..... our clinical teachers, regardless of their present desire, are without the foundation for full appreciation of the recent rapid advances in our knowledge of the behavior of the mouth. They practice and teach too largely from their own experience, and measure the success of their efforts by equally empirical yardsticks. Their attention has been focused so largely upon reparative procedures that prevention and health promotion are only vague ideals in their consciousness.£ There is pictured here a "teacher* who has become completely out of touch

Cushman, op. cit., p. 169. Ibid., pp. 166-66'.

55

with the progress within his own profession and who has largely forgotten all his "basic science work In his attention to the mechanical aspects of dentistry.

He does not view them as a means of treating diseased months;

they are ends in themselves*

Further, "because he has grown ont of touch

with the activity in his o m field, he relies on his own way of doing things to supply his teaching material*

Kronfield says,

Judging from the answers to the questionnaires I "believe that we are all too much inclined to consider our own way of doing the "best and only one, and to for­ get that 90 per cent of our daily activities as teachers is merely the combined result of tradition and circumstances* 2 Cushman makes a recommendation to teachers which refers in a way '

to the matter of losing touch with the profession*

He suggests that all

teaehers should he acquainted with the objective of the whole dental course as well as have a clear formulation of the particular objective of his own course*

If teachers followed this advice, undoubtedly they

would find that they were in rather close touch with the progress within their profession* gontinuous Study*

0 ,Rourke pointed out above that everything

pertaining to dentistry could not be taught the student during his stay in school*

32xe necessity for keeping in touch with progress in dentistry

and with the continually changing relationships of dentistry, medicine and sociology also places a great responsibility on the professional man. He must recognize its implications and assume it as a part of his professional obligation*

The teacher plays an important part in the

1

H* Kronfield, "Discussion," Proceedings of the American Association of Dental Schools, Tol* 14?, p. 350*

2

Gushman, op* cit*, p. 16£*

36

development of such, an attitude*

Cushman says,

The responsibility of the clinical teacher is primarily, then, to develop in his students those characteristics lead­ ing to continued education after graduation, and to carry him in school only to the point at which he is capable to safely begin practice free from supervision. 1 Cushman*s statement should be enlarged to read that this is the responsi­ bility of all teachers, not only that of the clinical teacher* Summary*

Dental writers suggest that teachers of dentistry should

make greater efforts to correlate the various subjects which comprise the dental curriculum, particularly the so-called basic science courses with the clinical«

This job is one which must be shared by basic science

teachers and by clinical teachers*

They advise that dental teachers should

be interested in the entire course of instruction of the dental curriculum, and that the biggest job that they have to perform is to stimulate students and build their interest in dentistry to such an extent that it will con­ tinue after graduation*

The Content of the Curriculum The Nature of the Curriculum* Without exception the curriculum is the most talked of subject in dental educational circles. predominate:

What should be taught and how much of it?

literature of the last few years bears this out* to the nature of the curriculum is made*

Two questions

The educational

However, some reference

For example, Gies writes,

The highest attainable function of an undergraduate curriculum in dentistry is the education of men and women to be wise and capable general practitioners, competent to begin a reliable independent service, and able to learn and

1

Guahman, op* cit*, p* 170*

also to grow steadily in proficiency and aspiration from experience and study* Instead of proceeding on the view that the undergraduate curriculum should afford a sound education in the fundamentals and an effectual training in the manual essentials of the general practice of dentistry, and that it should also develop strong inclination and ample ability in the student to continue to teach himself as a practitioner, many dental faculties seem to regard the curriculum as an educational kaleidoscope*1 And Marjerison has the following to say, It is becoming more and more evident how profound dentistry's responsibility is and how unprepared it is to meet its responsibilities* For this reason, I am particularly sensitive to am omission in the recommendations of the Survey Committee, which is failure to suggest any change in the fundamental philosophy of dental education* The recommenda­ tions still dodge the main issue which dentistry and university administrators have dodged for seventy-five years, namely, Is dentistry a profession or a vocational system or a university discipline? 2 In a speech to the assembled teachers and administrators at a meeting of the American Association of Dental Schools, Ford has the following to say on the subject, Tou have so perfected the techniques and procedures and refined and re-refined them, that you have lost sight of some of the major things with which as a profession you should be concerned. It is altogether too easy to keep your long acknowledged excellence in reparative techniques in the foreground, and to find your satisfactions in it lidien you ought to be divinely discontented, year after year, the longer you practice, the more the same diseases of teeth and tissues come back to you, and to eveiy fellow-practitioner without any progress having been made in their cause or scientific treat­ ment* The perfection of a technique may be a hindrance to real professional progress* It is an individual thing that can exist only in the man who has perfected it, and rarely in the pupils to whom he teaches it* It leads in the end, if it ends there, to scientific sterility, and to the avoidance of the major problems which can be solved only by resort to the ex­ perimental scientific laboratory.3 * IT* J* Gies, Carnegie Foundation's Bulletin on Dental Education, Few York, 1926, p* 191* 2 Marjerison, op* cit*, p. 57*

®

Ford, op* cit*, p* 75*

38

Essentially, these men are questioning whether our satisfaction should come from constructing a set of fine dentures for a middle aged person or from being able to say that through proper treatment and advice the need for the dentures has been prevented*

He is asking for a new

dignity, a new purpose, and a new aim in dentistry* O'Bourke

1

puts the plea in somewhat different language*

Because

of the need for self-education due to the increased knowledge in dentistry, he suggests a modification of the philosophy of dental education*

He says

that there must be more time for study and the student must not be bound so closely to the so-called practical with implications that the knowledge and skills with which he is dealing have enduring value*

He points out,

If the dental course is basic and merely the foundation for study after graduation, it must as a consequence have value in terms of continued growth; that is, it must aim at the development of proper habits and methods of study, selfreliance, resourcefulness, judgment, and other qualities essential to success in dental practice* Attainment of this remote aim is quite as important as is attainment of those which deal with skills, techniques, and subject matter . 2 But how shall this point of vie» be made to prevail? it cannot be accomplished by adding here and cutting there. much a quantitative factor as it is a qualitative one*

Certainly It is not so

Marjerison expresses

this as follows, The course of study, clinical as well as laboratory, should be permeated by the investigative spirit, creating thereby an atmosphere in which the intellectual content of the curriculum receives the major emphasis*®

0 9Eourke, op* cit*, p* 163* 8

m

,

p. 159.

Marjerison, op* cit*, p. 60.

39

McGuigan says. Dentistry is and should he a learned profession* As a profession it should have a compatible admixture of the practical and the theoretical, and neither of these can amount to much without the other* On the same point, Ward has the following to offer, But as one example of the situation that now exists in what might he the most influential schools, we observe some of them going to extremes in lengthening their curricula before they have created an effective spirit of inquiry among faculty and students which can he realized as soon as anyone comes into the schools* Length of curricula rather than quality is the type of leadership which is most easily observed in some of these places*g Lischer says it as follows, In addition to the fine skills and balanced judgment required for practice, a dental training should afford a liberal education* The many unsolved problems of dental science should make of every school a center of research and inspire its faculty and students to learn to interpret and to discover new truths*5 In discussing the matter of a curriculum based on the development of skills and techniques versus one based on the growth and power of the mind, Marjerison writes, The main point is what form of education offers the greatest possibility of solving the problems of dentistry* What can be done with our present curriculum to further this aim? As a starting point it will be necessary to break through the psychological barriers which have been set up by the traditional mechanical philosophy* Dentistry furnished a beautiful example of the power of a point of view* The H* A* McGuigan, "Teaching of Pharmacology in Relation to Its Practical Application," Proceedings of the American Association of Dental Schools, Tol* 10, p* 380. 2

M. Ward, "Problems Confronting Dental Education," Proceedings of the American Association of Dental Schools, Tol. 10, p* 192* ® B* E* Lischer, "The Selection of Students," Proceedings of the American Association of Dental Schools, Tol* 16, pp. 66-67.

40

mechanical point of view has colored its every action* For example it created and fostered the impression in the mind of the laity that the primary qualification for a dentist was mechanical ability* Shis is the conception which the majority of people have regarding: dentistxy* I contend that this con­ ception is entirely wrong* Finger skill, manual dexterity or whatever one wishes to call it is a neuro-muscular activity* Therefore, brains come first. In my judgment, finger skill is secondary to intellectual capacity In an address mentioned previously, Ford says, Row the natural dental educators has and to distribute it but upon more skills does not do any good basis . 2

resort, I am afraid, of medical and been too often to prolong the curriculum for a long time, not upon basic things, and more perfection in procedure* It to tinker with a curriculum on that

These men stress the importance of an understanding of fundamentals by the dental student.

They recognize, too, that his basic attitudes are

just as important as his mechanical skill.

The latter is significant, but

in itself it cannot assure the development of a good dentist.

The latter

ia characterized by them as a person who desires to learn and to investi­ gate the many problems confronting his profession, as well as to perfect by concentration of all his powers the service he renders his patients. The Basic Science Courses.

The opinion of some writers is that

dental educators must examine the basic science courses and determine their effectiveness in the development of the dental student.

O ’Brien

says, It has always impressed me in dentistry as far as preparing your students to meet the demands that are going to be made upon them, that you have a lot of bobtail courses in science that seem to lead nowhere, and finally after they get over the hurdle they get into so-called dental Marjerison, op* cit*, p. 59 2

Ford, op. cit*, p. 76.

41

subjects probably with a great sigh of relief* And fainter says, If the dental schools are to assert their importance as full professional divisions of knowledge, they must so organize their teaching of the fundamental sciences, on which the profession rests, that they he come a source of strength rather than a point of weakness, as at present* The decision must he made hy dental educators and adminis­ trators Wakefield sees in the basic science courses the material necessary for making clinical diagnosis*

He says that the dental schools fail to apply

them to dental practice and as a result the student fails to see their significance*

The latter can he shown only if the teacher makes use of *

the basic sciences in his teaching* However, the basic sciences cannot assume their full importance in dental education by simply increasing the time allotted to their study* Marjerison says, We should avoid the tendency to assume that the solution of the educational problem in dentistxy can be accomplished by the simple process of increasing the time given to traditional undergraduate instruction. Such a doctrine creates a false sense of security and fails to take into account the need for a change in our fundamental philosophy, particularly in relation to clinical teaching. He continues, Formerly dentistxy placed all emphasis on the development of technic* Mechanical technic was primary; science, secondary. As a result, educational expansion came in the clinic; very little

O ’Brien, op* cit,, p* 155* 2

Tainter, op, cit*, p* 87*

3

S, 0* Wakefield, "Mutual Advantages of a Dental School Hospital Affiliation,*’ Journal of Dental Education, April, 1940, p* 316.

42

stress was placed on science or research. Today in the light of m o d e m knowledge and the resultant change in view-point, the emphasis has shifted. Science "becomes primary; technical processes, secondary. Hence, we may expect to see contraction of technical instruction and expansion of scientific teaching and research. This it seems to me is the most outstanding phenomenon taking place in dental education today. The Glinical Sciences.

Clinical teaching follows logically that

of the basic sciences, for it is primarily the application of the latter to clinical problems.

Their close relationship st^gests the need for an

intelligent correlation of both fields.

Miner says,

We have* I think, been ill-adviadd in adopting a course of training which was specifically and predominantly directed to the development and training of the skills, of hand and eye — and the development thus of the immediate to the exclusion of the remote, requirements of the profession. 2 Toung says, Mechanical procedures are absolutely essential in dentistry, and no one can render adequate dental services without being skilled in their use. However, these procedures are merely a means to an end, which is the maintenance and restoration of the health of the patient. He is engaged in a profession rather than a handicraft. Dental education needs to emphasize this point of view in the training of students and its program should be adjusted accordingly.® Newman makes a direct reference to the importance of correlation, when he writes, The subject matter or information presented in the various courses or departments is of no real value and the teaching in the school must be considered weak until the departments cooperate in the linking up of their teaching and teach the student to bring the sum total of his train­ ing to bear on the case for the welfare of the patient. This will be found particularly difficult in relating the didactic 1 2

3

Marjerison, op. cit., pp. 64-65. Miner, op. cit., p. 94.

Toung, op. cit., pp. 270-271.

45

and laboratory work of the fundamental medical science to the clinical and practical work of the latter part of the course.* The Eeed for General Education.

A few dental educators have pointed

out the advantages of a "broad general education for dentists.

For example,

it is considered worthwhile to have an acquaintance with the lives of men who have contributed to the march of civilization.

Miner thinks that know­

ledge and understanding of their efforts to "banish ignorance, fear and prejudice "brings a sympathetic attitude toward the struggles of one's contemporaries.

2

O'Rourke makes a plea for character education, when he writes, Although the curriculum may not include a course in character education, such factors as precept, example, inspiration, discipline and other environmental features can and should he of such a nature as to contribute to the devel­ opment of ethical behavior. 3 Actually this objective is one of attitude and belongs, therefore, among the functions of the teacher.

It is important, as important as any factor

of the student's education, and must receive its full share of attention from dental educators, Laaby suggests that students in dentistry will be citizens with community obligations to discharge as well as doctors of dental surgery. With this in mind he advises some freedom of choice in the pre-dental course and adds that rigid requirements may retard the progress of real educational achievement.^ 1 Allen T. Eewman, "The Problems of Teaching in Dentistiy," Proceedings of the American Association of Dental Schools, Tol. 14, p. 265.

Miner, op. cit., p. 89* - —

O'Rourke, op. cit., p. 8 6 . ^ W. F* Dasby, "pre-dental College Requirements," Journal of Dental Education, Dec. 1959, p. 98*

44

Summary*

Mbs!* writers agree that there is need for a revision of

the point of view of dental educations

namely# that the dental curriculum

should strive for a thorough fundamental education and not for perfection in technical knowledge and skills.

It is felt hy them that these will

come later# if the student has heen inspired to a continuous growth and a seeking for knowledge.

They point out# too, that no other comparable

profession requires perfection to the same degree as does dentistry.

The

need for the development of good character is also mentioned and the view that the dentist is also a citizen and a member of society with a distinct social obligation# is advanced by some.

The dentist is expected

to be able to establish an ethical relationship not only with his fellow practitioners# but with society as well.

A few educators point to the

need for experimentation and for adapting some of the established and recognized educational procedures to dental education.

Method In the field of method there has been little scientific effort to develop a philosophy concurrent with that in educational circles.

The

field of dental education is rife with schemes and ideas, but it can hardly be said that they are founded in fundamental ideas.

One gathers

rather quickly the notion that many persons regard education as concerned almost entirely with methods of teaching; they seem to think that it is the business of professional educators simply to suggest how to teach -- much as one is told how to drive a car.

The latter performance requires no particular

knowledge of the car and the same idea is applied to teaching.

Let some

expert simply explain how a certain subject should be taught and then send

45

the teacher out to teach it that way.

Here one finds the same error as is

found in teaching: only the clinical aspects of dentistry and permitting the student to view the basic sciences as hurdles which must he cleared in one way or another before the clinical phases of dentistry are to be enjoyed.

To the experienced educator, however, method implies knowledge

of the individual, of educational psychology and philosophy, of subject matter, and of the teacher. Dental education has employed most extensively the following methods of teaching:

the lecture, the demonstration, the seminar, the

laboratory* the clinic, and the examination.

The latter is listed among

teaching methods, because there is evidence that a few dental educators wisely view examinations in this way. In 1935 shortly after the publication of the report of the Curric­ ulum Survey Committee* Tan Kirk wrote* Since the curriculum is new and its emphasis on health service is important, many immediate changes in method and material should be expected. Older educational methods and materials need careful study and re-evditeation in the light of a new and important emphasis.A The last sentence of his comment is undoubtedly true and should be a condition present at all times to insure the use of the best teaching methods.

That the changes he said were to be expected have come about

as universally as was implied is not yet evident. A Negative Approach.

A method with a negative twist that is

employed quite generally is shown in the following statement by Aisenberg, First, I do not believe that pulp capping should be taught

1

TanKirk* op. eit., p* 264,

46

to students* It poisons their minds and gives them an easy way out of doing root canal therapy. 1 Thi 3 recommendation implies that students will employ only those methods of doing things which they have been taught*

Knowledge of the individual

quickly indicates that this is far from the truth*

The question to he

decided in the example mentioned by Aiseriberg is where is it advisable to employ pulp capping?

