Dental hygiene and direct access to care: Past and present.

The American Dental Hygienists' Association (ADHA) defines direct access as the ability of a dental hygienist to initiate treatment based on their assessment of patient's needs without the specific authorization of a dentist, treat the patient without the physical presence of a dentist and maintain a provider-patient relationship. In 2000, there were nine direct access states; currently, there are 42 states that have authorized some form of direct access. The ADHA has been instrumental in these legislative initiatives through strong advocacy efforts. While research and data support the benefits of direct preventive/therapeutic care provided by dental hygienists, many barriers remain. This paper chronicles key partnerships that have influenced and advocated for direct access and the recognition of dental hygienists as primary healthcare providers. The National Governors Association released a report in 2014 suggesting that dental hygienists be 'deployed' outside of dental offices as one strategy to increase access to oral health care along with reducing restrictive dental practice acts and increasing the scope of practice for dental hygienists. The December 2021 release of the National Institutes of Health report, Oral Health in America, further supports greater access to dental hygiene preventive/therapeutic care. This paper also reflects on opportunities and barriers as they relate to workforce policy, provides examples of effective state policies and illustrates an educational curriculum specifically created to prepare dental hygienists to provide oral health services in settings outside of the dental office. Dental hygiene education must ensure that graduates are future-ready as essential healthcare providers, prepared to deliver direct access to dental hygiene care.

Dental Hygiene and Direct Access to Care: Past and present.

The American Dental Hygienists' Association (ADHA) defines direct access as the ability of a dental hygienist to initiate treatment based on their assessment of patient's needs without the specific authorization of a dentist, treat the patient without the physical presence of a dentist, and maintain a provider-patient relationship. In 2000 there were nine direct access states; currently there are 42 states that have authorized some form of direct access. The ADHA has been instrumental in these legislative initiatives through strong advocacy efforts. While research and data support the benefits of direct preventive/therapeutic care provided by dental hygienists, many barriers remain. This paper chronicles key partnerships which have influenced and advocated for direct access and the recognition of dental hygienists as primary health care providers. The National Governors Association (NGA) released a report in 2014 suggesting that dental hygienists be "deployed" outside of dental offices as one strategy to increase access to oral health care along with reducing restrictive dental practice acts and increasing the scope of practice for dental hygienists. The December 2021 release of the National Institutes of Health report, Oral Health in America, further supports greater access to dental hygiene preventive/therapeutic care. This paper also reflects on opportunities and barriers as they relate to workforce policy, provides examples of effective state policies, and illustrates an educational curriculum specifically created to prepare dental hygienists to provide oral health services in settings outside of the dental office. Dental hygiene education must ensure that graduates are future-ready as essential health care providers, prepared to deliver direct access to dental hygiene care.

Person-Centered Care in Dental Hygiene Education: Incorporation and evaluation of person-centered care in the curriculum.

Purpose Patient and person-centered care are often used interchangeably. The abbreviation PCC is used in this paper in instances where patient/person centered care reflects the definition of person-centeredness. The purpose of this study was to assess how PCC is taught and evaluated in entry-level dental hygiene education programs to prepare graduates for future collaborations with oher health care pprofessionals in a wide range of practice settings.Methods A cross-sectional study was conducted using a 10-item survey emailed to directors of 325 accredited, entry-level dental hygiene education programs in the United States in December 2021. Descriptive statistics were calculated for all variables. Associations with curriculum settings, teaching, and evaluation methods for PCC, according to program degrees granted, were tested with Chi-square and Fisher's Exact tests.Results The response rate was 23% (n=75). Seventy percent offered an associate degree (AS) and 29% offered a baccalareate degree (BS); 42% reported more than half of their curriculum is allocated to teaching PCC. Didactic lectures (100%), case presentations (97%), and clinical instruction (97%) were the most common methods used for teaching PCC. Baccalaureate programs used external rotations more than associate programs for teaching and evaluation of PCC (84.2% vs. 45.5%; p<0.01). The most common PCC terms used in Quality Assurance Plans included providing individualized care (99%) and delivering evidence-based care (91%). Ninety-three percent strongly agree-agree that teaching PCC prepares graduates for working in different settings (e.g., schools, nursing homes, etc.), and 82% strongly agree-agree that PCC prepares graduates to work with a variety of providers.Conclusion The allocation of curricula time for PCC varied widely across respondents. Conversely, the majority felt their graduates were well-prepared to work in different settings where both PCC and IPP are likely to be practiced. This study serves as a baseline for further analysis of how dental hygiene education is preparing graduates for future practice settings.

