Faculty diversity, equity, and inclusion in academic dentistry: Revisiting the past and analyzing the present to create the future

Validation of a Modified Group-Based Medical Mistrust Scale Among Young Latinx Adults in the United States

Medical mistrust is an important barrier to accessing health care among Latinx populations in the United States (US). However, research on the validity and reliability of medical mistrust scales is limited. We examined the validity and reliability of a modified bilingual version of the Group-Based Medical Mistrust scale (mGBMMS) among a sample of Latinx adults. Participants included 308 Latinx adults (ages 18-25), who responded in Spanish (n = 134) or English (n = 174). Following feedback from bilingual/bicultural staff during the English-Spanish translation process, we made three changes to the original GBMMS. Validation testing of our 12-item mGBMMS scale included: split-half and internal consistency reliability; discriminant, convergent, and predictive validity; and both exploratory and confirmatory factor analyses. The mGBMMS had good internal consistency (overall sample: Cronbach's α = 0.79; Spanish: Cronbach's α = 0.73; English: Cronbach's α = 0.83). The mGBMMS showed good convergent (moderately correlated with the experiences of discrimination scale, r = 0.46, p < 0.001) and discriminant (weakly correlated with the acculturation scale, r = 0.11, p = 0.06) validity. Split-half reliability was 0.71 (p < 0.001). Exploratory and confirmatory factor analyses found a two-factor solution. The mGBMMS was associated with satisfaction with care (OR = 0.60, 95%CI: 0.42-0.87), a sign of good predictive validity. Findings suggest that the mGBMMS is a valid and reliable scale to utilize among bilingual (Spanish/English) populations in the US. Further validation studies should be considered among Latinx respondents of different ages, backgrounds, languages, and US regions.

Problem-based learning curriculum disconnect on diversity, equitable representation, and inclusion

Diversity, equity, and inclusion (DEI) mission statements continue to be adopted by academic institutions in general, and by dental schools around the globe in particular. But DEI content seems to be under-developed in dental education. The objectives of this study were two-fold: to extract information from all the PBL cases at University of British Columbia's Faculty of Dentistry curriculum in terms of the diversity, equitable representation, and inclusion of patient and provider characteristics, context, and treatment outcomes; and; to compare these findings with the composition of the British Columbia census population, dental practice contextual factors, and the evidence on treatment outcomes within patient care. Information from all the 58 PBL cases was extracted between January and March 2023, focusing on patient and provider characteristics (e.g., age, gender, ethnicity), context (e.g., type of insurance), and treatment outcomes (e.g., successful/unsuccessful). This information was compared with the available literature. From all the 58 PBL cases, 0.4% included non-straight patients, while at least 4% of BC residents self-identify as non-straight; there were no cases involving First Nations patients although they make up 6% of the British Columbia population. Less than 10% of the cases involved older adults who make up almost 20% of the population. Only Treatments involving patients without a disability were 5.74 times more likely to be successful compared to those involving patients with a disability (p<0.05). The characteristics of the patients, practice context, and treatment outcomes portrayed in the existing PBL cases seem to differ from what is known about the composition of the British Columbia population, treatment outcome success, and practice context; a curriculum disconnect seems to exist. The PBL cases should be revised to better represent the population within which most students will practice.

Women in dental education and their desire to lead: A follow-up

The aim of this study was to provide a follow-up to the 2015 national survey of women in dental education to re-examine factors and perceived barriers to pursuing administrative and leadership roles. At the beginning of 2023, a survey was administered to full-time women faculty in predoctoral dental programs in the United States. The survey instrument employed a structured format along with open-ended questions to capture qualitative data. The overall response rate was 26% (527/1994) and included respondents from fifty-five of the sixty-seven dental schools contacted. Half of respondents indicated holding an administrative position and 20% reported administration as their primary appointment. There was a significant increase in the number of women holding a leadership role in 2023 (76%) compared to 2015 (53%). Those seeking a leadership position in 2023 were less likely to have participated in leadership training (p<0.01) and less likely to have previously sought an administrative position (p>0.01). Women in leadership and administrative roles were more likely to indicate receiving extra compensation for administrative duties (p<0.01) and a desire for higher rank (p = 0.04) compared to 2015, but perceptions persist among the majority of respondents (71%) that women are not being compensated equally to their male counterparts. Respondents highlighted the negative impact of the COVID-19 pandemic on career advancement and the positive culture changes that have contributed to greater workplace flexibility. Overall, respondents sent a resounding message that women in dental education need structural change to achieve success: pay equity, mentorship, and inclusive and supportive work environments.