(Then help students to understand this method of

dealing with the exposed dental pulp*

The author may be implying that

the student cannot be trusted to use accepted clinical methods, and that he may use some other method because of the ease it affords in dealing with the problem rather than the means it provides in dealing with it in the best interests of the patient*

If the implication is true the

status of dentistry and dental education is in a more serious position than generally supposed* The Lecture* schools.

The lecture method has been widely used in dental

It has been employed even in those courses where adequate text

material was available and amounted in some instances to a word for word repetition of the book* alert educators.

Such methods must eventually draw criticism from

It was to be supposed that such conditions could exist

only because the student was unable to read or the lecturer had nothing to add from his own experience*

Wright says,

The lecture method as generally practiced today is a remnant of the pre-printixg age of education, which has been superceded by the advent of textbooks. In dental education, the lecture has become a time-honored custom to which most teachers cling as to a birthright* When viewed in the light

^ M. f>* Aisenberg, "Discussi o n , Proceedings of the American Association of Dental Schools, Vol* 15, p. 608*

47

of present educational methods its advantages appear to he outweighed by its shortcomings* If lectures were necessary to the acquirement of education, we should expect to find educated people only among the graduates of colleges where the lecture method is practiced *••.* We know that the motive which stimulates a student is largely responsible for his desire to learn, and that learning, itself, can best be acquired by actual experience and personal study, not by lecture • *••* moat subject matter in dental education now being presented by lecture could better be taught through the use of adequate textbooks, or adequately prepared syllabi of course-content, together with carefully selected reference readings* This should be supplemented by conferences, dis­ cussion groups and effective testa** Blanch says, The traditional lecture in particular has been declared to be out of step with the principles of learning, since it places the student in a passive attitude and limits his activity to learning and taking down lectures* Another objection to the lecture struck at a common practice of professors in reading or dictating unpublished textbooks', obstinately ignoring the art of printing* Complaint was also made that many lecturers ignored the work of other scholars and acted as if they were the only ones who had ever dealt with the subject Certainly the lecture will remain as a means of communicating knowledge of a specific type from one individual to a group of individuals*

The

criticisms noted above could be overcome by giving simple attention to the elimination of many common practices associated with the lecture method* Obviously, to an individual capable of reading, the lecture is superfluous when it repeats the word of a text*

It is equally wasteful when it repre­

sents only the written word of the lecturerfa written notes or course-content syllabi*

It is a useless means of teaching when it attempts, unaided by

adequate illustrative materials, to transfer mechanical skills from the 1

W* H* Wright, '•'Critical Review of the Curriculum Survey Report on Complete Denture Prosthesis, Based on Statements from Teachers,” Proceedings of the American Association of Dental Schools, Vol* 14, p. 106*

S

Blauch, op* oit*, p* 150*

46

lecturer to his class.

It is totally inadequate when it is used hy a

person who speaks poorly, has little command of his subject, and is unstimulating in his attitudes toward his subject and his students#

But where

the lecturer is alert, sensitive to changes in his own and allied fields, capable of presenting his material in an interesting and stimulating manner, and equipped with adequate illustrative materials, the lecture remains an excellent means of communication between teacher and student#

On this

point Blauch says, When used skillfully the lecture can be a means of inspiring students, to arouse their interest, to motivate their efforts through his own enthusiasm, clear explanations, and the adaptation of the discourse to the interests and the backgrounds of the students, the lecturer has an excellent opportunity to give drive to students’ work, to a m u s e them to exert strong effort in perfecting themselves for their chosen profession, to make their efforts seen significant and useful# The dynamic quality of the well-spoken word combined with the force of a competent and enthusiastic teacher, can be far more effective than the printed page# The lecture method: is economical# By its use the essentials of extensive topics and fields of knowledge can be covered in a short time# Moreover, it has the obvious advantage of reaching to a large group of students in a short time# Blauch, in the following statement, points out the advantage of the lecture to the teacher, Finally, the use of the lecture method by a teacher con­ tributes much to his own clarity of thought# It compels him to rethink and organize the content of a field of study in a methodical and systematic way; and it forces him to deal with a zhole subject instead of only one narrow phase as he is wont to do when he specializes and devotes his attention primarily to a small aspect of it . 2

Blauch, op# cit#, p# 151.

8

m a . , p. 153.

49

The Seminar.

The seminar is rather widely used in some schools as

a means of promoting use of the library, examining controversial issues, and encouraging discussion,

Asgis, in discussing the seminar as a teach­

ing method, points out the character is ties of the seminar to he as follows, 1,

Both the teacher and the student participate*

2*

Subject matter is prepared voluntarily, and is discussed freely and critically*

3*

Material is integrated by the leader.

4*

Freedom, spontaneity, participation, synthesis, democratic attitude, new knowledge.^

He adds that the primary requisite is that the participants must possess adequate knowledge of the subject matter* The Laboratory* laboratory courses*

lischer asks for a more liberal policy in the

He writes,

Another need which has not beei fully discussed and which merits further consideration by dental faculties is the experimental method in pre-clinioal training courses. Several of these have become rather extensive and time-con­ suming, so that a generous number of class periods for a semester or a year are readily assigned to them. All members of a given class are then required to attend all of the scheduled periods* How some students, perhaps five or ten per cent, are very skillful and do not need the total number of periods set up as necessary for average and poor students to satisfactorily complete this training. Under such conditions promising students sometimes become loafers * It seems reason­ able to suggest that the skillful, industrious student be offered an opportunity to advance in accordance with his ability, that he be encouraged to do advanced work, or choose an elective course *2 The Clinic* dental educators*

Clinical experience has been the major concern of most

That is, the dental course has pointed toward the clinic,

^ A* J. Asgis, "The Seminar as a Method of Continuous Education of a Dental Faculty and Graduate Dentists,* Journal of Dental Education, April, 1940, P • 339 * 2

Lisher, op* cit*

and all non~clinical courses have been treated by many as academic barriers or hurdles which were to be cleared as soon as possible so that the student clinical experience might begin or continue.

But not much material appears

in the literature as to how the clinic might be conducted in the most satis factory manner.

Enloe says,

The objective to be attained in clinical operative dentistry may be stated quite simply. The student should be supervised closely until he has mastered the essentials, then guided until he has acquired a well-rounded experience«.in all the various divisions, and finally encouraged to undertake as difficult work as is possible for him to successfully complete.^ It would be interesting to know how many dental schools achieve this objective.

One will find several articles which deal with the clinical

teaching of particular subjects.

They are concerned primarily with the

kind of material and the quantity of that material to be taught.

Few

of them take a broad view of clinical teaching; it is, therefore, difficult to capture and distinguish a philosophy of clinical teaching in dental educational literature.

One has the feeling, however, that it suggests

primarily the technical perfection of the student. The Examination.

The examination of the student has become as

much a part of dental education as it has of any other branch of higher education.

Dental educators probably have paid as little attention to its

proper use as have others, but the examination in one form or another, is found widely used in dental schools.

In the large majority of instances,

it has been solely a means of determining student rank with little or no intention to help the student.

Curd2 believes that this is wrong; he

^ A. Enloe, "Evaluation of Student's Efforts in the Operative Clinic,” Proceedings of the American Association of Dental Schools, Vol. 16, p. 130. J. P. Curd, "The Essay Examination,” Journal of Dental Education, Oct. 1939, pp. 39-45. 2

51

thinks that examinations should he used to help students, not to classify them*

White 1 says that it is very important that grades should he used to

help the student*

McNulty concurs in these opinions when he says,

Fundamentally, any examination to he of full value either to the student or to the teacher, should he hoth diagnostic and correctional*2 A few dental educators have given careful attention to the matter of examinations*

In writing ahout the importance of examination grades

in guidance, Paterson says, Psychologists interested in the selection and guidance of students have heen forced to devote attention to this problem of achievement testing so that each student#s achievement in laboratory, shop, or theoretical courses could he measured objectively, fairly, and accurately* You cannot use grades received in courses as a basis for guidance unless those grades are accurately determined* Grades reflecting an off-hand guess or the whim of a professor are likely to be inaccurate. Such grades may do intolerable injustice to the individual who acts on the basis of them. Furthermore, prediction of success in courses where the grading is inaccurate becomes well nigh impossible *3 Some reference to the so-called objective type examination is made in the literature.

In discussing this kind of examination, McNulty says,

however, that, *Ehe type of questions used, whether they be discussion, essay, or the new type objective questions, should be deter­ mined by the nature of the knowledge to be measured.^ Shis is sensible advice*

It warns against the frequently found

W. C* White, "Measurement and Grading in the Professional School," Journal of Dental Education, Feb. 1940, pp. 193-205. 1o E. W. McNulty, "Comprehensive Examination in Dental Education," Journal of Dental Education, Feb* 1939, p. 160. g 1 ■ - -■ D* G, Paterson, "Mental Measurements," Proceedings of the American Association of Dental Schools, Tol* 15, p* 97*

McNulty, op* cit., p* 163*

52

policy of going with the tide#

The writer knows personally a teacher who

has swung completely to the true and false type of examination, offering page after page of guess items to his students • Hot so long ago he used exclusively the essay type of examination#

When something new comes along

he will probably go over to it completely# McNulty points out two of the advantages of the comprehensive examination#

He says that it has been found that it enhances the ability

of the student to learn and of the instructor to teach, and that it is also valuable in

helping to solve the problem

of relationships#

He concludes,

The task, however, could be made less difficult by a study of the research in this field of general education #1 Healey writes about the methods used in clinical grading#

First, he says,

When the student is given an evaluation of his clinical efforts in the form of a grade, he is informed as to his weaknesses which need his special future attention and as to his strong points which have been developed by his past efforts # 2 This agrees

with a previous statement to the effect that grades

be given to

help the student#

should

Healey concludes,

1 feel that clinic grades should indicate accomplishment

and not ability alone# If a capable student shews laziness and indifference and shirks his duties, he should be made to suffer the penalty of a leer grade, even though he meets the quantity requirement# On the other hand, if a less capable student who, after strenuous effort and application meets the quantity requirement, he should be given a higher grade not only as a reward for his past efforts but also as an added incentive for continued future effort#3

*

H# J* Healey, "Discussion,* Proceedings of the American Association of Dental Schools, Tol# 17, p. 1371 ~ Z

3

Ibid#

Ibid*, p# 13a.

63

E xam inations are used "by some as a teaching method.

Others*

probably the large majority, use them only to grade students.

Healey

recommends considering the ability and the capacity of the student, when grading him.

She philosophy of this suggestion is that the more capable

student should offer and produce more than the less capable one.

JL more

thorough understanding of examination would be helpful to many dental teachers.

Summary Many leading dental educators are thinking along the same lines as are leaders in general education,

They recognize the student as an

individual; they admit

his relationship and his obligation tosociety;

they suggest that some

way must be found to make him aware of these faats.

In the field of learning some are definitely taking views flfeich show that they believe that there are other types of learning besides repetition. The curriculum is seenas something more than an unrelated group of jects.

The basic science courses are gaining significance

sub­

intheir

thinking and are being viewed as extremely essential to the full development of the dental student.

These educators look upon dentistry as something

vastly more important than the expression of mechanical skills.

The teacher

is to them responsible for the building of character and basic attitudes in the dental student which will make the latter a respected and important member of society. Dental education does not need to change its course; it needs only to follow the one already set by its leaders.

It must at the same time be

very critical of what it is doirg^ and of what it intends to do.

It must

remain sensitive to the life about, it so that it may play an increasingly important role in that life.

Dental education must recognize the fact

that it carries an obligation to American society and that its first objective must remain to so educate young men and women that they may serve society as adequately as a full development of their powers will permit. While dental education seems to be following a potentially proper course, it is perfectly obvious that there is a need for strengthening the entire program.

The writer believes that at this point a critical

review of the literature in general education may serve to furnish an appreciable portion of this needed strength.

CHAPTER IT THE NATURE OP THE EDUCATIONAL PROCESS

The previous chapter has served to show that, even though dental education has some excellent leadership, dental education aims primarily to teach skills and technicpes.

It is only to a limited degree conscious

of the meaning of individual differences or of the relationship of the individual to society*

Learning, obviously, is treated mainly as a

process of repetition, as a matter of memorizing materials.

The curriculum

is viewed by many as a series of courses, each highly specialized and often unrelated to those preceding or following.

The teacher has, for some of

these educators, the responsibility for developing attitudes in students as well as for relaying material to them, but one must sooner or later reach the opinion that the teacher in dental education is not regarded with as much importance as he should be, simply because so little attention is given to his development. With these facts in mind it should prove profitable to survey the literary contributions of prominent educators for information regarding the broad areas of education.

Five important concepts constituted the

screen used to sift this material.

These were chosen because they seemed

to describe best the areas in which leading educators are thinking.

The

concepts discussed in this chapter are (1 ) the nature of the individual, (2) the relation of the individual to society, (3) the nature of the educational process, (4j the nature of the curriculum, and (5) the role of the teacher.

It is the opinion of the writer that information in these

areas can have important implications for dental education*

56

It is just as important for the dentist to recognize his responsi­ bility to society as it is for the business manj it is equally as important that he should be a well— integrated person as it is for the individual in any other profession or business*

Because of the nature of the relation­

ship between the dentist and his patient, it is especially important that the character of the dentist be exceptionally fine.

Therefore, dental

education must count among its aims and objectives, the broad aims of general education*

The close alliance of dental service and society

leaves little room for argument on this point*

The dental educator who

insists that the only responsibility of the dental school is for the technical competency of the student is assuming only a part of his obliges tion, both to the student and to the community that is to be served later* Education is interested in the growth and cultivation of all the powers of the self*

Education attempts first to help the individual dis­

cover his powers, and second to provide experiences vfoich will develop them*

Even in courses of study where teachers, seem to be concerned only

with the teaching of certain mechanical skills, and where one might think that only the student's ability to perform the skill would be of any con­ sequence, one is impressed with the attention paid to other characteristics of the person.

For instance, these technical teachers frequently discuss

students in terms of honesty, character, cooperativeness, and personality* One can conclude that they must attribute some importance to them, or they would not appear so prominently in their consciousness * Education strives to balance those powers in a harmonious relation­ ship*

That is, it attempts to integrate them.

The degree to which this

57

has been accomplished can “be determined "by the extent to which the self is acting' creatively to meet his own problems end to improve the society of which he is a member* If growth of society is to be assured there mast be a continuous and deliberate reconstruction of the culture*

The powers of society must

be cultivated and employed creatively to improve it*

Continuous improve­

ment requires that there be a transmission of heritage from one generation to the next so that the rich experiences of the past may act as a directing force in the solution of the problems of the present. Education should result in such a continued reconstruction of the heritage that the various parts of the culture may keep in harmonious relationship with one another*

If one part of society changes, it is

necessary that all other parts change in order to maintain harmony of the whole*

Such reconstruction must be deliberate*

Failure to do so

can result only in confusion and even in social chaos*

The Mature of the Individual The Feed for Understanding the Individual* understood cannot be employed intelligently*

That which is not

Where man has lacked

knowledge of physical nature, he has either submitted to it, or sought to control it through magic or force*

The teacher has failed to under­

stand the individual and as a result has attempted through imposition to control him*

When he recognizes -this failure and the importance of

rectifying it* the individual will come into his own in our educational system.

The benefits will accrue not only to the student, but to the

teacher and society as well.

Until this recognition comes, efforts to

56

improve teaching will he largely ineffective. Individual Differences,

One of the hasic assumptions of educational

guidance is that the differences between individuals in native capacity, abilities* and interests are significant. this, but obviously, some of them do not. follows;

Every teacher should realize Many classify students as

naturally bright, or dull and stupid; obedient or unruly.

As

a result students are expected to do much the same things, whether they show any ability for them or not. It has been shown that the youngest mind seeks action within the limits of its capacities.

2

Some teachers have recognized that students

have greater or lesser capacity to perform a certain task, but many have not allowed that observation to alter their educational approach in a material way.

On this point Dewey says,

I take little interest in demonstrations of the average low level of native intelligence as long as I am aware how little is done to secure full operation of what native intellectual capacity there is, however limited it may be , 3 And Jones says, There can be little doubt that capacity does act as a constantly accelerating force, when individuals are allowed to develop naturally,^ The capacity for doing certain things may develop unusual abilities and result in increased differences between those who have the capacity and

1 A, J, Jones, Principles of Guidance, (2nd ed,; Few Toxk: 1654), p. 59, '

John Dewey, Education Today, (Few lorks 1940), p, 290, 2

^

rbid,, p. 286.

^

Jones, op, cit., p, 65.

