Development of a rural outplacement programme for dental undergraduates: students' perceptions

Oral health services provided for Aboriginal and Torres Strait Islander peoples in Australia: a scoping review

Objective The shortage of oral health professionals in rural and remote regions of Australia directly impacts the access to oral health services for people who live in these regions, including Aboriginal and Torres Strait Islander peoples. This scoping review aims to explore where and how these services are provided for Aboriginal and Torres Strait Islander peoples and the relevant workforce model used. Methods Electronic databases, including MEDLINE, EMBASE, Cochrane, and CINAHL, were searched. Grey literature searches included the Australian Indigenous HealthInfoNet webpage, Australian Institute of Health and Welfare, and Advanced Google search. Results Oral health services were classified into the following categories: (1) clinical oral health services, (2) oral health promotion to improve oral health awareness, knowledge, attitudes, behaviours, or skills at patient/community level, and (3) oral health promotion including the use of single clinical interventions (e.g. fluoride varnish). Services were delivered in a variety of settings including community health clinics and schools or using mobile dental equipment. Both the dental and non-dental workforce were utilised to provide these services. Limited data were found on the experiences and challenges faced by the workforce that provide these services. Conclusion Oral health services provided for Aboriginal and Torres Strait Islander peoples in rural and remote regions of Australia vary in service type, location, and workforce involved. Future research is required to explore the experiences and support of this workforce. This can enhance delivery of culturally and clinically safe oral health services for Aboriginal and Torres Strait Islander peoples, particularly in rural and remote regions.

The Role of Soft Skills in Dental Education: Challenges and Importance

Soft skills encompass interpersonal abilities and values that enable individuals to adapt to diverse circumstances. In dentistry, a combination of soft and hard skills is crucial for successful practice and for achieving health care organization goals. However, dental schools face significant challenges in teaching and evaluating soft skills, including the subjective nature of assessment, variability in student engagement, and the lack of standardized curricula. The development of ethical and critical thinking skills is essential for students to balance competing interests in the profession while maintaining professionalism, such as dedication, accountability, competence, dependability, and respect for others. Health care professionals, including dentists, must cultivate soft skills to effectively guide and treat patients. This study aims to raise awareness of the importance of soft skills in dental education, specifically highlighting challenges in instruction and evaluation. Key conclusions include the need for a more structured approach to teaching soft skills, integrating them into the broader curriculum, and developing more objective assessment tools. By addressing these issues, dental education can better equip future dentists with the necessary skills for efficient patient care.

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.

Learning on the country: Motivating dental students to attend a rural placement

PURPOSE/OBJECTIVES

This research aimed to identify factors that affect dental students' attitudes toward participation in rural clinical outplacements (RCOP) in Australia, and to suggest strategies that will increase students' desire to attend RCOP in the future.

METHODS

Dental students from the nine dental schools in Australia were invited to an online survey on their willingness to participate in an RCOP and the factors that influence this willingness. These factors were grouped into themes of education, personal and health, social, financial, and information-related.

RESULTS

The study had an estimated response rate of 10% with 202 responses. More than two-thirds (68%) of students were willing to participate in an RCOP. Students who grew up in a rural area were significantly more likely to be willing to attend an RCOP, compared to those from urban settings. Attitudes toward the anticipated educational experience of RCOP were positive, while factors related to finances and pre-existing information were of concern to students. Educational, personal/health-related, and social factors had significant impacts on participants' willingness to attend RCOP.

CONCLUSION

Overall, despite students holding negative opinions on certain social and financial factors, their positive attitudes toward other factors outweighed these. Universities should aim to further promote the educational benefits of RCOP to improve students' attitudes prior to attending RCOP. In-depth qualitative analysis is required to explore students' concerns regarding RCOP and longitudinal research is warranted to monitor students' attitudes toward RCOP and rural work over time.