Using learning management software data to compare students' actual and self-reported viewing of video lectures.

PURPOSE: Student engagement is typically measured by class attendance and questionnaires. Learning management systems (LMS) provide additional sources of objective data that can evaluate student performance. This study compared dental students' self-report of course video viewing with LMS data. METHODS: Dental students in a 2018 flipped pediatric dentistry course were given a questionnaire after course completion that captured self-reported course video viewing. Student data and time spent on videos were extracted from the LMS and matched to the questionnaire. McNemar's test evaluated differences between self-reported and matching LMS data. RESULTS: Of the 109 enrolled students, 99 (91%) completed the questionnaire. Most students self-reported that they watched more than half of the videos (71%), re-watched at least once (89%), and watched at times other than 8 a.m.-5 p.m. (80%). Of the 104 students with data from the LMS, 40% of students watched more than half of the videos, 49% re-watched at least one video, and 60% watched between 8 a.m.-5 p.m. LMS data showed 14 (13%) students did not watch any videos. Significant differences were found between self-reported video viewing and matched LMS video data in (1) percentage of videos watched, (2) number of times videos were re-watched, and (3) most frequent time for watching the videos (p < 0.001 for all). CONCLUSION: Technology is a tool that helps instructors more accurately track students' study habits compared to observation or self-report. When evaluating time spent watching videos via an LMS, students tend to overestimate the amount of viewing time.

Associations of Self-Reported Oral Health Quality of Life with Actual Oral Health Status in Children.

Purpose: Quality of life is considered a component of patient centered care. The purpose of this study was to examine the relationship between self-reported oral health related quality of life (OHRQoL) and the actual oral health status of children.Methods: This retrospective cohort study consisted of pediatric dental chart reviews from three clinics. Demographic and dental visit data along with the child's OHRQoL utilizing the Pediatric Oral health-related Quality of Life (POQL) instrument, were collected. Associations with untreated decay, treated decay, or POQL score were tested, using Chi-square, Fisher's exact test, 2-sample t-tests, or ANOVA. Linear regression was used to evaluate the effect of statistical confounders in the relationship between untreated decay and POQL scores. Significance level was set to 0.05.Results: Two hundred ninety-seven out of 336 children had both POQL and caries data. White children and children with untreated decay had significantly more negative POQL scores. Children rating their oral health as "excellent" or "very good" and children with sealants on molars had significantly more positive POQLs. Associations between POQL scores were significant with untreated decay, but not sealants, when considering both variables in the same model. After adjusting for having sealants, POQL scores were on average 7.5 points higher (more negative) in children with untreated decay, than in children without decay (p<0.001).Conclusions: Collecting OHRQoL data allows oral health providers to easily incorporate patient perceptions in their assessment and care and would ensure that all oral health needs of the patients are being met. This is important for children, who may have difficulty expressing their concerns, particularly in clinical environments.

Expert consensus on Didactic Clinical Skills Development for orthodontic curricula.

PURPOSE/OBJECTIVE: Competence is expected of each beginning dentist and orthodontist. However, the broad definition of competence presents a challenge to academic programs in identifying the level of cognition for students to achieve competence. This study aimed to determine the Didactic Clinical Skills Development curriculum content and competency in predoctoral and advanced education orthodontic programs. METHOD: A modified Delphi method with a consensus threshold of 70% was employed using an expert panel of academic orthodontists. RESULTS: Round One (n = 26) identified that all topics proposed by a focus group were necessary, except for predoctoral Appliances, which was at 65%. Round Two (n = 23) included subtopics of Appliances to confirm the lack of consensus, plus subtopics of all the other topics and the level of cognition required for each subtopic. The expert panel reached a consensus that all 24 subtopics, hence all topics, were necessary. In Round Three, subtopic responses in Round Two were assigned a value between 1 (remember) and 6 (create) to generate a hierarchical level-of-learning scale. Mean values were calculated for each subtopic response. For all subtopics, the mean level of cognition for predoctoral education was at understand; for advanced education, it was at evaluate. CONCLUSION: This consensus suggests that, to be deemed competent, beginning dentists must learn these topics and subtopics in the cognitive domain of understand, and beginning orthodontists in the cognitive domain of evaluate. This study showed an expert consensus on Didactic Clinical Skills Development orthodontic curriculum content and a panorama of educational objectives that could be used as a template for curriculum design.

