A Critical Appraisal of Holistic Teaching and Its Effects on Dental Student Learning at University of Bergen, Norway

The curriculum of the dental faculty at the University of Bergen, Norway, was revised and a new curriculum implemented in 1998 based on the principles of holistic teaching and patient-centered treatment. The first candidates graduated in 2003. The change of curricula, experience gained, and lack of an evidence base for holistic teaching justify a general discussion of all relevant aspects associated with this approach. The purpose of this article was to make a contribution towards such a discussion. A PubMed search regarding holistic teaching in dentistry was performed. Of the 211 entries on holistic teaching, few discussed holism in depth; none reported outcome measures comparing old and new curricula. Data collected from students graduating in 2003 (new curriculum) and 2000 (old curriculum) on their satisfaction with the teaching comprise a possible outcome measure. In most respects, using prosthodontics as an example, no differences between the two groups of students were found. Students studying under the new holistic curriculum were less satisfied than those studying under the old one regarding the number of available teachers and teachers' feedback on student performance. Both holistic teaching/patient-centered treatment and a more traditional subject-specific approach have advantages and disadvantages, and neither can be practiced in its pure form for ethical and practical reasons. The quantitative results of this study did not support the hypothesis that holism improved students' satisfaction with the teaching. A wide discussion of holism in dental education is needed, along with outcome measures when curricula are changed.