Community Health Centre-Based Outreach Clinic for undergraduate dental education: Experience in Helsinki over 8 years

In Which Ways Does Community-Based Dental Education Facilitate Development of Professional Identity in Undergraduate Curricula? A Scoping Review

BACKGROUND

Community-Based Dental Education (CBDE) is becoming an integral part of undergraduate dental curricula globally. Literature has provided a wide range of benefits related to supporting the development of several professional skills such as communication and social interactions in community settings for dental students. While these skills are related to professional identity (PI) development, there has been little discussion linking CBDE with PI development in the current literature. To fill in this literature gap and explore pedagogical potentials to support PI for undergraduate healthcare curricula, this study provides a scoping review of the literature to analyse how published studies link CBDE to the development of PI.

METHODS

PRISMA extension for Scoping Reviews (PRISMA-ScR) was used to conduct the review. The review protocol was registered with Open Science Framework to ensure transparency. Multiple electronic databases were searched, followed by screening of the articles based on the inclusion and exclusion criteria. Qualitative analysis of the included articles was conducted using NVIVO by two independent reviewers.

RESULTS

A total of 4483 articles were identified from databases. The full-text screening was performed for 101 articles by two reviewers, out of which 35 articles were included in the analysis. The reviewed articles provide a diverse perspective of association and contribution to PI development through CBDE. Four dimensions were identified, including personal, clinical, interpersonal, and cultural. Most of the studies focussed on attaining clinical experience, while other studies explored confidence, teamwork skills, communication skills, and cultural awareness among undergraduate students in CBDE.

CONCLUSION

The current study explores the value of CBDE to foster PI development in undergraduate education. Although the existing literature identifies some elements in CBDE that may contribute to PI development, the link between it and CBDE does not appear to be articulated clearly. The results of the review provide practical implications for the future practice of CBDE and its relevance to professional identity development.

A Framework for Implementing Community-Based Dental Education

Community-based dental education (CBDE) is essential for equipping dental students with the practical skills required for independent practice while simultaneously addressing the oral health needs of the community through real-world experiential learning. The success of CBDE initiatives rely on effective collaboration across stakeholders, including educational institutions, community organisations, and students, to address both faculty educational goals and community oral health needs. This paper introduces a practical toolbox to support CBDE program implementation. Developed from an extensive literature review, analysis of relevant case studies, and insights from the authors' experiences, the toolbox provides structured, evidence-based guidance on planning, administration, and ongoing evaluation for CBDE programs. Key components include strategies for fostering robust partnerships with community organisations, designing program components that maximise student engagement, and implementing continuous quality improvement practices. The toolbox emphasises creating an adaptable framework that ensures CBDE programs remain responsive to the evolving needs of both students and the communities they serve and sustain long-term collaborations.

What are the public health benefits of community-based education in dentistry? A scoping review

Aim To examine what is known about the public health benefits of community-based education in dentistry.Method A scoping review was conducted using a modified Arksey and O'Malley framework. Database searches were undertaken on PubMed, Medline via Ovid, CINAHL via EBSCO and ERIC, and a grey literature search was undertaken on OpenGrey, Medlar, BASE and the British Library. Reference lists of included studies were also searched. Although no formal quality assessment was undertaken, observations on methodological rigour were recorded.Results In total, 31 studies from nine countries met the inclusion criteria. Most were from high-income countries. Methodologies of included studies varied: quantitative (n = 17); qualitative (n = 5); mixed methods (n = 6); and reviews (n = 3). Several potential public health benefits were reported: increased access to dental services (including improvements in their availability, affordability, acceptability, accessibility, and accommodation); improved awareness/health literacy of students and communities; and improved clinical outcomes. The overall quality of the evidence was low and had little community engagement.Conclusion Notwithstanding the methodological limitations of the included studies, several potential public health benefits have been associated with community-based education in dentistry. Rigorously designed, methodologically appropriate research is needed, which should include engagement with communities.

Community-Based Dental Education (CBDE): A Survey of Current Program Implementation at Australian Dental Schools

Purpose

Community-based dental education (CBDE) diverges from traditional dental school training methods by integrating dental students into primary care community settings. This immersive approach enables students to refine their clinical and hands-on skills while serving the oral health needs of underserved populations. This study aimed to identify ways in which Australian dental schools are currently implementing CBDE and compared to current evidence.

Materials and Methods

This study utilized a 24-item, self-completion survey, adapted from existing questionnaires, which was sent to the CBDE coordinators in the nine eligible dental programs in Australia between mid-January 2023 and mid-April 2023. The survey consisted of multiple-choice, binary, and open-ended questions, including information on the level of student involvement, types of external clinics used, length of rotations, student supervision and assessment, pre-rotation preparation, and post-rotation evaluation, as well as challenges faced in implementing programs.

