Teaching Cultural Competence and Cultural Humility in Dental Medicine.

Dental students need to be equipped as clinicians to treat diverse communities and to recognize oral health disparities that are rooted in the social determinants of health. Library instruction is frequently focused on information literacy topics. Within the health sciences this might include critical appraisal or evidence synthesis, and instruction centered on locating and using library resources. This paper details the unique experiences of two liaison librarians to the School of Dental Medicine who taught the topics of cultural competence and cultural humility to first-year dental medicine students. While the authors do not discuss typical information literacy instruction in this paper, they share strategies used to design the instruction sessions, reflections on teaching these themes, lessons learned, and suggestions for other liaison librarians who might have an interest in teaching about cultural competence or cultural humility.

To accept or decline academic remediation: What difference does it make?

Introduction: Academic remediation offered after failure in a knowledge-based progress-test assessment is voluntary and involves student-centered individualized support that helps students to learn most effectively for themselves. This paper explores whether accepting or declining the offer of academic remediation given to struggling students impacts their outcomes both short-term and longitudinally. Method: Data was collated from 2015-16, 2016-17, and 2017-18 and included all students offered academic remediation in the third, fourth, and fifth years of a five-year Dentistry program. Z-scores for each stage and test were calculated and centered on a triggering point; the point at which the offer of remediation was made. These students' average performance post-trigger test and longitudinal performance were analyzed. Results: While performance for both groups significantly improved for the immediate post-trigger test after academic remediation, those that accepted remediation sustained longitudinal improvements across subsequent tests compared to those that declined remediation. Discussion: Through the academic remediation support process students appear to increase their mastery of "learning to learn" and are able to implement sustainable effective learning strategies to carry with them throughout their program. Conclusion: Students who accept academic remediation maintain a more successful academic profile compared to those that do not take advantage of this.

Call for ACTion: Transforming Dental Education at the University of North Carolina at Chapel Hill.

The University of North Carolina at Chapel Hill Adams School of Dentistry is developing a transformative curriculum that prepares students to enter contemporary practice. The Advocate, Clinician, and Thinker (ACT) framework will provide the basis for developing a resilient workforce capable of meeting emerging health care needs over the next 40 years.

Review and analysis of Chilean dental undergraduate education: curriculum composition and profiles of first year dental students.

BACKGROUND: In Chile, dentistry has become a very popular career choice for students, which has resulted in a substantial increase in both, the number of dental graduates and dental schools. Nonetheless, there is a need for change in the way dental schools select and educate their students to keep pace with the rapidly changing nature of societal needs and to tackle the marked health inequalities that exist in the country. The aim of this study was to review and critique dental undergraduate education in Chile, with a particular focus on the curriculum composition and profiles of students admitted to dental schools from 2010 to 2014. METHODS: A descriptive and retrospective design was utilised. Two different methods were undertaken: primary data collection regarding curriculum and secondary data analysis in relation to students' profiles. Descriptive statistics were used to assess the relative proportions of subject modules within the undergraduate dental curriculum and in particular the public health components. The analysis of the student profiles described specific background factors, namely, gender, age, secondary school type, location, rural-urban status and student's year of admission. Also, trends of dental students' intake between 2010 and 2014 were investigated. Logistic regression analysis was undertaken to assess potential associations between the aforementioned background factors and students' choice of dental school. RESULTS: Regarding the curriculum review, a 67% response rate was obtained. The most dominant component of Chilean dental curriculum was the clinical subjects (33%), followed by the basic and biological sciences (16%) and then medical and dental sciences (13%). In relation to the admission of students, the majority attended private schools (72%); most were females (62%); aged 19 years or less (74%); had an urban origin (99%); and came from subsidised private secondary schools (48%). Significant differences were found between students admitted to traditional and private dental schools. CONCLUSIONS: Clinical sciences are the most dominant subjects in the Chilean dental curriculum. Overall, traditional and private institutions had a broadly similar composition in their curriculum with the exception of the public health component. Students from disadvantaged backgrounds were the minority in dental schools across Chile.

Integrating student feedback during "Dental Curriculum Hack-A-thon".