Black and Hispanic predoctoral dental students' perceptions and considerations of careers in academic dentistry

BACKGROUND

Dental schools aim to train and support a diverse dentist workforce. Among all faculty, full-time and part-time faculty who identify as members of historically underrepresented groups are 13.9% and 8.4%, respectively. The recruitment and retention of faculty is a known challenge, with growing faculty vacancies at dental schools. This study explored dental student perceptions of academic careers, specifically focusing on Black and Hispanic predoctoral students.

METHODS

From August to November 2022, we conducted focus group with second-, third-, and fourth-year predoctoral dental students who identified as Black or Hispanic using a semi-structured interview guide that was developed for this study. Data were analyzed using inductive thematic analysis.

RESULTS

Four themes emerged: (1) students perceived academic dental dentistry as inclusive but not diverse spaces for Black and Hispanic people; (2) academic dental careers were perceived as secondary careers; (3) academic dental careers were perceived as a career option with a lack of autonomy and less income, compared to clinical practice in other settings; (4) students expressed a lack of knowledge about pathways to academic dental careers. Despite these challenges, students expressed interest in academic dental careers and noted being inspired by younger faculty members.

CONCLUSION

Dental schools must do more to encourage dental students to consider careers in academic dentistry. Pathway programs, mentoring, and the presentation of academic careers as a viable career option for students by faculty should be further emphasized practices. Increasing the diversity of faculty members is also key. Students cannot be who they cannot see.

Uncover your inner power: Breaking leadership biases in global healthcare

Women currently represent approximately 70% of the global healthcare workforce, 60.9% of the global dental workforce, 77.6% of the US healthcare workforce, and 36.7% of the US dental workforce. The American Dental Association states that the number of practicing women dentists in the United States has increased by 2.25 times since 2001, with a projected trajectory to level off by 2040. Despite having a major impact on the healthcare sector globally, women earn 24% less than men and only serve in 25% of senior leadership positions. In the US dental schools, only 14% of faculty serve in administrative roles, and as of April 2022, 28.6% of the US dental school deans were women, indicating gender underrepresentation in the highest roles of academic leadership. This corresponds to the data on gender parity still not being the norm in many societies and workplaces and can be attributed to public policies, stereotypical perceptions, and individual factors. Five key factors have been identified to be crucial for women's entry or advancement in global health leadership: a) public policy, b) community, c) institutional, d) interpersonal, and e) individual. Individual self-improvement and institutional practices may be used to overcome these barriers to women's leadership in healthcare and shift the power dynamics toward reinforcing gender equality. These transformative changes are measured through women's collective capacities and skills, relationship dynamics, community perceptions, and environmental practices. This article recognizes the present obstacles to women in healthcare leadership and proposes strategies to achieve gender equality both through individual and institutional practices.

Gender and geographic diversity of global oral health organisations

Introduction Diversity of leadership of global oral health organisations is critical to ensure a global agenda.Aim To analyse the gender and geographic diversity of global oral health organisations.Methods Publicly available data on the gender of their staff and leadership, and congress locations, were analysed. Gender was allocated from photographs if available, and using Genderize, an online allocation platform. Location of leaders and global congresses were analysed by country, region and World Bank income category. The organisations analysed were the International Association of Dental Research (IADR), FDI World Dental Federation, International Federation of Dental Hygienists (IFDH) and 15 dental specialist global associations.Results The majority of headquarter staff in the IADR (76%) and FDI (84%) are female. Gender diversity in the leadership differs across the various organisations, with recent progress towards gender parity. The IFDH was and is exclusively female-led. The majority of leaders are from high-income countries in Europe and North America. Of the 370 congress locations, 90% were held in high-income countries.Conclusion There is recent progress towards gender diversity in the leadership; however, this leadership is essentially from high-income countries. There is an urgent need to publicly commit to diversity goals and implement strategies to reflect the oral health workforce and be truly diverse and global.

Gender diversity of the oral health leadership in Australia

BACKGROUND

Gender diversity in oral health leadership is important. Globally, this is dominated by men and does not equitably represent the increasing women in the workforce.

METHODS

Publicly available and gathered data on leadership positions for Australian professional associations, accrediting body, specialist academies, training institutions and the public dental sector were analysed for gender (men and women) diversity.

RESULTS

The gender diversity of the leadership varies across the oral health organizations and training institutions. Of the 383 identified leadership positions, 229 (60%) are held by men. Of the eight national dentist association presidents, six (75%) are men. Of the 65 leadership positions across 13 training institutions, 39 (59%) are held by men, and all schools training dentists are led by men. Men also dominate leadership roles in the specialist academies (62%), the research organizations (56%) and public dental sector (67%). Women do have the majority of senior leadership roles in the accrediting body (67%).