Assessment of Dental Student Satisfaction after Internships in Collaborative Dental Practices in Saxony-A Retrospective Questionnaire Analysis

The goal for dental students of a university-based program should be to learn about practice procedures in a dental office as part of their studies in order to gain insight into day-to-day activities, such as organizational management, patient communication, and problem-solving strategies. All dental students from the Faculty of Medicine at the University of Dresden in Germany, who completed a one-week internship in an external dental office in the last year before taking the final exam, were invited to participate in the survey (total n = 182 in years 2017-2019 and 2022). After completing the internship, the students were asked to anonymously rate the distinctive competencies they had acquired during their dental studies in terms of clinical and social communication skills. The results of the survey showed a good practicability of the acquired dental knowledge and a general satisfaction of students during their internships. No significant influence of the COVID-19 outbreak and the resulting special regulations in dental practices during the pandemic on student satisfaction was found. Students were more satisfied with their completed internships in smaller cities. Therefore, a stronger inclusion of practices outside the big cities should be considered in the current implementation of the new Dental Licensure Act in Germany.

'The dental nurse played a vital role in helping to manage the patient': a thematic analysis of undergraduate dental students' reflective journals from outreach placements

Introduction Community-based dental education, or 'outreach', forms a key part of dental courses in some high-income countries. Its educational benefits are well-established and once graduated, participants feel better prepared for their early career. Yet, it is less clear what students actually learn while on placements.Materials and method Qualitative document and thematic analysis of a convenience sample of anonymised dental student reflective journals (n = 51).Results The reflective journals described varied and broadly positive learning experiences. Analysis identified a number of themes of learning. Most related to the process and outcomes of care, but two key themes - dental anxiety and teamworking - were interrelated with both. Within teamworking, dental nurses appeared important in students' learning. Three process interrelated themes of learning were identified in the data. These were: tailoring your approach; communication and time; and evidence-based dentistry and minimising risk. Two broad interrelated themes relating to outcomes for patients and students were also identified: trust and confidence; and professionalism and personal development.Conclusion This research identified important and potentially transformative learning from outreach placements. This included how dental anxiety impacts patients and the dental team, the importance of teamworking, and the role of dental nurses in students' experiential learning.

Indigenous Cultural Safety Training for Applied Health, Social Work, and Education Professionals: A PRISMA Scoping Review

Anti-Indigenous racism is a widespread social problem in health and education systems in English-speaking colonized countries. Cultural safety training (CST) is often promoted as a key strategy to address this problem, yet little evidence exists on how CST is operationalized and evaluated in health and education systems. This scoping review sought to broadly synthesize the academic literature on how CST programs are developed, implemented, and evaluated in the applied health, social work and education fields in Canada, United States, Australia, and New Zealand. MEDLINE, EMBASE, CINAHL, ERIC, and ASSIA were searched for articles published between 1996 and 2020. The Joanna Briggs Institute's three-step search strategy and PRISMA extension for scoping reviews were adopted, with 134 articles included. CST programs have grown significantly in the health, social work, and education fields in the last three decades, and they vary significantly in their objectives, modalities, timelines, and how they are evaluated. The involvement of Indigenous peoples in CST programs is common, but their roles are rarely specified. Indigenous groups must be intentionally and meaningfully engaged throughout the entire duration of research and practice. Cultural safety and various related concepts should be careful considered and applied for the relevant context.

Assessment of radiology baseline knowledge of freshman North American dental students prior to any formal instruction

INTRODUCTION

There is a wide variation in the knowledge related to oral radiology. This study aims to assess the prior knowledge of radiology amongst freshman dental students prior to beginning any formal dental school instruction.

MATERIALS AND METHODS

A total of 139 newly matriculated freshman dental students were asked to complete a 7-question radiology, take-home survey regarding their prior knowledge. The questionnaire was built within their course site and was presented prior to beginning the radiology lectures.

RESULTS

The responses were varied for all seven questions based on previous experiences and existing knowledge. Significant variation was noted in responses to Q4, Q6 and Q7 as opposed to Qs 1-3 and 5. Many students believed that the acquisition of radiographs should be selective. The acquisition of radiographs in pregnant women yielded comments in line with the belief that dose and frequency of radiation exposure would impact the health of the pregnant woman and developing foetus. Additionally, many students agreed with the statement regarding orthodontists over-radiating children as reported in the New York Times. Perceptions based on social media and news outlets need to be addressed and changed in a dental school setting based on evidence.

