Dentists' considerations concerning treating patients from the Deaf and Hard of Hearing community: A national survey.

OBJECTIVES: Research shows that adults who were Deaf or Hard of Hearing (HoH) had poorer oral health than adults who did not belong to this community. The objectives were to assess dentists' education, knowledge, attitudes, and professional behavior related to treating patients from the Deaf or HoH community and the relationships between these constructs. METHODS: A total of 207 members of the American Dental Association and the Michigan Dental Association responded to a mailed or web-based survey concerning their education, knowledge, attitudes, and professional behavior related to treating patients from the Deaf or HoH community. RESULTS: On average, the respondents disagreed that they were well educated in classroom-based, clinical, or community-based dental school settings (five-point answer scale with 1 = disagree strongly; mean = 2.29/2.27/2.35) or by their professional organization (mean = 2.00) about treating Deaf or HoH patients. However, the more recently the respondents had graduated from dental school, the better they described their education about this topic (r = 0.29; p < 0.001). Additionally, 45.9% agreed/strongly agreed that they would like to attend a continuing education course about this topic; 68.9% agreed/agreed strongly that negative consequences for patients' general health can occur; and 61.1% that patients cannot be well educated about oral hygiene if Deaf or HoH patients do not have appropriate interpretive support in dental offices. The better dentists were educated about this topic, the more knowledge they had (r = 0.50; p < 0.001). On average, the respondents agreed more strongly that they were comfortable treating adult patients who communicated orally than patients using American Sign Language (4.02 vs. 3.25; p < 0.001). CONCLUSIONS: These findings show that efforts are needed to improve dental school and continuing education curricula about dental treatment for Deaf and HoH patients. The more recently the respondents had graduated, the more positively they described their education. Increased dental school and continuing education efforts are still urgently needed.

Improving Dental School Clinic Operations Using Business Intelligence Data.

In dental school clinics, students spend a great deal of time waiting for faculty members to check and approve their work. Traditionally at the University of Michigan School of Dentistry, students have left their cubicles to form lines behind supervising faculty members, and this line of students would follow the faculty member around from patient to patient. To address this problem and improve the patient experience, the school computerized the approval-seeking process by building the Faculty Request System (FRS) to enable students to stay with their patients while seeking the necessary approvals. The FRS produced a large volume of time-stamped, business intelligence data that enabled further evaluation. The aim of this study was to assess the effects of this change, including the quality/process improvement interventions that were possible due to information revealed by the FRS. The results showed no change in the number of students or faculty members per clinic session across the three years of this evaluation. With the FRS, the amount of time students spent away from their patients was reduced from 40.6 minutes to 12.1 minutes. After the FRS was implemented, there was an eradication of appointments that ended 30 minutes late (from 0.03% to zero) and a reduction of appointments that ended 15 minutes late (from 0.25% to 0.01%). There were also increases in students' starting appointments on time (9.8% of start checks to 25.8%), 15 minutes late (16.6% to 35.2%), and 30 minutes late (13.2% to 22.2%). By critically analyzing data from the new system, the school's leadership can analyze trends and make data-driven decisions to alter operations. The results of this study suggest that this process can improve the patient and student experience and faculty utilization.

Psychometric Evaluation of a 13-Point Measure of Students' Overall Competence in Community-Based Dental Education Programs.

Since 2006, the University of Michigan School of Dentistry has used a 13-point measure of overall competence instrument to assess fourth-year dental students' end-rotation performance at community clinics. The aim of this study was to assess the reliability and validity of this instrument used by preceptors to rate students' overall competence during community-based dental education experiences. The measure was analyzed using performance ratings for all fourth-year DDS students in the graduating classes of 2012 and 2013 (combined n=201). The results were that interrater agreement was satisfactory and the measure scored high for internal consistency; also, the measure loaded highly on a single overall competence factor. Ratings on this measure did not correlate with students' final cumulative dental school GPA, but showed a significant positive correlation with their fourth-year fall patient management grades (which signify students' conscientiousness in managing patients and their families in a professional and ethical manner). There were differences in grading systems between the 2012 cohort (which used a pass/fail system) and the 2013 cohort (which used a letter grade system) and the mean ratings they received (higher for the 2013 cohort). Overall, the study found that the 13-point measure demonstrated excellent reliability and validity, suggesting it is useful in determining a student's clinical competence in these settings.

Recruiting underrepresented minority and low-income high school students into dentistry while educating dental and dental hygiene students about academic careers.

The objectives of this project were to create a program that would expose underrepresented minority (URM) and low income (LI) high school students to dental professions and provide an opportunity for dental and dental hygiene students from URM/LI groups to be engaged in teaching activities. Data were collected from participants during the school years 2009-10 (high school students: N=23, dental students: N=21, dental hygiene students: N=5) and 2010-11 (N=27, N=11, N=3, respectively). The students participated in fifteen Saturday sessions from October through March each year. The data showed that, from the beginning, mentees and mentors were very interested in participating in the program and getting to know each other. Lectures, general program activities, and patient-related events such as organizing a health fair and shadowing during two outreach clinics were evaluated positively by mentees and mentors. The end of program evaluations showed that the program and the mentee-mentor relationships were rated very positively and that the mentees had an increased interest in oral health-related careers. In conclusion, creating opportunities for URM/LI high school students to explore dental careers and for dental and dental hygiene students to engage in teaching resulted in positive experiences for both groups.

Ability of dental students to deliver oxygen in a medical emergency.

This study was conducted to evaluate the ability of dental students to administer emergency oxygen to a patient during a simulated emergency. Forty third-year (D3) and fourth-year (D4) dental students were recruited and asked to demonstrate their ability in managing a simulated angina attack. Students were tested on their knowledge related to emergency medical protocols, the time taken to obtain oxygen, and operation of the oxygen equipment. Of the subjects tested, 68 percent independently identified the need for oxygen and the correct location of the equipment in the dental school. Only 15 percent of the students completed the experiment within a predetermined optimal time frame, and 50 percent of all students did not successfully operate the tank regulator to administer oxygen correctly. Although most participants in the study were able to verbalize the proper protocol for managing medical emergencies, the chairside execution in this situation demonstrates room for improvement. Incorporation of periodic simulation exercises, in addition to classroom education, is likely to improve the ability of dental students to manage medical emergencies.