CONCLUSION

Gender diversity of the oral health leadership shows some positive findings, but there is still an effort required to increase women leaders across many areas of this leadership. This should urgently be recognized as a problem, with the implementation of strategies to address this important issue. © 2023 Australian Dental Association.

Reshaping dental faculty development using collective healthcare experiences

Dental academics provide a fulfilling career path to educate the next generation of oral health professionals. The number of dentists choosing a career in dental academics is declining and existing faculty are opting for other career options. As the number of dental schools increase across the US, a critical shortage of educators may be evidenced. In dentistry, innovative approaches to develop academic faculty are not keeping pace with the growing needs of dental faculty, who are challenged to establish a fulfilling work-life balance. This work reviews existing methods that other health professions implement to develop faculty for successful career growth. This review highlights factors and related cofactors that influence career development among dental faculty. Recommendations are presented as potential solutions based on the assessment of similar experiences published by related academic healthcare professions. Dental academia must increase attention to faculty needs and awareness by conducting institutional-specific studies to address these issues with customizable solutions.

Men of color in the health professions: Proceedings from the 2022 ADEA Men of Color in the Health Professions Summit

The purpose of the American Dental Education Association (ADEA) Men of Color in the Health Professions Summit, held in August 2022 at ADEA's headquarters in Washington, DC, was to gather key thought leaders across a myriad of health professions and healthcare organizations and schools to cultivate intentional cross-disciplinary efforts in championing the need to address the low number of men of color entering not only dental, but also medicine, pharmacy, and health-related research careers. A pivotal follow-up step from the inaugural ADEA President's Symposium on Men of Color in the Health Professions at the March 2022 ADEA Annual Session & Exhibition in Philadelphia, the summit brought together academic health professions leaders, government agencies, health professions associations, and other key stakeholders to develop an action plan to support men of color entering the health professions. Moving the needle forward and increasing opportunities for underrepresented men of color in the health professions requires all academic health professions to work together. Highlights of the Summit included a keynote presentation by David Satcher, MD, PhD, the 16th Surgeon General of the United States; workgroup consensus statement development; health career pathways program presentations; strategic forecasting regarding challenges and opportunities in developing a coalition of health professions organizations to support men of color in the health professions; and frameworks for exploring coalition building.

Dentistry and Gender Gap: An Overview of the Italian Situation

Recently, the issue of the gender gap in dentistry and in the leadership in the dental field has placed new challenges on dental profession representatives and politicians. Indeed, the inequity between genders in healthcare workforces represents a limit to the progression of those in the professions, inhibiting talented colleagues from accessing high positions in the academic world and not providing adequate role models to inspire future generations. The Italian population practicing dentistry in 2021 was composed of 74% males and 26% females. The aim of this study is to analyze the level of the gender gap in the dental field in Italy by focusing on the gender distribution of professional leaders in institutional category associations and invited speakers at dental conferences accredited for the Continue Education in Medicine program. The search strategy considered three different fields in the national dentistry scene: the dental committee boards, the union category associations, and the cultural field. The roles in the dental boards were retrieved from the website of the National Medical and Dental Committee from 2018 to 2022; the roles in the union category associations at the provincial, regional, and national levels were retrieved from the related web pages, considering the period from 2018 to 2021; and the information about the speakers at national conferences from 1 January 2019 to 31 December 2021 was retrieved from the National Agency for Regional Health Services (Agenzia nazionale per i servizi sanitari regionali (AGENAS)) websites. The extracted data were grouped and examined using descriptive statistics (frequency), and due to the categorical nature of the data, non-parametric tests (chi-square tests) were used to assess any differences between the two genders. The null hypothesis was that there were no statistical differences between the two genders’ distributions. A p-value was considered significant when <0.05. In addition, aiming to understand the representation of male and female dentists, a comparison of the distributions of males and females in the dental boards with the percentages of female and male dentists operating in Italy in 2021 was performed using a binomial test. The analysis of the data regarding the composition of the dental boards and of the union category association boards revealed a statistically significant difference in the distribution of the roles between the two genders at the regional and local levels, with a p-value of <0.05, and a significantly low representation of the women practicing dentistry (p < 0.05). In Italy, women practicing dentistry are underrepresented in dental organizations and in cultural events, given the low numbers of female dentists in leadership and/or speaker roles in the years 2018–2021. Even though the glass ceiling effect continues to affect Italian female dentists, initiatives and political measures have been taken to improve this condition and reach gender equity.