CONCLUSION

Dental school instruction must use the cues from surveys similar to that used in this research and structure their instruction to increase the critical teaching of radiology. The eventual goal of such an instruction would be to have a scientifically accurate information and remove the perceptions that the students came with when they began their dental education.

Identifying features of quality in rural placements for health students: scoping review

OBJECTIVES

To explore and synthesise the evidence relating to features of quality in rural health student placements.

DESIGN

Scoping review.

DATA SOURCES

MEDLINE, CINAHL, Embase, ProQuest, Informit, Scopus, ERIC and several grey literature data sources (1 January 2005 to 13 October 2020).

STUDY SELECTION

The review included peer-reviewed and grey literature from Organisation for Economic Co-operation and Development listed countries that focused on quality of health student placements in regional, rural and remote areas.

DATA EXTRACTION

Data were extracted regarding the methodological and design characteristics of each data source, and the features suggested to contribute to student placement quality under five categories based on a work-integrated learning framework.

RESULTS

Of 2866 resulting papers, 101 were included for data charting and content analysis. The literature was dominated by medicine and nursing student placement research. No literature explicitly defined quality in rural health student placements, although proxy indicators for quality such as satisfaction, positive experiences, overall effectiveness and perceived value were identified. Content analysis resulted in four overarching domains pertaining to features of rural health student placement quality: (1) learning and teaching in a rural context, (2) rural student placement characteristics, (3) key relationships and (4) required infrastructure.

CONCLUSION

The findings suggest that quality in rural health student placements hinges on contextually specific features. Further research is required to explore these findings and ways in which these features can be measured during rural health student placements.

What do dental students value about their rural placements-Is clinical experience enough?

OBJECTIVES

Melbourne Dental School's (MDS) rural dental clinical placement program operates in two Victorian rural areas and offers final year dental students an integrated program of practical clinical experience and rural lifestyle exposure. The objective of this study was to understand the student's experiences to determine whether they increased the likelihood of them seeking rural employment after graduation.

DESIGN

The University of Melbourne final year dental students attended 5-week mandatory rural clinical placements in 2018 and 2019. At the completion of their placement, students were invited to complete an anonymous questionnaire about their experiences, which had both quantitative and qualitative questions. This study examined the qualitative data using thematic analysis to identify common themes.

SETTING

Rural clinical dental placements at Goulburn Valley Health and Latrobe Community Health Service.

PARTICIPANTS

Final year Dentistry and Oral Health students.

INTERVENTIONS

Clinical placementevaluation questionnaire.

MAIN OUTCOME MEASURES

To examinedentalstudents interest in rural practicepost rural clinical placement.

RESULTS

Of the 129 students who completed the survey, 116 completed the open-ended questions and four themes were identified. Rich clinical experience; social capital; rural life and infrastructure. High levels of satisfaction were reported across all themes.

CONCLUSION

This study demonstrated the rural clinical program to be a positive and enjoyable placement which increased dental students' clinical practice experience and their interest in considering rural practice upon graduation. Exposure to rural lifestyle and supportive clinical and social relationships were shown to be important influences. The current survey can benefit from refinement and further research following up MDS graduate workplace locations is recommended.

New Internship Course at Health Centers for Dental Undergraduates of Babol University of Medical Sciences in 2014: Students' Perception

Objectives:

This study aimed to evaluate an innovative internship course at health centers for final-year dental undergraduates and to report initial students’ perceptions.

Materials and Methods:

The Department of Community Oral Health, Faculty of Dentistry with the collaboration of the Vice-Chancellor of Health of Babol University of Medical Sciences prepared an educational and clinical training course, named Health Centers Dental Rotation (HCDR), in January 2014. Final year (6^th year) dental undergraduates were divided into groups of two or three and worked as an operator or assistant at 12 health centers (six rural and six urban). Students had to fulfill the educational and therapeutic requirements for three weeks. Students’ perspectives related to the course objectives were recorded using a five-point Likert scale with a voluntary anonymous questionnaire.

Results:

Forty-four dental students, 26 (60%) females and 18 (40%) males, provided oral health care services at the health centers. Based on the students’ perspectives, almost all students (95%) realized the limitations of the health centers. The HCDR improved the awareness of 75% of the students about oral health needs and problems of patients referring to these centers. Although 68% of the students declared that participating in this course was a valuable educational experience, 38.6% described it as displeasing.

