Critical Incidents, Successes, and Challenges of Community-Based Dental Education

Desirable clinical settings in general dentistry: moving towards the improvement of the educational program

BACKGROUND

The main task of dental schools is to prepare professional dentists with a high social responsibility. This study provided some practical suggestions from experts regarding desirable clinical settings, in order to establish an infrastructure for practical studies in Endodontics, Periodontics, Oral and Maxillofacial Surgery, Restorative Dentistry, Pediatric Dentistry, Oral and Maxillofacial Medicine, Prosthodontics, Oral Health, and Social Dentistry.

METHODS

This research was conducted using a modified Delphi technique in two rounds. The first round involved qualitative content analysis. Participants in interviews were selected purposeful and maximum diversity across the country. To determine the validity and reliability of the data, the four axes proposed by Lichon and Guba were utilized. The second round involved a researcher-made questionnaire, which consisted of 55 questions. This questionnaire was distributed to all dental schools across the country. The validity of the questionnaire were evaluated and by experts and then reviewed. The reliability of the tool was determined to be 0.96 using the alpha coefficient method.

RESULTS

The final codes from the interviews of the first round were divided into two categories: settings and educational programs. The final results of research were placed into 2 section: educational settings and instructors, and educational infrastructures. 70% participants agreed to use the college's clinical morning sessions. More than 80% agreed to start up a main clinic with the proposed structure and professors. The use of the hospitalization area also had an agreement of more than 80%. Additionally, community areas such as health service centers, welfare centers, special patient centers, factories, schools, etc. obtained an agreement of over 70%.

CONCLUSIONS

The results of this study are presented in the form of suggestions for improving the general dentistry program in relation to educational setting, educators, and educational infrastructures. The common agreement among participants regarding educational settings and their diversity, educational programs, and desired instructors reviewed in the research shows the necessity of reviewing and changing their educational programs in Endodontics, Periodontics, Oral and Maxillofacial Surgery, Restorative Dentistry, Pediatric Dentistry, Oral and Maxillofacial Medicine, Prosthodontics, Oral Health, and Social Dentistry.

Challenges in implementing community-based dental education programs in Australia: The lived experiences of program coordinators

PURPOSE

The benefits of community-based dental education (CBDE) are well documented and reach far beyond students' educational growth, encompassing advantages for both dental schools and their community partners. Nonetheless, barriers associated with administering CBDE programs can have a significant impact on program outcomes. This study aims to explore the challenges faced by dental school CBDE coordinators in implementing and managing their programs.

METHODS

This Interpretive Phenomenological study employed in-depth semi-structured interviews with CBDE program coordinators from Australian dental schools (n = 6). Interviews, conducted between February and May 2023, via Microsoft Teams, were audio and video recorded and lasted an average of one hour each. Interviews were analyzed using NVivo 13. Questions explored administrative challenges, required resources, student management issues, and development goals for CBDE programs.

RESULTS

Data analysis included deductive and inductive coding through a seven-step iterative process, organizing information into codes and sub-codes, forming emerging themes. Four major themes with subthemes emerged: 1) Program administration, encompassing challenges in scheduling, coordinating, and adapting to changes; 2) Funding, crucial for establishing and maintaining remote educational sites; 3) Student experience management, highlighting student supervision, student behavior, and exposure; and 4) Partner site relationships, particularly in clinical supervisor recruitment and training.

CONCLUSION

The successful implementation requires meticulous planning, effective coordination, and recognition of CBDE as an educational activity that should be grounded in evidence-based pedagogy. Dental institutions are therefore encouraged to establish collaborative partnerships with local community organizations, allocate resources for outreach initiatives, and facilitate appropriate guidance to coordinators, students, and external clinical supervisors.

Community-based education programmes in the context of dental education: A scoping review

BACKGROUND

Community education programmes are vital tools for teaching skills, such as understanding the larger cultural, economic and social determinants of health and how these factors impact people's health. It is currently unclear whether community education programmes in the field of dentistry deliver adequate value. This review aims to scope, collate and analyse globally published evidence concerning community education programmes in dentistry from inception, to gain an understanding of the intentions for these programmes and establish whether outcomes have shifted over time from the original intentions.

