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The introduction of mid-level providers to the U.S. dental workforce is currently a topic of heated debate. As little is known about the opinions of those who educate oral health professionals on the subject of such practitioners, a survey of U.S. dental school deans was undertaken to gauge their attitudes about alternative workforce models in the dental profession. The survey was sent to deans of the then-fifty-eight U.S. schools of dentistry; forty-four responded for a 76 percent response rate. Over three-fourths of the respondents agreed that the scope of practice for both dental hygienists and dental assistants should be expanded; significantly, over half agreed that the future of dentistry should include a dental therapist-type practitioner. Moreover, three-fourths agreed that such practitioners or expanded-duty hygienists would improve access to care for the underserved, and between half and two-thirds agreed that the quality of care delivered by these professionals would not be a problem. The attitudes of the deans about mid-level providers falls somewhere between that reported for U.S. dentists generally, who tend to be skeptical, and for dentists in other countries, who, once they have worked in a system with dental therapists, tend to be supportive.

With issues such as shrinking revenue, access to care, faculty workloads, and graying faculty, dental schools are faced with difficult challenges that fall to dental school deans to manage. Do dental school deans have the organizational skill sets and ethical frameworks necessary to address the challenges now facing dental schools? The purpose of this article is to pose questions and suggestions regarding some of the key issues in dental colleges today and to stimulate discussion in the dental community about needed changes in dental education.

This study explores the little-understood process of evaluating the performance of assistant and associate deans at dental colleges in the United States and Canada. Specifically, this research aimed to identify the methods, processes, and outcomes related to the performance appraisals of assistant/associate deans. Both deans and assistant/associate deans were surveyed. Forty-four of sixty-six deans (66.7 percent) and 227 of 315 assistant/associate deans (72.1 percent) completed surveys with both close-ended and open-ended questions. In addition, ten individuals from each group were interviewed. Results indicate that 75-89 percent of assistant/associate deans are formally evaluated, although as many as 27 percent may lack formal job descriptions. Some recommended best practices for performance appraisal are being used in a majority of colleges. Examples of these best practices are having at least yearly appraisals, holding face-to-face meetings, and setting specific, personal performance objectives/benchmarks for assistant/associate deans. Still, there is much room to improve appraisals by incorporating other recommended practices. Relatively high levels of overall satisfaction were reported by both assistant/associate deans and deans for the process and outcomes of appraisals. Assistant/associate deans rated the value of appraisals to overall development lower than did deans. Qualitative data revealed definite opinions about what constitutes effective and ineffective appraisals, including the use of goal-setting, timeliness, and necessary commitment. Several critical issues related to the results are discussed: differences in perspectives on performance reviews, the importance of informal feedback and job descriptions, the influence of an assistant/associate deans' lack of tenure, and the length of service of deans. Lastly, recommendations for enhancing performance evaluations are offered.

This study explores the little understood process of evaluating the performance of department chairs/division heads in dental schools. Specifically, this research aimed to elucidate the methods, processes, and outcomes related to the job performance of department chairs/division heads. Forty-three deans and 306 chairs completed surveys with both close-ended and open-ended questions. In addition, ten deans and ten chairs were interviewed. Results indicate that 80 to 90 percent of department chairs are formally evaluated, although as many as 50 percent may lack job descriptions. Recommended best practices for performance appraisal--such as having at least yearly appraisals, holding face-to-face meetings, and setting specific, personal performance objectives/benchmarks for chairs--are being used in most schools. Still, there is much room to improve appraisals by incorporating other recommended practices. Overall high levels of satisfaction were reported by both chairs and deans for the process and outcomes of appraisals. Qualitative data showed some convergence of opinions about appraisals with the notable exception of informal feedback. We explore some implications of these results, especially as they relate to improving performance appraisals.