Results

Six of the nine invited coordinators responded, resulting in a 66.7% response rate. All participants confirmed that their schools had a community-based teaching program. All six respondents reported that participation in external clinics is required for graduation. Implementation of CBDE appears to be influenced by (1) level of student involvement, (2) the types of clinics utilised, (3) allocation and length of rotation, (4) student supervision and assessment, (5) pre-rotation preparation, and (6) post-rotation evaluation. Six (n = 6) institutions reported requiring a post-rotation reflection from students and all respondents reported seeking feedback from clinical supervisors at external sites. Emerging themes from open-ended questions highlight challenges in coordinating external rosters, securing funding, supervising students at external sites, and ensuring diverse types of student exposure during external rotations.

Conclusion

This study provided insights into the implementation of CBDE in Australian dental schools. Results outlined in this research offer valuable insights for dental schools aiming to enhance their programs and improve student learning outcomes.

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.

Student and clinical supervisor perceptions of community-based dental educational experiences: A scoping review

PURPOSE

This scoping review was conducted to map the breadth of experiences in community-based dental education (CBDE), as reported by students and clinical supervisors.

METHODS

This scoping review was conducted following the structured framework proposed by Arksey and O'Malley and adhering to PRISMA-SCR guidelines for scoping reviews. Applying specified eligibility criteria, a systematic search of four electronic databases (PubMed, Scopus, Embase, and Web of Science) was followed by data extraction and data synthesis of full-text articles. Research was conducted between June 2022 and September 2022.

RESULTS

Sixteen articles were identified for the final full-text review. Utilizing a narrative thematic review, the following five domains emerged: preparation for autonomous practice, understanding of primary care dentistry, understanding of health disparities and patient needs, clinical confidence, clinical diversity, and skill development, and perspectives on quality of teaching and assessment.

CONCLUSION

Community/outreach dental education effectively supplements traditional dental school-based education from the perspectives of students and community-based clinical supervisors.

Community-based education programmes in the context of dental education: A scoping review

BACKGROUND

Community education programmes are vital tools for teaching skills, such as understanding the larger cultural, economic and social determinants of health and how these factors impact people's health. It is currently unclear whether community education programmes in the field of dentistry deliver adequate value. This review aims to scope, collate and analyse globally published evidence concerning community education programmes in dentistry from inception, to gain an understanding of the intentions for these programmes and establish whether outcomes have shifted over time from the original intentions.

METHODS

Arksey and O'Malley's framework for scoping reviews was employed to guide the reviewers. A systematic search of electronic databases and the reference lists in key papers was conducted.

RESULTS

A systematic search concerning community education in dentistry identified a total of 140 papers for full-text evaluations. After further exclusions, 115 articles were selected for data charting. There was a lack of clarity in the literature concerning programmes' definitions and strategies for achieving intentions. Origins, intentions and motivations of the programmes were identified. The literature largely focused on assessing students' clinical treatment skills, contradicting the programme's original idea and intentions. Only a few studies incorporated patient and community perspectives, and the majority of assessments were self-reported, primarily by students.

CONCLUSIONS

There is broad interest in integrating community education into dental curricula to teach complex concepts, dental public health principles and to ensure professional skills development. We identified issues in the literature around programme definitions, strategies, measurement approaches and programme success requiring additional research.

O-Health-Edu: A viewpoint into the current state of oral health professional education in Europe: Part 2: Curriculum structure, facilities, staffing and quality assurance

INTRODUCTION

Oral health professional (OHP) education is likely to vary across Europe in accordance with an EU directive that is open to broad interpretation. It is not clear how OHP curricula are structured or delivered across Europe. The objectives of Part 2 of this paper series are: (i) to provide an overview of common practices in curriculum structure, the availability of facilities, staffing (faculty) and quality assurance processes and (ii) to consider how the existing programme structures align to stakeholder guidance documents.

METHODS

A total of 27 questions from a 91-item questionnaire were used for this manuscript. The questionnaire was developed following the Delphi method to establish consensus from a group of experts. Members of the research team and colleagues from other countries in Europe completed a multi-step piloting process. An online data hub was created to allow the respondents to be data controllers and respond to the questionnaire. ADEE member schools (n = 144) were invited to provide data.

RESULTS

Totally, 71 institutions from 25 European countries provided data between June 2021 and April 2023, which represents a response rate of 49.3% of ADEE members. Data on curriculum approaches, teaching methods, integration of topics of interest, clinical education, staff-student ratios, access to facilities and new technologies, teaching staff (faculty) and quality assurance processes are presented for Primary Dental Degree Programmes.

