Mendive. Journal on Education, 22(3), e3791

Translated from the original in Spanish

Original article

Improvement program for Prosthetic Rehabilitation teachers for the development of stomatological consultation

Programa de superación del profesorado de Rehabilitación Protésica para el desarrollo de la consulta estomatológica

Programa de aperfeiçoamento de professores de Reabilitação Protética para desenvolvimento da consulta estomatológica

René Santana Delgado¹ https://orcid.org/0000-0001-9415-0728
Olga Aida Alfonso Pérez² https://orcid.org/0009-0002-0740-6567
Mirna Riol Hernández³ https://orcid.org/0000-0001-6171-2616
Martha María Ávila Rodríguez² https://orcid.org/0000-0002-4436-3933

¹Stomatology Teaching Clinic "Dr. Luis Páez Alfonso". Ciego de Ávila, Cuba. rensadel79@gmail.com
²University of Medical Sciences of Ciego de Ávila. Ciego de Ávila, Cuba. o.alfonsoperezcuba@gmail.com; maravilar59@gmail.com
³University of Ciego de Ávila "Máximo Gómez Báez". Ciego de Ávila, Cuba. mirnarh66@gmail.com

Received: February 27, 2024
Accepted: July 13, 2024

ABSTRACT

The professional improvement of teachers in Dentistry schools constitutes the way to achieve the improvement of their preparation in the area of Educational Sciences and becomes a space for scientific research with potentialities for development. An improvement program that arises from determined needs is considered a relevant scientific result. The objective of this article was to: propose a program to improve the teaching staff of the subject Prosthetic Rehabilitation for the development of dental consultation as a modality of education at work. The materialist dialectic was assumed as a general method and the methods of the theoretical level were used: historical-logical, analytical-synthetic, system approach; As empirical methods, observation, document analysis, discussion group and user criteria were used to demonstrate the scientific value, viability and feasibility of the program. The fundamental ideas of the program were presented, appropriate to the investigated context, the contents were determined, the demands in each of the areas and the organizational forms that are combined within the actions were established, and the paths for evaluation with their own guides were proposed. for it. The relevance of the improvement program was confirmed, in a new approach to the process of professional improvement of the teaching staff of the Prosthetic Rehabilitation subject, in achieving a more coherent and integrative relationship between the logic of the clinical method and the logic of the didactics of the Stomatological consultation as a modality of education at work.

Keywords: medical sciences; vocational training; odontology; teacher training program.

RESUMEN

La superación profesional del profesorado en las escuelas de Estomatología constituye el modo de alcanzar el perfeccionamiento de su preparación en el área de las Ciencias de la Educación y se torna espacio de investigación científica con potencialidades de desarrollo. Un programa de superación que surge de las necesidades determinadas se considera un resultado científico pertinente. El presente artículo tuvo como objetivo: proponer un programa de superación del profesorado de la asignatura Rehabilitación Protésica para el desarrollo de la consulta estomatológica como modalidad de la educación en el trabajo. Asumió como método general el dialéctico materialista y se utilizaron los métodos del nivel teórico: histórico-lógico, analítico-sintético, enfoque de sistema; como métodos empíricos se empleó la observación, análisis de documentos, grupo de discusión y criterio de usuarios, para demostrar el valor científico, la viabilidad y factibilidad del programa. Se presentaron las ideas fundamentales del programa, adecuadas al contexto investigado, se determinaron los contenidos, se establecieron las exigencias en cada una de las áreas y las formas organizativas que se combinan dentro de las acciones y se propusieron las vías para la evaluación con guías propias para ello. Se corroboró la pertinencia del programa de superación, en un nuevo enfoque del proceso de superación profesional del profesorado de la asignatura Rehabilitación Protésica, en el logro de una relación más coherente e integradora entre la lógica del método clínico y la lógica de la didáctica de la consulta estomatológica como modalidad de la educación en el trabajo.

Palabras clave: ciencias médicas; formación profesional; odontología; programa de formación de docentes.