Reliability of a grading rubric designed to evaluate the reflective ability of predoctoral dental students.

INTRODUCTION: Reflection and self-assessment are critical skills for healthcare providers. Identification of gaps in knowledge, skills and attitudes, along with the ability to critically think and problem solve to fill gaps, is the ultimate outcome for lifelong learning. The aims of this study were to (a) refine an instrument used for measuring reflective ability, and conduct comprehensive reliability testing, and (b) describe a process for rater calibration. MATERIALS AND METHODS: Students develop e-portfolios over a four-year span with assignments that require reflection and self-assessment. The final piece of the portfolio includes a global reflection written the last semester of the programme. Three faculty raters independently evaluated 106 dental students' global reflections using the revised grading rubric. An intraclass correlation coefficient measured the level of agreement between the three raters. RESULTS: Analysis of the 318 faculty ratings (106/rater) resulted in an intraclass correlation of .708. Based on a 5-point grading scale (0 = does not respond to the assignment to 5 = reconstructing), the ratings of the 106 global reflections ranged from 1.3 to 5.0 (M = 3.1, SD =0.66). DISCUSSION: This study provides confidence in the reliability of a grading rubric designed to assess reflective ability, along with suggestions for calibration. An overall mean of 3.1 (Level 3 = relating-includes evidence of lessons learned) illustrates the complexity of teaching reflection and self-assessment. CONCLUSION: Use of a reliable grading rubric for assessing reflective writing could assist schools interested in incorporating reflection and self-assessment into the curriculum, ultimately supporting lifelong and enhanced health care.

Scholarly Inquiry and Research: An assessment of graduate dental hygiene schools' requirements.

Purpose: Scholarly inquiry and research are core competencies for graduate dental hygiene education as defined by American Dental Education Association (ADEA). The purpose of this study was to examine how graduate dental hygiene programs in the United States (US) are meeting these competencies.Methods: The study sample consisted of the graduate programs in the US that award a terminal degree specific to dental hygiene (n=14). Graduate program directors were invited via email to participate in an electronic survey. The survey questions were developed based on the ADEA graduate dental hygiene education competency for scholarly inquiry and research. Descriptive statistics including frequencies and percentages were used to analyze the data. Exploration of relationships between variables were conducted using correlational analyses and t-tests.Results: A response rate of 71% was achieved (n=10). There was a significant difference in the minimum number of scholarly activity requirements between programs with lower student enrollments (M=4.43, SD=1.61) versus those with higher enrollments (M=2.00, SD=0; t(8)=2.51, p=.036). A negative correlation was found between the submission of a manuscript to a peer reviewed journal and the number of students accepted per year in the graduate program (r (10)= -.655, p <.05), indicating that students graduating from programs with larger enrollments were less likely to submit their scholarly work for publication.Conclusions: All program directors reported requiring students to participate in at least one scholarly activity as defined in the ADEA Core Competencies for Graduate Dental Hygiene Education. Program size was the biggest variable in relationship to the number of scholarly requirements. Schools with smaller enrollments required their students to participate in over twice the number of scholarly activities as compared to programs with larger enrollments. More research is needed to evaluate how graduate level dental hygiene programs are meeting the ADEA competencies.

ADEA-ADEE Shaping the Future of Dental Education III: Assessment in competency-based dental education: Ways forward.

Assessment in competency-based dental education continues to be a recognized area for growth and development within dental programs around the world. At the joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education III, the workshop on assessment was designed to continue the discussion started in 2017 at the ADEA-ADEE Shaping the Future of Dental Education II.1 The focus of the 2019 conference involved examining the potential of entrustable professional activities (EPAs) and current thinking about workplace-based assessment (WBA) within competency-based education in the 21st century. Approximately 30 years ago, George Miller wrote about the assessment of competence in medical education and challenged faculty to reach for higher levels of assessment than knowledge or skill.2 Acknowledging that no one assessment method can result in a valid assessment of competence, Miller proposed a four-level framework for assessment. The lowest level involves measuring what students know ("knows"), followed by assessment of the skill with which knowledge is applied in relevant tasks or problems ("knows how"). Next is an assessment of task performance in standardized settings ("shows how"), and finally, the highest level assesses the student's performance in the unstandardized clinical workplace ("does"). The 2019 assessment workshop focused on advances in the assessment of learners in the unstandardized workplace-the highest level of Miller's assessment pyramid ("does"). Research has shown that dental education has struggled to implement assessment strategies that meet this level.3 The workshop brought together individuals from around the world, with an interest in assessment in dental education, to consider how assessment in the "does" level, specifically EPAs and WBA, factors into competence assessment in dentistry/dental education.