McGraw-Hill,

Columbia University Press,

59

those who do not have it.

The important point is that the existence of

the differences is recognized and that the capacity of the individual for growth is permitted to take the desired direction. The Role of Interest. two ways.

Interest may he interpreted in either of

Bode says,

It may he construed to mean either that every activity must he motivated hy immediate interest or that every activity must have a recognized hearing on a way of life which the individual accepts as his own . 1 If one accepts the latter, one need not say that immediate interests are to he excluded, for they may still have great significance.

But they

must either he derived from or he merged into the larger interest if there is to he a dependable basis for continuity of effort. This fact is of great significance.

In the accomplishment of any

important task, certain aspects of it will be unpleasant, perhaps extremely so.

And still, if the desire to finish the task is sufficiently strong,

these will he endured.

In the study of dentistry, most students will find

some part of it uninteresting, hut the interest in becoming dentists will carry them successfully through such parts*

To insist that every action

must be motivated by an immediate interest represents a false interpretation of the role of interest in education and is certainly not in conformity with life itself. Impression and Expression.

While individuals differ in many respects,

there are some characteristics which depict likenesses.

Schools, hy and

large, proceed on the theory that youth is something to he impressed. 1

An

Boyd H. Bode, Progressive Education at the Crossroads, (Hew York and Chicago t Hews on and Company, 1938 J, p. 52.

eo

examination of the child’s development indicates, however, that the active side precedes the passives:

expression comes before conscious impression;

muscular development precedes sensory; movements come before conscious sensations; consciousness is essentially motor or impulsive; and conscious states tend to project themselves in action.^

Instead of expecting children

to remain quietly seated at a desk for several hours daily and absorb information presented by a teacher or by means of a textbook, their activ­ ities should be directed along lines which permit expression of ideas and emotions*

Kilpatrick has said,

Youth wishes to see results. responsibility.^

Youth wishes to carry

Youth can see results only as the outcomes of activity, and it can carry responsibility only in action,

As men and women, today’s youth

some day must show results and carry responsibility *

It is, therefore, the

business of education to provide young people with experiences which will make it an easy and natural thing for them to produce results and carry responsibility. Implications for Dental Education.

It should be perfectly obvious

at this point that dental education must pay more attention to individual differences among dental

students.

The issue cannot be avoided by saying

that there are certain minimum requirements that all students must meet, and that as long as the individual does so, education has no further concern

1

Dewey, op. cit., p.

12.

® W. H. Kilpatrick, A Eeconstructed Theory of the Educative Process, (New York: Teacher’s College, Columbia University, 1935),~p"725.

61

with him*

It is the function of dental education to develop all the powers

of the student and to help him use them.

It cannot fulfill this obligation

until it recognises the differences in capacities, abilities and interests among students.

Such recognition would mean greater growth for all students.

The Relation of the Individual and Society Kilpatrick says, It is the child himself who must by his own act learn direct his own ’freedom* as the key conception, but sad to they have often, thought of •freedom* as if in using it one disregard the consequences of his act. There could hardly greater perversion.i

to say, might be a

It is the term ^consequences of his aot* that suggests the relation­ ship of the individual and society.

Dewey has pointed out that all conduct g

is interaction between elements of human nature and the environment.

The

social environment supplies the material with which the new-born achieves a unique personality.

To cast out the social factor in consideration of

the individual leaves us only with an abstraction; to cast out the individual leaves us only with an inert and lifeless mass. All Human Experience is Ultimately Social.

To say that all human

experience is ultimately social means that experience does not go on simply inside a person*

Dewey says,

Every genuine exper ience has an active side which changes in some degree the objective conditions under which experiences are had. The difference between civilisation and savagery, to take an example on a large scale, is found in the degree in which previous experiences have changed the ob jective conditions under which subsequent experiences take place . 3 Kilpatrick, op. cit.. p. 27. ® John Dewey, Human Nature and Conduct, (Hew Torks 1922), p. 10.

Henry Holt and Co.,

® John Dewey, Experience and Education, (Hew Yorks 1938), p. 34*

The Macmillan Co.,

62

If the external conditions of our present civilized experience were des­ troyed, we would he bransformed into dumb animals* have to begin anew*

The human race would

There is no question that the child who is reared in

a fine home has experiences different from those had hy the child brought up in the slums*

Therefore it must he recognized that the environment

largely determines experiences of the child* The educator can control* of course* the school environment to a large extent*

It is true that the student who enters into it is what he

is at the time, and there is nothing that the teacher can for the moment do about it*

The latter is ahle, however, to influence the change which

must, necessarily, take place in the individual hy the hooks and tools which he provides him, hy the words which he speaks to him, and hy the way in which he speaks them and hy the entire environment of the school, physical, academic, and social* Democratic Living.

True democratic living means that the individual,

under proper conditions, attempts to hrlng out the hest in himself*

He

does this, however, not at the expense of others, hut in such a way that the hest is also brought out in them*

Democratic living becomes, then,

a matter of mutual respect, mutual toleration, give and take, and a sharing and pooling of experiences* Summary*

The Individual can he understood only in terms of his

relationships with society*

The Influence of society on the growth of

the person is determined largely hy the types of experiences it provides for him and it is, therefore, a major factor in the planning of an educa­ tional program. Implications for Dental Education*

Dental education must pay more

63

attention to the problem of responsibility for action.

The dentist assumes

great responsibility when he undertakes the care of the patient*s dental needs.

It is the writer's opinion that young dentists are not always as

fully aware of this responsibility as they should be, and that the reason may lie with their education. Dental education should be more fully conscious of the effect of the environment on the student,

The latter*s habits and attitudes can

in many instances be traced to the school environment.

Regard for sub­

ject matter, respect for human beings, habits of cleanliness, promptness and carefulness, and attitudes toward dentistry itself can be largely determined by the practices of the administration and the teaching corps •

She ffature of beaming Misconceptions of Learning.

Many teachers consider learning as

something which takes place in the individual when he reads a textbook or sits in the classroom and listens to the teacher.

They consider it

as that which manifests itself in the ability of the person to repeat verbatim the knowledge imposed on him by the textbook or the teacher. This leads to the statement that learning takes place primarily through repetition.

The student is advised to re-read and to recite his lessons.

The aptness with which he doe 3 so determines the degree to which the lesson has been learned.

Fo reference is made to the change which takes place in

the individual as a result of the experience, or to what extent it will affect the manner in which he faces future situations. Types of Learning.

Griffith says,

Processes of learning appear to fall into at least two groups, the one group standing at the opposite extreme from

64

the other, That is, there is only one kind of learning; hut this one kind may take two extreme forms because of the general character of the learning situation. At the one extreme there are those forms of learning which may he called rote learning or trial and error learning. This form of learning is characterized hy much practice. At the other extreme of learning processes, there stands a form of learn­ ing which may he described as quick or sudden 1 earning. 1 The various types

of learning are known as rote learning, trial and error

learning, the association of ideas, conditioning, and insight.

In rote

learning it is largely a matter of repeating an act often enough so that it can he repeated at will, important factors Trial and

Repetition, primacy and recency are the

in this aspect of learning* error learning requires a problematic situation. Here

the learner may find that he has no previously acquired skills to help him in solving the problem.

Thorndike thought that motor skill particularly

was a matter of stamping out unsuccessful attempts and stamping in the successful ones,

v

Woodworth explains Thorndike's theory as follows,

Thorndike conceived of learning as a process of estab­ lishing bonds or connections in the nervous system between the incoming nerves excited hy the stimulus and the motor nerves which aroused the muscles and so gave the motor response. He believed that the laws of this learning mechanism could be reduced to two; the law of exercise, namely that bonds are strengthened by use and weakened by prolonged disuse; and the law of effect, namely, that those bonds are strengthened, or gain advantages over others, which lead to a satisfactory issue of the situation.

This type of learning is dependent on the previous experiences of the individual, too*

The clinic student who has had good basic training

1 Coleman Griffith, An Introduction to Applied Psychology, (Hew Xork: The Macmillan Co., 1937}, p. 62H. ^ Robert S. Woodworth, Contemporary Schools of Psychology, (Hew Tork: The Ronald Press, 1931), pp. 53-54.

65

finds that he makes fewer mistakes in achieving his clinical assignments* Bat trial and error learning is used hy him to quite a degree.

He

experiments with the grasp of the instrument* the placing of the instrument against the tooth, the direction, and the amount of force.

Eventually, he

eliminates the wrong movements and stamps in the right ones. It has heen generally concluded that associations are not so much associations of ideas as of objects.

That is, one idea does not call up

another, hut, one object reminds one of some other object.

Ihen the

associative type of learning has been translated into purely objective terms it is known as conditioning. In conditioning the question arises as to the order in which the conditioned and the unconditioned responses should appear.

The con­

ditioned response

may appear simultaneous:ly* or it may appear just after

the unconditioned

response.

In the latter case learning takes place

most quickly. Conditioning is a process which takes place rapidly. contrast to rote learning and tried and error learning.

This is in

In rote learning

it may take many repetitions of material to enable the learner to repeat it in detail. procedures.

Trial and error methods usually entail the same lengthy In conditioning, however, it Is not unusual that the un­

conditioned stimulus will bring the desired response after one repetition. Griffith says, ••••• that learning by conditioning has commended itself to psychologists and to teachers, partly because it explains a good many actual instances of learning and partly because it offers itself as an objective way of studying events which hitherto have been highly subjective or mental* There are,

however, certain criticisms of this type of learning which mast he considered before one can accept it as the method by which all human growth of the psychological sort takes place.* It has been shown that conditioning is not necessarily permanent, but that repetition of the conditioned response without support from the original stimulus will lead to its extinction,

bong-continued practice,

if it is meaningful, makes for the highest degree of permanence.

This

is found in writing, use of words, and other stable skills pertaining to the individualfa work.

If the learning process involved here is to

be explained by conditioning, it must be supposed that repeated acts are supported at rather frequent intervals by original or unconditioned stimulus-response patterns.

It is difficult to detect such patterns in

the skills mentioned above. Conditioning explains one of the ways in which psychological nature can be changed. theory of learning.

However, it should not be looked upon as being It can be accepted that under certain conditions

two stimulus patterns which are presented to the subject almost, if not quite, simultaneously, will be related to one another in such a way that the one which did not previously affect a certain response will do so equally as well as the original stimulus. Learning by insight is characteristic of the highest type of learning.

Human beings and a good many of the hi^xer animals may discern

more or less quickly the essential relationship between hitherto unrelated / parts of a total configuration of events, and will have, on the spur of

1

Griffith, op. cit., pp. 400-401.

67

the moment, a mode of response iriiich will he adequate to the new stimulus pattern so that the problem or the difficulty supplied hy the new pattern Will "be s o l v e d L e a r n i n g hy insight is dependent on the ability of the learner to see the total picture*

A rat in a maze, where the goal and

the total situation are not discernible, is dependent to a large degree on trial and error learning* However, where the animal is ahle to view the total situation, he is less dependent on trial and method and seems to respond in terms of insight*

The student who is unable to visualize his goal, as in­

cluded in the total situation is dependent on trial and error learning to somewhat the same degree as the rat in the maze*

The individual who

has a goal in mind and can visualize it in the total situation tends to learn hy insight*

It would seem, then, that this type of learning demands

previous skills, including the ability to think in terms of oneness and wholeness*

It is less wasteful than trial and error learning and takes

place in direct proportion to the ability of the learner to discern the total situation* Summary* sight learning* of repetition*

Kote learning is found generally in the absence of in­ Failure to see the total situation leads to the adoption

The learner trusts to his memory to recall the acceptable

answer* There exists between trial-and-error learning and insight learning a reciprocal relationship.

The more complex the situation, the greater

1 Griffith, op* cit., p* 407*

68

Will "be the degree of trial-and-error learning employed*

In dentistry,

even though the student is ahle to understand the total situation, the difficulty of the skill will probably require a certain amount of learn­ ing by trial and error*

He will have to experiment with the grasp of

the instrument, and with the amount and direction of force* Some repetition is advantageous.

In dentistry it offers the

variations of a skill and permits trial and error to such an extent that the student can determine what suits his personal characteristics best* (Che learning process cannot be explained by any single type of learning.

More than likely all types are employed at one time or another*

It can be said, however, that learning by insight is on a higher in­ tellectual plane than the others* Learning as Growth*

It is just as Important to know what happens

to the learner as to know how he learns* volves the whole person*

Learning is something that in­

Kilpatrick says,

Each act of learning adds a certain change and increment to the very structure of the organism itself* 1 Structure must be viewed as the kind of thing that ia^ what it does, and not something that must necessarily be seen or present to the touch*

It

should be recognized that psychological growth may continue long after physical maturity has been attained, and can be referred to as structurebuilding as well as can the physical factor of the individual* The modified personality is the product of the individual inter­ acting with his

1

environment.

It has characteristics of the learner and

Kilpatrick, op* cit*, p. 4*

69

the environment, hut still it is different from each*

Learning, then, can

he viewed as something which conserves and at the same time creates*' The clinical student in dentistry, for example, is continually improving the skill with which he operates* experience*

Consider him after several weeks of clinical

A patient is in the chair, requiring the restoration of one

surface of an anterior tooth.

Present, too, are the student and the

instructor*

Both represent a certain amount of and a certain kind of

experience.

With the help of the teacher the student prepares the tooth

for a restoration*

Psychologically there has been an interaction between

the student and the instructor, which should manifest itself in an im­ proved student*

In the latter, there are observable characteristics of

the old student and of the instructor's teaching*

That is, there are

observable in the improved skill of the clinician, some of his old operating habits, but there are also discernible the effects of the teacher's influence* some changes*

It must be assumed too that the teacher undergoes

As a result of the experience with the student, the manner

in which he attacks his next teaching problem will be altered*

There is

present in this situation a mutual give and take, an exchange of ideas and experiences* Learning may be conceived as grewth in the meaning and the control of experience*

The total organism reacts in experience and reorganizes

the material accepted to create an altered personality*

The process of

interaction is always present and results in conservation and creation* The degree of interaction will determine how much is; conserved and how much is created*

70

Implications for Dental Education*

Dental education must come to

recognize that learning consists of much more than the repetition of a skill or of groups of words*

Probably learning in dentistry takes place

much as does learning in any similar field, namely by a combination of the most important types of learning*

In this combination must be

recognized the influence of repetition, trial and error, conditioning, and insight*

Learning by the latter method should be developed wherever

and whenever possible, for it implies and requires the ability to see the total situation* Although dental education must know how learning takes place, it is equally important that it should be aware of what happens to the learner.

It must realize that learning constitutes reaction of the

student with his environment, and that the latter is controllable by the SGhool*

Nature of the Curriculum Function of the Curriculum*

The curriculum should provide exper­

iences of such a nature and in such sequence that the greatest degree of desired

growth of the individual is achieved#

tion must so choose and so order experiences

For example, dentaleduca­ for the dental student that

the latter is assured the greatest possible opportunity for development* Experience*

In selecting experiences, according to Dewey, it is

necessary for the educator to consider equally two things: First, that the problem grows out of the conditions of the experience being had in the present, and that it is within the range of the capacity of students; and secondly, that it is such that it arouses in the learner an active quest

71

for information and for production of new ideas*^ The student should he expected to participate in experiences for which he is ready «•- experiences which follow logically the ones he has in the present and which are within the range of his capacity*

Further than that

they should he of such a nature that he is stimulated to seek expanding experiences and to create ideas* Specifically, dental education must provide experiences that will help the student become a fine clinician*

However, it must also strive

to furnish the kind of experience which will aid him in developing hospitality of mind, generous imagination, trained capacity of discrimina­ tion, and a sympathetic attitude toward human suffering regardless of the class, or sect in which it may he found*

It is n 6t the subject per se

that is conducive to such development, hut rather the previous experiences of

thestudent and the examples set him by the faculty and staff*

he

more truly regarded as a quality of basic attitudes and habits* Continuity of Experience*

It can

School curricula should be conducive

to the continuous growth of the individual*

TShen experiences are pro­

vided in such order that one expands logically out of the preceding one, growth will be continuous*

On this- point Dewey says,

What he has learned in the way of knowledge and skill in one situation becomes an instrument of understanding and dealing effectively with the situations which follow*** Chis is in effect the criterion of continuity and whether or not an experience

*

Dewey, Experience and Education, p* 97*

2

rbid.,

p. 42.