RESUMO

O aperfeiçoamento profissional dos professores das escolas de Odontologia constitui o caminho para alcançar a melhoria da sua preparação na área das Ciências da Educação e torna-se um espaço de investigação científica com potencial de desenvolvimento. Um programa de melhoria que surge de determinadas necessidades é considerado um resultado científico relevante. O objetivo deste artigo foi: propor um programa de aperfeiçoamento do corpo docente da disciplina Reabilitação Protética para o desenvolvimento da consulta odontológica como modalidade de ensino no trabalho. A dialética materialista foi assumida como método geral e foram utilizados os métodos do nível teórico: abordagem histórica-lógica, analítico-sintética, sistêmica; Como métodos empíricos foram utilizados observação, análise documental, grupos de discussão e critérios de usuários para demonstrar o valor científico, a viabilidade e a exequibilidade do programa. Foram apresentadas as ideias fundamentais do programa, adequadas ao contexto investigado, determinados os conteúdos, estabelecidas as demandas em cada uma das áreas e as formas de organização que se articulam nas ações, e foram traçados os caminhos de avaliação com guias próprios. proposto para isso. Confirmou-se a relevância do programa de aperfeiçoamento, numa nova abordagem ao processo de aperfeiçoamento profissional do corpo docente da disciplina de Reabilitação Protética, na concretização de uma relação mais coerente e integradora entre a lógica do método clínico e a lógica da didática da Consulta Estomatológica como modalidade de educação no trabalho.

Palavras-chave: ciências médicas; formação profissional; odontologia; programa de formação de professores.

INTRODUCTION

In Cuba, it is necessary to develop a continuous training process so that medical education teachers can meet the important challenges of the current context and guarantee the quality of teaching based on the solution of the problems that arise during their pedagogical performance. (Bonal et al., 2020).

It agrees with González et al. (2020) and Enríquez et al. (2021) in which teaching dentists assume the teaching-learning process with limitations in their pedagogical and didactic preparation. From this arises the challenge of developing, at the same time, their own assistance tasks from their jobs and the improvement of their professional pedagogical and didactic performance.

In the context of the teaching-learning process of the Dentistry career, it is essential to integrate the logic of the clinical method and the didactic logic of the dentistry consultation as a modality of education at work. This implies that teachers demonstrate not only high theoretical preparation in the disciplines and subjects they teach, but also in Didactic issues, which allow them to scientifically support their teaching practice.

Stomatological consultation constitutes the modality of on-the-job education par excellence for the training of professionals in the career of Stomatology; It is based on the application of the scientific method of Medical Sciences and the developmental approach of Didactics (Pérez, 2018).

In the Stomatology program at the University of Medical Sciences of Ciego de Ávila, the teaching staff of the Prosthetic Rehabilitation subject manifest limitations in the development of stomatological consultation as a modality of education at work, evidenced in:

• Limited planning by teachers of dental consultation as a modality of education at work.
• Inadequacies in the application of the clinical method in the dentistry consultation.
• Insufficiencies in the orientation, execution and control of professional skills in dental consultation as a modality of education at work.
• Limitations in the mastery of the pedagogical and didactic fundamentals for the interrelation of the clinical method and the didactic logic of the different stages of the dental consultation with the contents of prosthetic rehabilitation.

From these insufficiencies, research originates on how to contribute to improving the performance of teachers of the subject Prosthetic Rehabilitation for the development of dental consultation as a modality of education at work.

It is considered that professional improvement constitutes an important way to achieve the improvement and completion of the pedagogical and didactic preparation of the teachers of the Prosthetic Rehabilitation subject (Enríquez et al., 2021 and Gutiérrez et al., 2022).

The improvement of teachers and their continuous training have been addressed with interest within the educational field (Enríquez et al., 2021). From this perspective, professional development stands as the cornerstone of the quality of education. López and Rojas (2021) and Enríquez et al. (2021) agree that Cuba makes efforts for the so-called pedagogical professionalization of university faculty, materialized in actions for the systematic methodological preparation of teachers, as well as in different forms of organization of professional development and academic training.

