Educational debt and intended employment choice among dental school seniors

Impact of Dental Institutions' Values on Students' Intent to Practice in Underserved Communities: A Cross-sectional Study

AIM

To evaluate how an institution's values can impact students' intent to practice in underserved areas.

MATERIALS AND METHODS

The values of 71 accredited dental schools in the United States were searched and tabulated. The American Dental Education Association (ADEA) survey results were used to tabulate the desire to serve the underserved population before entering dental school and upon graduation. Additionally, responses on the total amount of educational debt on graduation was compiled for LLUSD and all other dental schools. Fisher's exact test was performed to compare the difference between the two cohorts and Wilcoxon test was used to assess difference within the groups. Tests were conducted at an alpha level of 0.05 with SAS v 9.1.3 (SAS Institute, Cary, NC, USA).

RESULTS

The top five values of US dental institutions based on frequency were excellence, diversity/inclusion, integrity, innovation, and respect. There was no statistically significant difference between LLUSD and all other dental schools in their desire to serve the underserved community upon graduation (p > 0.05, in all instances). Overall, there was a trend that upon graduation, the desire to serve the underserved had less impact on students' decision-making on their career choices. This drop in the desire to serve the underserved was statistically significant within both cohorts in the year 2021 (p < 0.001).

CONCLUSIONS

Dental institutions should focus on better understanding of how their values impact their students' career choices so that they can develop strategies to better align their values with the mission of addressing the dentist shortage in underserved areas.

CLINICAL SIGNIFICANCE

Dental institutions' values play a major role in impacting students' career choices upon graduation and should be assessed using metrics that are measurable.

The association of dental education with pediatric Medicaid participation

PURPOSE

This study examines whether characteristics of dental education, practice characteristics and state Medicaid policies are associated with dentists' pediatric Medicaid participation.

METHODS

Cross-sectional analysis of data about dentists' Medicaid participation in 2016, based on current practice characteristics and characteristics of dental schools they attended 5 to 10 years earlier. We analyze data about 22,500 general and pediatric dentists, drawn from the American Dental Association's Masterfile for 2016 and its dental school survey for 2009-10. The primary outcome is whether dentists participated in Medicaid-enrolled to accept Medicaid patients and payments-in at least 1 of their practice sites in 2016.

RESULTS

A majority (55%) of dentists accepted Medicaid in at least 1 practice site, while a quarter (24%) accepted Medicaid in all their sites. Dentists who attended schools with higher tuition rates were less likely to serve Medicaid patients at any site several years later (adjusted odds ratio [AOR] = .761). Dental schools' receipt of grants that encourage community-based training were associated with increased Medicaid participation at all sites (AOR = 1.22). Those practicing in rural areas also had higher Medicaid participation (AOR = 2.62). A 10% increase in Medicaid reimbursement rates was associated with increased Medicaid participation at any site (AOR = 1.24).

CONCLUSIONS

Dental school practices and state Medicaid policies are associated with whether dentists care for Medicaid patients. Changes in dental school or Medicaid policies, such as higher reimbursement rates, could help encourage more dentists to accept Medicaid patients, thereby increasing access to care.

Practice management curricular changes may lead to enhanced preparedness for practice

PURPOSE

The 2018 American Dental Education Association Survey of Dental School Seniors showed that 62.5% of graduates felt prepared in practice administration compared to 49.5% in 2013. The aim of this study was to survey and Internet search U.S. Dental Schools' Practice Management curriculum (PMC) to assess if and what changes, made in the past 5 years, may account for the continued increase in dental graduates' perception of preparedness for practice METHODS: An electronic survey was emailed to 64 dental schools querying factors for changes in PMC, updates in instructors, instructional methods, technology, topics, hours, and content enhancements. In addition, if a dual degree in business administration was developed or planned in the future.

RESULTS

Twenty-three schools responded for a 36.0% response rate. All participants (100.0%) indicated PMC changes, 73.9% responded that changes were motivated by student interest, and 60.9% planned future PMC improvements. All respondents (100.0%) updated subject matter and 52.2% had added technology, including Web-based business model and simulation courses. Two schools added dual degree MBA programs in 2017 due to student interest in entrepreneurship and administrative goals.

CONCLUSION

The study showed that upgrades in topics and teaching methods with Web-based technology, dual degrees, and additional focus on PMC hours, sequence, and number of practice administration courses in D1 and D2 years may be contributory factors for the development of enhanced skills and enhanced attitudes of graduates for practice readiness. Future study is needed to assess if these PMC improvements and advanced business courses have been successful in practicing dentists' careers.

Attitudes and behaviors regarding public health of dental school graduates from A. T. Still University

PURPOSE

To survey A. T. Still University, Arizona School of Dentistry & Oral Health (ATSU-ASDOH) graduates and evaluate the impact of completing a Master of Public Health (MPH) degree during dental school on a dentist's practice behaviors, volunteerism, and attitudes toward dental education, practice preparedness, and the dental profession.

METHODS

In 2018, a 35-question survey was emailed to 637 (ATSU-ASDOH) graduates from 2007 to 2017. Questions were related to demographics, obtaining an MPH, postgraduate education, practice setting, and attitudes regarding dental education on practice preparedness and the dental profession.

RESULTS

One hundred and seven dentists completed the survey for a response rate of 16.8%. Of those, 40 respondents received an MPH from (ATSU-ASDOH) at the same time as graduating with a DMD or within 5 years following graduation. Dentists with an MPH were more likely to practice in public health settings (P = 0.028). However, the MPH did not appear to influence attitudes toward the dental profession.

