Student-to-student local anesthesia injections in dental education: moral, ethical, and legal issues.

This article reports the findings of a survey-based study conducted to determine U.S. dental schools' institutional protocols regarding the practice of students' administering local anesthetic injections to fellow students as part of their process of learning this skill. The majority of schools ask students to practice local anesthetic injections on each other without obtaining informed consent.

Conscious sedation in Spanish dental schools: Current situation.

The current Spanish curricula for degrees in dentistry include conscious sedation (CS) as a basic training competency. However, is the CS training delivered by Spanish dental schools a consensus-based educational framework enabling students to use this anesthetic technique after graduation? To answer this research question, a study was designed aiming to identify the strategies used to teach this competency in Spanish dental schools and the characteristics of teaching. The authors reviewed legislation concerning officially established requirements for a degree in dentistry as well as curricula currently taught in Spain. Our analysis identified clear discrepancies among the schools of dentistry studied. The only overlap was observed in reference to the level of proficiency imparted, which prevents Spanish dentistry students from using this anesthetic technique after graduation. Specific features of the normative framework and of the Spanish legislative system underlying the design of the present curricula of degrees in dentistry would explain the discrepancies in CS competencies taught at our schools of dentistry. Almost 10 years since its implementation and in light of the new demands of the complex society in which we live, Spanish universities must unify their educational criteria regarding CS training to ensure the appropriate qualification of our new dentists in this technique.

Development and Implementation of a Uniform Dental School-Wide Electronic Treatment Consenting Process for Patients.

One approach to enhancing quality care outcomes and patient safety is through effective implementation of clinical risk reduction strategies. Clinical risk identification at The Ohio State University College of Dentistry revealed lack of a standardized informed consenting process for patients. The purpose of this project was to develop and implement a uniform college-wide informed consenting process. An operating procedure was also developed. The resulting consenting documents used a uniform approach in which clinics could use a basic readable and processable informed consent template. The template was edited for appropriate content suitable for an electronic health record. Implementing an operating procedure along with associated contemporary uniform electronic informed consent forms was realized through efforts of a core team with informed consenting experience. The core team developed the template and the majority of all documents before editing all division-based consents. This method relied on growing expertise and momentum. Outcomes of chart audits following implementation of the new electronic informed consent forms showed a transitory increase in missing consent forms. Subsequently, the number of missing consent forms decreased to near pre-implementation levels. Patient refunds related to missing informed consent issues dropped, and patient satisfaction remained high throughout the project. Other institutions can use this project as a guide for developing their own uniform consent forms and process.

Dental student enrollment and graduation: a report by state, census division, and region.

The purpose of this study is to provide descriptive data on the presence of dental schools, dental school graduates, instate enrollment, and interstate dental education agreements for U.S. states, districts, and regions. This information may be helpful in deciding to open or maintain a dental school. Data from the American Dental Association (ADA), American Dental Education Association (ADEA), and U.S. Census Bureau were used to conduct cross-sectional comparisons for states, census divisions, and regions for 2000. In 2000, there were fifty-four dental schools in thirty-two states and the District of Columbia. Total graduation across 1990-2000 was 43,289 dentists. Over half (56 percent) of the graduates were from public schools. The distribution of schools and graduates differed by geographic region. Alaska, Utah, Hawaii, and Nebraska were outliers with respect to high and low numbers of dental schools in states, in-state enrollment, and dentists to population. U.S. states, districts, and regions vary widely on the number of dental schools, dentists to population, first-year dental school enrollees, and dental school graduates. Further assessment on additional factors such as dental health provider shortage areas, state oral health status, and attractiveness of locations to dentists is needed to more fully understand the impact of these factors.

Honoring Dental Patients' Privacy Rule Right of Access in the Context of Electronic Health Records.