In the conception of the improvement process of the teachers of the Prosthetic Rehabilitation subject, limitations are seen that affect their teaching performance in the dental consultation as a modality of education at work. Improvement actions referring to the contents of the specialty are prioritized, to the detriment of pedagogical and didactic contents. These actions do not contribute from an integrative perspective to the development of pedagogical and didactic skills.

Therefore, a new approach to the process of improvement of the teaching staff of the subject Prosthetic Rehabilitation is required, so the objective of this article is: to propose a program of improvement of the teaching staff of the subject Prosthetic Rehabilitation for the development of stomatological consultation as modality of education at work.

This proposal acquires significance by contributing to the process of professional improvement from the relationship between the logic of the clinical method and the didactic logic of the different stages of the dental consultation as a modality of education at work, which contributes to the professional performance of the teaching staff. Prosthetic Rehabilitation in solving problems related to oral health rehabilitation. Through professional improvement it is possible to strengthen the pedagogical and didactic preparation of Prosthetic Rehabilitation teachers; their professional pedagogical performance will be benefited in directing the teaching-learning process of contents, skills and values related to the rehabilitation of oral health in the stomatological consultation as a modality of education at work.

The objective of this article is to propose an improvement program for teachers of the subject Prosthetic Rehabilitation for the development of dental consultation as a modality of education at work.

MATERIALS AND METHODS

The dialectical-materialist method was assumed as the general perspective of the research. The following theoretical, empirical and statistical methods were used:

From the theoretical level:

Historical-logical: to determine the historical trends of the improvement process and characteristics of dental consultation as a modality of education at work.

Analytical-synthetic: because it allows the processing of theoretical sources to deepen the study of stomatological consultation as a modality of education at work, as well as the interpretation of the results of the diagnosis of the current state in the improvement of Rehabilitation teachers Prosthetics.

System approach: for the development of the improvement program and the establishment of relationships between its components, based on the improvement of the teachers of the Prosthetic Rehabilitation subject.

From the empirical level:

Document analysis of the Stomatology degree study plan, to assess how the aspects related to the development of the dentistry consultation are integrated as an organizational form of education at work and the integration of the clinical method.

The observation of 15 dentistry consultations at the University of Medical Sciences of Ciego de Ávila, through an observation guide from the protocol to execute and control the development of education at work in Medical Sciences of the General Directorate of Medical Teaching (Ministry of Public Health, 2022), to identify the limitations of the performance and learning needs of the teachers of the subject Prosthetic Rehabilitation in carrying out the dental consultation as a modality of education at work.

Discussion group with the participation of the teaching staff of the Prosthetic Rehabilitation subject: to determine the contents to be integrated into the improvement program referring to dental consultation as a modality of education at work, in interrelation with the use of the clinical method.

Corroboration of the relevance of the improvement program was carried out through user criteria, selecting a total of 13, among whom were represented: four members of the Prosthetic Rehabilitation subject group, three teachers from the methodological group of the third year of the degree in Stomatology, three heads of teaching departments of the institutions in which the degree is taught and two of its directors, as well as the head of the Stomatology Section of the General Directorate of Health of Ciego de Ávila.

Statistics:

Descriptive statistics were used for the analysis, presentation of the information and its results.

The 15 professors of the Prosthetic Rehabilitation subject at the University of Medical Sciences of Ciego de Ávila, with the teaching category of Instructor and Assistant, were identified as the population. Ethical principles were complied with basics of respect for people, beneficence and non-maleficence, justice and autonomy, so participation in the study depended on the teachers' prior knowledge.

RESULTS

In the document analysis of the Study Plan "E" of the Stomatology degree, it was found that the methodological guidelines for developing the stomatological consultation from education at work are not explicitly declared, in correspondence with the different contents addressed in the Rehabilitation subject. Prosthetics and its connection with the clinical method.

