Status of Oral Health Training in U.S. Primary Care Programs: A Qualitative Study to Define Characteristics and Outcomes.

With increasing recognition of the important relationship between oral and systemic health, non-dental health professions schools and programs are now teaching their students about oral health in various ways. This study built on surveys of medical schools, primary care residency and fellowship programs, and other health professions programs conducted by the authors in 2017, which found some had made significant progress in integrating oral health into primary care training, while others lagged behind. The aim of the current study was to better understand the characteristics and climate of oral health education in non-dental health professions schools by conducting interviews with leaders of programs who had self-identified in the surveys as having a robust oral health curriculum. Hour-long interviews were conducted between October 2017 and March 2018 with 31 program directors or deans of medical specialty and allied health professions programs using a semi-structured interview guide. These interviewees were from 13 health disciplines. The coding of interview transcripts identified seven major themes: motivations to develop an oral health curriculum; rationale for curriculum topics covered; best aspects of the curriculum; evaluation and assessment strategies; relationships with dental providers and residents and dental hygienists; barriers and challenges; and advice and lessons learned. The interviewees reported a strong belief that oral health is an important health topic. Key elements that interviewees identified as helping them build robust oral health programs in their primary care curricula were the following: having an oral health champion; having some funding; building relationships with dental professionals; using local, state, and national resources; using curricular materials from existing sources; incorporating skills-based sessions; taking an IPE approach; and making oral health part of what the program already does. These findings should be useful for primary care schools and programs that are beginning to add oral health to their curricula and those seeking to improve their existing oral health education for their students.

Evaluating One Strategy for Including Reflection in Medical Education and Practice.

BACKGROUND AND OBJECTIVES: Reflective writing in medicine allows for the opportunity to analyze, interpret, and learn from clinical experiences. The purpose of this study was to evaluate the beneficial effects of reflective reading and writing for a department using a weekly listserve. METHODS: The Department of Family Medicine and Community Health at the University of Massachusetts Medical School sends out a weekly reflective writing story written by its members to celebrate clinical/teaching success. We conducted a 19-item questionnaire in the summer of 2014 among all 402 members. RESULTS: Questionnaires were completed by 161 of 402 (40%) readers and 50 of 122 (41%) writers. Readers found many benefits; 84% reported learning "a lot" about how a colleague handled a certain clinical situation, while 79% found that the reflective writing listserve helped them feel more connected to colleagues. A total of 83% reported that reading the weekly story positively affected their empathy and patient centeredness. Those who reported reading the stories most often were more likely to report achieving the most benefits. The majority of respondents who wrote stories agreed with all suggested benefits of writing; 73% reported that writing allowed them to celebrate a patient/research/teaching encounter that they were proud of, and 72% reported that it gave them better perspective or clarity about a patient experience "a lot" of the time. CONCLUSIONS: As departments struggle with provider burnout and feelings of being overwhelmed and disconnected, strategies like a reflective writing listserve may be a means to improve support and inspire clinicians and learners to feel fulfilled.

Transforming the culture of surgical education: promoting teacher identity through human factors training.

CONTEXT: Promoting a culture of teaching may encourage students to choose a surgical career. Teaching in a human factors (HF) curriculum, the nontechnical skills of surgery, is associated with surgeons' stronger identity as teachers and with clinical students' improved perception of surgery and satisfaction with the clerkship experience. OBJECTIVE: To describe the effects of an HF curriculum on teaching culture in surgery. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION: Surgeons and educators developed an HF curriculum including communication, teamwork, and work-life balance. MAIN OUTCOME MEASURES: Teacher identity, student interest in a surgical career, student perception of the HF curriculum, and teaching awards. RESULTS: Ninety-two of 123 faculty and residents in a single program (75% of total) completed a survey on teacher identity. Fifteen of the participants were teachers of HF. Teachers of HF scored higher than control participants on the total score for teacher identity (P < .001) and for subcategories of global teacher identity (P = .001), intrinsic satisfaction (P = .001), skills and knowledge (P = .006), belonging to a group of teachers (P < .001), feeling a responsibility to teach (P = .008), receiving rewards (P =.01), and HF (P = .02). Third-year clerks indicated that they were more likely to select surgery as their career after the clerkship and rated the curriculum higher when it was taught by surgeons than when taught by educators. Of the teaching awards presented to surgeons during HF years, 100% of those awarded to attending physicians and 80% of those awarded to residents went to teachers of HF. CONCLUSION: Curricular focus on HF can strengthen teacher identity, improve teacher evaluations, and promote surgery as a career choice.