CONCLUSION

To the best of our knowledge, this series of papers are the first attempts to provide a comprehensive overview of OHP education in Europe. Results showed that the majority of European dental programmes are engaged in providing innovative and scientifically grounded education in order to develop quality future OHPs. Nevertheless, significant variability in the delivery of clinical education across the European OHP schools was notable in this dataset. A comprehensive view of the state of OHP education in Europe is not yet available but the O-Health-Edu data hub provides a means for all education providers in Europe to contribute data to reach this goal. It is anticipated that the data hub will be updated and built upon over time to continually establish a clearer picture of the state of OHP education in Europe.

Outreach Medicine as an Experiential Teaching Tool to Improve Veterinary Student and Client Education

Outreach medicine is used to improve students' medical, technical, behavioral, and communication training among health professional schools; it is also used in veterinary schools, but little has been described on its educational impacts among pre-clinical veterinary students. Aiming to train practice-ready graduates, we established a monthly nonprofit vaccine clinic serving low-income clients to provide pre-clinical veterinary students with a realistic experiential learning environment. We developed surveys to assess the educational impacts of outreach medicine on pre-clinical veterinary student and client education. We received 101 student surveys, 26 educator (i.e., veterinarians and registered veterinary technicians) surveys, and 96 client surveys. Veterinarians, students, and technicians reported that students improved in important veterinary skills such as client communication, subcutaneous injection, patient handling, and physical examination. They also reported improved confidence in students' clinical decision making. Veterinarians valued the vaccine clinic as a favorable educational tool to teach behavior assessment and low-stress handling, and they highlighted that experiential learning via the vaccine clinic provided students with a clinical experience representative of most veterinarian practices (i.e., small animal general practitioner). Clients reported that the clinic's students and veterinarians greatly improved their knowledge of their pets' care and vaccines-notably, their knowledge of rabies and leptospirosis improved. Outreach medicine in the form of a vaccine clinic creates valuable experiential learning opportunities that increase veterinary student preparedness and complement didactic, laboratory, and case-based teaching.

Does the student-led osteopathy clinical learning environment prepare students for practice?

BACKGROUND

For many allied health disciplines, pre-professional clinical education takes place in student-led, on-campus clinic environments. In these environments, pre-professional students undertake patient care under the supervision of qualified health professionals. Literature exploring the benefits of the student-led clinical learning environment is limited and little is known about the role student-led clinics play in preparing pre-professional osteopathy students for professional practice.

AIM

To explore the perceptions of osteopathy clinical educators about the role of the student-led clinic at Victoria University (VU) in preparing pre-professional students for professional practice.

METHODS

A qualitative collective case study methodology was utilised to explore clinical educator perceptions. Individual interviews were conducted with clinical educators employed in the university osteopathy clinic. Interview questions were framed around the Capabilities for Osteopathic Practice which set the Australian osteopathy practice standards. Data were assessed by two of the authors using thematic analysis.

RESULTS

Nine clinical educators out of 31 employed at the university clinic (29%) agreed to participate. Qualitative analysis generated three themes: perceptions of the student-led clinic (SLC) as a learning environment; clinical educator perception of their role in the SLC; and, challenges to and of the SLC environment.

CONCLUSIONS

Clinical educators perceived that the student-led osteopathy clinical learning environment develops pre-professional learners to meet some, but not all, of the capabilities for professional practice as an osteopath in Australia. The environment may be improved through faculty development, fostering a proactive learning approach, addressing system-based issues, and providing opportunities to interact with other health professions.

Assessment of oral hygiene trends among dental patients in relation to chronic medical conditions by dental students. A cross-sectional study

INTRODUCTION

There is a lack of information about knowledge, attitude and behavior regarding oral hygiene and dietary habits of adult patients attending dental clinical settings. Hypertension, diabetes, obesity and caries are increasing among different populations, resulting in the deterioration of the quality of life related to oral and general health.

OBJECTIVES

To involve second year dental students in assessing oral health knowledge, attitude, behavior, dietary habits and general health of dental patients, and screening for blood pressure, blood glucose level and obesity.

PARTICIPANTS AND METHODS

A convenient sample of 652 adult subjects participated in the study. They were screened, and involved in an interviewer - led questionnaire, led by the students over the period of two successive academic years (2013-2014 and 2014-2015).

RESULTS

Subjects with high blood pressure and /or blood glucose levels were more likely to disagree regarding the presence of a relation between general health and dental health [(correlation coefficient (r) = - 0.159, probability value P < 0.001) (correlation coefficient (r) = - 0.257, probability value P < 0.001) respectively]. Subjects with high BMI were less aware of the importance of using the tooth brush in prevention of gingival inflammation. The overall students' satisfaction score was 71.5%. The practical part of the research had the highest satisfaction score (83.7%).

CONCLUSIONS

There is scarcity of data regarding dental healthcare knowledge and attitudes in dental clinical settings. Additional clinical training for dental students would increase their willingness to play a preventive and educational role in the oral care of patients.