Conclusion:

From the students’ perspectives, this course was a worthwhile and positive internship experience and provided an opportunity for students to understand the specific oral health needs of patients attending these health centers and to realize their key role in the oral health system.

Pre-Outplacement Perceptions of Dental Students Regarding Rural Oral Health Practice and Associated Factors

Rural outplacement programs have been offered by Australian universities to encourage dental students to consider rural careers. The dental curricula should be designed to provide graduates with a good understanding of oral health issues that rural oral health care workers face. Pre-outplacement perceptions of dental students on rural practice are considered imperative to review and update the outplacement programs; however, they have not been investigated in detail. An online, anonymous, voluntary survey was conducted among the first-year dental students. The responses were solicited on the level of awareness and understanding of rural oral health, intention to practice in rural locations and factors informing the appeal of rural dental practice. The mean of a seven-point Likert scale revealed that most students had some level of perceived knowledge and awareness of rural communities and oral health. Students with rural affiliation were more likely to have the intent to practise rurally after graduation (p = 0.001). For short-term rural practice, students overall expressed positive intention. Greater job opportunities were the main motivating factor, while the distance from family and friends was the main deterring factor for practising rurally. Rural affiliation influences the intent to practise rurally on graduation. The pre-outplacement perceptions, in this study, are comparable with post-outplacement observations reported in the literature.

The workforce outcomes of dental graduates from a metropolitan school 'Rural Clinical Placement Program' versus a 'Rural Clinical School'

INTRODUCTION

This study compares the workplace decisions from University of Sydney (USYD) dental graduates who participated in a 1-month voluntary Rural Clinical Placement Program (RCPP), USYD graduates who did not participate in the RCPP (non-RCPP), and with graduates who qualified from a dental Rural Clinical School (RCS) at Charles Sturt University (CSU).

METHODOLOGY

From mid-2015, USYD students who graduated between 2009 and 2013, and CSU graduates from 2013 to 2014, were requested to complete a telephone interview related to employment choices. For USYD, 135 interviews were completed (63% of contactable graduates) and for CSU, 39 interviews (68%). Mixed methods were applied to analyse the data.

RESULTS

For USYD, 33% of RCPP participants were working rurally compared with 18% of the non-RCPP, whilst 54% of CSU graduates were working rurally. For USYD, the self-reported influence of the RCPP on the graduates' employment decisions was a significant predictor of rural employment. For CSU, country of birth and employment status were weakly associated with rural employment. Across the three cohorts, key employment factors were as follows: job availability, family, personal relationships, good mentorship, clinical training, partner factor and lifestyle. In addition, both the RCPP and CSU graduates showed greater interest and awareness of rural employment than the non-RCPP.

CONCLUSION

The CSU RCS and USYD RCPP are leading to positive rural employment outcomes, and it is clear that the provision of a rural experience is influencing graduates to work rurally. Further investigation of the CSU program is required to fully assess its impact and to provide longitudinal workforce information.

Exploration of the factors that influence new Australian dental graduates to work rurally and their perspectives of rural versus metropolitan employment

INTRODUCTION

The challenges in the recruitment and retention of dentists in rural Australia have contributed to a lack of dental service provision to rural communities. This paper explores the workforce factors involved in the employment location decisions of dentists' post-graduation.

MATERIALS AND METHODS

Graduates between 2009 and 2013 from the University of Sydney, Dental School, were asked to complete a telephone interview related to their employment history. A total of 135 interviews were conducted, with 63% (135/214) of contactable graduates, or 33.4% (135/404) of all the graduates (2009-2013). Interviews followed a semi-structured script.

RESULTS

Key factors which positively impacted on rural employment included the following: job competition in metropolitan areas, good rural salaries, financial incentives, clinical experience, rural lifestyle and professional mentorship. Barriers were as follows: proximity to friends and family, building a social and professional network, isolation, less professional support and reduced access to education.

CONCLUSION

Recommendations to increase rural employment include: competitive rural salaries, financial incentives and formal mentorship during both recruitment and integration into a rural community. Dental schools should consider advertising identified drivers of rural employment, namely good salaries, full-time employment, clinical experience and rural lifestyle. This study provides important information related to rural employment and rural retention.

