The Beauty of Learning
By Diane Peters
How upgrades at faculties of dentistry impact learning, research, patient care and perceptions
Professor Siew-Ging Gong’s glassed- in office on the fifth floor of the Faculty of Dentistry’s 124 Edward St. building catches light from a row of windows that runs along the opposite wall. In turn, those windows more directly brighten open-concept work benches used by research associates, PhD students and people like Gong’s new postdoctoral fellow, who just arrived from India.
She used to have an office with a window, but this is a more egalitarian use of light. Plus, everything is new and put together in soothing shades of grey and white with blond wood. Gong isn’t sure if she’s working differently or more efficiently in this upgraded environment, but she likes being surrounded by well-thought-out design. “It’s nice to be in a nice space,” she says.
The $21.5-million renovation that made these bright work stations possible was completed in 2018, and encompassed the building’s fourth floor as well, giving each floor a new kitchen nook and shared lounge spaces, plus tech- enabled meeting rooms and classrooms. “You feel better being here,” says Gong. “There’s more light; it feels clean,” she says of the upgrades that also transformed individual labs into large, shared spaces, with the addition of numerous specialized labs, too.
While those who work, research and learn on the top two floors of the dentistry building enjoy their fresh surroundings, much of 124 Edward St. still requires upgrades. The building dates back to 1959, and until recently, its last major renovation had taken place in the 1980s.
The Faculty is fundraising to renovate Lab 4, the pre- clinical simulation lab, as early as 2022, and follow that up with work on Clinic 2. These upgrades will complement the recent work on the main auditorium and a central medical device reprocessing facility.
With a new satellite clinic in operation at 777 Bay St., the Faculty of Dentistry is ready to address the displacement of clinical operations caused by a temporary closure of Clinic 2. Meanwhile, the look and functionality of the new clinic, plus the successful remodelling of the upper floors of the main building, serve as reminders of what state-of-the-art spaces offer.
“There’s nothing wrong with 124 Edward St.,” says Steven Brown 8T0, a Toronto-based dentist who has been a clinical instructor at the Faculty since 2016. “It works. It’s livable. But it’s not as nice as we’d like it to be. It’s nice to see things are being updated.”
Adam Trotter, senior planner with University Planning, Design & Construction at U of T, says the work done at universities today balances practicalities and regulations — along with approaches to make buildings less carbon intensive — with the needs of those using the space. “The biggest part is making sure that the building they end up with is as ideal as possible to support the teaching, learning and research that happens.”
DESIGN IN DENTAL EDUCATION
Most faculties of dentistry in Canada date back a half or full century and are housed in buildings from bygone eras. Hence, many of the 10 schools have been modernizing.
That includes McGill University, which moved its clinic, teaching spaces, pre-clinical lab and administrative offices to a new location in 2014, investing $18 million. Dalhousie University opened a 50,000-square-foot, $28-million clinic in fall 2018 — it had last been renovated in the 1980s.
At the University of Alberta, the 1922 building dentistry shares with pharmacy is undergoing a $149-million up- grade. Both Western University and the University of Saskatchewan plan to renovate their dentistry facilities soon.
While universities upgrade all the time, dental schools face different complexities: no other group on campus has to encompass research, didactic learning, simulation labs, diagnostic labs and patient-facing clinics, all under one umbrella. “You’re literally running a dental hospital,” says professor Chris McCulloch 7T6, 8T2 PhD. This both keeps the dentistry building in the public eye and increases the cost of providing education.
IMPACT ON LEARNING
Design matters when it comes to teaching clinics and classrooms. Some older clinical spaces were designed to treat patients in large numbers and were not focused on facilitating instruction, particularly group teaching. “It’s really hard to demonstrate for one student, let alone eight to 10 students,” says Jack Gerrow, an adjunct professor at U of T and former registrar of the National Dental Examining Board of Canada, who has taught at and consulted with numerous dental schools. “Dentistry involves 3D skills, so sometimes you have to show people,” he says. In tight spaces, you can have just one or two students observe a procedure.
Students, instructors and patients at the Faculty of Dentistry have been able to see how a more modern space works in action at the new satellite clinic. The clinic has been carefully designed for today’s clinical teaching experience, complete with enclosed operatories that allow for sightlines between instructors and students. Technology is fully integrated with easier access to the tools and equipment students and instructors need.
Operations have dovetailed with the opening of the Faculty’s central medical device reprocessing facility, which ensures a standardized approach to sterilization. “Now that all devices are distributed and collected on a cart system, it frees up critical space in the clinic,” says Larry Schnuck, vice-president and leader of the higher education team at Kahler Slater, the U.S.-based firm that consulted on the facilities component of the latest Faculty master plan. This change benefits all the clinics and will influence design choices moving forward, too.
At McGill, the team opted for a streamlined design. “We built the clinic from the ground up with technology already incorporated into it,” says Jeffrey Myers, who was clinical director at the time of the move. “There’s no exposed wiring. And we designed the treatment rooms so they’re easy to clean and there’s limited storage space. Things are easier to keep track of and there’s no dust collectors.”