Predoctoral Curricular Revision for Dental Radiographic Interpretation Competence Based on OSCE Results.

Teaching radiographic interpretation skills to predoctoral dental students is challenging. The results of an objective structured clinical examination (OSCE) at one U.S. dental school failed to yield expected outcomes for students' radiographic interpretation skills. The purpose of this article is to describe the development of the radiology OSCE and subsequent curricular revisions based on the outcomes. Examples of curricular changes are a series of self-assessed radiographic interpretation cases using the university learning management system. Each case contains a set of four intraoral radiographs and a series of questions. In year 4, an OSCE and final radiographic interpretation competency exam are administered; students are required to pass both exams. OSCE outcomes over a period of six years were used to evaluate the effectiveness of the curricular revisions. A questionnaire developed to capture student perceptions of the curricular changes was administered. The pilot OSCE of 2.9% first attempt pass rates initiated curricular revision. The strongest results to date occurred in 2018 with a 73.3% first attempt pass rate. Results from the questionnaire showed that students reported greater confidence in their interpretation skills when it came to recognizing radiographic errors, dental caries, and periodontal disease/pathologies (65%, 64%, and 57%, respectively). The use of the OSCE for programmatic assessment revealed the need for curricular revision in radiology. Students' participation in the newly revised radiology curriculum resulted in improved student performance and outcomes. This article emphasizes the importance of global and programmatic assessment for assessing student competence along with analysis of how assessment and accompanying data can inform curricular decisions.

Expert Consensus on Growth and Development Curricula for Predoctoral and Advanced Education Orthodontic Programs.

Dental students and orthodontic residents must demonstrate competence in various areas prior to graduation. However, the Commission on Dental Accreditation (CODA) definition of competence is broad. The aims of this study were to obtain expert consensus on Growth and Development topics and subtopics in predoctoral and advanced education programs in orthodontics and to determine the level of cognition on the subtopics necessary to demonstrate learner competence. A modified Delphi method with a consensus threshold of 70% was used. In Round One, academic orthodontists who met the expert panel inclusion criteria were surveyed to determine whether a topic was necessary to the curricula. Round Two identified the subtopics under each topic and the level of cognition necessary to demonstrate learner competence using Bloom's taxonomy, which defines the ascending levels of remember, understand, apply, analyze, evaluate, and create. Round Three involved analyses and interpretation of Round Two results. The academic orthodontists determined that six topics (n=24) and 29 subtopics (n=15) were necessary for Growth and Development curricula. For all subtopics, they determined the mean level of cognition for predoctoral education was understand; for advanced education, it was analyze. This consensus on Growth and Development curricular content suggests that these levels are necessary for a beginning dentist and a beginning orthodontist to be deemed competent. Findings from this study can serve to guide curricular development and instruction by using the identified learning objectives to build instructional and assessment measures.

Measuring the Level of Reflective Ability of Predoctoral Dental Students: Early Outcomes in an e-Portfolio Reflection.

Learning to evaluate one's own skills through reflection and self-assessment prepares dental graduates for successfully navigating an ever-changing work environment throughout their careers, but the search continues for the most effective teaching and assessment strategies to develop students' skills in these areas. Beginning with the Class of 2017, the University of Missouri-Kansas City School of Dentistry adopted e-portfolios as a programmatic (four-year) global assessment measure in the predoctoral dental program, in large part to encourage the development of reflection. The aim of this study was twofold: to examine interrater reliability among raters when scoring reflective writing using a validated measure of reflection skill and to analyze students' level of reflective ability as fourth-year dental students. Reflections of all 102 students were independently evaluated by the three investigators using a grading rubric based on Bain's 5 Rs (reporting, responding, relating, reasoning/deconstructing, reconstructing). Intra-class correlation was used to assess interrater reliability among the three raters, resulting in a good range for agreement (ICC=0.67; 95% CI 0.54, 0.77). The results showed that the majority (70%) of the global reflections were rated at Level 2 (responding) and Level 3 (relating). Approximately 15% of the global reflections reached Level 4 (reasoning/deconstructing), and only one was rated at the highest level (Level 5, reconstructing). This study confirmed that reflection and reflective writing were difficult for students to accomplish. As a result, curricular enhancements at this school have been implemented that involve both faculty and student development. Ongoing evaluation is required to determine if those changes result in higher levels of reflective ability. The positive outcomes of reflection and writing warrant continued examination in how to improve this educational strategy across the curriculum.

