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<TITLE>COVID-19 and distance learning in Dentistry </TITLE>
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<p><em><font size="2" face="Verdana, Arial, Helvetica, sans-serif">EDUMECENTRO 2022;14:e1706</font></em></p>
<p align="right"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><B>LETTER TO THE EDITOR</B></font></p>
<p>&nbsp;</p>
<P align="center"><font size="4" face="Verdana, Arial, Helvetica, sans-serif"><strong>COVID-19 and distance learning in Dentistry</B>
  </strong></font>
<P align="center"><font size="4" face="Verdana, Arial, Helvetica, sans-serif">COVID-19 y educaci&oacute;n a distancia en Estomatolog&iacute;a </font>
<p>&nbsp;</p>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Jos&eacute; Osvaldo Enr&iacute;quez 
Clavero<SUP>1*</SUP> <FONT 
COLOR="#000000"><a href="http://orcid.org/0000-0003-2727-0732" target="_blank">http://orcid.org/</a></FONT><a href="http://orcid.org/0000-0003-2727-0732">0000-0003-2727-0732</a><br>
</font><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Jorge Otero Mart&iacute;nez<SUP>1 </SUP><FONT 
COLOR="#000000"><a href="http://orcid.org/0000-0002-6250-3534" target="_blank">http://orcid.org/0000-0002-6250-3534</a></FONT>
</font>
<p>&nbsp;</p>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><SUP>1</SUP> Villa Clara University of Medical Sciences. Faculty of Dentistry. Villa Clara. Cuba.
</font>
<p>&nbsp;</p>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif">* Author for correspondence. Email: <a href="mailto:joseoec@infomed.sld.cu">joseoec@infomed.sld.cu</a></font>
<p>&nbsp;</p>
<p>&nbsp;</p>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Submitted: 17/09/2020<br>
</font><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Accepted: 19/08/2021
</font>
<p>&nbsp;</p>
<p>&nbsp;</p>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif">To the editor:
</font>
<P align="justify"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Higher medical education aimed at training oral health professionals has been particularly 
affected by the pandemic that is hitting the world today. In Cuba their training processes have 
not stopped, but they have been subject to various adjustments. The undergraduate 
teaching-learning process has appealed, among other alternatives, to the possibilities offered by 
the already established &quot;distance learning&quot;, which is based on the so-called disruptive or 
information and communication technologies 
(ICT).<SUP>(1,2,3)</SUP>
</font>
<P align="justify"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">The objective of this letter is to reflect on the possible use of distance learning in 
undergraduate courses that contribute to the training of dentistry professionals in Villa Clara, under the 
influence of COVID-19, assuming it not only as adversity but as an opportunity.
</font>
<P align="justify"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">If the analysis takes into account the non-personal components of the teaching-learning 
process analyzed in the normative and curricular documents, there are subjects that, due to their 
objectives to be achieved and the characteristics of the content they include, could be taught regardless 
of face-to-face teaching activities, or only with some of them. Comparative studies between 
virtual and face-to-face teaching of basic science subjects in Medicine and Dentistry students 
show that learning in virtual environments reflects better 
results.<SUP>(4)</SUP>
</font>
<P align="justify"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">It would be difficult to replicate this practice in clinical 
subjects,<SUP>(1,2)</SUP> whose objectives 
presuppose direct contact with patients and their families and members of the health team, as well as 
with existing aids only in health institutions, because Its teaching content includes skills, habits 
and values that are predominantly oriented towards the formation of professional 
competencies, which could not be fully achieved through distance learning.
</font>
<P align="justify"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">There are countries where strategies such as videoconferencing, clinical case discussions 
or initial contact with patients through telemedicine are common in undergraduate 
studies.<SUP>(3)</SUP> Some universities have long used mannequins as simulators and the application of virtual reality 
systems, in an immersive and interactive three-dimensional environment, where students perform 
routine physical examination and practice interventions from a booth with specialized hardware 
and software, while being remotely monitored by 
teachers.<SUP>(5)</SUP>
</font>
<P align="justify"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Although it is true that currently there is no financial situation that allows the country to invest 
in the aforementioned technologies, it has the main thing to supply them: human capital and 
its innovative reserves. It is imposed, with the support of the virtual platforms available as an 
aid, and without trying to dispense with face-to-face as a form, to progressively incorporate 
teaching methods based on previous study, also known as inductive 
classroom.<SUP>(6,7)</SUP>
</font>
<P align="justify"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Here it&#180;s an edge of this reflection that allows us to assume COVID-19 as an opportunity. Yes, 
it has been an opportunity to discover and develop the potentialities of the 
non-face-to-face teaching-learning process in Dentistry, within Cuban medical education, especially those 
related to the possibilities of the virtual manner, all of which favors students to play a more 
proactive role. Doors have also been opened to increase professional collaboration in research 
projects, which is valid in education since this is essentially a social phenomenon. </font>
<P align="justify"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Note that this analysis has already turned to the personal components of the process: 
students and teachers. If it focuses specifically on their preparation to use ICT, it could be considered 
that all of the former currently exhibit a satisfactory level; but this is not the case with the 
teaching staff because most of its members do not 
classify,<SUP>(8) </SUP>as &quot;digital natives&quot; according to Prensky 
and have not experienced the need to improve themselves in this direction, they have not had 
the opportunity, or they have not demanded themselves to do so. </font>
<P align="justify"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">In this sense, it is the responsibility of the institution to guarantee the preparation of 
teachers with a view to achieving a gradual transition towards teaching supported by digital 
platforms, through methodological work or professional improvement. This should not be assumed as 
a temporary response to the situation faced, but as a guideline in terms of satisfying one of 
the quality indicators that academic excellence requires.