CONCLUSION

Dentists from (ATSU-ASDOH) who obtained an MPH and those who entered dental school wanting to work with the underserved are more likely to practice within public health settings. This study begins to paint a picture of a dual degree graduate. Future studies should explore which variables are more likely to result in a graduate working within a public health setting.

Trends associated with debt loads among oral and maxillofacial surgery chief residents

OBJECTIVE

This survey-based study was undertaken to investigate how total debt loads are impacting the personal and professional decisions made by graduating oral and maxillofacial surgery (OMS) residents. The aim of this study was to evaluate differences in total debt load on graduating residents and analyze the effects of this debt on career, family, and lifestyle choices after graduation.

STUDY DESIGN

This study was a cross-sectional, web-based survey of all graduating OMS residents in accredited OMS residency programs in the United States. Participation in the survey was optional, and all responses were anonymously collected and the data analyzed by using Qualtrics software. The respondents were analyzed as a collective, with the predictor of the study being program training length and the outcome being total debt load, with independent analysis of select other financial variables.

RESULTS

For the 246 deliverable emails, there were 120 respondents (48.7% response rate). The average graduating OMS resident was a Caucasian male (median age 32 years), living with a significant other or spouse who independently earned money, and had no dependents. The average range of accumulated debt of graduating residents was between $300,000 and $350,000, with 50.83% of the respondents having $350,000 or less in overall debt and 49.17% of the respondents having $350,000 or greater in accumulated debt. For those respondents completing 4-year programs, the average range of accumulated debt was between $250,000 and $300,000, and for those respondents completing 6-year programs, the average range of accumulated debt was between $400,000 and $450,000 (P < .08).

CONCLUSIONS

Graduating OMS residents carry with them a significant amount of debt whether graduating from a 4-year program or a 6-year program. However, when subjectively queried, most of these residents stated they would again choose OMS as a career choice.

A Long-Term Follow-Up Study of Former Dental School Teaching Assistants: Are They Teaching After Graduation?

There has been growth in teaching opportunities for dental students over the past two decades, but little research on whether these experiences have led to actual positions in academia. The aims of this study were to determine whether former teaching assistants at New York University College of Dentistry continued in dental academia after graduation or intended to teach during their careers and to assess their reasons for or for not teaching. Of the 294 former teaching assistants who taught their peers from 2003 to 2014, 106 responded to a survey, for a response rate of 36%. Of the respondents, 28% reported having teaching appointments, with 7% (n=8) having full-time teaching appointments and 21% (n=22) having part-time teaching appointments in a dental school or hospital-based program at some point after graduation. The most common reasons given for teaching were "intellectual stimulation" and "enjoyment" followed by "interactions with students." The most reported reason for not teaching was "student loan debt," followed by "too busy building private practice," "limited teaching opportunities in area," and "family commitments." Significantly, 95% of these former teaching assistants either taught or intended to teach during their careers, and they were six times less likely to rule out future teaching than dental school seniors in national surveys. These findings suggest that participating in teaching opportunities in dental school plants the seed for future teaching. More follow-up studies should be undertaken to see which types of teaching assistant programs are more successful in creating long-term teaching commitments.

The perceived impact of the group practice model on enhancing interpersonal skills of predoctoral dental students

Purpose

The purpose of this study was to assess if a clinical group practice model has an impact on enhancing the interpersonal skills of predoctoral dental students, what factors may influence the development of these skills, and what, if any, are innovative and technological solutions that can potentially influence interpersonal skills in predoctoral dental students.

Methods

This study surveyed the faculty responsible for teaching the dental students in a recently developed group practice model. Out of 18 eligible group practice leaders at one US dental school, 17 respondents (94.4%) completed the survey. In addition, this study asked the faculty to provide qualitative response and recommendations to improve interpersonal skills. Based on the feedback, a focus group was conducted to explore opportunities to further enhance the skills.

Results

The results of the study suggest that the group practice model has a positive and distinct impact on the development of overall interpersonal skills for students. Further research suggests that the greatest impacted areas of personal development are critical thinking skills and teamwork. However, as a way to make the model more effectual, most faculty suggested the need for additional time, for both students and faculty. To some extent, using technology and innovative teaching pedagogies could potentially address the challenge of limited time.

Conclusion

Based on the results of the survey, one may conclude that with adequate design and conditions, the group practice model can have a positive effect on the interpersonal skills of its students.

Should Dental Schools Invest in Training Predoctoral Students for Academic Careers? Two Viewpoints: Viewpoint 1: Dental Schools Should Add Academic Careers Training to Their Predoctoral Curricula to Enhance Faculty Recruitment and Viewpoint 2: Addition of Academic Careers Training for All Predoctoral Students Would Be Inefficient and Ineffective

This Point/Counterpoint considers whether providing dental students with academic career training and teaching experiences during their predoctoral education would be valuable to recruit dental academicians. While training the next generation of dentists continues to be the primary focus for dental schools, the cultivation and recruitment of dental faculty members from the pool of dental students remain challenges. Viewpoint 1 supports the position that providing dental students with exposure to academic career opportunities has positive value in recruiting new dental faculty. The advantages of academic careers training as a required educational experience in dental schools and as a potential means to recruit dental students into the ranks of faculty are described in this viewpoint. In contrast, Viewpoint 2 contends that such career exposure has limited value and argues that, across the board, allocation of resources to support preparation for academic careers would have a poor cost-benefit return on investment. Adding a requirement for educational experiences for all students would overburden institutions, students, and faculty according to this viewpoint. The authors agree that research is needed to determine how and where to make predoctoral curricular changes that will have maximum impact on academic recruitment.