Harnessing Memory Science, Achieving INBDE Success

Unique, New INBDE Prep Courses Build Upon Earlier Successes with Innovations in Teaching and Technology

For the past several years, our dedicated faculty and staff have been harnessing the science of learning to ensure our students' success on the Integrated National Board Dental Exam (INBDE), which is designed to provide information to U.S. dental boards seeking to determine whether licensure candidates have the necessary level of clinical skills to practice entry-level dentistry safely. Learning, retaining, and then applying all that has been taught within the rigorous predoctoral curriculum requires fortitude on the part of our students; leveraging new and innovative technologies to assist our students has become a hallmark of many faculty members' teaching at NYU Dentistry.  

According to Dr. Andrea Schreiber, who oversaw the student preparation process for the INBDE in her former role as vice dean for education, “One of my main objectives after the 2017 Commission on Dental Accreditation site visit was to focus on the transition of the national boards from the two-part National Board Dental Exam (NBDE I & II) to the single INBDE. Accordingly, we created the Senior Academic Leadership Team (SALT), with the aim of ensuring that we ‘teach and test in an integrated fashion.’ "

An Iterative Process: Leveraging Advances in Interactive Educational Technologies to Help Achieve Mastery  

In 2016, the College incorporated the use of the Cerego personalized learning platform to help students achieve mastery in head and neck anatomy in preparation for the  NBDE Part I. Built on proven memory science to help students learn faster and remember longer, Cerego employs two learning concepts — memory retrieval and spaced practice — and adapts to each student's learning speed and level of mastery (read more here). Use of the platform for the NBDE Part I review course proved successful: The Class of 2017 achieved a 100% first-attempt pass rate on Part I of the NBDE, and scored 2.6 standard deviations above the national mean in the anatomical sciences. Course directors Dr. Elena Cunningham and Mr. Eric Baker took note of the depth of the retained learning that occurs when information is retrieved from memory repetitively over increasingly spaced periods of time.

With the transition to the single INBDE, it was clear that the creation of the INBDE Prep Courses should leverage the memory science lessons learned from the Cerego investment, and Dr. Johanna Warshaw, Dr. Analia Veitz-Keenan, and Ms. Lillian Moran were tapped to join Dr. Cunningham and Mr. Baker in conceptualizing and developing a series of online prep courses that would start in the spring semester of the D1 year and continue each semester for a student's remaining three years at the College, thereby creating multiple spaced opportunities for knowledge retrieval. The effort required substantial planning, content creation, iterative changes, and administering exams: One course each semester builds upon and includes materials from previous semesters (e.g., the Spring D3 INBDE prep course contained material from courses in the D1, D2, and D3 years). With over 90 faculty members contributing educational content to populate the online prep courses, the organizational challenge was substantial, to say the least.

“Our primary concern as we were compiling and categorizing all this curricular content,” said Dr. Veitz-Keenan, who serves as the D3 and D4 course director, “was to ensure that our students were being provided with the best tools to enhance their retention of all the material that they learn over the course of their dental school career — with the ultimate goal, of course, being that they will become stellar health care providers.”

Weekly Online Quizzes and Knowledge Retrieval

Each course consists of a weekly online quiz comprised of approximately 10 questions; the quizzes remain open for a week and typically take students less than a half hour to complete. Students are provided with immediate feedback upon completion of each quiz, with rationale and evidence provided for each answer. The weekly quiz format and the ability to check their own knowledge allow our students to identify areas that they need to focus on. D3 and rising D4 students are also required to take and pass a series of three Mock Board examinations.

According to Dr. Cunningham, an anthropologist who studies primate cognition, "Our brains learn information that we use regularly and is repeated over long gaps of time. This is why cramming really doesn't work. Humans have very bad meta cognition and tend to think (or hope) that cramming for exams can work, but the continual retrieval process — a sort of slow and steady approach — is proven to be key to achieving mastery. Each time that a piece of knowledge is retrieved, that connection that the brain makes to that piece of knowledge is deepened."

Collaboration and Success

Educational Technology worked closely with Academic Affairs, the INBDE Prep Course Directors, and the content contributors to make the project truly integrated and user friendly. Each test item is mapped to the 56 clinical content areas and the 10 foundation knowledge areas defined by the Joint Commission on National Board Dental Examinations. While the course develoment process was time consuming and labor intensive, the significant investment in supporting our students’ success clearly is paying off: The Class of 2023 achieved a stellar 100% INBDE pass rate.

In addition, inquiries about the software application created to support the INBDE Prep Courses have led to efforts to license the educational technology app for other uses, a process that is now underway. Congratulations are in order for all involved!

Faculty Contributors: INBDE Prep and Mock Boards

Read more in this issue of Global Health Nexus