72

can satisfy it determines its degree of educative significance* Dewey also says, The principle of continuity in its educational application means, nevertheless, that the future has to "be taken into account at efery stage of the educational process*^It can he argued that the future will he the present when the time comes for dealing with it*

It has heen the custom of traditional education to

prepare individuals for the future hy insisting that they become acquainted with prescribed facts and truths which were supposed to possess great educational value*

However, to he prepared means to get out of one's

present experience all that there is in it for one at the time one has it*

When it means preparation for something in the future, the

potentialities of the present are sacrificed to a hypothetical future* When this is done, actual preparation for the future is distorted:

spend­

ing all effort in preparation for the future, of course, means that we are really not prepared at all to deal with the present; we have had no exper­ ience in that* give

therefore, attention must he given to the conditions .which

each present experience a worthwhile meaning.

This is the hest

preparation for the future* Subject Matter*

Taba says,

To stimulate the development of a creative attitude of mind it is necessary for educational material to he developed in the form of significant problems with their subject matter as experimental data for creative thinking in the solving of these problems, Curricular materials should he regarded by teachers or learners only as materials to think with creatively, and not as ready-made products to he mastered and digested,** Dewey, Experience and Education, p* 47* ^ H* Taba, Dynamics of Education, (New fork: 1932), p* 258*

Harcourt, Brace and Co*,

73

The subject matter selected and the methods of presentation, shall serve as an adequate means for the cumulative consistent and continuous growth of the person*

By this means education can help to free the powers of the

individual for creative efforts, which must remain the true measure of the effectiveness of the educational program* Summary*

Education is concerned, when building a curriculum, with

the capacity of the learner and his previous experience*

It is so con-*

c e m e d because it realizes that a curriculum in order to be conducive to growth end to stimulate

creativeness must

and an order, which fit

the individuals capacity and which spring from

his previous experiences*

permitexperiences of a kind

It is interested, too, in selecting subject

matter that will fit the individual for creative thinking in a special­ ized field, as well as to teach him basic attitudes and habits*

2he

problems of habit formation, the development of attitudes and apprecia­ tions, of action growing from critical and wise self-direction, of cooperative living, of social conduct and of character education must receive the attention of thinkers in curriculum building. Implications for Dental Education*

Curriculum thinking in dental

education must be done in terms of the whole course of study*

SJhere is

no place for any subject matter which does not provide experiences which have grown out of previous ones and which in turn provide a basis for those to follow*

Experiences provided should be of such a nature that

the student is stimulated to seek expanding experiences and to create ideas*

In other words,

the student learns will tions that follow*

the curriculum is

set upin such a way that what

act as a means of dealing effectively with situa­

74

Farther, the curriculum must he thought of not only in terms of narrow specialized knowledge in dentistry, hut also as a means of develop­ ing the habits and attitudes of mind that the student will take with him into practice* It is also perfectly obvious that the curriculum must serve to make the student conscious of his social obligations.

It must set forth

clearly the function of the dental profession and by so doing stimulate the student to seek information regarding the solution of the many prob­ lems involved*

The Bole of the teacher A Titalizing Factor*

The teacher vitalizes -the course of study.

Consequently, the teacher's role is one of the most important aspects of education.

It is by his efforts that subject matter becomes alive for

the student, and the means whereby experiences are provided within & special field of study which permit the greatest degree of development for him* Heflective Thinking and Attitudes*

Dewey says,

Active, persistent and careful consideration of any belief or supposed form of Impel edge in the light of the grounds that support It and the further conclusions to which it tends constitutes reflective thought*! Deflective thinking is important because it frees persons from merely impulsive and routine activity*

The reflective thinker is able to keep

the consequences of various lines of action before him and to choose the

* John Dewey, How We Think, (Hew Yorks p. 3.

D. (1. Heathi Co., 1910,)

75

best one after careful examination, scrutiny, and inquiry. The teacher probably cannot teach people to think reflectively, but he can influence their attitudes toward problems which require careful con­ sideration*

Dewey wrote,

Because of the importance of attitudes, ability to train thought is not achieved merely by knowledge of the best forms of thought* Possession of this information is no guarantee for ability to think well* Moreover, there are no set exer­ cises in correct thinking whose repeated performance will cause one to be a good thinker* Thq information and the exercises are both of value* But no individual realizes their value except as he is personally animated by certain dominant attitudes in his own character *3* The teacher's influence moat be toward the cultivation of those attitudes which are favorable to the use of the best methods of inquiry and test­ ing* Open-mindedne as * mindedness*

The first attitude that is important is open-

A person who is truly open-minded is free from prejudice,

partisanship, and any other habits that close the mind and make it un­ willing to consider new problems and ideas* mind is empty*

This does not mean that the

It means an active desire to hear and see

all sides of

a problem; to give attention to every possibility; and to realize that 2 deepest beliefs* Theteachercan help

there may be error

in our

student to develop

an open mind by helping him tocultivate

the

analert

curiosity and a spontaneous seeking for the new* Whole -heartednes s * is whole—heartedness*

The second attitude that should be developed

Whole-heartedness means that the person puts everything

* Dewey, How We Think,op* ait., p* 29. z

Ibid*, p. SO*

76

he has Into the task confronting him*

This is just as important in

intellectual development as it is in practical or moral affairs*

Dewey

says, There is no greater enemy of effective thinking than divided interest The student may seem to he giving attention to his teacher or his hook hut actually his innermost thoughts may he occupied with something very remote from the school room*

It is here that the teacher can he helpfttl.

The subject matter should he presented in such a manner that it becomes attractive and the center of the student,s thinking; it should he changed entirely, if the student *s attention cannot he obtained in any other way; and the teacher should become acquainted with the student*s interests in order to help him organize and direct them along lines that are conducive to his continuous growth*

Dewey says,

A genuine enthusiasm is an attitude that operates as an intellectual force* A teacher who arouses such an enthusiasm in his pupils has done something that no amount of formalized method, no matter how correct, can accomplish*^ Responsihility* of responsibility*

The third attitude that must he developed is that

The intellectually responsible individual considers

the consequences of a projected step*

Further than that, he is willing to

adopt those consequences when they follow reasonably from any position already taken.

Dewey® says that when persons continue to accept beliefs

whose logical consequences they refuse to acknowledge, or when they profess 1

Dewey, How We Think, p. 31. 2

11,1(1•» p*

3

Ibid., p. 32.

77

certain 'beliefs ‘but are unwilling to commit themselves to the consequences that flow from them, mental confusion results*

The teacher should see to

it that students do not study subjects that are too remote from their eacperience, that arouse no active curiosity, or that are beyond their power to understand.

Such, an educative program makes for intellectual irre­

sponsibility in that the student does not ask for the meaning of what he is learning; he is not interested in what differences the subject to be learned will make in the rest of his beliefs and actions, The same sort of irresponsibility and confusion result when so much material is forced upon the student that he does not have time to give consideration to its meaning,

Dewey says,

Fewer subjects and fewer facts and more responsibility for thinking the material of those subjects and facts through to realize what they involve would give better results to carry something through to completion is the real meaning of thoroughness, and power to carry a thing through to its end or conclusion is dependent upon the existence of the attitude of intellectual responsibility.^ The Talus of Teaching.

The quality and quantity of real teaching

is a very important factor in the extent to which

studentslearn.

initiative for learning, of course, lies with the

learner,because learn­

ing is something that the individual must do for himself.

The

But the teacher

can do much toward utilizing and directing the forces within the individual toward the formation of reflective habits.

There

are someforceswhich

operate in every normal person; these must be appealed to, Curiosity,

Dewey says,

There is no single faculty called fcuriosity*; every a *

Dewey, How We Think, p. 37.

78

normal organ of sense and of motor activity is on the qui vive* It wants a chance to he aotive and it needs some object in order to act* The sum total of these outgoing tendencies constitutes curiosity* It is the hasic factor in enlargement of experience and therefore a prime ingredient in the germs that are to he developed into reflective thinking*1 In discussing intellectual curiosity and teaching, Dewey writes, The crucial problem for the educator, whether parent or school teacher, is to utilize for intellectual purposes the organic curiosity of physical exploration and linguistic interrogation* This can he accomplished by attaching them to ends that are more remote, that require finding and inserting intermediate acts, objects, and ideas* To the degree that a distant end controls a sequence of inquiries and observations and binds them together as means to an end, just to that degree does curiosity assume a definitely in­ tellectual character *3 The development of curiosity to the intellectual plane becomes one of the essential roles of the teacher*

The teacher must prevent the

loss of curiosity in carelessness or indifference, or its degeneration into dogmatism* Spontaneity of Ideas*

The individual has no control over the

coming and going of thoughts and ideas*

It is true that the situation

he is in will increase or retard this tendency and that a person can be put into a situation in which he will likely have sensations and ideas which will lead on to something else*

Such ideas are suggestions.

They

come always as a result of the person's past experience and not as a result of his present will and intention*

It is the teacher's job to help the

student get control of the conditions that determine the occurrence of a suggestion and to accept responsibility for using the suggestion to see

^

Dewey, How We Think, p* 37*

Z

Ibid*, p* 39.

79

what follows from it* Interaction of Subject Matter and Stud out.

The teacher becomes the

important medium in bringing subject matter and student together in such a way that subject matter becomes meaningful In the total growth of the student, but does not become the end or goal of his efforts*

She teacher,

then, must be one who knows both subject matter and individual student, and in addition knows how to bring them together so that learning takes place*

This is no easy task*

knowledge of techniques*

It cannot be'accomplished simply through

The great teacher is truly an artist, in that

he is able to arouse enthusiasm, to communicate large ideas, and to evoke energy*

If interaction among teacher, subject matter, and student is

successful, the stimulus thus given to wider aims succeeds in transforming itself into power* To nurture inspiring aim and executive means into harmony with each other is at once the difficulty and the reward of the teacher.* Like the artist, he has the problem of creating something that is not the exact duplicate of anything that has been wrought and achieved previously. Intellectual Independence of the Educative Process*

The teacher

must be actively interested in maintaining the intellectual independence of the educative process and in striving for the right to present the defects as well as the excellencies of the existing economic order; even if by so doing some interests are offended*

It is his duty as well as

his right to show present society as dynamic, as undergoing continuous change*^ ^ o

Dewey, How We Think, p* 288*

Dewey, Education Today, pp. 267-268*

80

Summary*

The teacher, then, is seen as a person abundantly rich

in the subject matter of his special field and its important relationships; as one who is a student of the pupil*s mind; as a person thoroughly versed in professional knowledge; as one who sees the relationship of the school to society and strives to make that relationship ever more significant; and finally as a member of the educational corps who fights for his right to take a part in the formation of educational objectives and the choosing of materials and processes, and Yho, when provided that right, thinks through the various problems seriously and intelligently*

Implications for Dental Education*

Dental education must pay more

attention to the importance of the teacher in the educational process; it needs to see him as more than a mere dispenser of information*

The dental

teacher should be responsible for helping to develop in the student the attitudes which are favorable to the use of the best methods for examining and testing knowledge*

These attitudes are open-mindedness, whole-hearted­

ness and responsibility* The dental teacher should strive, furthermore, to develop in the student the forces of curiosity and of ideas*

Curiosity should be on a

high intellectual plane, the type that is used to investigate intermediate objects and ideas, and to bind them together to reach a more distant goal* The educational environment should be so developed that the ideas which are constantly coming and going in normal persons will be of a kind and caliber to be used in the solution of dentiatryfs problems* For the sake of the progress of dental education, the dental teacher must become increasingly interested and active in the problems of dental

81

education,

Only by his willingness to express himself as favorable or

unfavorable toward the existing order and only by his active participation in the solution of his profession#s problems, can dental education hope to make significant progress*

Summary For education to direct the educational process so that all the powers of the individual are harmoniously employed to face his problems and to help solve those of society, it must consider the abilities, capacities, and interests of the individual.

It must make him aware, too,

of his obligation to society, and what his relationship to it means, 5?o fulfill its objectives education must understand the process by which learning takes place, and must concern itself with the effeet of learning on the individual.

Probably all the major types of learning

play some part in the learning process, and in varying degrees will cause the individual to react with his environment in such a way that there will be a conservation of the old and at the same time a creation of something new, •The curriculum must be built on a sound philosophy of experience. Experiences will permit active participation by the learner and will be so provided that the capacities of the learner will act as a motivating force.

Experiences will be so ordered that one will lead logically from

the other to provide the student with eaqpanding opportunities for growth, so as to exercise and expand all his powers, 37he teacher is viewed as one who is concerned not with subject matter

alone, but who recognizes the great importance of basic attitudes and habits

62

in the student.

His efforts will he directed toward cultivating and using

them in the growth of the individual.

The teacher knows, too, that there

are certain common forces such as curiosity, spontaneity of ideas, and interaction of subject matter and student in all individuals that can he used constructively, if they are developed.

Further, the educator is

willing to assume the responsibility for sponsoring change in the economic order when he views such change as desirable •

And finally he is willing

to fight for his ideas and to point out the defects as well as the ex­ cellencies of the education he represents.

CHAPTER T SOCIO-ECONOMIC FACTORS AFFECTING RENTAL EDUCATION

It is the purpose of this chapter to discuss certain important areas of the American social scene and to draw implications from them for dental education.

Current sociological literature and various govern­

mental reports were reviewed with the aim of determining what these areas should he.

Health care, population trends, employment, the public works

program, housing, and social planning were selected on the basis of this review.

Health Care The function of the medical and dental professions is to maintain the health of the American people at the highest possible level.

America

has the scientific knowledge and every necessary resource to accomplish this objective*

The health professions cannot properly interpret their

role except as they see it in relation to the needs and conditions of American life as a whole.

Neither the professions nor the American people

should be satisfied with anything less than the maximum achievement possible.

It is the function of the medical and dental professions through

education and service to make the American people as nearly physicallyperfect animals as is possible. The Loss from Preventable Illness and Accident. preventable illness and accident is enormous.

The loss from

The National Resources

Committee says, Each male worker, on the average, loses about one week each year, 7 to 9 days. The average loss for each female

84

worker is somewhat greater, from 8 to 1 2 days , 1 And, The daily productivity of American workers is apparently out directly by ah out. 2 per cent through absences due to acute illness and accident* ilhen additional losses in production resulting from delays, disorganisation of routine, time spent in training substitutes, and lowered efficiency resulting from acute disabilities are taken into account, it is probable that the total loss from such disabilities is at least 5 per cent of the normal productivity of the Nation, At the 1929 price level, this estimated waste of productive capacity represents an annual loss to the Nation of about 4 billion dollars, This is approximately equal to the ordinary expenses of the Federal Government in 1929*2 This amount is almost twice that expended during 195 6 for medical service by government agencies and the public,

The report states,

Unlike education, a relatively small proportion of the national outlay for medical care is financed through social expenditures* Medical care supplied by governmental agencies in 1986 was estimated to have been 516 million dollars, as compared with consumer disbursements for this category of 2,205 million dollars, Thus consumer expenditures repre­ sented approximately 81 per cent of the total outlay. This proportion becomes slightly lower — 77 per cent — if account is taken of the outlays for medical care supplied by philanthropy and industry, amounting to approximately 135 million dollars , 5 Money Spent for Medical and Dental Care,

The money spent provided

approximately 45 per cent of the medical care considered to be essential 4

for adequate care; the dental care was 24 per cent,

Based on the figures

^

"Population Problems," National Resources Committee, May 1938, p, 167*

2

rbid*, p, 168.

® "Consumer Expenditures in the United States," National Resources Committee, 1939, pp* 55-66, ^ "Doctors, Dollars, and Disease," Public Affairs Pamphlet, No, 10, 1940, pp* 4-5.

