Spiral Approach Used to Teach Clinical Skills Across Years

Tufts University School of Dentistry has piloted a course for fourth-year students “that now involves a team of students from each year and a real-time student response tool that plants the seeds of community in previously anonymous auditorium classes,” according to a new Educause article.

The course teamed “each fourth-year student with a third-year student, a second-year student, and a first-year student so they could work together on the fourth-year student’s case. This is a new pedagogical approach called ‘Student-driven Pedagogy of Integrated, Reinforced Active Learning (SPIRAL),’ modified from a program designed by Mark Wolff and Andrew Spielman from New York University College of Dentistry (see figure 2).


According to course developers, “Each student has particular responsibilities to align with their progress through the program.

  • First-year students are responsible for presenting information pertinent to the case that has to do with the patient but represents ‘Normal’ (see figure 2).
  • Second-year students are responsible for presenting information on the medications the patient is taking, any illnesses the patient has, and risk factors.
  • Third-year students are expected to answer a clinical question using evidence-based principles.
  • Fourth-year students select one of their patients for the case presentation and coordinate the team project while working with their patient. They also must demonstrate leadership skills through coordination of their team, and afterwards they conduct a self-assessment.

“For the peer-review element, the students analyze one another as a team by reflecting on the project to discover areas for improvement and assess factors of one another’s teamwork, presentation, and time-management skills. We also have mentors for each team — faculty and clinical staff members who oversee the team and monitor its progress.”

Read the complete “Integrating 21-st Century Workplace Skills into Lecture Based Courses article.

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