Implementation of Portfolios as a Programmatic Global Assessment Measure in Dental Education.

Studies of assessment have shown that three elements-multiple assessments, over time, with multiple evaluators-provide the best strategy for global assessment of student competence in a valid and reliable manner, while experts on competency-based education (CBE) have defined the use of portfolios for assessment as a best practice for CBE. The aim of this article is to describe the five-year experience of one U.S. dental school's implementation of portfolio assessment of student competence as a programmatic global assessment strategy and to share the lessons learned. From approval by the Curriculum Committee to the first graduating class's portfolios, the steps and lessons learned along the way are described, in hopes of providing guidance to other schools interested in adopting portfolios for global assessment. This assessment strategy required the collaboration of a broad range of administrators, faculty, and students, as well as a high degree of faculty and student development. Calibration of the summative evaluators resulted in an interrater reliability estimate of 0.81. An important lesson learned was that development of reflective writing was underestimated, resulting in initial failure of 12 (11%) of the portfolios for the Class of 2017. Dental schools interested in adoption of portfolios should expect to invest time in the preparation of faculty and students. However, the result of this investment will be an assessment measure considered a best practice in both the assessment and competency literature.

Dental Students' Study Habits in Flipped/Blended Classrooms and Their Association with Active Learning Practices.

In recognition of the importance for dental education programs to take a student-centered approach in which students are encouraged to take responsibility for their learning, a pediatric dentistry course redesign aimed at promoting greater active and self-directed learning was implemented at one U.S. dental school. The aim of this study was to examine the association between the students' self-reported study habits and active learning practices necessary for meaningful learning in the flipped/blended classroom. A convenience sample of two classes of second-year dental students in spring 2014 (SP14, n=106) and spring 2015 (SP15, n=106) was invited to participate in the study. Of the SP14 students, 84 participated, for a response rate of 79%; of the SP15 students, 94 participated, for a response rate of 87%. Students' self-reported responses to questions about study strategies with the prerecorded lecture materials and assigned reading materials were examined. Non-parametric analyses resulted in a cohort effect, so data are reported by class. In the SP15 class, 72% reported watching all/more than half of the prerecorded lectures versus 62% of the SP14 class, with a majority watching more than one lecture per week. In the SP15 cohort, 68% used active learning strategies when watching the lectures versus 58.3% of the SP14 cohort. The time of day preferred by the majority of both cohorts for interacting with course materials was 7-11 pm. Both SP14 and SP15 students reported being unlikely to read assigned materials prior to coming to class. Overall, the course redesign appeared to engage students in self-directed active learning. However, the degree to which active learning practices were taking place to achieve meaningful learning was questionable given students' self-reported study strategies. More work is needed to examine strategies for promoting study practices that will lead to meaningful learning.

Experiences of the Kansas Extended Care Permit Providers: A descriptive study.

Purpose: A total of 40 states to date have expanded the role of dental hygienists with the goal of improving access to basic oral health services for underserved populations. In Kansas, legislative changes have resulted in the Extended Care Permit (ECP) designation. The purpose of this study is to describe the experiences of registered dental hygienists in Kansas holding ECP certificates (ECP RDH) as of July of 2014.Methods: Secondary data analysis was performed utilizing data collected from a survey conducted in 2014 by Oral Health Kansas. All registered ECP RDH's were sent the 32-item survey via Survey Monkey®. Descriptive statistical analyses consisted of frequency distributions, and measures of central tendency. Inferential analyses using t-tests and ANOVA were conducted to compare groups.Results: A total of 73 responses were received from the (n= 176) surveys that were e-mailed for a 41% response rate. Of the clinicians who responded, 80%, worked at least part-time and in school settings. The most consistent barriers to providing care were the inability to directly bill insurance (52%), financial sustainability (42%) and physical requirements (42%). Follow-up tests found significant differencs between clinician groups when examining barriers.Conclusion: Although the ECP legislation appears to be expanding access to care for citizens in Kansas, significant barriers still exist in making this a viable model for oral healthcare delivery.