85

previously cited, the cost of adequate medical care for all would have amounted to approximately 2 "billion dollars; adequate dental care would have coat about 1% billion dollars, making a total of

hillion dollars

for medical and dental care largely on the "basis of private practice as it is now conducted# and nursing care#

*Ehia figure is, of course, exclusive of hospital

$he 4 hillion dollars lost annually in manpower through

preventable accident and illness would easily cover this phase of adequate health care# However, another factor must he considered which would undoubtedly reduce this part of the total cost and leave enough to provide for adequate hospital and nursing care#

She following data are given:

Our present facilities, if fully used, would provide nineten tha of the medical care and one-half of the dental care which satisfactory standards require# Actually, according to estimates of Dr# Roger I# lee and his associates, we now have only ahout half the required medical care and only ahout a quarter the required dental care#l If nine-tenths of the required medical care could he purchased for 900 million dollars (the estimated figure of money actually expended} and one-half of the required dental care for 366 million dollars (the estimated figure of money actually expended), the total cost of pro­ viding adequate medical and dental service for all would amount to approximately 1,732 million dollars# would he a generous figure#

On this basis 2 hillion dollars

fhis estimate is based on the assumption

that physicians and dentists are receiving satisfactory incomes under present conditions, and that their services are not being used as fully

1

"Doctors, Dollars, and Disease,** op# cit#, p* 8#

86

as they could tie* Who Gets Medical and Dental Care*

It has "been, reported "by the

Technical Committee on Medical Care of the Rational Health Conference that: American families spend, on the average, 4 to 5 per cent of their income for medical care up to incomes of $5,000* Beyond that the proportion tends to decline. Average expenditures in 1928-1931 ranged from #39*08 a year for low-income families in towns and rural areas to #546*80 a year for those in the #10,000 — and — over class in large cities.i As would be expected, the amount of medical attention varies with different income groups*

For example,

The proportion of disabling illnesses, lasting seven days or more, receiving no medical care from a physician was much larger among relief and other poor families than among the well-to-do* In families with incomes in excess of $5,000, 1 ? per cent of such sicknesses had no medical care* For relief families, the figure was 30 per cent. For families not on relief but with incomes sunder $1,000, 28 per cent.g The report shows further that the higher income families had 46 per cent more medical service for each attended illness than had families on relief*

The relief and low-income groups are not only more frequently

ill,, but their illnesses, on the average, are of longer duration — per cent longer than in the group with incomes over $3,000*

63

The amount of

disability from chronic sicknesses was three times as great as among the upper income families.

The latter lost 3.9 days, while the relief group

was losing 11*9 days* Who Gets Hospital and nursing Care.

In a Public Affairs Pamphlet,

1

"Who Can Afford Health?” Public Affairs Pamphlet Ho. 27, p. 26.

a

Ibid., p. 14*

87

entitled "Who Can Afford Health?* it is reported, City people get ranch more hospital care than those living in the country. Ahout £7 per cent of all the disabling cases of illness in the cities had the benefit of hospital care. And wealth or poverty made relatively little difference, though it did make some. For relief families, the proportion was 27 per cent; for non-relief families with incomes under $ 1 ,0 0 0 , 24 per cent; for families with incomes of # 3 , 0 0 0 and over, 30 per cent.l It was shown that the larger the population center, the more hospital care was received by the relief and low-income groups. While the gap between the relief and low-income groups and the upper income groups was relatively small in the amount of hospital care received, in the amount of nursing care received a situation similar to the one dealing with the amount of medical care is found.

One report

indicates, Only one per cent of disabling illness among the families on relief had care from a private-duty nurse as compared with 12 per cent in families with incomes of $3,000 and over. This was partly offset, however, by the fact that 13 per cent of the illnesses in the relief families received care from a visiting nurse . 2 The amount of health service rendered the American people is inadequate to assure the nation the efficiency of manpower that it should and could have, if the health professions fulfilled their function.

In

times of war the full productive power of every man, woman, and child is especially important to the welfare of the American people.

Therefore,

this problem deserves the full vigor of the medical and dental pro­ fessions now.

*

"Who Can Afford Health?" op. cit., p. 18.

8 rbid.,

p. 15.

88

Present research leads to the conclusion that adequate medical and dental care could he secured for 5 hillion dollars per year, if the pro­ fessions operated efficiently.

This is approximately

hillion dollars

per year more than is now paid to physicians and dentists.

It would seem

altogether reasonable to assume that this added expenditure and efficient operation of the profession would save the American people at least one hillion dollars annually in lost productive capacity. today pay such dividends.

Pew investments

If the professions operated efficiently not

only to cure existing ills;, hut also to develop a sound educational program of preventive medicine, the nation could, in time, save a still greater portion of lost productive capacity.

It must he clear that there are few

investments the American people can make that would yield the returns that flow from an all-out health program, iookii^ toward "both cure and prevention, and toward the highest state of physical perfection possible for the American people. Hot only would this mean a vastly improved service to the American people, hut it would mean, also, economic and social security for the pro­ fessions themselves.

It would mean that ph^s-lcians, dentists, and nurses

would receive a stable income.

Further, there wou3d he a much greater

esteem for the professions because of the realization that they were serving their country to a much greater degree. Implications for Dental Education.

However well the professional

training in medical and dental science and technical skills may he, it must he clear that the health professions are completely untrained with respect to the political, economic, and sociological background of their professions.

If it is assumed that it is the responsibility of these

89

professions to maintain the American people at the highest possible level of physical vigor, health, and vitality, their function is not performed until these services are actually rendered*

A part of their problem is

clearly technical and scientific, and in these areas there is reason to think that their training is of a high order*

But insofar as the problem

is social and economic, the professions are clearly incompetent*

Instead

of facing the problem, investigating the facts, seriously considering a variety of

proposals, the bulk of the profession expends its intelligence

explaining why we should or should not have socialised care* This dissertation does not presuppose any answer to the problem of how the health professions can fulfill their health objectives* maintains, however, that four conditions must be met*

It

(1) The health

professions have not fulfilled their functions until they have actually rendered to the American people the best service that existing science and technical skill new makes possible*

(2) The social and economic

aspects of this problem are as much a part of the medical and dental professions, belong as surely to them, as do the problems of medical science and technical skill*

The professions cannot evade these aspects

of their problem by asserting that they belong to someone else*

Every

other profession may do the same, with the result that no one, then, is responsible for dealing with the social and economic problems of our culture, and hence, they are left unsolved*

The American people must look

to the respective professions for the larger social policy of those professions*

(5) This dissertation would further set forth that the

professions can solve these social and economic problems only upon the basis of the same kind of training requir ed to deal with the narrower

90

medical and technical ones*

Tested interest, prevailing prejudices, and

personal hlas in this area can only frustrate and defeat both the pro­ fession and the American people* professional ethics*

(4) There must he an expansion of

At present ethics is thougvfc of in terms of the

relationship between the professional man and the patient, and that existing among professional men* he more than personal*

In maturity, professional ethics must

It should take into account the basic obligations

of the professions to the American people as a whole* It would seem perfectly clear that the medical and dental pro­ fessions cannot hope to perform their roles fully until they include in their training programs a body of sociological, economic and political science material as scrupulously collected and organized as any other of the scientific materials of instruction*

This is not to argue that

medical scientists should turn sociologists, economists, and political scientists; it is, however, an argument for bringing into the training programs of the professions, scientific students in the areas of sociology, eoonomics, and political science, who are especially interested in their fields from the point of view of the professions*

Below are discussed

some other areas of the American social scene, with which every progressive professional man should be acquainted*

Population Trends Basic to all problems dealing with human resources is that pertain­ ing to population trends*

Galloway says,

. ..*• the study of population reveals underlying biological forces which have far-reaching influence on economic productivity, distribution of income, national

91

security, and personality development. 1 There are slightly over two billion people in the world* half live in Asia* the 20th century*

Over

This half will probably be doubled before the end of Galloway reports that,

Meanwhile, the nations with the highest level of living and the greatest scientific resources stand at the threshold of a period of population decrease* This trend, if counter­ active forces are not brought into play, may become fairly precipitous and lead to very serious consequences* For example, if the fertility rates and death rates at specific ages prevailing in England at the outbreak of the present war were projected without change into the future, the number of English children would be reduced by 50 per cent in two generations*^ It has been pointed out that the United States is definitely tending toward the ‘cessation of population growth and a subsequent period of population decrease*

The only factor which might give the opposite

impression is the present annual excess of births over deaths*

With

900,000 more births than deaths in 1958, it looks as if there is still a comfortable margin of population increase* case***

However, this is not the

The 1940 census showed a total of 151,669,275 people in the

United States *4

Then Chase points out,

If the population had grown as fast from 1950 to 1940 as it did from 1920 to 1950, there would be 142 million Americans in the country today.5 1 George B* Galloway, "Planning for America," (Hew York; Co., 1941}, pp* 547-548*

2

Henry Holt and

"Population Problems," op* cit*, p* 11*

g Galloway, op* cit*, pp* 348-349. 4 Stuart Chase, "What the Hew Census Means," Public Affairs Pamphlet, No* 56, p* 2 * 5

Ibid., pp* 2-3*

92

And, "ft is clear that if the present trends continue," said the Census Bureau in its official report on Dec. 4 , 1940, "the United States is faced with a stationary or even a declining population in ahout thirty or forty years. The slowing down in population growth can he laid to the falling "birth rate and the virtual stoppage of immigration from abroad.1^* Chase points out further that there were more than 21 million children enrolled in elementary schools all over the country in 1930*

By 1938

the figure had fallen to ahout 2 0 million.** The National Resources Committee reports that, The birth rate has been declining for many decadesj the total number of births per year reached a peak in the years 1921-25, Since 1929 there has been a general trend toward decrease in the number of births each year. Moreover, when ftrue rates* are computed to eliminate the temporary effects Of variation in age distribution, it is found that the In­ trinsic reproductive trend is already slightly below that required for permanent population replacement. In other words, if no change occurred in the proportions of persons surviving from birth to different ages, population growth would gradually cease. Actually there is good reason to expect that further decline in fertility rates will be more rapid than the rise in survival rates. Furthermore, there will be a peak in the number of young persons of marriageable age about 1945 (about 20 years after the peak in the number of births already mentioned). Therefore, after the middle of the century further decrease must be expected in the number of births each year unless present trends in fertility are re­ versed or unless the population is augmented by heavy immigration .3 The United States must look for a gradual leveling off of its population in the next few years and perhaps a decrease of our present total population by the end of the present century.

The industrial

Chase, op. cit., p, 4, 2

Ibid., pp. 4-5.

® "The Problems of a Changing Population,** National Resources Committee, May 1938, pp. 6-7.

93

revolution 150 years ago made conditions favorable for increase in population in western civilisation.

Medicine helped to prolong life,

and science gave mankind a great boost in the 19th century.

How the

population has caught up with its environment and science has helped check the increase with bombs and birth control*^

In the lowest estimate,

assuming high mortality, low fertility, no immigration, the crest will come in 1955 at a population of 137,172,000, and the total will fall to 127,571,000 in 1980, about four million people less than at present. Che largest estimate, as sinning high fertility, medium mortality, and immigration of 1 0 0 , 0 0 0 persons a year, brings the crest more than forty years in the future, with population still growing in 1980. takes much stock in the maximum estimate.

Fo expert

Something between the two is

favored, with a peak around 1970 of between 140 and 150 million.

Another

10 or 15 million persons, another thirty years to go, before the total 2

begins to fall. Quoting Chase, Here in the United States there were 37 births for each thousand of the population in 1875, 8 8 in 1912, and 18.5 in 1940* (Jut in half in sixty years} Germany had a birth rate of 17 in 1930 and claimed to have increased it above 20 in 1939. England and France have birth rates of about 15, and Sweden only 14. Italy*s rate in 1935 was 23, and falling. All over the world birth rates are falling, but especially in Europe, Horth America, Australia and Hew Zealand. Che b i g population spurt of the 19th Century has ended.5

1

Chase, op. cit., p. 9.

2

Ibid., pp. 14-15.

3

Ibid., p. 9.

Galloway sums up the trend as follows, Thus, all available evidenoe points to the cessation of population growth in the United States some 20 to 40 years hence, followed by a period of population decrease, unless a very different set of social forces from those now affect­ ing the birth rate come into play* After the trend toward population decrease has become well established, the pre­ ponderance of aged persons in the population will bring about an age distribution unfavorable to natural increase.^ Factors Contributing to Population Changes#

There are four factors

contributing to change in population, namely, birth, deaths, immigration, and emigration.

It has been pointed out that the birth rate is decreasing

rapidly and is probably the most important factor to be considered over a long period of time.

Medicine has prolonged life, but to be effective in

increasing population, it must continuously lengthen the life span. Immigration and emigration will always pley roles in population changes, but in periods like the present neither plays an important part.

Chase

says that the birth rate of any country can be stimulated only by a broad and indirect improvement of living conditions through more opportunity economic

2

security, public health measures, and better housing.

It is going to become increasingly necessary, because of population stabilization, to wlevel up** the less favored groups and sections to corres­ pond more closely to what is usually thought of as the American standard of living.

This probably requires a stimulation of more varied economic

development in regions where the plane of living is low, with emphasis on a well-rounded agricultural system as well as upon the development of

*

Galloway, op. cit., p. 350.

2

Chase, op. cit., p. 27.

95

manufacturing and. the trade and service occupations#

It is also dependent

upon a continuous redistribution of population, with movement from the less 1

favorably situated areas to those of greater opportunity* The national Beaources Committee furnishes the following information on these points, In recent decades the dominant feature of internal migration has been the movement from farms to cities* This movement is, in large part, an expression of shifts in in­ dustrial production made possible by improvements in technology* Between 1880 and 1930 the proportion of gainful workers employed in the extractive industries (agriculture, mining, forestry, and fishing) declined from over 45 to under 25 per cent, the proportion in manufacturing and mechanical industries increased from BO to 29 per cent, and that in the distribution and service trades from 34 to 47 per cent*& The benefits of stabilization and redistribution to the United States would be primarily those resulting from better living conditions, better educational opportunities, and an increasing, or at least, a main­ tained adequate birthrate* Alarmists say that the drop in the birth rate will mean poorer children, because more children will come from poor families.

However,

figures show that in some countries birth control was more effective among poor classes than among well-to-do families*

Further, it is

impossible to prove that children from poor families have less intelli­ gence or real merit than rich children. have been conspicuously successful*

The careers of many poor children

Unquestionably, poverty undermines

the quality of the population, because of poor housing, inadequate food,

*

Chase, op* cit*, p. 27.

®

'♦Population Problems,* op* cit*, p* 9.

96

and insufficient education; hut certainly not through heredity.^

Certainly

there is no need of hysteria* because of this gradual decrease in the proportion of children*

The resulting problems should he carefully

analyzed and it should he remembered that it would he a mistake to project hastily past trends into the future*

Ghase points out that*

Many leaders had begun to realize that our economic system, geared for more than h hundred years to expansion, had to he readjusted to a slower growth* eventually to no growth at all.* The Rational Resources Committee says, The increasing proportion of aged persons in the pop­ ulation raises cultural as well as economic problems# Vigor and contentment in old age rest on the foundations of good health and intellectual vitality in youth. Education has commonly been viewed chiefly as preparation for the middle years of maximum production. Educators now insist that it must also interpret the immediate experiences of childhood and youth and there is a growing idea that education should make possible an intellectual development continuing through­ out life. The place of aged persons in the family has received little attention from American psychologists and sociologists* Here* as in relations between parents and children, mutual tolerance and appreciation may contribute to a greater sense of personal, security, the enlargement of individual experience, and the increase of human happiness* Thus the changing population — pattern in the United States carries far reachirg implications for education, recreation* conditions of labor, and family living. 3 Distribution by Ages.

Chase calls attention to the possibility

that* By 1980 there will be 14 million fewer children than in 1930*4* 1

Chase, op. cit.* pp. 17-18*

^ 3

Ibid., pp# 17-18.

4

“Population Problems,* op. cit., p. 8 .

Chase, op. cit., p. 16*

97

And lie soys that the number of people over 65 is gaining steadily. were 6 . 6 million in 1930 and there will be33 million in 1980# group will gain to about 1970 and then begin to drop*

There

The middle

He points out that

the productive age group (20-65) will increase both absolutely and in proportion to the rest of us* ulation in 1930*

It accounted for 56 per cent of the pop­

In 1950, according to the statistician, it will account

for more than 60 per cent*

The census figures show that the number of

people of this age increased by about 13 per cent in the last ten years, or almost twice as fast as the total population*

It begins to look now

that this country will have to worry about a surplus of manpower when the war ends* Implications for Dental Education*

Two important implications

for dental education are seen in population trends in the United States* The first has to do with the number of dentists to be educated and the second with the type of dentistry which must be taught them. Previous data showed that there are in the United States sufficient dentists to care for one-half of the dental needs of the American people* This figure is based on the present population of approximately 132,000,000 people*

The most acceptable estimates fix the population at about 150,000,000

by 1970*

If dental service were to remain as it is, that is, largely of a

remedial nature, more than double the present number of dentists would be necessary.