In the observation of dental consultations, in 66.67% (10 consultations) insufficiencies were found in the development of the dental consultation as a modality of education at work, based on didactic and pedagogical limitations related to the teaching of the content, following the logic of the clinical method.

In 60% (nine consultations) limitations in the communicative interaction between students, teachers, oral health team and patient were evident. There was no adequate evaluation by the teacher regarding the student's progress, nor the treatment of self- and collective evaluation of learning. Finally, in 66.67% (10 consultations), no initiatives were carried out for students to carry out actions aimed at solving health problems, individually or in groups, according to their learning needs.

The discussion group was held with the participation of the 15 teachers of the Prosthetic Rehabilitation subject. Its objective was to integrate the evaluations of the teaching staff on the contents to be integrated into the improvement program, referring to dental consultation as a modality of education at work, in interrelation with the use of the clinical method. The essential characteristic of the discussion group was an adequate climate of communication and exchange between the participants.

Two central ideas were specified as structuring elements of the debate and reflection, referring to the level of satisfaction of the teachers with their performance in the development of the dental consultation as a modality of education at work and the determination of contents to be integrated into the actions of professional improvement to be developed in the improvement of said performance.

The participants joined the dialogue and were able to express their criteria and evaluations, contributing their experiential experiences during the teaching of the subject and the insufficiencies that they presented to be able to adequately address the didactic orientation in the teaching-learning process, from the possibilities of dental consultation as a modality of education at work and in interrelation with the use of the clinical method.

The integration of the results of the different methods, with emphasis on the teachers' criteria, which was achieved in the exchange with the teachers of the Prosthetic Rehabilitation subject, made it possible to determine the main contents to be included in the improvement program to improve performance. in carrying out the dental consultation.

The following were determined as essential contents:

• The teaching-learning process in Medical Sciences, from a developmental perspective.
• The forms of organization of the teaching-learning process in the Dentistry major.
• Education at work as a guiding principle of Medical Sciences. Its specificities in the Dentistry major.
• Didactic principles of dental consultation as a modality of on-the-job education in the subject of Prosthetic Rehabilitation.
• Interrelation of the clinical method and the didactic logic of the different stages of the dental consultation with the contents of prosthetic rehabilitation.
• Pedagogical communication and study activity during the dental consultation as a modality of education at work.
• The development of professional skills in the different stages of dental consultation, from the use of the clinical method.

Taking into account the specific needs for professional improvement of the teaching staff of the subject Prosthetic Rehabilitation of the University of Medical Sciences of Ciego de Ávila, the possibilities of the program are assumed as a scientific result and the program for the improvement of the Prosthetic Rehabilitation teaching staff is proposed for the development of dental consultation as a modality of education at work.

In the foundation of the improvement program, the contributions related to the professional improvement of the teaching staff of the Stomatology major are assumed. From this perspective, the foundations that consider dental consultation as a particular form of education at work are also integrated, which has as its fundamental setting consultations with dental units in dental clinics, polyclinics and hospitals and contributes to the development of skills, search information and problem solving.

As an axis that integrates the different areas and actions of the improvement program, the didactic orientation of the different elements and characteristics of the dentistry consultation is required as a modality of education at work, from the interrelation with the use of the clinical method.

With these results, the structural components of the improvement program were determined:

1. Area of contextual assessment of the improvement process of Prosthetic Rehabilitation teachers for the development of dental consultation as a modality of education at work.

Objective: to assess the process of professional improvement for the development of dental consultation as a modality of education at work in the teaching staff of the subject Prosthetic Rehabilitation of the University of Medical Sciences of Ciego de Ávila.

Actions to develop:

• Carry out reflection and criticism workshops.
• Prepare observation guides and instruments, according to the methods to be used.
• Identify insufficiencies and potentialities, when making a diagnosis based on the analysis of the applied instruments.

The evaluation of the diagnostic results, through the qualitative and quantitative interpretation of the applied instruments.

The socialization of scientific results in events of the Stomatology major.

