Will Online CE Become Standard?

Terri Lively

The way dental professionals earn their continuing education credits changed during the COVID-19 pandemic. But will the change be permanent?

During the COVID-19 pandemic shutdown, which necessitated a change to business as usual and closed many dental practices to all but emergency care, online continuing education (CE) programs flourished. Dental education companies had surges in participation in their online offerings that they never had seen before. Even after restrictions lifted and many practices reopened for routine patient care, online CE participation has remained high.

However, as the vaccine rolls out and travel restrictions begin to lift, will online CE become the standard? Here’s what some dental education experts have to say about what they saw change during the pandemic and what the future holds for CE.

Philip Klein, DMD, CEO of Viva Learning, says his company has been seeing an upward trend in online CE engagement for some time. However, he says that although the closure of live CE events brought attention to Viva Learning’s program, the quality of the company’s premium content qualityis what maintains their numbers.

“We’re seeing average attendance at our CE webinars more than double, and month after month registrations on our site continue to rise,” Dr Klein says.

In late February 2020, Dr Klein says Viva Learning began a significant effort to create high-quality online CE programs that focused on COVID-19 and the dental practice. The Viva Learning team worked with top dental educators in infection control and launched more than 25 hours of training for the year, including CE webinars and podcasts.

“Dental professionals consumed it at a rate we’ve never seen before. I’m talking 2000 to 3000 attendees on a webinar and thousands listening to the podcasts. New Viva accounts were skyrocketing at a rate of [more than] 10,000 new users per month. Our efforts proved successful in disseminating critical COVID-19 information—during the height of uncertainty and fear—in a simple to understand, easy to access format,” Dr Klein says.

Dr Klein says this strategy grew Viva Learning’s user base to almost 300,000 users, including GPs, specialists, dental hygienists, assistants, office staff, and dental sales representatives.

“It is currently the most highly visited dental CE site in the world,” Dr Klein says. “Dental professionals realize that there are real benefits to taking their continuing education online.”

Lou Graham, DDS, founder of Catapult Education, is the clinical director of Midway Dental Supply, a dental distributor that also has an educational platform. Dr Graham says the pandemic necessitated that the 2 companies create a significant shift from predominately live programs to unique online formats.

Midway Dental, which hosted numerous monthly programs at its Midway Education Center sites before the pandemic, shifted 100% to an online platform. Midway Dental also created a 20-minute live interview program called “The New Norm” with Dr Graham speaking to various industry professionals, particularly on COVID-19–related dental subjects. The show gathered thousands of followers with its biweekly broadcasts, he says.

“There were so many things happening all at once that the show, in a sense, brought some reality to the ongoing changes,” Dr Graham explains.

Catapult Education also made significant changes to its speakers’ platform. Before the pandemic, Catapult’s 25-plus speakers were presenting at more than 400 live events nationwide.

“In an instant,” Dr Graham says, “all live events were shut down, as were our practices.”

Like Midway Dental, Dr Graham says Catapult Education had to change its platform to a combination of traditional webinars and unique 3-hour symposiums.

“Now, with 50,000 YouTube followers on our channel and growing monthly, there is no doubt this shift is constantly expanding,” Dr Graham says.

Catapult’s core speakers, along with additional outside speakers from the United States and abroad, designed an educational experience Dr Graham describes as interactive and informational. With a moderator hosting 3 to 5 speakers, presentations are 30 to 45 minutes long and focus on specific subjects with a Q&A closing panel discussion. Dr Graham says that questions came flying in, making the symposiums fun.

“Doctors and teams want to interact, and we must provide the formats to allow it. This format is a new way. People lose their attention span when it’s multiple hours of the same person presenting online. It’s tough to hold an audience,” Dr Graham says. “The manufacturers love these symposiums that we’ve done because the audiences are very involved, and it’s a great learning experience.”

“A full day of digital can be a huge challenge when it comes to implementing adult learning styles,” says Dawn Gregg, DDS, training director for Millennium Dental Technologies.

