One year later: Faculty of Dentistry dean on change, compassion and lessons learned from COVID‑19

- May 4, 2021

(Danny Abriel photo)
(Danny Abriel photo)

When COVID-19 forced Dalhousie to close its campus in March 2020, it created unprecedented challenges and disruptions to people’s lives, educational experiences and careers.

Since then, the Dal community has found new and notable ways to teach, forge connections and be of service. As we complete a full year within these circumstances, we’re checking in with a few of Dal’s academic leaders to learn how their communities overcame obstacles and found opportunity, and to commemorate the effort that’s gone in to getting it done.

Below, we hear from Ben Davis, dean in the Faculty of Dentistry.  

How did the upheaval brought on by COVID-19 affect clinic operations and research in the Faculty of Dentistry?

A huge part of our students’ curriculum is clinic-based, and that can't be replaced by online didactic teaching alone. Last March, Public Health closed down all private dental offices in the province — including our clinic in the Faculty — for two months. That had a significant impact on our senior dental hygiene and dentistry students, who were scheduled to continue their experiential clinical learning into May. Fortunately, we were able to assess their clinical experiences up to that point and agreed that they met the Commission on Dental Accreditation of Canada requirements and were able to graduate.

Our more junior students were out of the clinic completely from mid-March, and we weren’t able to bring them back into the Faculty until the end of June. It was important to get them into our simulation lab so that they could practice their clinical skills before returning to the clinic in early August to start treating patients again.

Although our clinics were closed to regular patient care and learning for two months, we were able to open up an emergency oral health clinic, which for several weeks was one of only three in the entire province alongside our affiliated pediatric dental clinic at the IWK and the oral and maxillofacial surgery clinic at the Victoria General Hospital. The Department of Health and Wellness was grateful that we were able to offer this much-needed service when all private dental offices were closed across Nova Scotia.

Although lab research came to a halt during the lockdown, a working group of faculty members, grad students, and residents was able to undertake a comprehensive review of the literature and develop evidence-based clinical protocols, which allowed our clinics to manage urgent and emergent oral care and then eventually to provide more comprehensive care. This document and protocols provided guidance to Atlantic Canadian dentists and other faculties of dentistry across Canada.

What do you see as some of the lasting effects of the pandemic on dental education at Dal?

I think the pandemic has made us appreciate just what we can deliver online in terms of curriculum. Even though we're all anxious to return to in-person learning, I think the online resources we have created for students will continue to be used post-pandemic. That's going to be a long-lasting positive impact.

I also think that the way in which we assess students’ readiness to practice may change slightly. The pandemic has made us more flexible and less dogmatic about counting how many procedures of a certain type a student has done, and we’re moving toward a more holistic way of assessing each student's readiness to practice. Our small group practice model has helped us to assess students’ progress in that way.

We have also learned that people can be very effective working from home. And when this is over, we're going to have to find the balance between what on-site support we need and what staff can work from home and for how many days a week. We know there are people who are excited to get back. But there are also people who have become very adept at working from home and want to continue to do so. It will be a matter of finding how we can best support the mission and vision of the Faculty while still allowing some flexibility.

I also think we have probably entered a new era of personal protective equipment. I expect we will continue to use face shields when we undertake aerosol-generating procedures and we’ll probably continue to use gowns. My hope is that we will remember the lessons learned from COVID, masks and hand hygiene particularly, which are critical to preventing the transmission of most pathogens. And I hope there'll be an appreciation of the need to support colleagues who are sick and to remove the stigma when people do not come into work because they are ill.

What has been the most inspiring aspect of leading the Faculty over the past year?

I have been so impressed with the adaptability of our staff, students, and faculty, even when the changes we had to make required a significant amount of work and effort on their part. They did it for the greater good of everybody and to ensure that our patients were provided with the care they needed and that our students received the experiential learning they required to graduate and become licensed practitioners.  

What innovations have you seen emerge out of the Faculty as a result of the pandemic?

I mentioned earlier on that we had a working group of faculty, grad students, and residents looking at clinical protocols. This was very innovative in that they were the first group to look closely at all the literature around the risk of virus transmission during aerosol-generating procedures and then come up with guidelines that all Canadian dentists and faculties of dentistry now have access to.

They were the first group to really show — based on evidence in the literature — what personal protective equipment was required during both aerosol- generating and non-aerosol generating oral health procedures. This document became the foundation on which many regulators across the country based their return-to-practice guidelines. The guidelines and requirements for the opening of more dental offices for urgent and emergent care were also based on the protocols we developed here at Dalhousie.

How has the Faculty contributed to the efforts to combat and raise awareness about the different impacts of COVID-19?

We appreciate that our most vulnerable communities in terms of oral health are often the same communities that are most at risk for COVID-19. The significant curtailing of oral health care during the spring of 2020 meant that many patients’ oral health was profoundly affected by the lack of access to care. In our outreach clinics, we’ve had to find a balance between providing much-needed access to oral health care for these often-vulnerable populations, while keeping everyone safe from COVID-19 transmission.

Our outreach clinics in Harbour View Elementary and Nelson Whynder Elementary School stopped operating when the schools were closed. But once the school board reopened those schools, we were back in again and operating. Similarly, in our Government Assisted Populations (GAP) clinic and our clinic in the North End Community Health Centre, we brought those populations back in as soon as we could so that we could care for them.

See also: Helping those who need it: Providing emergency dentistry during COVID‑19

What have you missed most about in-person operations and what are you most looking forward to getting back to post-COVID 19?

You know, I really do miss the connections with people. It’s just not the same now. With virtual meetings, I miss being able to scan a room and see who's engaged or who might not be comfortable with the conversation. And I really miss the efficiency of being able to pop into somebody's office and, in five minutes, figure out the solution to an issue or concern — without having to schedule a half-hour virtual meeting. There is an informal efficiency that takes place when people are in the building. We can often settle a lot of work-related questions by just speaking to somebody in the hallway.

There are also the obvious big misses, like convocation and the white coat ceremony, that are so important to us.  We look forward to having those special ceremonies again once the pandemic restrictions are lifted.  It’s also the little things — the things that make us more human — that I’ve really missed, like sharing a laugh with a student or staff member while in line for a morning coffee.  

What important lessons did you learn from guiding the Faculty through the pandemic?

It's remarkable how resilient many people are. But there still is the need to be compassionate, to be kind, to be empathetic, and to not judge quickly. I think we have come to realize over the past 14-15 months that not everybody copes the same. A lot of people have many other things happening in their lives, including personal tragedies, that affect how they cope and react to the stress of a pandemic.

The other important point for me is that the changes we made this year have led me to believe that maybe we shouldn't be so dogmatic about how we view the curriculum and pedagogy. We had to pivot in many ways this year. And we still graduated really well-trained young professionals. I think we’ve seen that even though something has been done a certain way for the past 40 years, it doesn't necessarily always have to be done that way.

I’ve come to appreciate, too, that a lot of the people we tend to take for granted during normal times, like our custodians, our MDR team, and the patient services staff, have become our heroes. We always appreciate what they do, but it’s not until we have a situation like this that we fully appreciate just how essential they are to the normal operations of our Faculty.


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