University-based initiatives towards better access to oral health care for rural and remote populations: A scoping review

This scoping review maps a wide array of literature to identify academic programs that have been developed to enhance oral health care for rural and remote populations and to provide an overview of their outcomes. Arksey and O'Malley's 5-stage scoping review framework has steered this review. We conducted a literature search with defined eligibility criteria through electronic databases, websites of academic records, professional and rural oral health care organizations as well as grey literature spanning the time interval from the late 1960s to May 2017. The charted data was classified, analyzed and reported using a thematic approach. A total of 72 citations (67 publications and seven websites) were selected for the final review. The review identified 62 universities with program initiatives towards improving access to oral health care in rural and remote communities. These initiatives were classified into three categories: training and education of dental and allied health students and professionals, education and training of rural and remote community members and oral health care services. The programs were successful in terms of dental students' positive perception about rural practice and their enhanced competencies, students' increased adoption of rural practices, non-dental health care providers' improved oral health knowledge and self-efficacy, rural oral health and oral health services' improvement, as well as cost-effectiveness compared to other strategies. The results of our review suggest that these innovative programs were effective in improving access to oral health care in rural and remote regions and may serve as models for other academic institutions that have not yet implemented such programs.

A longitudinal evaluation of the Rural Clinical Placement Program at the University of Sydney Dental School

INTRODUCTION

Australia has a lack of dental practitioners in rural and remote regions. This study evaluates the impact of a Rural Clinical Placement Program (RCPP) offered to final year students at the University of Sydney (USYD) Dental School on the graduates working locations.

MATERIALS AND METHODS

University of Sydney students who graduated between 2009 and 2013 (n = 404) were invited to complete a telephone interview. One hundred and thirty-five graduates were interviewed, 90 RCPP participants and 45 non-participants.

RESULTS

The majority of graduates interviewed were from a metropolitan background (87%), 47% were female, 77% worked full time, and 70% were employed in private practice. A higher proportion (33%) of the RCPP participants were working in rural Australia compared with 18% of the non-participants. The graduates reported that the RCPP was a high-quality program with excellent rural clinical supervisors, provided broad clinical dentistry; they met appreciative patients and enjoyed the rural lifestyle.

CONCLUSIONS

The RCPP was a valuable and positive experience with many considering it as a highlight of their dental education. A large proportion reported the program positively influenced their employment location choices, and a higher proportion of the RCPP participants were identified as working rurally, compared to the non-participants.

Exploring the impact of Aboriginal health placement experiences on the preparation of dietetic graduates for practice with Aboriginal communities

AIM

A health workforce with the ability to practice with Aboriginal communities is crucial to bridge the health gap between Aboriginal and non-Aboriginal Australians. This study aimed to explore the impact of university Aboriginal health placements on preparing dietetic graduates for practice with Aboriginal communities.

METHODS

A mixed methods sequential explanatory design was used. A sample of 594 dietetic graduates was invited to complete a survey that identified Aboriginal health experiences and measured attitudes and self-confidence towards working in Aboriginal health using a five-point Likert scale. Participants were divided into placement versus no-placement groups and compared using chi-squared tests. Sixteen of 33 participants who had completed an Aboriginal health placement were invited to participate in a semi-structured interview to explore how placement influenced practice with Aboriginal communities. Interviews were analysed using content analysis.

RESULTS

A final sample of 120 participants showed that placement participants reported significantly higher self-confidence towards working in Aboriginal health compared with no-placement participants (No-placement = 35% agree, 36% neutral, 29% disagree; Placement = 74% agree, 11% neutral, 16% disagree; χ2 (2, 88) = 9.4; P = 0.01). Fifteen participants were interviewed. Interview data indicated that situated learning experiences, breaking down stereotypes, empathy through learning from Aboriginal people, and Aboriginal health role-models were key components of Aboriginal health placements in preparing dietetic graduates for practice with Aboriginal communities.

CONCLUSIONS

The results suggest that Aboriginal health placements may be an effective strategy for preparing dietetic graduates for practice with Aboriginal communities. The feasibility of placement or alternative curriculum content needs to be explored.