METHODS

Arksey and O'Malley's framework for scoping reviews was employed to guide the reviewers. A systematic search of electronic databases and the reference lists in key papers was conducted.

RESULTS

A systematic search concerning community education in dentistry identified a total of 140 papers for full-text evaluations. After further exclusions, 115 articles were selected for data charting. There was a lack of clarity in the literature concerning programmes' definitions and strategies for achieving intentions. Origins, intentions and motivations of the programmes were identified. The literature largely focused on assessing students' clinical treatment skills, contradicting the programme's original idea and intentions. Only a few studies incorporated patient and community perspectives, and the majority of assessments were self-reported, primarily by students.

CONCLUSIONS

There is broad interest in integrating community education into dental curricula to teach complex concepts, dental public health principles and to ensure professional skills development. We identified issues in the literature around programme definitions, strategies, measurement approaches and programme success requiring additional research.

Process and outcome evaluation of the Oral Health Improvement through Outreach (OHIO) Project

Academic dental institutions serve a foundational role in meeting the oral health needs of Americans through community-based learning experiences.

PURPOSE

The purpose of this study was to longitudinally evaluate an ongoing primary objective of the Oral Health Improvement through Outreach (OHIO) Project Program, which is to build strong partnerships between The Ohio State University (OSU) College of Dentistry (CoD) and community-based dental facilities and increase access to dental care for underserved populations.

METHODS

Upon exempt Institutional Review Board approval (2004H0067), a longitudinal evaluation study was conducted of 15 years of the OHIO Project during the 2004-2019 academic years. Descriptive statistics were used to evaluate the OHIO Project using process and outcome evaluation methods.

RESULTS

The data from 107,510 patients were analyzed. Process evaluation revealed the OHIO Project has been reaching the target population of communities with dental care needs and limited access, as evidenced by the main methods of patient payment/non-payment and the quantity of completed restorative/oral surgery procedures. Outcome evaluation revealed the OHIO Project has been building strong partnerships between the CoD and communities to address dental care needs and improve access, as evidenced by the increased number and distribution of the community-based facilities throughout Ohio.

CONCLUSION

Process and outcome evaluation revealed the OHIO Project has been meeting its primary goal of building strong partnerships between the CoD and OHIO Project community-based facilities to address the basic dental needs and increase access for Ohio residents. Future research is needed to evaluate the dental student impact of providing community-based care.

Reflective Learning Outcomes of Community-Based Experiences: A Qualitative Study

The aim of this study was to explore the meaning of community-based experiences for senior dental and dental hygiene students through the use of critical incident essays. A total of 108 senior dental students and 22 senior dental hygiene students were invited to participate in the study. Each student was required to write about one critical incident that occurred at one of four community clinic rotation sites during the 2012-13 school year. The participation rate was 78% of the students. Professional responsibility, a willingness to volunteer, and an understanding of the importance of oral health education were the main themes that emerged from analysis of the essays. These results suggest that community-based learning, with reflection, challenged how these students perceived oral health disparities and expanded the meaning of professional responsibility for them.

A model for community-based pediatric oral heath: implementation of an infant oral care program

The Affordable Care Act (ACA) mandates risk assessments, preventive care, and evaluations based on outcomes. ACA compliance will require easily accessible, cost-effective care models that are flexible and simple to establish. UCLA has developed an Infant Oral Care Program (IOCP) in partnership with community-based organizations that is an intervention model providing culturally competent perinatal and infant oral care for underserved, low-income, and/or minority children aged 0-5 and their caregivers. In collaboration with the Venice Family Clinic's Simms/Mann Health and Wellness Center, UCLA Pediatrics, Women, Infants, and Children (WIC), and Early Head Start and Head Start programs, the IOCP increases family-centered care access and promotes early utilization of dental services in nontraditional, primary care settings. Emphasizing disease prevention, management, and care that is sensitive to cultural, language, and oral health literacy challenges, IOCP patients achieve better oral health maintenance "in health" not in "disease modality". IOCP uses interprofessional education to promote pediatric oral health across multiple disciplines and highlights the necessity for the "age-one visit". This innovative clinical model facilitates early intervention and disease management. It sets a new standard of minimally invasive dental care that is widely available and prevention focused, with high retention rates due to strong collaborations with the community-based organizations serving these vulnerable, high-risk children.