Innovation and Flexibility

Dental accreditation has been criticized for being inflexible, overly prescriptive, insufficiently independent of dental society leadership, and too focused on process and structure. It is said, thus, to stifle innovation. Further, the current system is criticized as being too little concerned with outcomes. It places excessive burdens on satisfactory schools while inadequately protecting students and the public from unsatisfactory programs. Even if accreditation results were valid, the confidentiality of accreditation results for specific dental schools raises questions about how well the process can protect students and the public.

In response to the argument that accreditation standards and processes are inflexible and stifle innovation, the Commission on Dental Accreditation argues that its standards are designed to allow for considerable flexibility. Its work to devise outcome assessments reflects its interest in methods for better evaluating innovative as well as traditional educational programs. Dental schools have, in fact, initiated a number of innovative programs over the years independently and with the assistance of organizations such as the Pew Foundation (Barker and O'Neil, 1989, 1992). The committee heard, however, that some of the schools had faced opposition from accreditors that had created time-consuming and stressful delays in implementing program innovations. For example, efforts to give students some leeway from the traditional "lockstep" curriculum by instituting special focus tracks encountered concerns that the tracks amounted to early specialization, which is restricted under current standards stating that "specialization must not be permitted until the student has achieved a standard of minimal clinical competency in all areas necessary to the practice of general dentistry."

Governance and Representation

Accreditation is, like various other professional standard-setting processes, sometimes criticized as a self-serving mechanism for professional control and protection from competition. For example, a recent suit against the accrediting activities of the American Bar Association (ABA) charged that the ABA process imposed "costly and unnecessary standards that protect the financial interests of professors, law librarians and standardized-test services" (Slade, 1994, p. A19). That the Commission on Dental Accreditation operates under the auspices of the ADA raises ques-

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