Rural placement experiences in dental education and the impact on professional intentions and employment outcomes-A systematic review

CONTEXT/INTRODUCTION

The availability of clinical dental services in rural locations is a major concern for many countries as dental care professionals gravitate to work in metropolitan areas. This systematic review examines the literature on Rural Placement Programs within dentistry and their impact on workforce intentions and employment outcomes. The review provides a detailed analysis of the methodological characteristics of the literature, considers the quality of the evidence and compares the outcomes within an international context.

MATERIALS AND METHODS

The systematic review identified published literature between 2005 and 2016 from databases including EMBASE, MEDLINE, PubMed, NursingOVID and Cochrane. The PRISMA protocol was adopted for the development of the study, and the Health Gains Notation Framework was implemented to assess the quality of the selected research papers.

RESULTS

Eleven studies considering Rural Clinical Placement Programs met the inclusion criteria. The studies were from Australia, South Africa, United States, Thailand and India. The evidence in this review indicates that well-designed, financially supported programmes that provide a perceived valuable clinical experience, good supervision and professional support in a rural environment can lead to dental students stating increased intentions to working in a rural location. However, there was a lack of evidence and research into whether these rural intentions result in positive action to take up employment in a rural location.

CONCLUSION

The evidence suggests that well-prepared rural clinical placements, which have experienced clinical supervisors, good professional student support from the dental school, provide a valuable clinical experience and are sufficiently funded, can increase intentions to work in a rural location upon graduation. However, there is a lack of evidence in dentistry into whether intentions translate into practitioners taking clinical positions in a rural location. Future research should be planned, which will undertake longitudinal cohort studies to identify factors that have an important influence on rural job choice.

Transformative effects of Aboriginal health placements for medical, nursing, and allied health students: A systematic review

The aim of the present systematic review was to investigate whether placements in Aboriginal health affect the self-perceived skill in working in Aboriginal health settings and career aspirations of health students, and in particular, aspects of the placement that had the greatest impact. The Embase, Cinahl, ProQuest, Scopus, Informit, Ovid MEDLINE, PsychINFO, and PubMed databases were searched in April/May 2016. Placements of at least 1 week duration in an Aboriginal health setting involving Australian students of medical, nursing, dentistry, or allied health disciplines, with outcomes relating to changes in students' knowledge, attitudes, and/or career aspirations, were included. The search retrieved 1351 papers. Fourteen studies were eligible for inclusion in this review. Narrative synthesis found that work placements in Aboriginal health increased understanding and awareness of Aboriginal culture, promoted deeper understanding of Aboriginal health determinant complexity, increased awareness of everyday racism toward Aboriginal Australians, and enhanced desire to work in Aboriginal health. There is a need for improved teaching and learning scholarship to understand whether placements improve students' skill working with Aboriginal people in health care or increase the likelihood of future employment in these settings.

A Community Engaged Dental Curriculum: A Rural Indigenous Outplacement Programme

BACKGROUND

Indigenous people worldwide suffer from poor oral health as compared to non-Indigenous citizens. One of the approaches to bring about improvement in Indigenous oral health is to enhance the service provision by implementing oral health outplacement programmes. A case study of such a programme for dental students in Australia reports how an educational institution can successfully engage with an Indigenous oral health service to provide learning experiences to the students as well as deliver much needed services to the community.

DESIGN AND METHODS

The assessment of this ongoing outplacement programme over the period of 2008-14, based on students' feedback, highlights some of the key beneficial outcomes. Students agreed that the Indigenous outplacement programme improved their understanding of Indigenous issues (mean ± SD: 4.10±0.8; 5 refers to strongly agree on 5-point scale) and increased the possibility that they will practise in Indigenous health (3.66±1.0). They were pleased with the assistance received by clinical supervisors and clinic staff at the Indigenous dental clinic (4.28±0.8).