Dr Gregg says CE had become more automated, less personal, and less “connected.” Platforms since have evolved, becoming more secure and offering opportunities for interaction via chat function or microphone use if the presenter or administrator allows, she says.

Online CE became popular, Dr Gregg says, when offices closed and doctors had more time. She says individuals who typically would prefer in-person CE were “thrown into a technology world” and adapted quickly.

Is Online CE Becoming the Standard?

Without a doubt, online CE was the necessary standard for 2020. But will it remain so after the pandemic passes? Dr Klein thinks so.

“In my mind, the pandemic brought online CE to the forefront of the profession, especially for those dental professionals who had not yet experienced e-learning. Now, many of those folks see the benefits and the value and will continue to rely on online CE going forward,” Dr Klein says.

Dr Klein says that the convenience and efficiency of the online model are appealing to dental professionals. Viva Learning offers a plethora of timely dental information, he says, and users can search content by keywords, dental topics, or speaker. The content, which includes podcasts, videos, and live interactive webinars, is available from any device at any time. Dental professionals can listen, watch, or participate in a live event and earn participation and self-study CE credit.

“When you compare that with taking time away from your office, driving to a location where you have to park your car, and everything else involved with traditional in-person CE events, the benefits of online CE are pretty clear,” Dr Klein says. “Of course, there is always a need for hands-on programs that require in-person attendance, but, for the most part, online CE just makes more sense for most dental professionals.”

Dr Graham has a different take based on what happened last year. As Midway Dental was hosting The New Norm and Catapult was ramping up its symposium-style education programs, there also was a deluge of free CE onlineDr Graham says . People could spend up to 8 hours a day getting CE credits. He says a lot of it was good, and some of it was redundant. However, Dr Graham says that by June people were tired of webinars that were 45 minutes to an hour long.

Jody Rodney, vice president of marketing and education at Planmeca, agrees that online CE leaves a little to be desired. She says that there is a craving for in-person interaction. Planmeca’s digital academy shifted from 100% in-person to 100% virtual continuing education at the beginning of the shutdown. Like Viva Learning, Planmeca also had unprecedented attendance numbers at their live, virtual programs at the beginning of the pandemic, often with participants numbering in the thousands. However, as soon as they could, Planmeca returned to in-person training to meet the demand.

“Honestly, everybody had a little bit of cabin fever,” Rodney says. “And for those who were willing to risk it, they were ready to travel.”

Rodney says the pandemic made her team much more adaptable. At the beginning of returning to in-person education, they learned the importance of versatility, mainly when last-minute changes to guidelines affected in-person events. Without a backup plan, these changes caused a lot of stress for the team.

“Now we’re much more proactive and we’re planning for multiple scenarios,” Rodney says. “If the guidelines change and we know that we can only have so many people in 1 room, we can have a plan B and have additional facilities available for the customers.”

Rodney says virtual training is still available and Planmeca continues to optimize it. The education team instituted self-guided work the participants do before the virtual training session. Rodney says the pretraining work kickstarts the learning process. To respond to clinicians who want more training in specific areas, Planmeca offers 1-on-1 sessions with clinical specialists after the virtual training. Rodney says it gives practices a chance to focus on areas of technology where the end-user doesn’t feel comfortable.

“We’re doing more planning and building to help them be more prepared, especially in those virtual environments where we can’t be there. We can’t watch them scanning, designing crowns, or positioning the patient, so you have to be more flexible and adaptable and more available to them,” Rodney says.

Rodney says Planmeca prefers to offer in-person training. Planmeca’s customers agree. Rodney says the virtual training is not requested as much as the team at Planmeca anticipated outside of specific areas with strict travel guidelines. Practices still want the team to train them in person, and Planmeca is happy to do so.

“The biggest thing that we want is to adapt and try to provide as many personal interactions with the doctors as possible because they want it. We want it. We’re humans,” Rodney says.