BACKGROUND: The future of dental education is at crossroads. This study used the parameter of the 2016 Dental Curriculum Hack-a-Thon to assess intra- and inter-institutional agreement between student and faculty views regarding dental curriculums to determine if there is an impact in student perceptions towards dental education from before and after the event. METHODS: This exploratory, cross-sectional study involved two surveys, with Survey 1 being distributed among four faculty-student pairs of the four participating dental schools answering 14 questions. Survey 2 assessed the views of 20 participating dental students through 26 questions in a pre- and post- event survey design. Descriptive statistics were used to explore differences in perceptions towards dental education across both instrument surveys. RESULTS: The results revealed valuable student insights regarding intra- and inter-institutional agreement relevant for the change in dental curriculum that needs to occur. Survey 2 revealed that mandatory attendance in didactic courses, electronic based examination preferences, and the preference of preclinical courses being held in the first and second years of a four-year dental curriculum were of particular importance to student participants. CONCLUSIONS: The results of this study indicate that exposure and participation in subjects pertaining to dental education can be influential on student preferences and opinions on how dental education should be delivered in a four-year curriculum.

Female dental students' perceptions of patient safety culture: a cross sectional study at a middle eastern setting.

BACKGROUND: Patient safety is an integral part of all health care specialties, including dentistry. Dental students are exposed to patient safety culture during their clinical training. The aim of this study was to evaluate the perception of female students enrolled in dental degrees and dental hygiene programs towards patient safety culture and to determine its associated factors at a Middle Eastern setting. METHODS: This is a cross sectional study, based on a self-administered, English language questionnaire distributed by convenience among female dental students enrolled in two major Colleges of dentistry in Riyadh, Saudi Arabia. Participants had fulfilled at least one year of clinical training. Sample characteristics included the specialty and years of clinical training. Student's perception was measured using the validated Safety Attitude Questionnaire (SAQ) that consists of 36 statements, distributed over six domains. Responses were rated on a five point Likert scale and the average positive response rate (APRR) was calculated. Binary logistic regression models were constructed to determine factors significantly associated with positive perceptions. RESULTS: The response rate of both student programs was 221/312(70.8%). Students of dental sciences and dental hygiene programs were 133(60.2%) and 88(39.8%) respectively. Almost 42% of students were in their 1st and 2nd years of clinical training. The APRR of: Team Work Climate domain was 54.4 ± 28.0, Safety Climate domain was 51.4 ± 29.7, Job Satisfaction domain was 64.5 ± 33.8, Stress Recognition domain was 56.2 ± 37.8, Perceived Management Support domain was 50.7 ± 37.7, and Working conditions was 55.3 ± 32.1. Female students in their 3rd and 4th year of clinical were adj.OR = 2.3[1.3-4.0] times more likely to have positive perception regarding the team work climate domain when compared to 1st and 2nd year clinical students, P = 0.005. At each of the six individual domains, the odds of having a positive perception were also significantly higher among dentistry students in comparison to dental hygiene students with a range of adj.OR 2.6-4.6. CONCLUSIONS: Apparently patient safety is a concern among female dental students enrolled in dental degree and dental hygiene programs. This requires more attention from the staff, dental college's leadership/management, and faculty/students. Perception of dental students towards patient safety culture is expected to improve with the increase of clinical training.

How Does Pretesting for PubMed Knowledge Spark Student Learning?

Predoctoral students enter dental school with varying skill levels for searching biomedical databases and a tendency to overestimate their abilities. Accordingly, PubMed instruction is embedded within a required dental course and includes a graded component. This article describes a pretest/intervention/posttest developed for the PubMed session. The expectation for this new assessment was that motivation to learn PubMed would increase during the intervention if pretesting objectively showed students the difference between their self-perceived versus actual PubMed abilities. The goals were to help students better self-assess their genuine searching abilities, spark learning during the instruction session, and elicit measurable improvement in skills.

Global networking: Meeting the challenges, facilitating collaboration.