Dental education must seriously consider ways and means of

increasing the number of dentists* The type of dentistry rendered varies with the age of the patient* For the next 25-30 years there will be an increase in the productive group (20-65) and in the groups over 65*

The latter will increase rapidly so

98

that 'by 1980 there will he approximately 2 3 million in this group*

There

will be a decrease in the number of children, but this trend will give the profession an opportunity to put its knowledge of prevention of oral dis­ ease into effect, so that the present groups of children, and succeeding groups too, should go through life with less need for dental service than present adult groups are requiring.

Employment The most important social problem facing our nation is; that of the full employment of men and machines.

On this point the Rational

Besources Committee says, When the problem of full employment is disentangled from the problems of balanced and efficient use of resources, it becomes apparent that the development and adoption of techniques for bringing about and maintaining reasonably full employment of men and machines is not only a major problem, but is today the Rationfs most pressing economic problem, relegating all other economic problems to a secondary position so long as it remains unsolved* Its solution would simplify and reduce to manageable proportion most, if not all, of the other important economic problems of the day, while the lack of reasonably full employment intensifies and constitutes such a major element in each of these other problems that a sound solution of them cannot be worked out in the presence of extensive un­ employment of men and machines *1 The Committee continues, The lack of success of efforts to deal with the problem of unemployment can be traced in large part to the lack of agreement, as to what set of policies appropriate to a democracy is capable of bringing about reasonably full em­ ployment* Without more substantial agreement in this field, the inaction or ineffective action associated with conflict over policies is likely to continue* The conflicts appear to be so deep seated that substantial agreement is unlikely -1 y

" ■ ' 1n

"The Structure of the iSmerican Economy," Rational Resources Committee, Part II, June 1940, p, 6 *

99

unless a more determined drive is made to understand the factors involved Every individual is interested in security* a rule is loss of income* family —

Income enables him to care for himself and

to house them adequately, to feed, to clothe, to educate, and

to afford them some recreation* items that disturbs him* —

His greatest fear as

It is the possible loss of any of these

Income ceases primarily because of unemployment

unemployment caused by lack of suitable work, old age, or ill health*

These latter items constitute the three major threats to the security of workers and their families* Lack of a Suitable Job*

Some people remain unemployed due largely

to the fact that society has not learned how to employ them*

The Fational

Resources Committee points out, There is fairly general agreement that in this country we have inherited from the nineteenth century a system of national policies which in combination were supposed to bring about reasonably full and effective use of resources* This system of policies assigned to government three major types of function; (1 } to establish conditions conducive to private enter­ prise by such actions as protecting property, enforcing contracts and providing a safe money medium; (2 ) to insure reasonable prices by enforcing competition where the latter could be effective and by regulating or operating enterprise in those cases where com­ petition was not regarded as a satisfactory regulatory device; (3 ) to supply services which private enterprise could not effectively supply, such as police and fire protection, highways, postal service, and education*2 It was felt that such policies would insure reasonably full and effective use of resources*

The committee continues by saying that the control of

"The Structure of the American Economy," op* cit*, p* 9* 2

Ibid*, pp. 9-10.

100

our huge economic machine is out of the hands of individuals,

To quote

the committees Sos in industry after industry, the individual workers, and those in control of the machines have little power as individuals to effect the volume of activity in their respective industries. The increasing recognition of this impotenoy of the individual has forced the realisation that excessive unemployment is a national, not an individual prob­ lem and that, because of its magnitude, it is today the country,s most basic economic problem.* Employment of our human resources is Just as important as the proper use of our natural resources and is absolutely essential to the welfare of our country.

It is true that natural resources have been wasted and

major steps are being taken by government to remedy this great mistake, but it is equally true that our human resources have been wasted too and with a greater effect on our national economy.

The committee says,

Equally important, but less often thou^it of as resources, is the idleness of men and machines that could be productively employed* The power of individuals to produce is a resource like unharnessed water power. It is gone if it is not employed. It cannot be stored. If 1 0 million men are able and willing to work, but are forced to be idle for a year by lack of jobs, the community has wasted the valuable resources of manpower, And because of idleness, the individuals are likely to suffer a loss of skill and a breakdown of morale . 2 But how is unemployment to be combat ted?

It is simple to say that

if a person is ill or injured and cannot work, he should be paid enough so that he can continue to live in his accustomed fashion and to pay his bills. If he is too old or if economic conditions force him out of a job, he should also be paid a sum of money for the rest of his life which will keep him and

"The Structure of the American Economy,* op. cit., p. 11. 2

Ibid,, p. 1.

101

his dependents properly housed, fed, and clothed. as easy as it might seem.

But the solution is not

The loss of income during unemployment is most

obviously connected with our industrial structure and the cause of our most striking manifestations of mass insecurity*

Galloway says,

Among the social security measures, unemployment insurance and related plans for dealing with the consequences of job­ lessness are of paramount importance. Prior to the Great Depression of the 1930fs, there was no system of unemployment insurance in the United States, nor were there any other permanent measures for relieving the distress caused by un­ employment* Only scattered attempts to meet the problem of unemployment were made — by the trade unions through un­ employment benefit schemes, by private employers through various voluntary measures for stabilizing or guaranteeing employment, and by tentative attempts to discover ways and means of meeting the problem of private insurance Government is vitally interested in maintaining a fully efficient working force.

It has learned that economic insecurity, regardless of source,

produces social and economic losses of such magnitude that some degree of security should be provided against the risks to which our economic system subjects workers.

Planning seems absolutely essential if the g

present economic system and a sound democracy are to be preserved. Old Age*

Old age is the second great cause of unemployment*

Galloway points out, Although a coordinated plan of employment security will protect the worker against the primary threat to his security and the security of his family during his working years, this program leaves untouched a second cloud ^diich hangs over workers in our economic system — the certainty that his ability to hold a job will cease when he becomes old and the probability that lack of resources will force him to rely on others for support. The scope of this problem will increase steadily because the proportion of aged persons in our population is mounting steadily.3 ^

Galloway, op. cit., pp. 465-466.

2 3

rbid»» P* 464, Ibid., p. 477.

102

Broil in instances where the family head earned enough to put aside sufficient funds for his voluntary or involuntary retirement, economic depressions, or prolonged ill health have served to wipe out his savings# Such cases are pathetic#

Ho one has a great deal of sympathy for the

spendthrift, oblivious of the fact that the day must come when old age would cause him his job; but for the person who has thought of this and provided for it to the best of his ability, trusting the economic system of his country to uphold his faith in it, to lose it all after years of frugality is a tragedy#

When the efforts of private corporations, clubs,

insurance companies, and others fail, then it is indeed time that govern­ ment take a hand# 111 Health#

The third great cause of the loss of a job and sub­

sequent loss of income is ill health#

Galloway points out,

1 1 1 health, whether caused by sickness or by accident, is the third major economic risk faced by the wage earner and his family# Planned protection against this risk con­ stitutes the third broad objective of measures designed to make wage earners less insecure#

In this country accident compensation for workers injured in the course of employment was the earliest form of social insurance# Workmens* compensation spread from state to state for about 30 years until in 1941 there was only one state in which some form of accident compensation did not exist#1 Galloway points out that there are two basic deficiencies in the present state laws relating to workmens* compensation# First, compensation for occupational disease acquired in the course of employment is paid in only a few states and for only a few specific diseases# Second, accident compensation is limited to the worker himself and to those accidents which occur on or incident to the job# The failure to provide adequate

i

Galloway, op# cit., p# 464#

105

workmens* compensation can "be largely attributed to the fact that this program is still on a state-by-state basis and is, therefore, limited in its development by the exigencies of interstate competition, 1 Galloway believes that federal government aid is the best way to solve the problem.

He reports, Local political subdivisions, the states, and the federal government all provide through tax-supported medical departments public medical care primarily pre­ ventive in character, although some remedial treatment is also provided* This type of protection is community-wide in scope and is aimed at the elimination or restriction of disease. Treatment and medical care are often applied gen­ erally on the principle that for certain types of diseases, the prompt and effective treatment of the sick is the best preventive against the spread of the disease among the population in the community. Public medicine of this type has long been recognized as a function of government, and it is merely noted here as a form of social security which may in the future supplement the health insurance measure just as old-age assistance payments buttress the old-age and sur­ vivors* insurance pian.2

Medical care is an expensive commodity. men as physicians and dentists*

Long years are needed to prepare

Such preparation is necessary to assure

patients that they will receive adequate and proper care.

Such a long

educational process is expensive, and particularly in the case of a dentist, considerable money is necessary to equip an office for practice. These things coupled with the fact that medical care is an individual service explains in part at least the expense involved in the care of a patient.

If, in addition, hospitalization is required, the cost is beyond

the reach of the great majority of our population. National Income.

The national Eesources Committee reported in 1958

^

Galloway, op. cit,, pp. 482-483,

z

Ibid., pp. 484-485.

that 29 million families earned as follows: 14$ 42$ 65$ 87$

of all families received leas than $ w w

w »

» w w

w w

w w w

w w w

500*00 1,000*00 1,500.00 2,500.00

Above the $2,500 level there were about 10$ with incomes up to $5,000, about 2 $ receiving between $5,000 and $10,000, and only 1$ with incomes of $ 1 0 , 0 0 0 or more.^

The report shows that single individuals —

servants

boarders, etc. constituted nearly 8 $ of the total population, and received 19$ of the total consumer income,

The distribution of income among these

individual consumer units resembles very closely that for families, ex­ cept that there was considerably greater concentration in the lower brackets.

It says that 61$ received less -than $1,000, 95$ less than

$2,500, and 1$ more than $5,000.^

It is inter estirg to note that the

share of the aggregate income received by this lower third of the nation was just over 10$ of the total of 59 billion dollars,

The mean income of

fZ

the group (13 million consumer units) was $471.

Further, the report

showed that the middle third of the nation (13 million families and single individuals) received from $780 to $ 1 , 4 5 0 during the year.

The total

income received by all consumer units in this middle group amounted to 24 per cent of the aggregate income. was $1,076.

The mean income per consumer unit

The committee says that about 13 per cent of this group were

dependent on relief sometime during the year.^

The incomes of the upper

"Consumer Incomes in the United States," National Resources Committee August 1938, pp. 2-3.

2

105

third (13 million consumer units) ranged from $1,450 to over a million dollars*

Over 80 per cent of this upper third were non-relief families* When we compare the non-relief families in the three income groups according to size of family*, we find that families of three to six persons show the largest pro­ portion in the upper third* As chart 6 indicates, two person families are about equally divided among the three thirds, while the three to four person families and those of five to six persons are twice as numerous in the upper as in the lower group* This difference is probably due to the fact that the larger families are likely to have more earners than the two person families, and the age of the principal earner and consequently his income, is apt to be greater *1

The report continues, The total income received by all of the 15 million consumer units in this top third of the nation was 39 billion — about 6 6 per cent of the aggregate income of all families and single individuals* The average (mean) income of the group as a whole was thus just under $5,000*3 Statistics show that the average incomes of non-relief families varies with the type of community studied*

For instance in six types of communities,

they ranged.from lowest to highest as follows, farms (about $ 1 ,2 0 0 ), rural non-farm (about $1,600), small cities (about $1,700), middle sized cities (about $1,850), large cities (about $2,150) and metropolises (about $2,700).3 Taking the data as a whole one cannot possibly see how the lower third can do more than barely exist; the middle third can make its way a little easier and live a little better; the upper third has someihing left for such things as old age insurance, life insurance, medical and dental care, and advanced educational opportunities for its children*

"Consumer Incomes in the United States," op* cit*, p. 10* 2

rhid., p. 1 1 .

3

Ibid*, p. 24*

106

Implications for Dental Education*

On the present basis of render­

ing dental service* the full employment of the American people would make it possible for many more to obtain dental care*

However, full employment

would not insure care for all, because it must be obvious that families in the lower income group and many of those in the middle group would still be unable to pay for adequate medical and dental care*

Methods of fur­

nishing service for these families must remain as a problem for the professions to solve* fhe federal government is interested in solving the problem of unemployment in the United States.

Along with this must be considered

the efficient use of the nation*s manpower.

It was previously pointed out

that there were dentists enough in this country to render half of the necessary dental work, but that only twenty-four per cent was being rendered.

It seems perfectly clear that the United States government may

concern itself in the near future with the full employment of the dental manpower of the United States.

Dental education should be prepared to

state how it may be best employed.

Public Works Program 3Jhe public works program has drawn considerable attention during

recent years.

Huge sums of federal money have been spent in planning and

executing it.

Its purpose has been to supply some of the common needs of

certain groups of people by presenting the opportunity to work, to supply such a commodity as electricity at low rates, to reduce floods and thus make it possible for inhabitants of flood areas to build more securely, and to insure them greater protection against disease and loss of life.

107

The National Resources Planning Board says, The "basic objective of a public works program is to provide public facilities required for the maintenance and progressive development of the standard of living of the American people* No economic system merely a means employed must be translated into services needed for the

is an end in itself; rather, it is to satisfy human wants • These wants terms of facilities* goods and standard of life to which we aspire.

The board continues, As a Nation, we are, therefore, confronted today with the problems of planning for a conservation and better utilisation of our resources, planning for the provision of needed public facilities, and planning also for the productive employment of our resources in human skills and energies, including the related aim of employment stabilization.2 Further on in the report one finds the following,

03» *

It has also been demonstrated that a series of ♦emergency* programs of public works construction may be self-defeating in achieving the aim of employment stabilisation. Throughout the entire period discussed, there was no definitely continuing policy to guide the planners and administrators of Federal, State, or local governments. Each program was set up as if it were the last. The consequence was sort of ’deadline* type of administration, with projects chosen for prosecution in accordance with their degree of readiness and the quickness with which they would put great numbers of men to work, rather than in accordance with the urgency of demand for the improve­ ment being undertaken. When these two criteria worked together, important and socially valuable community improvements resulted when they conflicted, community value had to take second place.

The board insisted on a public works program that was chosen because of its worth to the public welfare and that was not to be used merely as a political football.

It should go on regardless of the political party in power,

"Development and Stabilization of Employment in the United States," National Resources Planning Board, Jan* 1941, p. 3. Z

Ibid., p. 3.

3

Ibid., pp. 18-19.

108

because its value had been carefully established before it was put into effect.

She board has the following' to say, Public works construction is a means toward an end in itself. Great though the process values may be in providing jobs in a period of economic strain, the primary aim of the process must be a product that will contribute to the develop­ ment of the nation. Public works projects are not luxuries, mere ornaments to society. They are part and parcel of the physical plant that is demanded by civilization as fundamental and indispensable to its functioning.! The matter of employment stabilization has been an important factor,

however, in the

development of our public works progrem.

This fact is

verified in the following statement, The past decade has clearly been an extremely significant period for public works. Principally because of the nation's efforts to utilize its public construction activities as a means toward employment stabilization, there have been important changes in the amount of activity undertaken inthis field, in the scope of the field itself, in the relations of the Federal government to it, and in the methods by which the activity is administered and carried on.2 It is further pointed out that the shift has not been so much in the total expended, but a sharp shift toward Federal financing.3 Tennessee Valley Authority.

The Tennessee Valley Authority is one

of the best examples today of a well-planned and carefully developed public works project.

This great program has been undertaken after a careful study

of the needs of the Tennessee Valley and after a determination of the possibilities of developing its natural advantages.

The National Resources

Planning Board says,

1 "Development of Resources and Stabilization of Employment in the United States," op. cit., p. 25.

Ibid., p. 31. 3

Ibid.

109

It is clear that the techniques for determining the needs must first he perfected and that the methods of making such comparisons must he worked out. Only on the has is of such determinations can a long-term public works program he properly formulated. Only in that way can we he confident that we shall he using our resources to the best advantage in the protection and development of the national estate.^ The Tennessee Talley Authority was undertaken only after it was completely established that it was better to follow an integrated Federal policy than a medley of unrelated projects. it.

A sound Federal policy is exemplified in

It is concerned, not with water by and for itself, hut with the

promotion of public safety, public health, the public convenience and comfort, the economic welfare of the public, and the establishment or maintenance of a high standard of living.

Further, it seeks to promote

the maximum integrated control and use of water, and to treat drainage areas as units.

And, of great importance* it will hold facts to be in­

dispensable prerequisites to sound action.