CONCLUSIONS

This programme has demonstrated that structured student outplacements are valuable in building relations across cultures especially with Indigenous communities. It has also shown that university engagement with the public health sector can be beneficial to both institutions. Significance for public healthAn oral health outreach programme is one of the suggested approaches to effectively address the endemic issues of poor oral health among Indigenous people around the world. An Indigenous dental clinical outplacement in Australia provides an example of beneficial outcomes of such an approach. It provides dental students with an opportunity to experience the health issues related to Australian Indigenous communities and prepare future graduates to work comfortably in the public health care system. Indigenous people also develop trust and feel comfortable in receiving oral health care services from non-indigenous clinicians.

The influence of a clinical rural placement programme on the work location of new dental graduates from the University of Sydney, NSW, Australia

INTRODUCTION

In Australia, as in many other countries there is a disparity in the number of dentists working in rural locations compared with metropolitan areas, and this is a growing problem. The aim of the research was to monitor the location of recent graduates who undertook a rural clinical placement whilst in the final year of Sydney Dental School, to determine whether it influenced their choice of job location.

MATERIALS AND METHODS

Students who graduated in 2008 and 2009 were followed up to ascertain their working location. Forty per cent of the 2009 graduates participated in a rural placement during their undergraduate degree and 60% did not. In 2008, none of the students went on a rural placement as the scheme had not been implemented. The Australian Health Practitioner Regulation Agency (AHPRA) internet website was used to find the working location of the graduates. The rural, remote and metropolitan areas (RRMA) classification system was used to classify which areas of Australia were metropolitan, regional, rural and remote zones.

RESULTS

The graduates of 2008 and 2009 were followed up in 2011 and 2012 to ascertain their working location. In 2011, 12.7% of the 2008 graduates were employed in a rural location compared to 27.6% of the entire 2009 graduating class. In 2011, of those 2009 graduates who participated in the rural placement programme, 44.8% were working in a rural or remote region compared to 17% of the graduates who did not participate. In 2012, the second follow-up found that 18.6% of the 2008 graduates were working in a rural location compared to 25.9% of all the 2009 graduates. In 2012, 43.3% of the 2009 rural placement participants were found to be working in a rural location compared to 14.9% of the non-participants.

CONCLUSIONS

The study followed up recent dental graduates' working locations to provide longitudinal evidence of the influence of an undergraduate rural placement programme on their work choices. It was found that a higher proportion of graduates who participated in the rural placement programme were working in a rural location when compared with those who had not been offered a placement.

Appointment attendance at a remote rural dental training facility in Australia

Background

Non-attended appointments have impacts on the operations of dental clinics. These impacts vary from lost productivity, loss of income and loss of clinical teaching hours.

Methods

Appointment data were analysed to assess the percentage of completed, failed to attend (FTA) and cancelled appointments at an Australian remote rural student dental clinic training facility. The demographic and time characteristics of FTA and cancelled appointments were analysed using simple and multivariate multinomial regression analysis, to inform interventions that may be necessary.

Results

Over the 2-year study period a total of 3,042 appointments were made. The percentage of FTA was 21.3% (N = 648) and cancelled appointments 13.7% (N = 418). The odds of an FTA were in excess of 4 times higher in patients aged 19–25 years (OR = 4.1; 95% CI = 2.3-7.3) and 26–35 years (OR = 4.4; 95% CI = 2.5-7.9) compared to patients 65 years and older. The odds of an FTA was 2.3 (95% CI = 1.8-3.1) times higher in public patients compared to private patients. The odds of a cancellation was 1.7 (95% CI = 1.1-2.6) times higher on a Friday compared to a Monday and 1.8 (95% CI = 1.1-2.9) times higher on the last appointment of the day compared to the first appointment. For cancelled appointments, 71.3% were cancelled on the day of the appointment and 16.6% on the day before.

Conclusions

Non-attended appointments (FTA or cancelled) were common at this remote rural dental clinic training facility. Efforts to reduce these need to be implemented; including telephonic reminders, educating the community on the importance of attending their appointments, block booking school children and double booking or arranging alternative activities for the students at times when non-attendance is common.

Dental care provision by students on a remote rural clinical placement

BACKGROUND

In 2009, the School of Dentistry and Oral Health, Griffith University, commenced a clinical placement in a remote rural and Indigenous community in Australia. This paper analyses the type of treatment services provided from 2009 to 2011 by year, type of patient and age of patient.

