Attitudes of the first cohort of student groups trained together at the University of Portsmouth Dental Academy towards dental interprofessional education

Exploring dental and oral hygiene students' interprofessional readiness: a cross-sectional study in joint paediatric outreach training

BACKGROUND

Interprofessional education is vital in oral healthcare education and should be integrated into both theoretical and work-based education. Little research addresses interprofessional education in dental hands-on training in authentic oral healthcare settings. The aim of the study was to examine the readiness and attitudes of dental and oral hygiene students towards interprofessional education during joint paediatric outreach training.

METHODS

In the spring of 2022, a cross-sectional study was done involving dental and oral hygiene students using the Readiness for Interprofessional Learning Scale (RIPLS) during joint paediatric outreach training. The 19-item tool was answered on a five-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, and 5 = strongly agree). Means, standard deviations, minimums, maximums, and medians were calculated for each subscale and overall score. Students grouped according to their categorical variables were compared for statistically significant differences. The Mann-Whitney U-test was used for groups of two and the Kruskal-Wallis one-way analysis for groups of three or more. The internal consistency of the scale was measured with Cronbach's alpha. Statistical level was set at 0.05.

RESULTS

The survey included 111 participants, consisting of 51 oral hygiene students and 60 dental students, with a response rate of 93%. The questionnaire yielded a high overall mean score of 4.2. Both oral hygiene (4.3) and dental students (4.2) displayed strong readiness for interprofessional education measured by the RIPLS. The subscale of teamwork and collaboration achieved the highest score of 4.5. Students lacking prior healthcare education or work experience obtained higher RIPLS scores. Oral hygiene students rated overall items (p = 0.019) and the subscales of positive professional identity (p = < 0.001) and roles and responsibilities (p = 0.038) higher than dental students. The Cronbach's alpha represented high internal consistency for overall RIPLS scores on the scale (0.812).

CONCLUSIONS

Both oral hygiene and dental students perceived shared learning as beneficial and showcased high readiness for interprofessional education, as evident in their RIPLS scores. Integrating interprofessional learning into oral hygiene and dental curricula is important. Studying together can form a good basis for future working life collaboration.

Evaluation of student-perceived competence of interprofessional working in Gerodontology

OBJECTIVE

To evaluate pharmacy, dental and dental therapy undergraduate students' perceived competence of interprofessional working before and after attending an interprofessional education (IPE) Gerodontology workshop.

BACKGROUND

Whilst there is international recognition of the importance of collaboration between the dental profession and systemic healthcare providers to enhance patient care, there remains a paucity of research into IPE in Gerodontology.

MATERIALS AND METHODS

Pharmacy, dental and dental therapy undergraduate students attended a 2-hour Gerodontology case-based workshop. Students completed anonymised Interprofessional Collaborative Competencies Attainment Surveys (ICCAS) before and after attendance.

RESULTS

108 questionnaires were received, 7 were withdrawn (1 incomplete with only pre-workshop side completed, 6 did not identify degree programme). From 101 included questionnaires, 37 were from pharmacy, 56 dental and 8 dental therapy students resulting in response rates of 84%, 82% and 67%, respectively. Each student group recorded an increase in positive reflective competence median (IQR) after taking part in the workshop. Overall median (IQR) reflective competence before the workshop was 6 (1), 5 (2) and 6 (2) for pharmacy, dental and dental therapy students, respectively, which increased to 7 (1) for all groups. There was variability in reflective competence before attending the workshop between dental and pharmacy students for two questions, and dental and dental therapy students for two different questions.

CONCLUSION

All students reported increased reflective competence of interprofessional working following the workshop. These findings suggest that introduction of IPE events into Gerodontology curricula may improve student understanding and appreciation of interprofessional working when providing care for older people.

Large-group simulation as a learning method to promote interprofessional collaboration and older adults' patient centered-care

AIMS

This study described the influence of a large-group simulation on social and health care students´ working life competence concerning interprofessional collaboration (IPC) and patient centered-care.

METHODS AND RESULTS

The target group (n = 319) was social and health care students from several different degree programs taking part in a large-group simulation concerning older people´s oral health as a part of his comprehensive well-being and health. Data were collected with a questionnaire containing background questions, statements about interprofessional practice and open-ended questions about learning experiences. The number of respondents was 257, including 51 oral health care students (OHCS). The data were analyzed using descriptive and statistical methods and content analysis. Working life competencies covers the overall social and collaborative skills which health-care professionals need in their work. They were reported to be improved in IPC and patient-centered care (PCC). The main described learning experiences in open responses included appreciating different professionals' competencies and the importance of interprofessional decision-making, interpersonal communication competence and patient-centered attitudes in care provision.

CONCLUSION

The large-group simulation is a good model for educating larger student groups simultaneously and it functioned well in improving understanding of IPC and PCC among older adults.