The cost of constructing and

operating the various projects will be assigned among the agencies con­ cerned, in general accordance with the distribution of benefits; general benefits as well as special benefits, potential benefits as well as immediate benefits will be taken into consideration in determining whether or not projects are justifiable and in distributing the costs of projects among the benefi claries &

Specifically,

The completion of the system of dams now under construction or proposed by the Tennessee Talley Authority will provide regulation of the Tennessee Kiver for navigation, flood control, and incidental development of power. An all-inclusive plan for the main river and its tributaries is still under investigation. The objective of this plan is the ultimate unified development development of Resources and Stabilization of Employment in the United States,* op. cit., p. 32. 2

"Water Planning," Rational Resources Committee, Feb. 1938, pp. 11-15.

110

of the entire system. (The method of attaining that end remains an experiment in governmental planning and administrati on* ^ It can he said that the TTA is helping the people of the Tennessee Talley to remake their culture, to acquire a new outlook and to develop a new way of living,

The project seems to he just "good sense".

Pope says,

It has been said that good sense is a thing for which people usually cannot work up very much enthusiasm. This may apply to the Tennessee Talley Authority for its work is based on sheer good sense. And yet I know of no program that has created as much interest among students of social and economic problems and more disturbance among the devotees and representatives of private monopolistic interests than has the program of this agency. It has been called something *new under the political sun* and *the most exciting thing in America* • Comments on its work have ranged from the highest possible praise by students of liberal thought to fiercest condemnation by apologists of private monopolies. It has been described as *a preview of the future government of the United States* by one of the most eminent writers in America and as a vicious and fraudulent experiment in state socialism by a newspaper of wide circulation in the Middle West.2 Along with other public works, the Tennessee Talley developments will be watched with great interest by all of America. favorably; others will criticize it severely.

Some will view it

But it behooves everyone

to remain objective and to realize that it is an experiment to improve the living conditions of some fellow Americans. Implications for Dental Education.

There is no direct relationship

between the public works program and dental education.

However, it is

becoming increasingly obvious that the federal government is willing and apparently able to take hold of any problem that affects the welfare of

1

"Water Planning," op. cit., p. 24.

2 James P. Pope, "The TTA — A Hew Corporate Tenture," Presented before the Political Science Department of Northwestern University, April 22, 1940. p ♦ 1.

Ill

the American people*

This fact should prove a strong incentive to dental

education to recognize the need for a "basic study of dental care for the American people*

Housing Housing and health are closely allied.

Until the housing problems

of the American people have been adequately solved, there must remain a number of medical questions which cannot be answered satisfactorily, Galloway points out that, In spite of universal family efforts to find good housing, and because of the mixed motives of those who provide houses as a business, American housing is still to some degree a failure! Millions of families cannot now secure the simple minimum of light, dry, warm shelter. More millions are forced to live in neighborhoods where everything in sight is dismal and dishearten­ ing, Only the fortunate few are able to live in homes that are satisfying to either body or spirit,! A government with an eye for the betterment of livirg conditions would eventually do something about such a state of affairs, particularly where it had existed for many decades, with little hope or indication that it would become better through private efforts,

The United States govern­

ment has become interested and in 1937 Congress passed the United States Housing Authority which brought about the creation of local housing authorities and created local interest in public housing.

Galloway has

the following to say, The most controversial and stormy phase of the federal governments* housing activity is that connected with the

Galloway, op, cit., p, 395* a

Ibid., p. 402,

112

•public housing movement, • the effort to have low-cost urban housing built and owned by public agencies* The Few Peal era has seen the first, major attempt of the American federal government to undertake public housing. In most of the European countries national governments have been building and subsidizing publicly owned housing. Many Americans have seen these housing projects in Europe and have brought back the stimulus of their example. Citizens and citizens groups, with an inclination to favor public action in meeting social problems, have pushed for public housing. Labor groups have advocated and backed the public housing move­ ment, both because they want better houses for low-income families and because the vast need represents such enormous possibilities for employment* Seizing the opportunity offered by the advent of the Few Peal in 1933, these interests focused on Congress and obtained the inclusion of housing among the functions of the Few Public ¥orks Administration. The PWA Housing Pivision was instrumental in building some 30,000 dwelling units.1 Implications for Pental Education.

Again there is no direct

implication for dental education; but the governmentfs interest in raising the standard of American living should awaken the realization in dental educators that unless the dental profession takes hold of the problem of improving the oral health of the American people, the federal government may decide that it should do so.

Social Planning. Planning is the most significant and the most important character­ istic of the government#s varied social program. recognized.

This fact must be fully

Galloway described planning as follows,

It is a function of collective activity in achieving a collective objective or in solving collective problems. It depends upon research and experiment rather than hunch and guess, and it is concerned with the coordination of

1

Galloway, op. cit., pp. 401-402.

specialized activities. And, finally, planning is a specialized service function that requires the temperament and capacity for fact-finding, calm and keen analysis, logical synthesis, and perfection of arrangements in order to achieve its objective. But planning does not mean the same thing to everyone.

For

example, To conservatives it has been a red flag of regimentation heralding the d r a m of collectivism and the twilight of the old order of free private enterprise and the democratic way of life. But to the humble practitioners of the art viewing the matter with the cold eye of engineering rationality and a matter-of-fact indifference either to crusades, Bed hunts, the class struggle, or the omnipotent state, it has been merely a process of coordination, a technique of adapting means to ends, a method of bridging the gap between fact­ findings and policy-making.® The greatest misgivings in regard to social planning seem to be centered on the fact that it is a governmental undertaking.

Again Galloway

points out, It is also true that business and industry have for many years used research and planning as basic tools. The splendid long-range planning for future expansion of the American Telephone and Telegraph Company is a well-known example. The typical citizen has the greatest respect for planning in industry, but has serious misgivings about the wisdom of government using these identical techniques to plan for the future welfare of all of us collectively.3 The logic of this statement seems: clear. misgivings of the typical citizen.

One might, however, explain the i

The latter has never had a great deal

of faith in the politician; and he considers social planning to be con­ ducted by the politician.

Actually, of course, it is conducted by persons

who would probably make very poor politicians. 1

„ Galloway, op. cit., p. 7.

Social planning may not

114

always appear to be of the best nor to prove "very productive* but research in industry* business* and the university* has also proved to be costly in many instances*

The latter institutions* however* do not consider it

expensive if an occasional important contribution is received*

Should we

expect important results any more frequently from our governmental agencies? The Heed for Planning*

The great social issues facing the American

people today can be adequately solved only if they are studied according to the principles of scientific research*

This is the essence of planning.

Its adoption (!) will clarify for society the objectives of that society* (E) will provide research to help understand the problem, (5} will furnish alternative solutions, (4) will provide for intelligent examination of the proposed solutions to determine the best one, including the frequent choice of doing nothing* and (5) will make possible a detailed execution of the chosen alternative*^ It seems clear that such must be the course of the federal government if an intelligent solution of social issues is to be forthcoming, Certainly the problems outlined by the Rational Resources Committee in the following quotation would require it.

The Committee says,

This problem* the basic problem facing economic states­ manship today, can be stated as follows: How can we get effective use of our resources, yet* at the same time preserve the underlying values in our tradition of liberty and democracy? How can we employ our unemployed* how can we use our plant and equipment to the full* how can we take advantage of the best modern technology* yet in all this make the individual the source of value and individual fulfillment in society the basic objective? How can we obtain effective organization of resources yet at the same time retain the maximum freedom of individual action? This is a problem so large that no solution

1 Galloway, op* cit*, p* 6.

115

is likely to Be arrived at except over a period of years and through the efforts of many people.1 The Kational Resources Committee in another report asks for toler­ ance and patience.

It points out,

It is vital to the progressive development of the economy of the United States that we approach proposals for recon­ struction in the spirit of critical inquiry regarding their remote and immediate effects, and with tolerance for divergent opinions* in order to hring ah out those changes that will release most fully the potentialities of the whole population for productive activity and free spiritual development.^ But Galloway thinks that there is growing evidence that the American people are Becoming more sensitive to the need for careful planning in all government activities •

He writes,

The American people are Becoming poignantly aware of the tragic human and social costs of not planning during past decades. The consequences of wasted manpower and wasting natural resources, of droughts and floods, the plight of share croppers and migratory workers, the squalor of urban and rural slums, wide-spread illiteracy and illness, the one-third who are ill-fed, ill-olad, and ill-housed, the ravages of recurring depression — all these frustrations are matters of common knowledge and the stuff of which fascism is made.5 If the American people will accept social planning freely and permit it to Become a part of their culture, the improvement that will come

to their standards of living will Be great.

with

a minimum of waste and will Be of lorg duration, and not affected By

changes in political control.

Benefits will Be reaped

It is ooneeivaBle, too, that if the American

"Structure of the American Economy,* op. cit., p. 3. ^

"Population Problems," op. cit., pp. 250-251.

3

Galloway, op. cit., p. 82.

116

people do not accept planning without compulsion, it will he forced on them "by revolutionary means, because the failure of private enterprise to meet basic human needs must eventually lead to an impassi. Incentives for Planning*

Social planners are interested primarily

in developing and using efficiently the vast resources of our country. They wish to see the present tremendous waste ended* The waste of resources from these three sources, ruthless exploitation, idleness of men and machinery, and failure to use the most effective known technology, all combine to give a tremendous total of wasted resources* How great this waste is it is impossible to estimate, but some suggestion of its magnitude can be given by estimating a single item: the depression loss in income through idleness of men and machines during the last 8 years The authors continue by saying that the estimated loss in national income from 1929 to 1937 is 200 billion dollars.

The committee points out,

The full meaning of this failure to use resources effectively can only be realized by considering its impact upon individuals. Practically every individual in the community suffers as a result of these wastes. And further it is explained, Even more basically significant is the individual frus­ tration resulting from the inability- to find an effective use for one*s skills* Without the satisfaction of useful activity, without the sense of security in a job well done, moat men lose some of their self-reliance and some of their ability to be productive*2 These statements can undoubtedly be accepted as a true statement of fact, but that does not make the problem much easier. Popular acceptance of planning in a democracy is con­ ditioned by a variety of factors. Among them are the nature

* ^Structure of the American Economy,” pp. 2-3. Z

Ibid., p. 3.

117

of "the plans i what people understand planning to mean* and the results they expeet or fear will ensue from their adoption. Inherited hahits of thought have a potent influence upon proposals to modify the traditional relation "between govern­ ment and "business* the individual and the state. The individual’s attitude may also "be affected "by his occupation in life and his level of income as well as "by his group and political affiliations. The question must naturally arise in the minds of people whether or not the proposed plans are actually for the "betterment of social conditions, or that the planners may have miscalculated and results will actually "be less favorable than prevailing conditions.

The education of the public

is undoubtedly extremely important and should not be overlooked or its importance underestimated. The entire American public policy has had significant changes in objective in the last decade.

The Brookings Institute has noted these

as follows: (1) To provide economic security by regulating the pace of general business activity and assuring a minimum income to those in need; (£) to preserve the competitive position of particular industries or groups by some f o m of special aid, e.g., to agriculture, soft coal, transport, petroleum, and natural gas; and (3) to preserve small independent businesses against the competition of their larger rivals. The policy is to better, wherever and whenever it can be done, the living conditions of our people.

It has made greater strides in some aspects of

the problem than in others, but in all the general plan has been as follows:

Avoiding competing ideologies and aLienisms, American planning takes the biological and engineering resourcesneeds approach and asks these questions: 1. What are the basic common needs of the American people, adequate to support a decent and healthy level of life?

Galloway, op. cit., p. 27. 2

Ibid., p. 11.

118

2.

4*

What material and social resources do we have avail­ able for the satisfaction of these needs? Where are the deficiencies, surpluses, bottlenecks? How can we reorganize the economy and utilize our resources so as to promote steadily rising levels of living for all the people?1

The basic principle in seeking answers to these questions is that the fullest possible use of all available productive resources should be made, up to the point at which the community begins to value additional leisure more than additional goods; and that all practices which result in available resources being left unused, or under-used, should be prevented, Implications for Dental Education,

Z

It seems clear that dental

education must grow increasingly aware of the importance of social planning, and of the part it can play in planning for the improvement of the health of American society.

As was pointed out previously, the health problems

of the American people belong to the medical and dental professions.

And,

it will be only through careful planning that they can be adequately solved.

Summary The professional student must be acquainted with the larger social areas of American life*

Included in these are health care, population

trends, employment, public works program, housing, and social planning. The latter is basic to the whole social program of the American government, and must remain so, if the benefits which accrue from it are to be of maximum value.

1

Galloway, op. cit., pp. 11-12.

2

Ibid., p. 12,

119

The function of the health professions is to provide adequate health care for the American people*

They are failing to do so, because,

primarily, they are unprepared to do so*

Until students of medicine and

dentistry are made acquainted with the political, sociological, and economic background of their professions, the obligation of the health professions to society must remain largely unfilled* The population of the United States is expected to be stabilized about 1970 at approximately 150,000,000 people#

There will be a continuous

decrease in the number of children, an increase in the productive group (20-65) until 1970, and then a decrease, and a rapid increase in the number of people over 65* of 22,000,000 by 1980*

The latter group is expected to reach a size

These trends will affect the number of dentists

needed and the type of dentistry required* Employment remains the most serious problem of American society* The large majority of the American people can purchase little more than their daily needs* and dental care*

It is impossible for them to obtain adequate medical It is obvious that the federal government is interested

in using American manpower as efficiently as possible, and will probably become interested in using dental manpower just as efficiently, unless the dental profession can solve the problem for itself* The public works program is a great American experiment*

It is

indicative of the fact that when the United States government becomes interested in a problem which is concerned with the raising of the standards of American living, it will spend a great amount of energy and money to accomplish its objective.

It behooves the dental profession to think in

120

terms of its obligations to the American people. fhe federal government has made only a meager start in solving the housing problem.

However, there is reason to think that its efforts in

this direction will continue, for without ample and adequate housing, many other social problems must go unsolved. It was pointed out above that social planning must remain the basis for the entire social program of the United States.

Planning is

the careful application of the principles of scientific research.

Many

Americans have accepted the wisdom of social planning, while others are perfectly willing to accept planning in industry and research, but seem unable to realize its benefits in the solution of social problems.

Dental

education must awaken to the need for the application of planning prin­ ciples to the problem of meeting the dental needs of the American people. It is only through such a systematized approach to the problem that it can be solved adequately.

CHAPTER Tl DENTAL EDUCATION LOOKS &HT3ATI

It becomes increasingly clear that dental education must direct its intelligence and its creative efforts towards the clarification of its position in relation to those whom it is to teach and to society which it is to serve.

Without any question the future of dental educa­

tion depends on the thinking which it does in these important areas* It can justify itself only on this basis and the respect and esteem in which it is held by society will be in direct ratio to the quality of performance in the fulfillment of these responsibilities.

Teaching As one reviews the whole field of dental education,' it becomes increasingly clear that the success or failure of the educational program, viewed in the light of the aims and objectives of dental education, is dependent upon the quality of its teaching.

There is little purpose in

discussing the necessity for attention to individual differences, to the relation of the individual and society, or to the learning process, if the persons who are doing the teaching are not receptive to such dis­ cussion.

There is required prior to such discussion, first, a receptive

teaching corps, second, a teaching corps which has the time and the ability to think in terms of its true function, and third, one that is willing to fight for its ideals and ideas. It is obvious that dental education must develop its own teachers, because by and large the teaching staff must consist of persons who have the dental degree.

However, a dental school should always be on the alert

122

for opportunities to interest young men in dental teaching who hare hroad educational backgrounds, who hare shown that they are always seeking new knowledge, who are sensitire to the relationships of the profession, and who are interested primarily in dental education*

inhere must he a grow­

ing realization on the part of the profession that teaching also is a profession and that knowledge of subject matter alone does not qualify a person as a teacher*

It is readily admitted that promising dental

students who can fill the qualifications abore should be encouraged to become teachers, but it should also be made perfectly clear to them that to qualify as teachers will demand of them intensive study in the fields of education, sociology, and medical science, as well as in dentistry. Those responsible for the selection and the development of teachers of dental subjects, must recognize more and more the importance of the teacher in the educational program*

Dental school administrators

should realize that young men skilled in the special techniques of dentistry must have additional study to qualify as teachers, and that this study must be directed along lines which will assure the most fruitful results.

They must recognize the fact that the fulfillment

of the aims and objectives of a university dental school will require teachers who are aware of the full significance of the principle of individual differences.

For actually, teaching means that there is a

deliberate attempt to change people.

In dental education, the teacher

is trying to direct the characteristics and the forces of the individual student into channels which make of him a dentist, capable of assuming his proper place in society.