Dr Gregg also says their training relies on in-person, hands-on, synchronous learning to teach the LANAP® protocol for treating gum disease. The training benefits from real-time faculty-participant discussion, peer interaction, and active participation to teach the surgical procedure.

“What we have found over time is that to make our training successful—as evidenced by positive, reproducible, regenerative patient outcomes—the training has to be done in person, not on a CD-ROM, not on Zoom, and not even on pig jaws,” Dr Gregg says.

Dr Gregg says Millennium discontinued in-person training until pandemic-responsive protocols could be developed and implemented. While the training was on hiatus, Millennium launched “Webinar Wednesday,” a series offering free CE on a variety of topics.

“We also launched podcast series to round out our online presence and create more engagement. While this wasn’t CE, it is storytelling and adding a human connection that is missing from a lot of CE platforms,” Dr Gregg says.

Millennium was the first live-patient training center to reopen. Dr Gregg says this meant increased safety protocols in the classroom and the clinic when treating patients. In addition to the usual COVID-19 social distancing, personal protective equipment, and screening requirements, the company upgraded the air purification during lectures, included new high-volume evacuation units, and added PECO and ultraviolet air filtration systems in each operatory.

“Being in Southern California, our restrictions have continued at a higher level than many other parts of the country,” Dr Gregg says. “We continue to survey doctors about their comfort level regarding the precautions taken during training. Most respondents are very comfortable with the precautions we have taken and have no concerns about the live patient treatment.”

Dr Gregg says that online CE has both advantages and disadvantages. The on-demand feature makes online CE convenient for dentists and easy to share on a global platform. However, some instruction cannot be done online, such as the surgical training they do at Millennium, which requires tactile learning.

“Surgical training on live patients still needs to be in person for immediate clinical feedback and adjustments. Though surgical demonstrations can be done using online platforms, the Institute for Advanced Laser Dentistry uses live-patient treatment where the instructor imparts proper hands-on muscle memory to the student. This cannot be done remotely,” Dr Gregg says. “Using laser light to modify tissue has a different tactile sensation than traditional hand instruments. This must be felt with one’s own hands to be fully understood and internalized. Viewing a demonstration online doesn’t suffice.”

Mark Hyman, DDS, MAGD, an adjunct full professor at UNC Adams School of Dentistry in Chapel Hill, North Carolina, and an international speaker for the dental industry, agrees that in-person learning is better than virtual. Moreover, his best learning experiences happened in person.

“When you’re in a class lecture room with your colleagues, and people are shoulder to shoulder, and there’s the energy and the vibe, and you are focused and dialed in, you learn dramatically better,” Dr Hyman says. “Some of the best learning in my life has been at dental meetings and then talking to people after the lecture and going to the exhibit hall and test-driving things.”

Dr Hyman’s love of teaching in-person influences his opinion about online learning in part. Dr Hyman estimates that he spoke to more than 30,000 people last year on Zoom, but he says teaching 82 students in person at the dental school was far more rewarding.

“I loved it. I love the eye contact. I love the sharing and the participation,” Dr Hyman says.

However, he doesn’t think virtual CE is all bad.

“For someone who doesn’t have access to in-person CE and for young professionals, virtual learning is a fantastic start to education,” Dr Hyman says.

Dr Hyman also appreciates how dental organizations and companies, including the American Dental Association to Jameson to The Pankey Institute to Spear Education, all made their information available online with podcasts and webinars during the shutdown. Many dental professionals took online courses during the shutdown they would never have had the time to take during regular practice.

“We took lemons and made lemonade,” Dr Hyman says about online CE during the shutdown. “Virtual learning is here to stay, but I guarantee you it cannot be as impactful as in-person learning. We are a profession that needs hands-on learning.”