The constant change of information and technology advancement as well as the impact of social media has radically changed the world and education and, in particular, the needs of students, organisations and disadvantaged communities who share the aim of training and providing quality healthcare services. Dental organisations and education centres around the world have recognised the importance of networking in delivering effective education to students, healthcare professionals and communities. Networking is one way to meet the challenges of delivering healthcare education and services. This can be achieved by sharing of resources, expertise, knowledge and experience to benefit all the stakeholders in healthcare delivery. The joint ADEE/ADEA Meeting in London on 8-9 May 2017 has facilitated discussions amongst dental educators from all over the world during a workshop on "Global Networking: the how and why for dental educators." The aim of this workshop was to determine how can dental educators worldwide network to share ideas, experience, expertise and resources to improve both the curricula and the teaching and learning environment. A pre-conference survey was designed and implemented to identify the domains of interest and needs of participants. A structured questionnaire was administered, and this information was used to guide discussions on three main themes: curricula, faculty development and mobility of faculty and students. Four questions were then defined to help group leaders to frame discussions in the four working groups. The four groups engaged in parallel discussions, with the ideas recorded and collated by group leaders, which later served for the thematic analysis across the groups to draw the key points discussed. Overall, a great desire and potential to create a global networking to share and gain support and expertise at individual and organisational level was apparent and the working group has proposed an action plan, acknowledging that it requires great planning, effort and commitment.

Periodontal education and assessment in the undergraduate dental curriculum-A questionnaire-based survey in European countries.

OBJECTIVES: This survey aimed to evaluate whether periodontal education and assessment in undergraduate dental curricula amongst the member countries of the European Federation of Periodontology (EFP) follow the competency-based curricular guidelines and recommendations developed by the Association for Dental Education in Europe. MATERIALS AND METHODS: A multiple-choice questionnaire was emailed to 244 dental institutes amongst the 24 EFP member countries between November 2014 and July 2015. RESULTS: Data were received from 16 (66.7%) EFP member countries. Out of 117 responding dental institutes, 76 (64.95%) were included as valid responders. In most of the institutes (86.3%), a minimum set of competencies in periodontology was taken into account when constructing their dental education programmes. Out of 76 responders, 98.1% included lecture-based, 74.1% case-based and 57.1% problem-based teaching in their periodontal curricula, whilst a minority (15.9%) also used other methods. A similar pattern was also seen in the time allocation for these four educational methods, that is, the highest proportion (51.8%) was dedicated to lecture-based teaching and only a small proportion (5.7%) to other methods. Periodontal competencies and skills were most frequently assessed by clinical grading on clinic, multiple-choice examination (written examination) and oral examination, whereas competency tests and self-assessment were rarely used. Only in 11 (14.5%) cases, access flap procedures were performed by students. CONCLUSION: Great diversity in teaching methodology amongst the surveyed schools was demonstrated, and thus, to harmonise undergraduate periodontal education and assessment across Europe, a minimum set of recommendations could be developed and disseminated by the EFP.

[Reform efforts in dentistry - national and international approaches]. / Reformbemühungen in der Zahnmedizin ­ nationale und internationale Ansätze.

The Study of dentistry in Germany is in need of reform. The actual regulation on licensing dentists in Germany is from 1955, with the last changes made in 1993. Recently there have been different initiatives related to reform: a national catalogue of competency-based learning objectives in dental education (NKLZ), changes and stipulations in the respective rules relating to undergraduate curriculum in dental medicine, and an initiative of the Germany Ministry of Health to tackle and reorganize dental education in Germany.This article presents and reflects on these reform efforts in the context of actual teaching in Germany, Europe, and the United States.The reform process is an opportunity for dental education in German faculties of medicine. New dentistry programs are allowed at all faculties with model educational programs in medicine. Therefore, an example of actual reform efforts are presented based on the experiences of Hamburg. Research on dental educational programs revealed interesting approaches in dental education in other European faculties of medicine. Selected faculties were visited. These experiences led to the formulation of five main goals of reform: interdisciplinary study, problem- and symptom-based learning, early patient contact, science-based education, and communication training. The main goal is a dental education program designed along science-based, prevention-oriented, multidisciplinary, and individualized dental care that contributes to the life-long oral health of patients.

Effectiveness of an oral health education seminar for paediatric and family medicine residents.

