Teaching Cultural Competence and Cultural Humility in Dental Medicine

Comparison of Cultural Competence Between Dental House Officers and General Dentists: A Cross-Sectional Study

Background

All patients deserve quality care, regardless of their cultural, ethnic, or linguistic backgrounds. In Pakistan's diverse society, cultural competence in dentistry is crucial for patient-centered care. This study assesses and compares cultural competence levels between dental house officers (DHOs) and general dentists (GDs).

Methods

A cross-sectional, self-reported study was conducted at Altamash Institute of Dental Medicine, Karachi, over 6 months. A validated questionnaire (α = 0.856) on a 4 to 5-point scale assessed five attributes via Google forms. Data were analyzed using SPSS 23. Independent Sample t-test was used to compare DHOs and GDs, while ANOVA evaluated differences in GDs' qualification and practice settings.

Results

A total of 316 participants (response rate: 79%) were included. The mean age was 24.77 ± 2.02 years for DHOs and 31.32 ± 7.49 years for GDs. Females were predominant, and 27% of GDs worked in private practice. Both groups were somewhat culturally competent, with DHOs showing significantly higher self-perception (2.09 ± 0.61 vs. 1.92 ± 0.26, p = 0.001). However, GDs scored slightly higher in patient-centered communication, practice orientation, and cultural competence behaviors. GDs in private practice were more culturally competent than those working only in OPDs (-0.274*, F: 3.542, p = 0.001).

Conclusion

Overall, participants perceived themselves as somewhat culturally competent. DHOs demonstrated greater self-awareness and sensitivity than GDs. GDs in training and private practice exhibited higher cultural competence than those in OPDs alone.

Assessing gaps in predoctoral dental curriculum for LGBTQ+ specific content

BACKGROUND

Despite growing recognition of health disparities faced by the Lesbian, Gay, Bisexual, Transgender, Queer (or Questioning) (LGBTQ+) population, significant gaps remain for inclusion of LGBTQ+ content in health professions education, particularly dental curricula. This study aims to address these gaps by investigating the integration of LGBTQ+ content in a midwestern dental school curriculum.

METHODS

Curriculum mapping and focus group discussions were utilized to identify gaps and recommend integrating LGBTQ+ content into a predoctoral dental curriculum. The Doctor of Dental Surgery program was mapped to identify LGBTQ+ specific content relevant to cultural competency. A focus group of nine faculty members provided insights and recommendations, with data transcribed and analyzed for themes.

RESULTS

Out of 121 courses, 28 included or had potential for LGBTQ+ content, with 16 already inclusive and 12 involving direct patient interaction. Integration varied, highest in the first year (28.6%) and lowest in the fourth year (5%). Focus group themes included the need for broader awareness and education about LGBTQ+ health, integrating topics into basic and behavioral science courses, and addressing practical clinical skills (e.g., using pronouns). Barriers included personal discomfort, lack of formal training, and potential conflicts with personal or religious beliefs.

CONCLUSIONS

This study highlighted the need for increased faculty awareness and enhanced inclusion of LGBTQ+ content throughout the predoctoral dental curriculum to prepare future practitioners for culturally competent care.

Models of DEIB: Part I - Approaches to Inclusion from Other Health Professions for Consideration by Dentistry

This article represents a prologue of the discussion of the article "Models of DEIB: Part II-Exploring Models of Inclusion from other Health Professions for Dentistry". It explores existing practices and philosophies from other disciplines that could be applied toward creating environments of inclusion and belonging in dentistry. The primary focus here is to provide an opportunity for the dental profession to leverage knowledge and experiences from other health professions to enhance and expand inclusion efforts and provide enhance engagement at all levels.

Oral Health Strategies: Surveying the Present to Plan the Future of Community-Based Learning

Introduction: Oral health literacy relates to the capacity of individuals to acquire, understand and to act upon oral health information to make appropriate health decisions. This scientific review's main goal is to analyze the strategies that improve oral health literacy within the community, specifically oriented to a community-based learning model focused on the most vulnerable risk groups in society. Materials and Methods: The current review is based on the literature on oral health literacy within community-based learning strategies. The present review selected scientific studies by searching MEDLINE and related databases, such as Web of Science and PUBMED, and by consulting existing bibliographies. Results: Based on the application of the inclusion criteria to the abstracts, 45 publications were retrieved which explicitly dealt with the definitions of oral health literacy, community-based learning, and service learning. Several studies have demonstrated that health consumers with low health literacy fail to understand the available health information. Therefore, innovative oral health literacy strategies should be undertaken. Service learning is an example of an educational approach where the student learns specific soft skills in the classroom and collaborates directly with an agency or institution and engages in reflection activities to deepen their understanding of what is being taught. Conclusions: One of the main strategies used to incorporate the oral health professional in social responsibility and direct contact in the community is through experiencing community-based learning projects. The future graduate must be an educator capable of educating patients in order to themselves acquire high-level skills in oral health literacy.

Promoting Cultural Humility by Integrating Health Equity Literature into the Pharmacy Curriculum

Strategies that introduce students to unconscious bias and social determinants of health (SDOH) are critical to develop them as effective health care providers. We developed a semester-long activity that utilizes disease-relevant scientific literature to implement cultural humility training in a second-year rheumatology pharmacy course. Students were first re-introduced to implicit bias and then completed an anonymous survey at the beginning and conclusion of the course using a 5-point Likert scale to assess their perceptions of the role of biases and SDOH in patient care. Throughout the semester, five journal articles were assigned that relate to course material and focus on one characteristic (e.g., gout—gender). Students’ evolved perceptions of SDOH were compared to baseline data and characteristics of assigned articles indicate an improved understanding of SDOH including race/ethnicity (3.0 to 4.4, p < 0.0001); gender (2.8 to 4.0, p < 0.0001); and religion (2.3 to 2.9, p < 0.01). Among characteristics that were not directly discussed in the assignments, only education showed a significant increase (3.0 to 3.6, p < 0.01). Scientific articles that focus on health inequities relevant to course-specific diseases provide a strategy to integrate discussions that help students evaluate their biases and SDOH with the goal of improving patient care.

Assessing the experience of dental students with an asynchronous online course about racism, cultural competence

PURPOSE

University of Pennsylvania School of Dental Medicine and the University of Pennsylvania School of Social Policy and Practice (SP2) designed an asynchronous online course about racism and cultural competence to address student concerns about harmful interactions with peers across race/ethnicity. The Penn Experience Course establishes common language and concepts to facilitate difficult conversations about racism in the classroom and clinical spaces.

METHODS

The course included six modules addressing the history of racism in the Philadelphia area and at the University of Pennsylvania: implicit bias and microaggressions; racism and other forms of oppression; gender identity and sexuality; construction of whiteness and white supremacy ideology; cultural humility, disparities, and equity; and access in healthcare. Students completed pre- and post-course surveys about their likelihood of engaging with the neighborhood surrounding Penn, confidence discussing the topics covered, and general experience with the course.

RESULTS

Four hundred forty-nine students completed post-course surveys, 220 of which could be linked to precourse survey responses. Overwhelmingly, students reported a positive experience with the course, an increase in their likelihood to engage with the Penn neighborhood, and increased confidence in discussing course topics with peers. Many students suggested incorporating synchronous discussion, while a smaller group expressed resentment about the focus on whiteness, white fragility, and anti-Black racism. Several students of color expressed concern that the course centered the learning needs of white students.

CONCLUSION

Asynchronous online content offers an effective and efficient way of teaching dental students about the basics of cultural competence. Educators should anticipate resistance from some white students and the distinct learning needs of students of color.