An Assessment of Oral Health Training in Obstetrical Care in Massachusetts

PURPOSE

Oral health (OH) has significant effects on pregnancy and infant outcomes. This study assesses the perspectives of obstetrical clinicians about OH education and promotion.

METHODS

A fifteen-item survey was developed and circulated to obstetrics and gynecology (OBGYN) and family medicine (FM) physicians, and other prenatal health clinicians in Massachusetts (MA). Additionally, eight physicians were purposively sampled for in-depth interviews to discuss their experience with prenatal OH training and practice. Bivariate relationships between outcome variables from the survey (e.g., previous OH training, awareness of OH guidelines, asking about OH during prenatal visits) were analyzed along with coding and analysis of the qualitative interview data.

RESULTS

The majority (77%) of the 86 survey respondents did not feel well-trained in OH. We found significant associations between being well-trained in OH and: (1) awareness of state guidelines (X2 = 11.85, p < 0.001); (2) asking about OH during prenatal visits (X2 = 9.21, p = 0.002); and (3) routinely referring patients for dental care (X2 = 15.35, p < 0.001). Lack of access to dental insurance and dental professionals were found to be major perceived barriers to care. Responses from the interviews reinforced these findings.

APPLICATION OF SPORTS BIOMECHANICS IN THE TECHNICAL ANALYSIS OF TAEKWONDO KICKING

ABSTRACT Introduction: With the gradual improvement of the theoretical system of sports biomechanics and the high requirements of Taekwondo development, the scientific research of Taekwondo is no longer restricted to a monothematic perspective; sports biomechanics is a combination of the complex forms of movement and body changes in the sport, a discipline that combines the principles of mechanics and biology for research. This discipline, allied to the study of sport, contributes to the correct understanding, training, and mastery of movement techniques. Objective: Apply a technical analysis of the taekwondo kick through a sports biomechanics approach. Methods: Using a three-dimensional kinematic motion capture system, volunteers of 58kg, 68kg, 80kg, and three other weight classes, in a total of 30 athletes, participated in this research. The movements included technical kicks and the collection of motion trajectories when hitting the target. Results: There were significant differences in the angle, angular velocity, torque, action time, displacement, and velocity of the lower limb joints of the three weight classes (P<0.05). Conclusion: The higher the athlete’s weight, the lower the body agility; although the striking distance is relatively long, the impact on movement speed is relatively minor. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Integrating Oral Health into Health Professions School Curricula

Oral health is essential to human health. Conditions associated with poor oral health involve all organ systems and many major disease categories including infectious disease, cardiovascular disease, chronic pain, cancer, and mental health. Outcomes are also associated with health equity. Medical education organizations including the Association of American Medical Colleges and National Academy of Medicine recommend that oral health be part of medical education. However, oral health is not traditionally included in many medical school, physician assistant, or nurse practitioner curricula. Several challenges explain this exclusion including lack of time, expertise, and prioritization; we therefore provide suggestions for integrating oral health education into the health professions school curriculum. These recommendations offer guidance for enhancing the oral health curriculum across institutions. We include key organizational and foundational steps, strategies to link oral health with existing content, and approaches to achieve curricular sustainability.

Oral health curriculum evaluation tool (OHCET) for primary care training programs

BACKGROUND

Primary care training schools and programs lack a validated tool to assess their oral health curriculum, and researchers lack a tool to compare oral health curricula across programs/schools and different disciplines.

OBJECTIVE

This study describes the process and results of creating a 15-item oral health curriculum evaluation tool (OHCET).

METHODS

Three-phased development of the OHCET from 2018 to 2020 including (a) Delphi group/tool development; (b) tool pilot test; and (c) tool validation/cognitive interviews.

RESULTS

A total of 23 program deans/directors participated in the tool validation/cognitive interviews. Summarizing accuracy scores of all 15 items, the mean accuracy score was 87.1. There was a high correlation (0.917) between the program's total score and the program director's self-assessed competence of their learners at the time of graduation.

CONCLUSIONS

The OHCET was validated and can be used in primary care training programs and schools across the country for institutional evaluation and for research purposes. Program directors and deans can also have some confidence that their ability to subjectively assess their learner's oral health knowledge and skills at graduation is accurate.

Context matters: Integration of social determinants of health in AEGD and GPR curricula

PURPOSE

To examine the integration of social determinants of health (SDH) in the US Advanced Education in General Dentistry (AEGD) and General Practice Residency (GPR) programs.

METHODS

This study used an explanatory sequential mixed-methods approach. A 46-question survey was sent to all 265 AEGD and GPR programs in February 2019. Descriptive statistics and multivariate analyses were conducted to identify factors influencing SDH curricular inclusion. A convenience sample of program directors (PDs) was interviewed between June and December 2019. Through content analysis, themes and subthemes were identified.

RESULTS

Of the 265 AEGD and GPR PDs, 111 completed the survey (42% response rate). Almost three-quarters of PDs (72%) agreed that it was important for residents to understand basic SDH concepts. However, programs lacked eight of the 10 surveyed SDH subtopics. The odds of teaching five or more SDH subtopics were 0.09 (95% CI: 0.02-0.41) for programs with none-to-minimal levels of SDH integration in their clinical settings compared to close-to-fully integrated ones. Coding of PD interviews (N = 13) identified five major themes: 1. influences to integrate SDH, 2. training strategies, outcomes, and outputs, 3. reasons for training strategies, 4. barriers and solutions, and 5. future integration goals. Most PDs cited delivering SDH content during patient care and reported time and organizational culture being barriers to more curricular inclusion.

CONCLUSIONS

AEGD and GPR curricula are deficient in SDH content and risk underpreparing residents for caring for the underserved. PDs and organizational leaders must prioritize SDH inclusion in order to train dentists for integrated person-centered care.