Intraprofessional learning: Dentistry and oral health students' readiness and experience

INTRODUCTION

Intraprofessional learning is a promising approach to enhance teamwork and patient care. This mixed-method study aimed to assess the readiness and experience of dental and oral health students toward intraprofessional learning.

METHODS

Dental and oral health students were paired alternatively in a clinician and assistant role in a pediatric clinical setting. The Readiness for Interprofessional Learning Scale was adapted for a pre- and post-survey. Focus groups were conducted to elicit the students' shared learning experience.

RESULTS

Approximately 50% of dental and oral health students participated in the pre- and post-survey. Pre-test findings revealed similar attitudes toward intraprofessional practice for both groups. However, a statistically significant lower score (p < 0.022) for the oral health students in the post-test suggested a less positive attitude toward their experience. Qualitative results indicated that dental students acquired a better understanding of the clinical scope of oral health students, and they learned clinical skills and behavior management from their counterparts. Conversely, oral health students experienced a hierarchical lack of collegiality and reciprocity from dental students, which may have contributed to their lower post-test score. Despite this, some oral health students gained more confidence in their roles and abilities within the intraprofessional team. Overall, dental students valued this learning experience more and desired more intraprofessional opportunities.

CONCLUSION

Both groups of dental and oral health students had similar readiness levels to enter intraprofessional practice, appreciated the intraprofessional experience, and gained an increased appreciation for the collaborative approach to patient care. Intraprofessional learning during training may assist with developing collegiality across the dental professions in practice.

Oral Health Workforce in Africa: A Scarce Resource

The World Health Organization (WHO) African Region (AFR) has 47 countries. The aim of this research was to review the oral health workforce (OHWF) comprising dentists, dental assistants and therapists, and dental prosthetic technicians in the AFR. OHWF data from a survey of all 47 member states were triangulated with the National Health Workforce Accounts and population data. Descriptive analysis of workforce trends and densities per 10,000 population from 2000 to 2019 was performed, and perceived workforce challenges/possible solutions were suggested. Linear regression modelling used the Human Development Index (HDI), years of schooling, dental schools, and levels of urbanization as predictors of dentist density. Despite a growth of 63.6% since 2010, the current workforce density of dentists (per 10,000 population) in the AFR remains very low at 0.44, with marked intra-regional inequity (Seychelles, 4.297; South Sudan 0.003). The stock of dentists just exceeds that of dental assistants/therapists (1:0.91). Workforce density of dentists and the OHWF overall was strongly associated with the HDI and mean years of schooling. The dominant perceived challenge was identified as 'mal-distribution of the workforce (urban/rural)' and 'oral health' being 'considered low priority'. Action to 'strengthen oral health policy' and provide 'incentives to work in underserved areas' were considered important solutions in the region. Whilst utilising workforce skill mix contributes to overall capacity, there is a stark deficit of human resources for oral health in the AFR. There is an urgent need to strengthen policy, health, and education systems to expand the OHWF using innovative workforce models to meet the needs of this region and achieve Universal Health Coverage (UHC).

Understanding oral health disparities in children as a global public health issue: how dental health professionals can make a difference

Oral disease in children is an urgent public health issue worldwide. Early childhood caries (ECC) affects 600 million children globally, yet it is entirely preventable. Dental health professionals around the world need to act to improve use of measures to prevent ECC and of quality dental health care to improve oral health worldwide. The University of California/Los Angeles (UCLA) Center for Children's Oral Health hosted an interprofessional innovation forum to discuss and recommend options. We present the policy, educational, and public health-related suggestions for improving outcomes and professional collaboration and five key areas for action: (1) increase advocacy efforts, (2) support interprofessional education and practice, (3) promote oral health education and increase health literacy, (4) increase collaboration with community and school-based oral health care workers, and (5) use of technology to increase access to dental care and health information.

Attitude towards shared learning activities and Interprofessional education among dental students in South India

BACKGROUND

Interprofessional Education (IPE) and Interprofessional Collaboration (IPC) are being introduced in healthcare institutions gradually to enable comprehensive learning and its application to enhance community health outcomes.

OBJECTIVES

To assess the attitude of dental students towards Interprofessional Education (IPE) and Interprofessional Collaboration (IPC) To assess whether Readiness for Interprofessional Learning Scale (RIPLS) is a suitable instrument to measure the attitude of under graduate dental students towards IPE. To assess how the study year and gender affect the attitude of under graduate dental students towards IPE.

METHODS AND MATERIALS

The research design was a cross-sectional survey. The dental students of first to fifth year based on availability of students and the existing academic calendar were participated in the study. A total number of 417 validated RIPLS questionnaire were distributed to dental students studying in two dental institutions at Manipal in South India in the year 2017 with the collected response rate of 81.53%. Principal component analysis of the responses was applied to the data along with Varimax rotation and Cronbach alpha to confirm the internal consistency of the questionnaire. Independent sample t test and ANOVA were used to assess the differences between the groups.