AIM: To assess the immediate effect of a 60-minute oral health educational seminar for paediatric and family medicine residents in improving their knowledge, attitude, likelihoodtowards incorporating oral health preventive practice in their current practices to well-child visits, and confidence in identifying and referring patients with dental trauma. MATERIALS AND METHODS: Baseline pre- and post-test design was used to evaluate the immediate effect of a 60-minute PowerPoint oral health educational seminar given to the paediatric and family medicine residents. STATISTICS: Multiple-choice items were used and the pre- and post-test data were analysed with McNemar and Wilcoxon signed-rank tests. A p-value <0.05 was considered statistically significant. RESULTS: Sixty-eight residents participated in the oral health educational seminar and completed the questionnaire. The mean age of participants was 29.9 years old (SD ±4.8 yrs.). Immediately following a 60-minute oral health educational seminar, there was an overall significant increase in participants' knowledge, attitudes and likelihood towards incorporating oral health preventive practice in their current practices to well-child visits (p<0.05). More confidence in identifying and referring patients with dental trauma was reported by 100% of participants. CONCLUSIONS: A 60-minute oral health educational seminar was effective in improving paediatric and family medicine residents' immediate knowledge, attitude, and likelihood towards incorporating oral health preventive practice in their current practices to well-child visits. Significantly more residents felt more confident in identifying and referring patients with dental trauma. Key messages: an oral health educational seminar can be effective in improving paediatric and family medicine residents' immediate knowledge, attitude, and likelihood towards incorporating oral health preventive practice in their current practices to well-child visits.

Performance of Dental Students in Shade Matching: Impact of Training.

OBJECTIVE: The present study evaluated the effect of training on dental students' ability for matching two different shade guides. MATERIALS AND METHODS: The study was conducted in 2012. The participants were 88 male and female undergraduate dental students from Brazil and Portugal, with or without previous color education and vision refractive errors (response rate of 73.33%). They were asked to match a pair set of the shade guides Vita Classical (VC) and Vitapan 3D Master (3DM), with a 20-minutes' rest between each match. The sets were assembled over a neutral gray background and under controlled light. About 7-10 days later, all participants watched a video lecture on color education and repeated the matching procedure. The percentage of matches was calculated and submitted to statistical analysis for the variables gender, geographic region, shade guide and previous color education (Mann-Whitney tests), vision refractive errors (Kruskal-Wallis), and training (Wilcoxon signed rank). All tests were performed at a confidence level of 95%. RESULTS: Training increased the percentage of matches for all groups, except for Portuguese and hyperopic individuals (VC and 3DM) and men (3DM). Previous color education affected VC shade matching before training. Gender, refractive errors, and geographic region did not affect shade matching ability. CONCLUSIONS: Previous education and training in color positively affected shade-matching ability of dental students on shade guide pairing tests. CLINICAL SIGNIFICANCE: The subjectivity of the visual method might not be a clinical concern in daily practice. The human eye can detect small differences in color and visualize the tooth with all its complex geometry, multilayered tissues, and secondary color parameters. Therefore, any color-matching task will be judged by the patient and/or other observers with consideration to this complexity. In other words, visual assessment is paramount to the success/failure of esthetic restorative procedures. The efficiency of the visual color method may be improved by color education through the development of professional color discrimination ability. This would make the students responsible for color selection, reproduction, and evaluation and lead to increased capability over a layperson observer receiving the restorative treatment. (J Esthet Restor Dent 29:E24-E32, 2017).

The Graduating European Dentist-Domain III: Patient-Centred Care.

This position paper outlines the areas of competence and learning outcomes of "The Graduating European Dentist" that specifically relate to patient-centred care. This approach is becoming increasingly prominent within the literature and within policy documents. Whilst working to an evidence base is critical, dentists must also be aware of the scientific basis that underpins the treatment they provide. The evaluation process, which supports treatment planning, also requires dentists to be able to listen, collate, and record pertinent information effectively. In addition, the ability to account for a patient's social, cultural and linguistic needs (cultural competence) will result in a practitioner who is able to treatment plan for patient-centred care.

