Appendix A

Appendix A. Author's Impressions of Vignettes

Vignette #1

The professor provides a continuous stream of information. He does not elicit or ask students questions throughout. He presents material in almost a run-on fashion, without pausing, and does not take time to assess student comprehension. He does not provide examples that illustrate the connections among oral health, patient care, and the information he is disseminating.

Vignette #2

During instruction the professor controls the pace and flow of information that is disseminated. The entire period is spent discussing legal definitions and concepts. The professor does not assess student comprehension, nor does he give students experiences directed at promoting critical thinking skills or opportunities to be active in learning. The professor does not pose low- or high-level questions.

Vignette #3

The professor begins class by soliciting volunteers, who read and write a description of the case study on the board. The professor gives students some prompts to use while analyzing the case, and he provides them with some questions to guide their inquiry. Instruction is interactive. The professor prompts students to reason about the appropriate care for the medically compromised patient as well as the impact and contraindications of drugs on the care of that patient. However, rather than expect students to process the case in class, he has provided them with an exercise outside of class to: (1) think through this case, (2) make treatment decisions that consider the patient's symptoms, dental and medical conditions, and oral exam, and (3) formulate an appropriate and justifiable treatment plan to present during the next class session. This professor combines a case-based scenario with content while promoting the acquisition or use of critical thinking skills and creates a classroom atmosphere that encourages student ownership of learning.

Vignette #4

The professor provides a case to the students and then asks them to write down their next steps. She asks students to volunteer their thinking and when nobody does, she provides wait time. When students do not respond, the professor prompts them by asking what other information is needed. Students begin to volunteer and share their thinking aloud. After receiving a number of suggestions, she asks students to form groups and rank their suggestions. When the professor reconvenes the whole group, she provides additional information about the case using a radiograph. She asks more questions and then asks students to write how and what they will communicate the diagnosis, treatment, and cost to the patient. The professor creates a climate of inquiry and uses "think aloud" and written assignments that require students to analyze the problem, provide rationales for diagnosis and treatment, and compare alternatives.