The United States declared a nationwide state of emergency mid-March as a result of the global pandemic that still affects us today. Businesses, schools and travel shuttered as mandates and guidelines were put in place to help contain COVID-19. Dental schools across the country were forced to adapt on the fly. Massachusetts quickly became a hotbed for the virus, overwhelming the usually robust health care system. At Harvard School of Dental Medicine (HSDM), a delicate balancing act of ensuring the safety of all community members while optimizing education and patient care began.
The landscape changed almost daily. Students in their didactic education were told to expect remote learning indefinitely. Clinical operations were reduced to emergency care only. For those students in their clinical education, questions concerning their patients, experience and graduation timeline weighed heavily. Behind the scenes, faculty, staff and administration gathered to formulate a plan for the future.
Perhaps most uniquely, the graduating class of 2020 finished their requirements on time for graduation, even with two months less of clinical time. Board and licensing exams were completed just a few weeks prior, and graduation requirements of patient care were generally complete. At some other schools, students are taking licensing exams on mannequins and completing cases well past their intended graduation date.
Those in the class of 2021 at HSDM were supposed to be treating patients full time. Instead, they lost months of clinic time. To ensure adequate clinical experience while balancing social distancing measures, the Faculty Group Practice is now exclusively used for students, in addition to the Teaching Practices. Evening and weekend clinic times are strongly being considered, especially as the next class plans to enter clinic.
The class of 2022 was in the midst of a month-long period in March with no classes where students were expected to take a break, complete NBDE Part I and conduct research. Pre-clinical hands-on education that would normally begin in April was delayed with any planned lectures being frontloaded and delivered virtually. These lectures began at 10 a.m. eastern time to prevent pre-dawn Zoom sessions for those on the west coast. The pre-clinic now operates at half capacity, resulting in half-day sessions for students and full-time teaching for faculty. Full PPE, including face shields, is being strictly enforced, even in the pre-clinic.
For the class of 2023, they now enter a virtual dental school classroom environment through December 2020. Waxing sessions, which are normally the first introduction to hand skill exercises, are taught via Zoom. The lack of direct faculty feedback makes this especially challenging. For the new class of 2024 with a didactic medical school curriculum normally dependent on small group and flipped classroom-style learning, their ability to experience the true learning environment is limited. They too are scheduled virtually through the end of the calendar year.
Throughout the time away from school, class and school-wide virtual meetings allowed for discussion and clarification of the ever-changing curriculum. Amongst students, predictions for our return circulated via group messages. In March, we hoped to return by May. When May rolled around, we thought June must be the month. Although HSDM prepared a plan for return, it was up to Harvard University to approve the plan, leading to delays and doubts. Fortunately, the school reopened to D3, D4 and resident students following the Fourth of July weekend, albeit with safety and social distances measures including daily temperature checks and app check-ins, greatly reduced capacity and weekly testing. I applaud our faculty and administration for acting quickly and with students and patients at the forefront of their decision-making.
Will this be the new normal? Will a vaccine allow us to return to the pre-COVID world? The only certainty seems to be that unpredictability will remain. Schools must adapt quickly to ensure the best for their faculty, students and patients.
~ Richard Shen, Harvard ’22