2. Area of methodological guidance for the development of stomatological consultation as a modality of education at work.

Objective: methodologically guide the improvement process of Prosthetic Rehabilitation teachers for the development of dental consultation as a modality of education at work.

Actions to develop:

• Teach the postgraduate course "Stomatological consultation as a modality of education in the performance of teachers of the subject Prosthetic Rehabilitation".
• The different organizational forms of the course are fundamentally supported by teaching aids, linked to Information and Communications Technologies, personal computers and other devices of the participants.
• Carry out scientific debate workshops, related to the importance of pedagogical communication, study activity in the teaching-learning process and the training and development of professional skills in dental consultation.

The evaluation of the workshops will be systematic, based on group observation and reflective syntheses of the subjects and the group.

3. Area of updating and integration in dental consultation as a modality of education at work.

Objective: to integrate the stages of dental consultation as a modality of education at work, through the self-preparation of teachers in the topics of oral maxillofacial Prosthesis and Dental Implantology, through the use of self-improvement guides.

Actions to develop:

• Socialization of self-improvement guides on the topic of oral maxillofacial Prostheses and Dental Implantology.
• Integration of self-preparation results.

4. Evaluation area.

Objective: to evaluate the changes and transformations in the professional performance of the teaching staff of the Prosthetic Rehabilitation subject for the development of dental consultation as a modality of education at work.

Actions:

• Socialization workshop.
• Assessment of the relevance of the previous areas: specialized conferences, discussion groups, methodological workshop, workshop system and improvement course.
• Carry out reflection and self-evaluation workshops.

For the adequate development of the actions that make up the improvement program, the proposed contents are required so that the teachers of the Prosthetic Rehabilitation subject achieve the knowledge, skills and attitudes to deepen and perfect their professional performance as a teacher, from a projection systemic, contextualized and with a critical and participatory conception of the improvement process.

During the development of the different actions of the improvement program, the spaces offered by the training scenario itself are used in interrelation with the planning of the different actions. These must be projected from group exchange, dialogue and reflection of all those involved and must respond to individual and group needs. They must demonstrate compliance with the stages of education at work and, in particular, compliance with the methodological actions of each stage of the dental consultation as a modality of education at work.

The cognitive independence of teachers must start from exchange and a critical reflective approach, so that they reach conclusions and assume new modes of action; This will be a fundamental principle during the development of all activities.

The conscious participation of teachers must be achieved; not due to administrative impositions, but motivated by awareness of the needs for improvement to direct the teaching-learning process.

The actions represented in the different areas that identify the improvement program encourage reflective and critical exchange. The guides for the development of self-preparation must contribute and promote self-learning and include activities that allow self-assessment, co-evaluation and group exchange between all those involved. All the possibilities offered by holding workshops are taken advantage of, to be able to evaluate the changes and transformations and the impact of the different actions on the improvement of Prosthetic Rehabilitation teachers.

To corroborate the scientific-methodological relevance of the improvement program, it was subjected to user criteria. Assuming the criteria of Fuentes et al. (2018) the opinions of the subjects who become users or direct beneficiaries of a proposal or a scientific result derived from research are considered user criteria; Furthermore, they are or will be responsible for the application of such results in the immediate or intermediate future in their actions.

In the workshops held, the users had a consensus on the relevance of the theoretical foundations of the development of dental consultation as a modality of education at work and the formulation of the objectives, linking them with the technical area of Prosthetic Rehabilitation.

They considered the active methods used in the actions of the improvement program as contributors, since they were very effective in developing the proposed skills and the benefit provided for the fulfillment of the teaching function.

They recognized the adequate scientific level, the timeliness of the improvement program and the use of self-preparation activities from the work setting itself.

As suggestions, users proposed contextualizing the actions of the improvement program, taking into account the overload of care manifested in specialized dental services. In this sense, they considered the need to expand the scope of self-preparation in the self-management of knowledge by teachers, from greater use of Information and Communications Technologies.