METHODS

All treatment data provided were captured electronically using the Australian Dental Association (ADA) treatment codes. Audited reports were analysed and services categorised into six broad treatment types: consultation, diagnostic, preventive, periodontics, oral surgery and restorative services.

RESULTS

The bulk of dental care episodes provided over the three-year period were for clinical examinations, restorative and oral surgery services. Preventive and periodontic services generally comprised less than 10% of the care provided. Over time fewer clinical examinations were conducted and restorative dentistry increased in the second and third years of the placement. There were no significant differences in the types of care provided to public and private patients.

CONCLUSION

Clinical placement of final-year dental students in remote rural settings has helped address a largely unmet dental need in these regions.

IMPLICATIONS

Dental student clinical placement is effective in providing care to communities in a remote rural setting. Student placements are, however, only able to deliver dental care in few remote rural communities, and therefore will make a negligible impact on the level of untreated dental disease in the short term. It is hoped that the experience will lead to more graduates serving some of their professional lives in remote communities.

Faculty staff and rural placement supervisors' pre- and post-placement perceptions of a clinical rural placement programme in NSW Australia

INTRODUCTION

Staff views on a rural clinical placement involving 4th year dental undergraduates from the University of Sydney (Australia) were collected in order to monitor whether the programme was feasible and acceptable to the academic Faculty Staff and the rural clinical supervisors.

MATERIALS AND METHODS

An evaluation of the rural placement programme was undertaken in 2009 at three rural sites in New South Wales (Australia). Semi-structured pre- and post-placement in person interviews recorded the views of three University Faculty Staff whilst similar data were collected by telephone interviews for three supervising clinicians at the rural clinical sites. Interviews gathered opinions on the organisation, implementation and outcomes of the rural placement programme.

RESULTS

Eight qualitative analysis identified themes were specified and included communication, programme duration, effect on students and staff, benefits of the programme, rural intentions, programme sustainability and the success of the programme. Positive pre-placement aspects were potentially good clinical experience, new environment, sharing of knowledge and interaction with a rural community. Negative issues were anxieties about students' clinical ability to offer a service, missing lectures and maintaining clinical training quotas. The post-placement themes were generally positive; staff reported that the students enjoyed the rural community experience, their communication and clinical skills improved.

CONCLUSION

According to the staff, the placement programme was feasible and provided acceptable positive clinical and personal development for the students. This research will help educators planning to incorporate a rural clinical programme into a University curriculum.

Evaluation of a community-based clinical teaching programme by current and former student dental therapists and dental hygienists: a pilot investigation

AIM

There has been considerable expansion in the involvement of community-based clinical teaching programmes (sometimes termed 'outreach teaching') in UK and other international dental schools. While there has been much interest in the role of this educational methodology in the professional and educational development of student dentists, there has been little, if no, consideration of this form of teaching in relation to dental care professional (DCP) students. The aim of this pilot investigation was to report the feedback and evaluation of current and former student dental therapists and dental hygienists on their experience on the St David's community-based clinical teaching programme at Cardiff.

METHODS

In Autumn 2009, a questionnaire was distributed by hand to the current second year student dental therapist and dental hygiene class at Cardiff (n = 18) and by post to the dental therapist and dental hygiene classes of 2004 (n = 16) and 2007 (n = 17). The questionnaire included both 'open' and 'closed' questions.

RESULTS

Thirty responses were returned (response rate = 59%; 2004 (n = 5, 31%), 2007 (n = 9, 53%), current class (n = 16, 89%)). Seventy percent of respondents (n = 21) reported that they found the community-based clinical teaching programme to be a pleasant working environment and close to subsequent independent practice. Seventy-seven percent (n = 23) reported that their confidence performing nonsurgical periodontal treatment had increased while at the programme. One respondent commented that the programme was '...an invaluable and insightful introduction to what it would be like working in practice. Without being given the experience, it would have been a big shock to the system when I started working in practice...'

CONCLUSION

This pilot investigation has revealed that current and former dental therapist and dental hygiene students are enthusiastic in their support for the inclusion of community-based clinical teaching programmes in their educational and professional development. Most former and current dental therapist and dental hygiene students noted the positive effects of this form of training on their subsequent clinical careers.