November 2011 ■ Journal of Dental Education 1411 Educational Methodologies A Case Completion Curriculum for Clinical Dental Education: Replacing Numerical Requirements with Patient-Based Comprehensive Care Sang E. Park, D.D.S., M.M.Sc.; Peggy Timothé, D.D.S., M.P.H.; Romesh Nalliah, B.D.S.; Nadeem Y. Karimbux, D.M.D., M.M.Sc.; T. Howard Howell, D.D.S., M.M.Sc. Abstract: The aim of this article is to describe the development and implementation of a case completion curriculum as a new clinical education model for the predoctoral program at Harvard School of Dental Medicine. In this innovative model, students conduct patient-based comprehensive care and complete assigned patient cases on which their performance is assessed, in contrast with a traditional model based on procedural numerical requirements. In our new model, senior tutors, who are full-time faculty members, act as group leaders responsible for patient assignment, treatment planning, monitoring of student performance, and verification of patient care. The number of completed patient cases in this new comprehensive care system increased from a previous average of 12.8 cases per student prior to graduation to 22.8 cases. Additionally, the number of patients who had to be transferred due to outstanding or pending treatment when their student provider graduated or because of students’ need to fulfill discipline requirements has decreased from an average of 16.4 to 4.6. Dr. Park is Senior Tutor, Harvard School of Dental Medicine; Drs. Timothé and Nalliah are Senior Tutors, Harvard School of Dental Medicine; Dr. Karimbux is Assistant Dean of Dental Education and Associate Professor, Harvard School of Dental Medi- cine; and Dr. Howell is Dean and Professor, Harvard School of Dental Medicine. Direct correspondence and requests for reprints to Dr. Sang Park, Harvard School of Dental Medicine, 188 Longwood Ave., Boston, MA 02115; sang_park@hsdm.harvard.edu. Keywords: dental school curriculum, dental education, comprehensive care, clinical education, case-based learning Submitted for publication 12/24/10; accepted 3/23/11 I n 2002, the Harvard Medical School (HMS) and the Harvard School of Dental Medicine (HSDM) began a comprehensive review of the New Pathway hybrid problem-based learning cur- riculum implemented at HMS in 1986 and at HSDM in 1994. As a result, HMS and HSDM introduced a new curriculum in 2006, and as part of its review, the clinical threshold or numerical-based assessment system at HSDM was found to have problems. Sub- sequently, a case completion curriculum (CCC) was developed in the summer of 2009 as a component of the reformed predoctoral curriculum for fourth- year dental students. The purpose of redesigning the clinical component of the curriculum was to achieve a patient-based comprehensive care environment in the student teaching practice. The benefits of a comprehensive care patient delivery system have been widely acknowledged and are being implemented in a number of dental schools. 1-3 More than half of the dental schools in North America claimed to be using a “Primarily Comprehensive Care” model even back in 1997; 4 however, there is wide variation regarding the defini- tion and application of comprehensive care. 5,6 While students in many schools are expected to perform treatment in a comprehensive care clinic, only a few have students completing comprehensive treatment plans. Concerns at HSDM surfaced upon a closer look at the traditional numerical procedural requirement system, even though responsibility for patient care had been emphasized for at least the past couple of decades. 6 The traditional form of the clinical cur- riculum has insisted that students meet procedural requirements for discipline-specific guidelines as part of dental schools’ assessment of students’ com- petence and their ability to meet criteria for gradua- tion. However, this teaching model has consequently encouraged student- and faculty-driven patient care rather than patient-centered care, thus posing a chal-