What the Future Holds for Dental CE

For 2022 and beyond, in-person CE programs will resume, but Dr Klein thinks there will be fewer of them. He believes study clubs will thrive because dentists enjoy in-person discussions, collaboration, and social activities with their colleagues. Also, Dr Klein sees value in hands-on programs because it is important to attend in person when it comes to using new technologies and equipment. However, Dr Klein also sees a future where technology improves to the point that online CE can accomplish many of these things.

“No doubt, the world of dental CE has changed forever, and online CE will be the predominant way the entire dental team maintains their professional development and continuing education,” Dr Klein says.

Dr Gregg says that the future of CE will be in-person or online based on the topic. She believes advanced training on implants and periodontics, which requires hands-on learning, will rebound to in-person but that basic courses and top-level learning will stay online. However, the overall formula of CE at trade shows may not return to what was before the pandemic.

“When you combine the younger generations’ preference for online learning and comfort level with technology with this huge shift of all companies providing online education, there will be a significant amount of people who don’t want the extra expense involved in traveling for basic types of CE,” Dr Gregg says.

Dr Graham also doesn’t think online CE is dead. He says that dentistry will look back and see that the pandemic created a huge shift in virtual education—and it’s just beginning.

“There are many great formats of online education, and they can come in subscription platforms, as 1 example, or an approach that uses a combination of physical learning materials that come to registered users who learn online like college students do today,” Dr Graham says. “We are dentists, we love to touch and feel what we are using, and this will absolutely be offered more and more in online programs.”

However, Dr Graham also sees the limitations of online education.

“It’s tough to entertain, teach, and keep a crowd when you have no interaction,” Dr Graham says. “So, I don’t think that will be the future. I do not think people will want to sit in front of their computers for 6 or 7 hours and listen to 1 speaker at a time.”

In addition, Dr Graham thinks that all-day in-person programs will change. In-person sessions will be offering more hands-on components with the lectures because listening all day to 1 speaker, he says, leads to the question, “Who stays after lunch?”

“The future will also be blended,” Dr Graham says, “with learning live and online mixed together in many different formats.”

Dr Graham sees the future of blended learning taking a modular format. The first mode would be a live course. Then, once dentists complete the live class, the next series would be online modules with the same attendees followed with community learning. The community learning would be led by 1 of the module speakers.

“Community learning will be considerable because now you could have a group of 50, 100, or more doctors learning and sharing their cases and experiences,” Dr Graham explains.

Another significant change to CE’s future is snippet learning, which is facilitated by technology and artificial intelligence. Dr Graham says that people want quick hits of information. Catapult is creating fast, 2-minute lessons on different topics to capitalize on this interest. Then, based on cookies collected by browsing history, Catapult will push these snippets out to dentists interested in the various topics. The program would then make a recommendation for further education courses. Snippet learning could also direct dental professionals toward speakers they like, Dr Graham says.

“Snippet learning is a huge thing. It will be big on Facebook and other social media. It’s like a mini-YouTube, and you’ll see a lot of that coming down the road,” Dr Graham says.

Dr Graham sees these blends of live and online learning modules facilitated by communities driving CE’s future, particularly with younger doctors. Millennials want to do CE when and where they want. As this generation of dentists takes over dental education, Dr Graham says they will want blended learning.

Even before the pandemic hit, Dr Graham and other Catapult speakers saw these changes in preferences. As speakers, they routinely saw dentists 50 years and older in their audiences, but not the next generation of dentists. He thinks the changing balance of demographics and younger dentists with different family responsibilities and work schedules will influence how dental professionals get their CE. Dentists see the benefits of online, blended learning at their convenience rather than attending full-day, live programs, and the industry has been preparing for it. Moreover, the past year accelerated the transition to the new way of delivering CE.

“You are going to see huge changes in dental education that have been fast-forwarded because of the pandemic,” Dr Graham says. “You are going to see that if you want to learn implants, you are going to learn them live and online. You are going to learn dental sleep live and online. That’s going to be, without a doubt, the future of where we’re all going together.”