RESULTS

Seventy five percent of the respondents were females, and the mean age was 21.26 years (SD = 1.34). The mean scores in RIPLS and all its subscales were high. The mean scores were also higher as the year of study increased and with female students. Senior and female dental students had more encouraging attitudes towards shared learning.

CONCLUSIONS

The RIPLS can be utilised to determine the different subscales of learning namely learning behaviour, attitudes, teamwork and collaboration, professional identity perspectives, and roles and responsibilities towards interprofessional education of dental students. The dental students with an Indian outlook, perspective and training had a favourable attitude towards interprofessional learning.

The Dental Hygienists in Sweden and Portugal: A Comparative Study

Aims and Objectives:

The aim of the present study was to identify the dental hygienists (DHs)’ working areas and compare these findings between Sweden and Portugal.

Materials and Methods:

A web-based questionnaire was sent by E-mail to all 2943 members of the Swedish DH Association and 381 members of the Portuguese DH Association. The questionnaire contained questions about; number of years of work, which patient groups they worked with, if they had got sufficient knowledge from the education and what different tasks they worked with. Independent sample t-test, relative risk, and logistic regression analysis were used as statistical methods.

Results:

The response rate for Sweden was 31% (n = 923) and the corresponding figure for Portugal was 53.5% (n = 204). The most common tasks for the DHs, in both countries, were to diagnose and treat patients with periodontitis and to diagnose and perform caries prevention. In Portugal, 86.5% worked with orthodontic patients compared to 32.3% in Sweden (P = 0.001). The logistic regression analysis showed that there was a 25% (P = 0.02) higher probability that Swedish DHs took more X-rays and 38% (P = 0.042) probability that they had more communications skills compared to the Portuguese DHs.

Conclusion:

The DH profession in Sweden and Portugal was overall quite similar. Despite a few local differences, both the academic education and scope of practice corresponded well between the countries. The few discrepancies could be explained by differences in legislations in each country.

Dental and Dental Hygiene Students' Perceptions of Status Quo, Benefits of, and Curricular Suggestions for Shared Learning: On the Road to IPE?

In 29 U.S. academic institutions, dental and dental hygiene students are educated on the same campus. The aims of this study were to explore the perceptions of dental and dental hygiene students on the same campus concerning the status quo of shared educational experiences, the benefits of shared education, and their curricular suggestions for shared education. Additionally, the study investigated whether the number of shared courses was correlated with the perceived benefits of shared learning. A survey was sent in 2016 to a chief administrator at all 29 dental school and dental hygiene programs that were on the same campus, with a request that the administrators forward the invitation email to all their students. A total of 375 dental and 117 dental hygiene students at 12 universities responded. The students reported that three of the nine dental hygiene programs and two of the six dental programs had no shared courses. The majority of dental/dental hygiene students agreed or agreed strongly that having joint classes would allow them to develop better relationships between dental and dental hygiene students (57%/57%) and gain a better understanding of each other's roles (50%/63%) and of what the other discipline "is all about" (54%/46%). Compared to dental hygiene students, dental students were less supportive of suggestions for curricular interventions such as partnering up in lab (on a five-point scale with 5=most positive: 3.99 vs. 3.56; p<0.001), using in-class time for shared group projects (3.83 vs. 3.27; p<0.001), and shadowing in clinics (4.26 vs. 3.16; p<0.001). The more courses dental and dental hygiene students jointly attended, the higher their percentage of clinic time spent on collaborative care (r=0.19; p<0.001). Having dental and dental hygiene programs on the same campus offers opportunities for shared learning, and this study's results suggest those opportunities may translate into increased shared learning.

Interprofessional Education in U.S. Dental Hygiene Programs: Program Director Responses Before and After Introduction of CODA Standard 2-15