A person's right to access his or her protected health information is a core feature of the U.S. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. If the information is stored electronically, covered entities must be able to provide patients with some type of machine-readable, electronic copy of their data. The aim of this study was to understand how academic dental institutions execute the Privacy Rule's right of access in the context of electronic health records (EHRs). A validated electronic survey was distributed to the clinical deans of 62 U.S. dental schools during a two-month period in 2014. The response rate to the survey was 53.2% (N=33). However, three surveys were partially completed, and of the 30 completed surveys, the 24 respondents who reported using axiUm as the EHR at their dental school clinic were the ones on which the results were based (38.7% of total schools at the time). Of the responses analyzed, 86% agreed that clinical modules should be considered part of a patient's dental record, and all agreed that student teaching-related modules should not. Great variability existed among these clinical deans as to whether administrative and financial modules should be considered part of a patient record. When patients request their records, close to 50% of responding schools provide the information exclusively on paper. This study found variation among dental schools in their implementation of the Privacy Rule right of access, and although all the respondents had adopted EHRs, a large number return records in paper format.

Clinical assessment in dental education: a new method.

Among the many challenges that face modern dental schools is the development of appropriate assessment systems. The more litigious nature of modern education makes it important that the systems developed are transparent and can withstand the processes of legal challenge. Coupled with this demand for robust assessment is a growing demand from universities and health providers for dental schools to keep rigorous records of student clinical productivity. This brief review outlines a system developed at the School of Oral Health Sciences at the University of Western Australia. The system integrates both qualitative and quantitative assessment and uses criterion-based assessment as its foundation. Detailed analysis and real-time reporting mechanisms using a suite of personally written software tools is now possible. The system provides both students and staff with effective data to enhance the learning process.

Accommodating dental students with disabilities.

The passage of The American with Disabilities Act (ADA) has broadened the legal protection afforded students with disabilities. Since it is most likely that dental schools, or their parent universities, have been in compliance with the Rehabilitation Act of 1973, they should experience minor additional requirements, in the academic arena, from the ADA. Dental schools increasingly will be asked to consider the special needs of disabled students, and may encounter conflicts between students' accommodation needs and clinical requirements and academic standards. This paper reviews federal law that protects the disabled from discrimination. More specifically, federal court decisions that have interpreted federal law were examined to see how the respective interests of disabled professional students and school administrators were treated.

The hepatitis B e-antigen positive dental school applicant.

There are few guidelines available for dental school faculty and administrators in the management of hepatitis B e-antigen positive (HBeAg+) dental school applicants. It is apparent that this serostatus is unique and requires a different approach from that used for applicants with other infectious diseases, such as the human immunodeficiency virus (HIV). The issue is examined from a number of perspectives, including the science, policy, legal, and ethical considerations confronted in establishing a policy for the HBeAg+ dental school applicant.

Management considerations for an HIV positive dental student; ethical and legal commentary.

This article provides an ethical and legal analysis of a previously reported case involving an HIV-positive dental student at the Medical College of Georgia. We conclude that the college acted appropriately from an ethical point of view and probably exceeded its legal obligations to accommodate the student.

Perspectives on affirmative action in academic dental institutions: the U.S. Supreme Court rulings in the University of Michigan cases.

In June 2003 the U.S. Supreme Court upheld the constitutionality of using race as a factor in higher education admissions decisions. This article considers the impact of the Supreme Court decisions on admissions procedures at selected academic dental institutions (ADI) and their parent institutions. We interviewed fifty-eight leaders considered to be individual stakeholders at seven ADI and their related parent institutions, state dental associations, and state legislatures using a common set of questions about the Supreme Court decisions. Educators from the ADI and their parent institutions were consistent in their responses that the rulings upheld affirmative action as necessary to achieve diversity. State organized dentistry officials did not appear to be as aware as others of the rulings, whereas legislators were mixed in their responses. Except for the University of Michigan undergraduate admissions procedures, it remains to be seen what the impact will be for other higher education institutions and for academic dental institutions. Although the rulings have provided guidelines for achieving diversity using race/ ethnicity as one of several factors, the rulings will possibly be challenged, thus requiring vigilance on the part of parent institutions and their ADI to ensure compliance with the spirit of the rulings and to avoid attack from opponents of affirmative action.

Educational implications for copyright in a digital world.