This can happen only to the degree in which

1J23

the tea.oh.er understands "the individual*

When this happy situation occurs

in dental teaching, dental education will come to recognize a standard ^or ea°k student, as well as a minimum standard for all* After the capacities of the student have been carefully discerned, the teacher must know how to direct them to the greatest fruition.

It is

not conceivable that this guidance can be accomplished without knowledge of the learning process*

The teacher must be aware that learning changes

the learner, and that learning takes place as the result of interaction between the learner and his environment*

The latter is, to a large

extent, under the control of the teacher*

How that control should be

exercised can be determined only by the person who is fully cognizant of the possibilities of such control and of its implications* I&ivironmental control has several important implications for the teacher.

What direction it will take, will be determined primarily by

his own objectives and by the light in which he defines the aims and objectives of the university dental school*

That is, if the social

obligation of dental education and of the dental profession occupies a prominent place in his thinking, he will attempt in his teaching to impart this outlook to his students*

On the other hand, if the teacherfs

social thinking is nil or decidedly limited in scope, his students will be left insensible to their social obligation*

in this example there

is discernible the importance of attitudes in the whole field of teach­ ing.

It is the quality of these attitudes and the ability of the teacher

to impart them to his students that determines the success of his teach­ ing*

It is the presence of these qualifications to a person that makes

124

him a teacher rather than a demonstrator*

The latter can show a skill,

hut the implications of the skill mean little to him*

As a result, his

students never he come aware of the larger goal* The teacher must assume the responsibility for providing educa­ tional experiences which will permit the full use of the powers of the student, and which will assure their maximum possible growth in the desired direction*

For this to occur, the teacher must he acquainted

not only with the student as an individual, and with the learning process, hut he must also have a sound philosophy of experience and a thorough understanding of the whole curriculum of his school*

Without these

important qualities, his teaching must consist of a disjointed and un­ related series of educational experiences* The teacher is the crux of the teaching effort*

Dental education

must hend its efforts to attract to the teaching field the hest material available and then go on to develop it to the maximum*

The efforts it

makes in these directions will he repaid in the full knowledge that dental education continues to assume an ever-increasing place of importance in the education of American youth and in the service of the American people*

American Society Dental education must recognize the fact, and this very soon, that dentistry in fulfilling its function in American society is faced with the problem of providing maximum dental service to the American people*

It

can, furthermore, he reiterated here that if the health professions do not accept this responsibility, it will he done for them and perhaps not to their taste*

125

Before adequate health planning can "be accomplished "by the pro­ fessions) they must find a suitable frame of reference*

In the past)

so-called reform movements have failed because they represented the interests of special groups, the labor movement, the farm bloc, and others*

3!he frames of reference of these groups did not go beyond their

own narrow limits*

It can be said of dental education also that its

frame of reference has seldom gone beyond its own narrow and restricted field*

*Ehe whole area of professional ethics is guilty of this short­

sightedness*

Here again one finds the professions thinking in terms of

professional interests rather than in terms of professional function* Without any question the frame of reference must be in terms of America* When the professions l e a m that their planning activities must take this outlook, not only will the American people benefit, but the professions also will be improved* 3!he political situation in the world at the moment is a classical demonstration of what planning can do in terms of a nation*

In twenty

years Germany rose from the ashes to a power so great that today it commands the resources of all of Western and Southern Europe.

It

accomplished this by the full utilisation of its human as well as natural resources*

But still more noteworthy is the fact that the only nation

that so far has been able to resist successfully the onslaught of Germany is another nation which rose from a feudalism to a state in which there has been a remarkable utilization of manpower and natural resources through planning.

And it is becoming increasingly obvious that when

America reaches its peak in production and human performance, this status

126

also will "be the result of careful planning*

One big difference, however,

between Germany and Russia on the one hand and America on the other is that in America one can expect democratic planning — * democratic, provided the American people will see the wisdom of careful and intelligent planning* Dental education must plan its future course in terms of America, rather than in terms of its own interests alone*

Only by attacking its

problems on this basis can dental education assume and retain leadership in the solution of these problems*

It was pointed out previously that

the function of the dental profession was to maintain the American people at the highest possible level of oral health* provided, that function has not been fulfilled*

Until this service is Therefore, dental

education must provide for dental students meaningful experiences in the fields of sociology and economics in order to prepare them, as members of the dental profession and of American society, to cope intelligently with these problems*

The University As one views the problems of dental education and the resources for their solution, one cannot help consider the place of the university in the total situation*

Dental education has succeeded after many years

of genuine effort in being recognized as an important branch of the American University*

This recognition means that dental education plays

a major role in fulfilling the function of the university, namely, to develop leadership in all the important divisions of American life* Further, this situation implies that dental education has accepted as its aims those of all branches of American education —

the development

127

of the powers of the individual and of society with the aim of creating a better individual and a better society*

In order to strengthen

its relationship with the university and to increase its importance in the development of American youth, dental education must continually re**interpret its specific aims and objectives in the lig^it of the aims and objectives of the University, and of the society which the university is to serve* The mere re-statement of its role is not sufficient*

Bather,

each part and the whole of the curriculum must be continually surveyed and criticised in the light of the aims and objectives of the university dental school and of the dental needs of American society*

The willing­

ness of dental education to do this will signify to a large extent its degree of consciousness of the role it can and should play* University Membership*

The privilege of university membership

carries with it some benefits and some responsibilities.

The university

offers something to its member schools and it should in turn expect to receive something from them.

Without this mutual give and take, there

exists a relationship which is apparent only in the school catalog* On the teaching staffs of all great universities there are men whose interests are primarily in the fields of education, sociology, economics, political science, or medicine*

The thinking of these men

is specialized and expert thinking, and is important only as it is related to the life about them*

It seems logical that the leadership in

the other schools of the university should feel the impact of their thoughts and ideas first.

To support this suggestion one must assume

that any school becomes a part of a university* because the latter

128

"believes that the new member can aid the university in the fulfillment of its obligation to society*

It is as much a mistake to isolate a school

and its thinking in the same sense, but to a greater degree, as it is to isolate a subject-matter course from the rest of the curriculum.

That

university will become great which will develop a cross-fertilization of ideas and use them intelligently.

That university will advance which

can develop in its member schools a great sense of responsibility to the university and which can instill in those schools a keen and eager desire to help solve each other’s problems. Dental education has become a member of the university, but it still needs to interpret and define the full significance of that relation­ ship,

Obviously, dental education has some serious problems; but just as

obviously, it requires help to solve them.

It seems that the place to

start looking for such help is in the university*

Some areas of univ­

ersity thinking are more closely related to the problems of dental education than are others.

This; is as would be expected.

Education,

sociology, economics, political science, and medicine can all contribute to the advancement of thought in dental education.

Of those mentioned

medicine is in a position to do this least of all, because the problems of medical education run along much the same lines as do those of dental education, and there is no reason today for believing that medical educa­ tion is any closer to the solution of its problems than is dentistry. It is not assumed that dental education is simply to ask for advice, then to accept it and use it.

Rather, it is considered that there

shall be common discussion of problems that may be actually considered

129

mutual ones*

For example, if education and dental education were to dis­

cuss the matter of individual differences among dental students, it would he as much a problem of the educator as of the dental educator, for it should he considered a function of the educator to contribute to the advancement of teaching in all fields*

Further, dental education is

faced with the need of improving its thinking in the field of social relationships; it can do this task better with the help of the sociologist* At the same time it must be considered the function of the sociologist to contribute all that he can to these particular problems of dental educa­ tion*

However, the responsibility for initiating mutual thinking must

he with dental education* Benefits to be Derived*

If dental education will study its short­

comings as well as its strengths, in the light of its aims and objectives, in order that it may see clearly its own problems, then the initial step toward a fuller growth has been made*

It will be, then, in a position to

interest other member schools of the university in the problems of dental education*

The writer can see only benefits to be derived from such a

relationship, because the steps to be taken as a result of mutual think­ ing must be taken by dental education*

It seems that such a university

relationship would afford to dental education a broader interpretation of its role in the teaching of American youth and in the service of the American people.

It is only by the process of cross-fertilisation that

the dental school can feel the impact of the dynamic thinking of leaders in the departments of sociology, economics, psychology and education* seems clear that dental education must employ this means to insure

It

150

maximum "benefit from a university affiliation. Dental education should attract to the field of dentistry young men who possessed "basic training in related fields and who would he inter­ ested in applying their earlier education to the development of dental education.

For example, a man with medical training might he very

instrumental in working on problems concerned with the relationship of dentistry to systemic disturbances, A young man with a thorough train­ ing in sociology might bring that background into dentistry and thereby make significant contributions to the definition of the sociological background of American dentistiy.

Until dental education lays its

problems on the university council tables, these young men will not influence the profession of dentistry, except in rare instances, and then only by accident. What specific direction the planning for dental care should take is not developed in this dissertation, general points that should be considered.

fhere are, however, some First, dental education

must continue to improve its teaching, so that the dentists of the future will be better able to serve the American people.

Second,

students must be made conscious of the sociological, economic, and political bacltground of American dentistry.

!Ehird, they must see ethics

not as a narrow relationship between two professional men or between professional man and patient, but in maturity as the relationship between the profession and society.

Fourth, dental education must recognize the

need for full employment of dental manpower.

Fifth, it must strive to

educate the public and the profession to the need for prevention of oral

131

diseases, rather than only for their treatment.

Sixth, it must think

in terms of the American people, rather than, in terms of its own narrow professional interests.

I^y merging these narrower professional

interests in the larger national interests, by losing itself in America, dentistry will find itself and find itself more abundantly. It should make its motto, "American dentistry for all the American people."

132

BIBLIOGRAPHY Books

Bode, Boyd H«, Progressive Education at the Crossroads, Hew York and Chi cago s Hew son and Company, 1938, Dewey, John, Experience and Education, Hew Yorks 1938. — -----------------, Education Today, Hew Yorks 1940 ___________ $ How We Think, Hew Yorks

Columbia University Press,

D, 0, Heath and Co., 1910.

, Human Hature and Conduct, Hew York:

1922

The Macmillan Co•,

Henry Holt and Co.,

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Galloway, George B., Planning for America, Hew Yorks Co., 1941.

Henry Holt and

Griffith, Coleman, An Introduction to Applied Psychology, Hew Yorks The MacmillanCo., 1938. , An Introduction to Educational Psychology, Hew Yorks Farrar and Rinehart, Inc., 1935. ~ ' Jones, A. J., Principles of Guidance, 2nd Ed., Hew Yorks 1934.

McGraw-Hill,

Kilpatrick, W. H., A Reconstructed Theory of the Educative Process, Hew Yorks Teachers College, Columbia University, 1935. Prescott, D. A., Emotions and the Educative Process, Washington, D. C.s American Council on Education, 1938. Taba H., Dynamics of Education, Hew York;

Harcourt, Brace and Co., 1932.

Woodworth, Robert S., Contemporary Schools of Psychology, Hew York: Ronald Press, 1931.

The

Periodicals Asgis, A. J., **The Seminar as a Method of Continuous Education of a Dental Faculty and Graduate Dentists,?f Journal of Dental Education, April 1940, pp. 337-344.

153

Curd, J. P., "The Essay Examination," Journal of Dental Education, Oct.

1939, pp. 39-45. Hinds, F. W., "Aptitudes for the Study of Dentistry," Journal of Dental Education, Feb. 1939, pp. 167-174. Horner, H. H., "Inventory in Dental Education," Journal of Dental Education, April 1941, pp. 261-276. Lasby, W* F., "Pre-dental College Requirements," Journal of Dental Education, Dec. 1939, pp. 97-98. “ ” McNulty, B. ¥., "Comprehensive Examination in Dental Education," Journal of Dental Education, Feh. 1939, pp. 159-166. 0 ,Rourke, J. T •, "Aims of Dental Education," Journal of Dental Education, Feh* 1941, pp. 155-166. ” -------------------TanKirk, I. E., ’"The Teacher and the Hew Curriculum," The Journal of the American College of Dentists, Dec, 1935, pp. 263-264. Wakefield, B. G., "Mutual Advantages of a Dental School, Hospital Affiliation," Journal of Dental Education, April 1940, pp. 316-320. White, ¥• C., "Measurement and Grading in the Professional School," Journal of Dental Education, Feh. 1940, pp. 193-205.

Reports and Proceedings Aisenherg, M. S., "Discussion," Proceedings of the American Association of Dental Schools, Tol. 13, p. 608. Jjnidon, Beulah, 1939.

'Who Can Afford Health?

Public Affairs Pamphlets, Ho. 27,

Blauch, L. E., "Teachers and Dental Teaching," Proceedings of the American Association of Dental Schools, Tol. 14, pp. 243-251. Chase, Stuart, What the Hew Census Means, Public Affairs Pamphlets, Ho. 56. Enloe, A., "The Evaluation of the Student’s Efforts in the Operative Clinic," Proceedings of the American Association of Dental Schools, Tol. 16, pp. 129-13$. Foster, William T., Doctors, Dollars, and Disease, Public Affairs Pamphlets, Ho. 10, 1940.

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Cries, William J., Dental S due at ion in the United States and Canada, Boston; The Merrymount Press, 1926• * "Carnegie Foundation's Bulletin on Dental Education," Hew York, 1926. Healey, H. J,, "Discussion," Proceedings of the American Association of Dental Schools, Tol. 17,“ p# 137. Kronfeld, R., "Discussion," Proceedings of the American Association of Dental Schools, Tol. 14, pp. 350-352, Lischer, B, E«, "The Selection of Students," Proceedings of the American Association of Dental Schools, Tol. 16, pp. 66-85. M&rjerison, H. M., "To Maintain Dental Education in Full Accord with the Highest Requirements of Professional Education in the Public Service," Proceedings of the American Association of Dental Schools, Tol. 16, pp. 55-65* Miner, L. M. S., "Pre-dental Education," Proceedings of the American Association of Dental Schools, Tol. 12, pp. 89-95. McGuigan, H. A., "Teaching of Pharmacology in Relation to its Practical Application," Proceedings of the American Association of Dental Schools, Tol. 10, pp'. 380-393. Rational Resources Committee, Consumer Expenditures in the United States, 1939. , Consumer Incomes in the United States, August, 1958. , Development of Resources and Stabilization "of Employment in the United States, January 1941. , The Problems of a Changing Population, May 1938* , The Structure of the American Economy: Part I, June 1939. , The Structure of the American Econony, '' Part II, June 1940. , Water Planning, February 1938. R e m a n , A. T., "The Problems of Teaching in Dentistry," Proceedings of the American Association of Dental Schools, Tol. 14, pp. 263—268.

135

O'Rourke, J, f*# ^ m , Report on Objectives of Dental Education," Proceedings of the American Association of Dental Schools, Tol. 10, p. 83. ~— Pope, James P., The TTA — A New Corporate Tenture, Presented before the Political Science Department of northwestern University, April 22, 1940* Robinson, J, Ben, Proceedings, Dental Centenary Celebration, Baltimore: Waverly Press, 1940, pp. 1012-1013. Semans, H* M., "President's Address," Proceedings of the American Association of Dental Schools, Tol, 16, pp. 15-22* Swenson, M. G., "What Laboratory Procedures Should the Students be Required to do When Treating Patients in the Dental School Clinic?" Proceedings of the American Association of Dental Schools, Tol* 14, pp • 135-15$♦ Turner, Charles R#, "Presidential Address," Proceeding of the American Association of Dental Schools, Tol* 16, pp. 17-24* Ward, M., "Present Problems Confronting Dental Education," Proceedings of the American Association of Dental Schools, Tol* 10, pp. 191-206. Wright, W* H., "Critical Review of the Report of the Curriculum Survey on Complete Denture Prosthesis; Based on Statements from Teachers," Proceedings of the American Association of Dental Schools, Tol* 14, pp* 99-116* Young, A* P*, "The Problems of Teaching in Dentistry," Proceedings of the American Association of Dental Schools, Tol* 14, pp. 269-274.

VI

T A

Name:

GEORGE WILLIAM TEUSCHER

Birth:

January 11, 1908 - Chicago, Illinois

Education.

^9) Northwestern University; D.D.S. 1929; M.S.D., 1936; 1932-30; M A lQ/n 1938-41) ■' 94

Experience.:, 1929Practice of Dentistry for children 1933-3&, Part-time instructor in children1s dentistry, Northwestern University 1938-41, Assistant Professor of Pedodontia, Northwestern University 19W1Associate Professor of Pedodontia, Northwestern University