The Graduating European Dentist: A New Undergraduate Curriculum Framework.

With "The Graduating European Dentist", ADEE provides a new approach that reflects best academic practice for European undergraduate dental education. The new suite of documents sees increased emphasis on important curriculum components such as patient safety, working as a team and patient-centred care. There is also an increased emphasis on teaching excellence, student satisfaction and student preparedness and support. Guidance relating to methods of teaching and learning, and assessment (educational measurement), is also provided. It is anticipated that this new format will further increase accessibility and utility for educators, institutions, societies and regulators, across the sector.

The Graduating European Dentist-Domain I: Professionalism.

This position paper outlines the areas of competence and learning outcomes of "The Graduating European Dentist" that specifically relate to Professionalism. Professionalism is a commitment to a set of values, behaviours and relationships, which underpin the trust that the public hold in dental care professionals. Shortcomings within this domain are often responsible for patient dissatisfaction, concern and complaint-and emphasis is placed on the importance of embedding these values from an early stage within the curriculum.

The Graduating European Dentist: Contemporaneous Methods of Teaching, Learning and Assessment in Dental Undergraduate Education.

It is often the case that good teachers just "intuitively" know how to teach. Whilst that may be true, there is now a greater need to understand the various processes that underpin both the ways in which a curriculum is delivered, and the way in which the students engage with learning; curricula need to be designed to meet the changing needs of our new graduates, providing new, and robust learning opportunities, and be communicated effectively to both staff and students. The aim of this document is to draw together robust and contemporaneous methods of teaching, learning and assessment that help to overcome some of the more traditional barriers within dental undergraduate programmes. The methods have been chosen to map specifically to The Graduating European Dentist, and should be considered in parallel with the benchmarking process that educators and institutions employ locally.

The Graduating European Dentist-Domain II: Safe and Effective Clinical Practice.

This position paper outlines the areas of competence and learning outcomes of "The Graduating European Dentist" that specifically relate to Safe and Effective Clinical Practice. Dentists are required to ensure that they are capable of providing appropriate care for their patients, whilst also effectively managing and leading the wider clinical team. The care that is provided should align to a contemporaneous evidence base wherever possible, and the quality of care and the management systems that underpin it should be regularly audited and improved.

The Graduating European Dentist-Domain IV: Dentistry in Society.

This position paper outlines the areas of competence and learning outcomes of "The Graduating European Dentist" that specifically relates to Dentistry in Society. In addition to treating individual patients, a Dentist must be able to focus on promoting health, monitoring interventions and implementing effective strategies of care at community and population levels. This necessarily involves understanding population demography and health trends, engaging with health policy and promoting health. A Dentist must also understand population demography and health trends, in the context of the healthcare system within which they work.

Harmonisation of Dental Education in Europe - a survey about 15 years after visitation of dental schools participating in the DentEd project.

INTRODUCTION: The DentEd Thematic Networks (TNP) were funded from the EU to converge and harmonise the dental curricula. Forty-four dental schools participated in this visitation process between 1998 and 2002. The aim of the survey was to evaluate the implementation of the Dented outcomes in the curricula and if the concept of core competences are integrated in the curriculum. MATERIAL AND METHOD: In October 2012, questionnaires were sent out to all dental schools participated in the visitation process of Dented and Dented evolves. The main question blocs were as follows: structure of the curriculum and facilities, education of students, content and quality of education, assessment, research, European involvement and value of visit for the school. RESULTS: Twenty-five dental schools (57%) answered to the questionnaire. The responder represented 20 European countries of 22, whose schools were involved (91%). The self-assessment report was stimulating the continuation of curriculum improvement. Most of them acknowledge that major competences are essential outcome for the graduated dentist. Twelve schools (58%) rated the value of the DentEd visit with strong positive influence. DISCUSSION: The visits showed strengths, weaknesses and threats. Three-quarter of all schools implemented the European Credit Transfer System (ECTS). But most of them did not realize the unit of ECTS with modules among the Bologna process. CONCLUSION: The self-assessment report was a core issue for the continuation of curriculum improvement. The challenge for the ongoing curriculum improvement is the implementation of the module system among the Bologna recommendations.