A 2014 survey found that dental hygiene program directors perceived interprofessional education (IPE) as a priority for themselves and the dental hygiene profession in the U.S. The aim of this study was to explore whether IPE collaborations in dental hygiene programs and program directors' attitudes changed from 2014 to 2017 since the Commission on Dental Accreditation (CODA) Standard 2-15 on IPE was introduced in August 2016. In May 2017, directors of all 325 U.S. dental hygiene programs were invited to participate in a web-based survey. A total of 117 directors responded, for a 38% response rate, and their responses were then compared with the responses in 2014 (that survey had a 33% response rate). The results showed that, while the percentage of responding dental hygiene programs with a nursing program on campus had decreased (90% to 80%; p<0.022), the likelihood of having other health care-related programs on campus did not change. In 2017 as compared to 2014, the programs were still most likely to collaborate with nursing (50% vs. 46%) and other allied health professions (44% vs. 56%) and in intraprofessional education with dental assisting programs (41% vs. 41%). IPE was still most likely to occur in volunteer activities (68% vs. 73%), basic science courses (65% vs. 60%), and communications training (63% vs. 63%). In 2017, program directors rated IPE as less challenging for programs to manage than in 2014 (on five-point scale with 1=not at all challenging: 3.31 vs. 3.62; p=0.022). However, the responding directors did not view IPE as being as important to the profession in 2017 as the respondents reported in 2014 (3.29 vs. 3.88; p<0.001). The majority in 2017 agreed/strongly agreed that Standard 2-15 will improve the profile of dental hygiene as part of the health care team (77%) and contribute to integrating dental hygiene into interprofessional care (IPC) teams (78%). Overall, this study found that the introduction of an explicit IPE dental hygiene CODA standard in 2016 had already resulted in changes after only one year. However, the responding program directors' lower agreement with statements concerning their graduates' IPC-related competence deserves further attention.

Interprofessional education in dentistry

A collaborative health workforce is required to respond to the increasing demands on healthcare resources. Various national and international bodies are promoting interprofessional education (IPE) as a method to provide this collaborative health workforce. IPE is therefore becoming increasingly prominent within healthcare training and will be an essential aspect of dental education. A literature search was completed to provide this narrative review which will introduce IPE, discuss the rationale for IPE within dentistry and the challenges faced. Based on current literature, it will provide practical advice on how to implement an effective IPE learning activity within dentistry.

Dental participation in geriatric interprofessional education courses: A systematic review

INTRODUCTION

Although the interdisciplinary management of the ageing individual is highly stressed, there is limited information on the outcomes of interprofessional education (IPE) activities of dental students in geriatrics. This systematic review aimed to identify studies with dentists participating in formal IPE courses in geriatrics and assess the outcomes reported.

MATERIAL AND METHODS

Electronic databases (PubMed, EMBASE, CINAHL and Scopus), reference lists from relevant studies and cited papers were investigated. The inclusion criteria were as follows: about formal interactive learning; learners from at least 2 disciplines; including dentists; related to geriatrics; any study design; reporting any outcome; only full papers; published in peer-reviewed journals; English language.

RESULTS

Of the 1259 records retrieved, 26 were assessed for eligibility based on defined inclusion criteria and 7 studies were included in the final analysis. Two studies reported specific outcomes for dentists with lower, or even negative, post-training scores for interprofessional collaborative practice competences compared to other disciplines, but only one of them used a previously validated scale. There were no reports on the effect of IPE courses on dental trainees' gerodontology skill improvements or on their attitudes towards the older persons.

CONCLUSION

The existing evidence is insufficient to determine any outcomes of formal interprofessional training of dentists in geriatrics. More studies with better experimental design should be developed. Among the strengths of IPE in geriatrics are the interdisciplinary nature of geriatric care, the sharing of common geriatric competences among participating disciplines and the opportunity to use nursing homes as a training site.

A comparative study of interprofessional education in global health care: A systematic review

BACKGROUND

The World Health Organization (WHO) and its partners identify interprofessional (IP) collaboration in education and practice as an innovative strategy that plays an important role in mitigating the global health workforce crisis. Evidence on the practice of global health level in interprofessional education (IPE) is scarce and hampered due to the absence of aggregate information. Therefore, this systematic review was conducted to examine the incidences of IPE and summarize the main features about the IPE programs in undergraduate and postgraduate education in developed and developing countries.

METHODS

The PubMed, Embase, Web of Science, and Google Scholar were searched from their inception to January 31, 2016 for relevant studies regarding the development of IPE worldwide, IPE undergraduate and postgraduate programs, IP interaction in health education, IPE content, clinical placements, and teaching methods. Countries in which a study was conducted were classified as developed and developing countries according to the definition by the United Nations (UN) in 2014.

RESULTS

A total of 65 studies from 41 countries met our inclusion criteria, including 45 studies from 25 developed countries and 20 studies from 16 developing countries. Compared with developing countries, developed countries had more IPE initiatives. IPE programs were mostly at the undergraduate level. Overall, the university was the most common academic institution that provided IPE programs. The contents of the curricula were mainly designed to provide IP knowledge, skills, and values that aimed at developing IP competencies. IPE clinical placements were typically based in hospitals, community settings, or both. The didactic and interactive teaching methods varied significantly within and across universities where they conducted IPE programs. Among all health care disciplines, nursing was the discipline that conducted most of the IPE programs.

CONCLUSION

This systematic review illustrated that the IPE programs vary substantially across countries. Many countries, especially the academic institutions are benefiting from the implementation of IPE programs. There is a need to strengthen health education policies at global level aiming at initiating IPE programs in relevant institutions.