Identifying threshold learning outcomes to shape undergraduate dental curricula

Abstract The theory of threshold concepts (Meyer & Land, 2003) is a promising framework with which to innovate and integrate curricula. Using Threshold Learning Outcomes (TLOs), and reflective assessment tasks to help achieve those outcomes, can prepare students for an unknown future by ensuring that they graduate with the capabilities to tolerate ambiguity, make effective decisions, be reflective practitioners, and demonstrate professional attitudes and behaviours. The idea of TLOs provides the impetus to consider the learning continuum of the developing professional dentist. To date, there has been little charting of TLOs within dental curricula, and the identification of threshold concepts in the healthcare professions on the whole is relatively new (Barradell, 2013). Threshold concepts are known to be transformative, reconstructive, integrative, irreversible, troublesome, bounded, discursive, and liminal (Kobus, 2011; Meyer & Land, 2005; Tsang, 2011) and also need to be successfully sequenced in order for the TLOs to achieve an integrative function within curricula. In this paper, the authors describe the potential TLOs identified in an undergraduate dental course. For example, in Year 1 of the course we specify that the relationship between form and function in craniofacial and dental anatomy is a troublesome concept that is also bounded, integrative, and irreversible. Reaching this threshold of understanding enables students to more readily grasp and apply their understanding in later years to other TLOs, such as abnormal structure and function in the maxillofacial region, management of the oral environment, and developing reflective practice. We will present a model utilising key reflective practice assessment tasks to achieve the TLOs in each stage of the course, and discuss the process by which we constructed the model. We welcome feedback on the model and seek to promote discussion about TLOs in the dental profession.