examined in Chapters 5 and 6, are critical in their own right but are also crucial contributors to the kind of educational enterprise recommended in this chapter.

The discussion below tends to focus on dental schools as discrete entities. The committee did not, however, intend to understate the role of organizations such as the American Association of Dental Schools (AADS) or limited-purpose consortia of several dental schools as promoters of change. These groups serve many valuable purposes, for example, by stimulating discussion, facilitating communication about innovative programs, devising model approaches to common problems, providing technical support, collecting and analyzing information, and promoting good relationships with organized dentistry and others. Collective as well as individual effort is essential if the changes recommended are to be achieved.

Curriculum in Context

A curriculum embodies the values and vision of an institution and a discipline. As expressed in the principles stated in Chapter 1, dental education should be scientifically based, clinically relevant, medically informed, and socially responsible. It should emphasize outcomes as well as services, efficiency as well as effectiveness, and community as well as individual needs. It should prepare students to critically assess both new and old technologies and practices throughout their careers.

Traditionally, faculty have largely controlled school and department decisions about what is taught, by whom, and in what fashion. As discussed in a later section of this chapter, among the most important and difficult factors affecting the direction and pace of curriculum change are those involving the composition, power, and disciplinary organization of faculty.

Seventy Years of Curriculum Critiques

In the course of this study, the committee heard a lively debate about the strengths and weaknesses of current curricula and the values and vision that curriculum reform should reflect. As the background paper by Tedesco underscores, most critiques of the dental curriculum are long-standing. The core concepts behind changes that are still being advocated date back several decades.

Moreover, if the word "medical" were changed to "dental," the basic points of several persistent critiques of undergraduate medi-



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