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How USyd’s Dentistry School is mapping out a new direction for graduates

'Academic Excellence'

Published in NSW Dentist August 2021 issue

ADA NSW Media Advisor Stuart Turner met University of Sydney School of Dentistry Head of School and Dean Heiko Spallek to discover how the teaching of graduate dentists is changing to address Australia’s oral health inequalities.

Growing up in communist-run East Germany opened Heiko Spallek’s eyes to injustice at an early age.

It also spurred the Head of School and Dean at the University of Sydney School of Dentistry’s desire to tackle oral health inequalities and educate others to do the same.

“If you weren’t a member of the Communist Party, as I wasn’t, you were considered a second-class citizen,” Professor Spallek said. “Growing up in East Germany, being seen as an ‘intellectual’ was dangerous. I was the first member of my family to attend university.

“I think growing up there taught me at a young age how systemic discrimination exists in the world in many forms and how maybe as an academic I could at least do my bit to fight against it.

“I wanted to do something with my life that combined using my hands and my brain, so a career in dentistry appealed in that way. I’ve also never lost the satisfaction of knowing we help people who need it.”

Graduating from Humboldt University’s Dental School – a stone’s throw away from the former Berlin Wall – in 1993, Prof Spallek practised in the university’s Department of Periodontology before embarking on a remarkable and hugely diverse research and academic career across the globe (see biography opposite).

A typical work day for the 54-year-old married father-of-two usually starts at 3am (“I’m very lucky – I’ve never needed much sleep”) with video calls to counterparts in America, where he worked as former Associate Dean for Faculty Affairs at the University of Pittsburgh School of Dental Medicine before moving to Australia in 2016.

He then starts his ‘day job’ at the University of Sydney School of Dentistry, where he is currently overseeing a major review of the Doctor of Dental Medicine curriculum.

Heiko Spallek has published more than 70 peer-reviewed papers, including in the fields of education, usability engineering, medical and dental informatics and computer science.

  • He has served as Associate Dean for Faculty Affairs at the University of Pittsburgh School of Dental Medicine (2001-2016) where he co-founded and lead the Center for Informatics in Oral Health Translational Research.

  • He has a Fellowship in the International College of Dentists and is a member of several national and international dentistry bodies.

  • He is an Honorary Visiting Professor at Japan’s Osaka Dental University.

  • He also serves as Academic Lead at the University of Sydney Faculty of Medicine and Health’s Digital Health and Health Service Informatics group.

The new curriculum, which will be launched in 2023 and which Prof Spallek says will bring the School to “the forefront of dental education in the world,” focuses on producing graduates who will “serve the community as professional practitioners with a robust understanding of the nature of their work in the context of society.”

In broad terms, Prof Spallek said this means teaching graduates to take a leading role as dental practitioners as part of a coordinated approach to healthcare.

“I believe there’s been a generational mindset change in dentistry,” Prof Spallek said. “Fifty years ago dental graduates would think, ‘I’m doing my own thing’ but now graduates recognise it’s necessary to partner with medical professionals to deliver healthcare services.

“We’re aspiring to produce graduates who can provide leadership in oral, dental and craniofacial issues and work more collaboratively alongside the broader health care team members, such as nurses, pharmacists and other public personnel.

“There’ll always be a place for those dentists who just want to do their ‘own thing’, especially in rural settings where it’s maybe not possible to have those larger teams. Without doubt, though, the global vision for the future of dental education is changing to a more integrated care-coordination approach.”

Prof Spallek contributed to the 2019 Grattan Institute’s Filling the Gap report, which highlighted how two million Australians delayed or put off seeing the dentist every year due to cost and advocated the introduction of a universal dental health scheme in Australia.

The Dental School’s curriculum reform is driven by what Prof Spallek believes is the need to further improve the understanding in society – and the dental profession itself – of the link between oral and general health.

“We try and instil in our students that good oral health is for everyone, no matter their background, situation, age or economics,” Prof Spallek said. “I believe federal governments in Australia have underestimated the importance of dentistry so we must work as a profession to highlight how oral health is integral to overall health.

“I also feel we are moving towards a paradigm where good oral health and dental appearance ties in to denote status, social position and overall health. This doesn’t reflect the enormous burden of poor oral health for society. It’s another reason why dental education programs must be expanded – so graduates can assume the important leadership roles in all areas of public health.”

Prof Spallek and his colleagues have also driven curriculum reform to incorporate the increasing impacts of new technology on dentistry.

Over the coming years, the curriculum will include teachings on aspects such as telehealth, social media, computerised clinical decision support–making systems and also introduce students to issues including data privacy, security and governance and the role of AI in analytics.

“The new generations of Australian dental graduates are already capable and enthusiastic and trained to integrate new technologies such as 3D printing, cone beam computed tomography and electronic dental records,” Prof Spallek said. “We know there’s more to it than that, though. We need to give our students foundational skills in informatics and human factors so they can adapt to future technologies.

“We’re not planning to teach our students to program computer code, but we need to prepare them for a future that will significantly be shaped by AI.”

Last year’s COVID-19 outbreak and its ongoing effects forced the School to quickly revamp its teaching methods, including online and remote learning and “intense” simulation clinical time replacing practice exposure.

While a “challenging” period, Prof Spallek is confident less practical time will not detrimentally impact undergraduates’ clinical skills.

“I think the pandemic has accelerated things such as the adoption of remote learning technologies, which possibly was needed anyway,” he said. “Yes, our graduates last year had less practice time, but will they be ‘lesser’ dentists because they have fitted x fillings when they graduate, rather than y? I think not.

“I feel this period has helped our undergraduates gain new skills such as increased flexibility and adaptability to changed circumstances. It’s also helped prepare them for life under a pandemic, which we’re likely to see again in the future.”

Prof Spallek believes showing empathy to colleagues and those around you in the workplace is key to successful leadership.

“Putting yourself in the shoes of others and discovering what motivates them is the way to take your organisation forward and bring people on the journey with you,” he said. “I am fortunate and privileged to work alongside a wonderful team of colleagues and students (and) I see my role to remove all the potential barriers stopping them from achieving their absolute best.”

Almost 40 years after starting his professional journey, Prof Spallek said he still loves helping develop the next generation of dentists.

“Unlike other areas of medicine, where graduates go into internships after completing studies, dentistry graduates go out into the ‘wide world’,” he said.

“They start with possibly a ‘naivety’ around oral health and leave with the professional skills to practise at least competently. I love how we have that impact on young graduates’ lives.

“I believe that, with the evolution of our curriculum, the Dental School will become a world leader in dental education. There’s still so still much to achieve but that’s very exciting.

“I won’t mind if I am waking up at 3am for a while longer yet.

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