</font>
<P align="justify"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">In summary, distance education for the degrees that oral health professionals train in the 
province faces the same challenges that other authors have 
described.<SUP>(1,2)</SUP> Without forgetting the technological or infrastructure limitations -which are still perceived- to provide quality 
connectivity to all students in the places where they live, assuming that each of them has a mobile device 
or terminal equipment.
</font>
<P align="justify"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Finally, if the aspects addressed above behave favorably, could ICT totally replace 
face-to-face in the undergraduate teaching-learning process? These authors consider that it&#180;s not possible. 
In the first place, it would not be consistent with the application of the pedagogical model at 
its core to the in-service training. Second, didactics teaches us that ICT in this process are 
only teaching-learning aids and that the face-to-face figure of the teacher is irreplaceable. 
However, the feasibility of using the distance learning modality in the training of oral health 
professionals should be the subject of future research. </font>
<P align="justify"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">There is already comment on the post-COVID-19 stage; we are in a so-called &quot;new normal 
life&quot; to emphasize that nothing will be as before. In other words, changes occur in all spheres of 
life, including university life, where those supported by science must be introduced, since it is 
known that mistakes made in the training of human resources have serious long-term consequences. </font>
<p>&nbsp;</p>
<P align="center"><font size="3" face="Verdana, Arial, Helvetica, sans-serif"><B>BIBLIOGRAPHIC REFERENCES</B>
</font>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif"> 1. Enoki-Mi&ntilde;ano ER. El aprendizaje a distancia en odontolog&iacute;a como una alternativa de 
la universidad ante la COVID-19. Rev Cubana Estomatol [Internet]. 2020 [citado 
28/07/2020];57(3):[aprox. 4 p.]. Disponible en: 
<a href="http://www.revestomatologia.sld.cu/index.php/est/article/view/3308/1843" target="_blank">http://www.revestomatologia.sld.cu/index.php/est/article/view/3308/1843</a></font>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif"> 2. Cayo Rojas CF, Agramonte Rosell RD. Desaf&iacute;os de la educaci&oacute;n virtual en Odontolog&iacute;a 
en tiempos de pandemia COVID-19. Rev Cubana Estomatol [Internet]. 2020 [citado 
28/07/2020];57(3):[aprox. 4 p.]. Disponible en: 
<a href="http://www.revestomatologia.sld.cu/index.php/est/article/view/3341/1844" target="_blank">http://www.revestomatologia.sld.cu/index.php/est/article/view/3341/1844</a></font>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif">     3. Almarzooq Z, Lopes M, Kochar A. Virtual Learning during the COVID-19 Pandemic: 
A Disruptive Technology in Graduate Medical Education. J Am Coll Cardiol [Internet]. 2020 
[citado 28/07/2020];75(20):[aprox. 3 p.]. Disponible en: <a href="https://pubmed.ncbi.nlm.nih.gov/32304797/" target="_blank">https://pubmed.ncbi.nlm.nih.gov/32304797/</a></font>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif">     4. Golchaia B, Nazaria N, Hassania F, HadiM. Computer-based E-teaching (Virtual 
Medical Teaching) or traditional teaching: A comparison between Medical and Dentistry 
students. Procedia -Social and Behavioral Sciences [Internet]. 2012 [citado 09/06/2020]:47:[aprox. 
3 p.]. Disponible en: <a href="https://cyberleninka.org/article/n/551419" target="_blank">https://cyberleninka.org/article/n/551419</a></font>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif">     5. Pottle J. Virtual reality and the transformation of medical education. J Future 
Health Care [Internet]. 2019 [citado 18/01/2020];6(3):[aprox. 4 p.]. Disponible en: 
<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798020/" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798020/</a></font>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif"> 6. Prieto Mart&iacute;n A. Flipped Learning: aplicar el modelo de aprendizaje inverso. 
Madrid: Narcea S. A; 2017.</font>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif"> 7. De la Torre RM, Rojas MN, Bilbao CM, Torres MI, Barroso ML. Curso en red: 
&quot;Ense&ntilde;anza virtual en la docencia m&eacute;dica&quot;. EDUMECENTRO [Internet]. 2016 [citado 
18/07/2020];8(1):[aprox. 12 p]. Disponible en: 
<a href="http://www.revedumecentro.sld.cu/index.php/edumc/article/view/416/html_96" target="_blank">http://www.revedumecentro.sld.cu/index.php/edumc/article/view/416/html_96</a></font>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif">     8. Mompe&oacute;-Corredera B. Metodolog&iacute;as y materiales para el aprendizaje de la 
anatom&iacute;a humana: percepciones de los estudiantes de medicina `nativos digitales'. Rev de la 
Fundaci&oacute;n Educaci&oacute;n M&eacute;dica [Internet]. 2014 [citado 18/01/2020];17(2):[aprox. 5 p.]. Disponible 
en: <a href="https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2014-98322014000200007" target="_blank">https://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S2014-98322014000200007</a></font>
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<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><B><FONT COLOR="#000000">Declaration of interests</FONT></B>
</font>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif">The authors declare no conflict of interest.
</font>
<p>&nbsp;</p>
<p>&nbsp;</p>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><B>Authors' contribution</B>
</font>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Jos&eacute; Osvaldo Enr&iacute;quez Clavero: conceptualization, methodology and preparation of 
the manuscript.<br>
</font><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Jos&eacute; Osvaldo Enr&iacute;quez Clavero and Jorge Otero Mart&iacute;nez: review of the manuscript, editing 
and approval of the final version of the article. </font>
<p>&nbsp;</p>
<p>&nbsp;</p>
<P><font size="2" face="Verdana, Arial, Helvetica, sans-serif">This article has been published under the <a href="https://creativecommons.org/licenses/by-nc/4.0/deed.es_ES" target="_blank">Creative Commons</a> license.</font>
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