Development Of Curriculum Of Anatomy For BDS Students In UZ, Harare: A Survey-Based Study

Objective: To evaluate and optimize the anatomy curriculum for BDS students in UZ. Study design: It is a survey-based study. Place and duration of study: A six-month study was carried out in the Anatomy Department, College of Health Sciences, University of Zimbabwe, Harare (March to August 2020). Material and Methods: A survey-based study was conducted in UZ, College of Health Sciences. To collect the data, two separate structured questionnaires were prepared. The structured questionnaires were then administered to medical faculty, BDS students of 3 rd , 4 th & 5 th yr and practising dentists & internees, respectively. The sample size of the study was 70. Results: The data collected via the two structured questionnaires was analyzed. Analysis showed that all the stakeholders thought that the c ore dentistry subjects should be introduced earlier to the BDS students. Moreover, it was recommended that CBL/PBL be added to the curriculum to make the overall BDS curriculum more effective. Conclusion: The majority of the faculty members, BDS students, dentists and internees thought that the content of Anatomy for BDS students should be concise, specific and pertinent. The respondents supported the incorporation of CBL/PBL in the existing curriculum to make it more worthwhile.


Introduction
The term curriculum is formally used for a course of conceptual studies which is undertaken by students in an educational institution.In other words, the curriculum is a broad teaching program to provide resources including faculty to achieve the increasing demands of a vibrant community 2 .So, we can say that curriculum refers to the bond among nations, the community and educationists concerning the instructional skills that learners must encounter during a particular period of their lives.The significance of good dental hygiene has always been considered a matter of paramount importance in the whole world.Accordingly, Bachelor of Dental Surgery (BDS) students are required to be groomed and educated to fulfil society requirements 5 .It is, therefore, essential to regularly review the BDS curricula to match the latest advancements 6 .Over the past few years, BDS training in developed countries has been carried out using competency-based curricula rather than the traditional time-based apprentice approaches 7 .Competency-based medical/dental education curricula are being approved as the preferred instruments of medical instruction throughout the world 8 .Such curricula are considered to be better at producing practising graduates for all groups and communities.The competencies desired to be achieved is taken as a first step in the development of the curriculum 10 .Moreover, to confirm that every instrument of instruction is distinctive to its institution, locality, vision and mission 11 ; this curricular philosophy formulates a union of teaching and evaluation techniques by different sub-specialities and disciplines contributing to the courses 12 .Dental graduates require both theoretical and practical knowledge of dentistry to empower them to act cautiously and beneficially as healthcare professionals 13 .It is the primary liability of the institutions to devise the best methods to train the dental students 14 .It is the principal requirement of the time to reorganize, modify and improve the ongoing BDS curriculum regarding the duration, assessment and evaluation system with active teaching and learning.At present the health care problems faced by sub-Saharan Africa are especially crucial.It is, therefore, emphasized that the continent's medical/dental schools should beget graduates who have the potential to meet the specific demands of society 17 .Competency-based medical education is a resultbased training paradigm that focuses on imparting the graduate with knowledge, skills, and attitudes which are pertinent to the host habitants 18 .This educational framework is an appropriate evaluator for the rapidly changing health demands of individual societies 19 .Hence, it is progressively being approved by medical schools globally to confer graduates with the skills essential for modern medical and dental practice.

Materials & Methods
A survey-based study was conducted after its approval by the joint research ethics committee for the University of Zimbabwe, College of Health Sciences and Parirenyatwa Group of Hospitals.The participants for the current research were lecturers, students of BDS, dentists and internees.The participants were strongly encouraged to fill out the questionnaire but their participation remained voluntary.They were informed about the study and signed a consent form.The names and other personal information of the study participants were protected.The sample size was 70.The number of lecturers, BDS students, dentists and internees who participated in this study was 12, 38, 7 and 13, respectively.The data was collected by two separate structured questionnaires.The first questionnaire was given to faculty and BDS students in 3rd, 4th & 5th years while the second questionnaire was filled up by dentists and internees to evaluate the Anatomy curriculum taught to BDS students in UZ.Analysis was done using SPSS V20.A T-test was applied to check the significance.A p-value <0.05 was taken as significant.

Results
The response of the participants regarding questionnaire 1 and 2 in term of frequency and percentage is shown in table 1 and 2.

Discussion
According to the Medical and Dental Professions Council of Zimbabwe (MDPCZ), the regulatory body for dental education, the duration of undergraduate training for (BDS) in Zimbabwe is six years; five-year studies followed by one year of mandatory rotatory internship.
The subjects which are being taught in the basic medical sciences during the first two years are human anatomy human physiology, biochemistry, dental anatomy and behavioural science.
The BDS students take the subject of human anatomy along with the MBBS students.Hence they study the subject of anatomy in the same detail and extent as done by MBBS students.
The present survey was conducted to review, revise and improve the current curriculum of Anatomy for BDS students at the University of Zimbabwe.
The data was collected through questionnaires from medical faculty, BDS students of 3 rd , 4 th , 5 th years, dentists and internees.There were 70 participants, which included 12 faculty members, 38 students, 7 dentists and 13 internees.
The study recorded some important findings which were necessary for the improvement and up-gradation of the existing curriculum of dentistry at the University of Zimbabwe.
Moreover, the study emphasized making the curriculum of anatomy more comprehensive and pertinent to achieve the mandatory goals of dentistry in UZ.
The first questionnaire was distributed to faculty and BDS students.

Questionnaire 1 Response
P value = 1.09613E-05 (P ≤0.05 significant) A mixed response was obtained from both the faculty and students regarding teaching non-essential content (considered) to the BDS students.The majority of the faculty (83%) supported 'early teaching of core dentistry subjects' and 'incorporation of CBL/PBL'.Similarly, 79% of the students also supported the addition of CBL/PBL in the curriculum of BDS while only 42% of the students agreed with the idea of early teaching of core dentistry subjects.
The second questionnaire was disseminated to dentists and internees.Both the groups provided mixed responses regarding teaching, and content of Anatomy considered non-essential, to BDS students.

Questionnaire 2 Response
P value = 2.47323E-05 (P ≤ 0.05 significant) 57% of dentists and 69% of internees were in favour of early teaching of the core subjects of dentistry, while 57% of dentists and 61% of internees showed satisfaction with the existing curriculum of anatomy.Similarly, 57% of dentists and 85% of internees also found that the current curriculum meets 'hands-on training requirements'.Moreover, the majority of dentists (86%) and internees (92%) fully supported that CBL/ PBL be incorporated into the BDS curriculum.The results of this study offer valuable information on the current perspectives of all stakeholders about the curriculum which was being taught to BDS students in UZ.

Conclusion
Based on the input of all the stakeholders, the curriculum of anatomy was reviewed and revised to make it more effective.The core density subjects were moved earlier in the program and CBL/PBL made an integral part of the existing curriculum.Despite known (and expected) challenges in the execution process, the project had been worthwhile and was expected to improve the knowledge and performance at the concluding assessments.An official evaluation and implementation of this curriculum was being planned.A similar exercise may be carried out after 3-5 years to gauge the effectiveness of the updated curriculum to fine-tune it further as required.The curriculum as well as imparting and gaining approaches should be dynamic to beget BDS graduates equipped with knowledge, skills and attitudes.

Table 1
Distribution of the respondents according to the category for Questionnaire 1. (n=50)

Table 2
Distribution of the respondents according to the category for Questionnaire 2. (n=20)