With these results, a favorable consensus was evident in the comprehensive evaluation of the foundations, objectives, structure, relevance and applicability of the improvement program for Prosthetic Rehabilitation teachers for the development of stomatological consultation.

DISCUSSION

The proposed improvement program emerges from the significance of education at work in medical education and reveals links with some studies on the role of the teacher in the teaching-learning process in that context. It is assumed that the teacher, as a facilitator, counselor, conductor and leader of the teaching-learning process, in education at work, gives the role to the student, who assumes an active role in learning (Rodríguez and Soler, 2020).

It is agreed that a challenge of education at work is the permanent updating of teachers and tutors in health units; This implies its systematic and comprehensive improvement (Quintana et al., 2021).

Jiménez et al. (2019) consider that education at work should not be spontaneous; These authors make a proposal that makes it easier for the teacher to work on the evaluation component of the teaching-learning process.

In Pedagogical Sciences, especially in the area of Didactics, what is stated by Enríquez et al. (2020, 2021) is important by assuming that There are deficiencies in the pedagogical and didactic performance of Stomatology teachers, as limitations are evident in the mastery of its laws, principles and categories, as well as in the adequate management of the components of the teaching-learning process. From this perspective, it is considered that the improvement of these professionals will be the way to contribute to said performance.

There is agreement on the importance of energizing the process of professional development of teachers in the integration of knowledge, skills and values that consolidate their pedagogical and didactic performance (Vidal et al., 202 1; Gutiérrez et al., 2022).

For their part, López and Rojas (2021) define professional improvement as "a pedagogical process that has a continuous, prolonged, permanent character and occurs during the performance of the professional's functions, which seeks to expand the scientific horizon, with the intention of enhance in the individual the intellect, feeling and action committed to the transformation of their practice" (p. 305).

The professional development of Stomatology faculty has been approached from different angles (Díaz et al., 2019; González et al., 2020 and Enríquez, et al., 2020, 2021). In particular, the references regarding the improvement of teachers in the subject of Prosthetic Rehabilitation are limited; the proposals are interested in the knowledge and skills necessary for healthcare work and, to a lesser extent, for teaching work.

In the specific context of the teaching staff of the Prosthetic Rehabilitation subject, proposals for improvement actions have not been adequately integrated to resolve the limitations that these teachers present in the effective implementation of dental consultation as a modality of education at work, in connection with the use of the clinical method.

The proposed improvement program provides a new approach to the professional improvement process of these teachers, by taking into account:

• The integration of the contents required by the teaching staff of the Prosthetic Rehabilitation subject for the adequate didactic orientation of their teaching-learning process.
• It proposes actions aimed at eliminating the deficiencies detected in the diagnosis carried out.
• The use of methods that enhance evaluative actions and the personal reach of the participants is prioritized.
• The course is the central activity; but it will be combined with other organizational forms such as the workshop and self-preparation.
• The workshops are organized for theoretical-methodological preparation, promoting group work.
• The evaluation is systematic in nature and self-assessment is encouraged.
• It encourages the exchange of experiences to solve problems related to their pedagogical practice.
• It can be applied in different contexts, specialties and institutions with due adaptation.

The improvement program allows a more coherent and integrative relationship between the logic of the clinical method and the didactic logic of the dental consultation as a modality of education at work, depending on the performance of the teaching staff of the Prosthetic Rehabilitation subject.

The improvement program makes it possible to improve the performance of the teaching staff of the Prosthetic Rehabilitation subject to take advantage of the potential of dental consultation as a modality of education at work.

The program assumes the role of teachers in their self-transformation, for the appropriation of conceptual, procedural and attitudinal contents. On this basis they will be able to assume the didactic orientation of the teaching process of the Prosthetic Rehabilitation subject, from the integrative logic of the dental consultation as a modality of education at work and the use of the clinical method.

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Conflict of interests:

The authors declare not to have any interest conflicts.

Authors' contribution:

The authors participated in the design and writing of the article, in the search and analysis of the information contained in the consulted bibliography.

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