Statutory law and court cases currently leave fair use of copyrighted material poorly defined and fail to provide effective guidance for the use of others' work. Copyright legislation is undergoing significant change, accelerated by the evolution of computing and communication technologies. This paper reviews copyright issues, fair use guidelines, and applicable laws and statutes to help administrators and educators understand and comply with copyright regulations. The paper describes principles of copyright and ownership, the rights of copyright holders, and the conditions under which copyrighted material can be used by others. Recently introduced legislation, such as the 1998 Digital Millennium Copyright Act, may significantly affect how educators can use copyrighted material in the future. The integration of computer and communication technology into education raises a number of intellectual property issues for dental schools. This paper provides some general guidelines regarding copyright issues in academic environments.

A HIPAA strategy for dental schools.

Certain health care organizations, including dental schools, should be readying themselves to comply with the numerous requirements described within the administrative simplification section of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The intent of administrative simplification is to streamline the management of health care transactions while protecting the privacy of certain written, oral, and electronic patient information. There are no field-tested plans for implementing the law because only recently has the health care industry begun to respond to the multitude of requirements. It is essential that each organization create a customized compliance plan that best fits its structure and needs. The purpose of this paper is to propose a five-stage theoretical strategy that could assist a dental school in achieving HIPAA compliance. The first stage involves the selection of a HIPAA task force. The second stage selects the applicable HIPAA requirements, determines the current states of confidentiality and security, manages the electronic transactions standards, and composes a gap analysis. The third stage examines risk analysis and management. The fourth stage encompasses technical modifications, policies and procedures, legal input, and training. The fifth stage addresses the maintenance of the implementation.

The first dental college: emergence of dentistry as an autonomous profession.

Old as the ills of mankind, dentistry has been practiced as a specialty of surgery by physicians, surgeons, and artisans, at various times with titles such as barber surgeon, toothdrawer, operator for the teeth, and surgeon dentist. There being universal need for dental services, and lacking enforceable standards of practice and qualification, the profession was invaded by dubiously prepared pretenders at practice. The unconscionable consequence remained largely unremedied until realization of a philosophically sound basis of professional literature, organization, and education incident to the institution of the first dental college and the American system of dental education that elevated dentistry to the status of a recognized autonomous profession.

Creation of the dental courses in Brazil.

The arrival of the Royal Family of Portugal in Brazil during the Napoleonic wars resulted in several changes in Brazilian society, as well as the founding of schools of medicine. The dental courses became independent with the imperial decrees of 1882 (Budget of the Empire) and 1884 (New Statutes of the School of Medicine) which are discussed.

Use of social media in dental schools: pluses, perils, and pitfalls from a legal perspective.

One of the ways dental education is changing the way it is preparing the next generation of learners is through efficient utilization of interactive social media. Social media, which facilitates interaction and sharing of new ideas, is being utilized to educate students, residents, and faculty. Unfortunately, as with most improvements in technology, there are growing pains. Faculty, student, and patient interaction on social media platforms, such as Facebook and Twitter, can lead to inappropriate or embarrassing situations. Striking the appropriate balance between free speech rights of students and faculty and the need for colleges and universities to have efficient operations is often left to the judicial system. The concepts of free speech and contract law and how each is applied in educational settings should be understood by students, faculty, and administrators. This article provides a review of legal cases that led to current social media policies, as well as present-day cases that exemplify the application of these principles, to help dental educators gain a greater understanding of the boundaries of protected speech. It also provides a set of sample guidelines for communicating through these media.

The role of enrichment programs in strengthening the academic Pipeline to dental education.

Academic enrichment programs can be essential to efforts by dental schools to recruit and enroll underrepresented minority students (URM). Many summer academic enrichment programs provide additional preparation and support to URM students in the sciences. They often address barriers to student achievement such as unevenness in academic preparation, less rigorous educational background, family influence on preparation aspiration and success, unease in a new setting, and lack of professional role models. To be successful, these programs must address both the academic and social complexities of URM students and often require a range of programs to meet the specific needs of different student groups.