The design of the Faculty’s satellite clinic allowed for staff to organize operations to help strengthen relationships between students and instructors. Brown says he’s assigned to a single row in the clinic, so he works with the same students week after week. “When you see a student over and over again, you feel comfortable knowing what they need.”
Practicalities aside, the new space is also just an aesthetically pleasing place to be. “It’s incredible. You can see the whole of the city, it’s all windows, all glass. Everyone says it but it really is like night and day; it’s daylight all the time at 777,” says Brown.
Jacob Thomas, a DDS4 student, appreciates being able to learn in a fresh environment. “It’s so nice to be in the clinic. Everything’s so new,” he says.
A CLASSROOM SHIFT
Newly renovated classrooms feature multiple screens and tables and chairs on wheels, which creates the so-called flipped classroom that supports student-centred learning. “We’re still trying to get people to realize that student-centred teaching is a lot more effective way of getting information across,” notes Gerrow. “The big lecture hall enables a method of teaching that’s not as effective for novice learners.”
Indeed, changes in both clinical and didactic environments in dental schools reflect emerging teaching values. “There’s been a shift in pedagogy through universities, and dentistry is a part of that,” says Trotter. “All these new renovations we’ve done and are planning are keeping up with these trends.”
SUPPORTING RESEARCH
The open-concept labs on the research floors of the dentistry building were intended to maximize space — the walls between small, individual labs eat up valuable square footage — and enable collaboration.
McCulloch worked for most of his lengthy research career at the century-old FitzGerald Building in what he calls “rabbit runs.” Now that he spends his days in open labs and has an office with a glass door, and can have a coffee break or lunch in comfortable, shared settings, he’s getting to know more of his colleagues.
“Collaborations are easier,” he says. McCulloch had never met assistant professor Karina Carneiro before 2018, but thanks to running into her at work, they’ve landed four grants together. “That never would have happened without this kind of space.”
Modern labs come better equipped to deal with needs around power and technology, but also infection control. And it’s not just the motion-activated sinks — although those help. “The material of the new work surface is more easily cleaned and so much easier to maintain,” says lab manager and research associate Delphine Dufour. She also appreciates the bigger and brighter work space, which makes her work day more pleasant.
In older spaces, labs and desks would be side by side, now they’re separate. “This change reflects a much higher standard of biosafety and overall lab safety,” says McCulloch.
And while enclosed labs may seem safer in the era of COVID-19, the larger, well-ventilated labs at 124 Edward St. have been safe to use during the pandemic. “Social distancing has been made vastly easier,” says McCulloch.
The Faculty’s foresight in designing these new labs also meant investing in core facilities to enable specialized research — even when the researchers did not yet have the equipment for these labs. McCulloch’s own fibrosis research has recently yielded sizable infrastructure grants to fill an imaging lab at the Faculty.
MATTER OF PERCEPTION
Thomas says the differences between the on-campus DDS clinic and the new location are subtle — after all, the quality of the care and level of hygiene is the same. “The patients are really happy to get to the new clinic. It’s subjectively a better experience.”
And while the new clinic is equipped with enclosed operatories to align with the latest infection control guidance, this layout also more closely resembles the usual dental visit experience. “It’s a change from a patient care standpoint,” says Schnuck.
For students, the new space mimics where they might work as a trained dentist. “It just feels like we’re closer to graduation. We’re more professional instead of in a student environment,” says Thomas. Schnuck agrees: while not all students go on to work in private practice, learning in an environment that feels somewhat similar, plus is equipped with the type of technology they’d see in regular dental clinics, helps them transition into the profession.
At labs, too, design changes have made the research environment more congenial. “Social interactions did certainly change. Walking through lab space that is not ours and seeing members from other teams is very pleasant,” says Dufour, noting that you get more smiles and hellos now than ever before.
Designers involved in these kinds of projects aim to make space better for everyone. “Our goal is to make it as inviting and welcoming as possible,” says Trotter. To that end, for instance, work is being planned for 124 Edward St. that will take advantage of natural light and improve wayfinding for visitors and new students. “We’re going to make the environment more modern, brighter and fresher. I think that goes a long way,” he says.
These perceived differences matter to staff, faculty and alumni, who want to be proud of their school. “I’ve seen it where something has been added to a school or there’s been a new renovation, and you can see the instructors and the students bringing their friends and colleagues in and saying, ‘Wow, look at this,’” says Gerrow.
Trotter agrees that when universities present new spaces to the public, everyone is curious. “The renewal of a place tends to bring a renewed interest in the public eye to the department or faculty,” he says.
McCulloch thinks investing in physical space better supports teams in achieving excellence and meeting expectations. “We’re part of U of T,” he says. “We’re competing internationally. We’re not doing our job within the University if we’re not staying in step with the larger mandate of being part of a world-class research university.”
Illustration by Graham Roumieu
Interested in more stories? Read the PDF edition of the U of T Dentistry Magazine Winter/Spring 2022 Issue