Student Preparation for the National Board Dental Hygiene Examination: A national survey of dental hygiene program directors.

Purpose: Dental hygiene students nearing completion of their educational programs are required to take written and clinical examinations in order to be eligible for licensure. The written licensure exam, the National Board Dental Hygiene Examination (NBDHE), is administered by the Joint Commission of National Dental Examinations (JCNDE). Failing a licensing examination is a costly experience for students and has the potential for a negative impact on a program's accreditation status. Nursing programs have published extensively on strategies used to prepare students for licensure examinations. However, there appears to be a gap in the literature as to how dental hygiene programs prepare their students to take the NBDHE. The purpose of this study was to conduct a national survey of U.S. dental hygiene program directors to determine what strategies their programs employ to prepare students to take the NBDHE and to explore the viewpoints of dental hygiene program directors regarding student preparation methods for the NBDHE.Methods: An survey instrument was developed, pilot tested, revised and mailed to directors of the 335 CODA accredited U.S. dental hygiene programs. The survey consisted of a combination of response formats including forced choice, multiple allowable answered, and open-ended written comments.Results: A total of 154 surveys were returned, yielding an overall response rate of 45% (154/341). The vast majority of directors (93%) reported they use specific methods and practices to prepare students for the NBDHE. The top two strategies identified were dental hygiene review texts (84%) and a board review course (83%). The majority of directors (84%) reported supporting student participation in non-mandatory, commercial review courses. In regard to mock board exams, directors "agreed/strongly agreed" (75%) that the mock board exam is a useful coaching tool in the overall process of NBDHE preparations. A majority (65%) indicated they were not concerned with failure rates, and 43% reported failure rates do reflect on the program.Conclusion: These results suggest that the majority of dental hygiene programs are utilizing strategies to prepare students for the NBDHE with board review textbooks and board review courses named as the top two strategies.

Change Is Here: ADEA CCI 2.0-A Learning Community for the Advancement of Dental Education.

On May 12, 2005, the inaugural meeting of the American Dental Education Association Commission on Change and Innovation in Dental Education (ADEA CCI) was convened. Comprised of thought leaders representative of dental education and practice, the ADEA CCI published groundbreaking white papers that effectively helped bring dental education across the threshold of the 21st century. Twelve years later, a new ADEA CCI has been convened-ADEA CCI 2.0. The ADEA CCI 2.0 is a broad-ranging, strategically interconnected, flexible, and multifarious community of stakeholders situated within and across all facets of oral health education and practice. Whereas the first iteration of the ADEA CCI made the case for change regarding revisions of the dental curriculum and learning environment, the ADEA CCI 2.0 will focus on external domains that are having a global impact on the content and delivery of health care and health professions education and, ultimately, how health care benefits people. The principal work of the ADEA CCI 2.0 will be to create educational and implementation resources and opportunities for dental educators to contemplate, investigate, and ultimately define the future needs of their academic dental institutions in this constantly changing world.

Which Way to Lean? A National Study of Women Dental Faculty Members' Career Aspirations and Choices.

The aim of this first national study of women in academic dentistry was to explore factors and perceived barriers for why administrative/leadership positions were or were not sought via data collected from full-time women dental faculty members in the U.S. In fall 2015, the researchers conducted a survey that employed a combination of response formats: forced choice from a menu, multiple allowable answers, and open-ended written comments. The overall response rate for the survey was 35.6% (537/1504). Respondents were from 48 of the 65 U.S. dental schools. Half of the respondents indicated their primary appointment was in clinical sciences, 22.9% were in administration, 7.3% in research, 7.1% in basic science, and 2.5% in behavioral science. While a quarter of the respondents indicated administration as their primary appointment, over half reported holding administrative positions, and nearly all (92.4%) reported currently holding leadership roles at their institutions. For those not currently in administrative/leadership roles, 52.6% indicated a desire for an administrative role and 70.7% a leadership role. Of those in administrative/leadership roles, 62.1% indicated not receiving extra remuneration for those responsibilities. Half of the respondents perceived that they were paid less in their current position than men doing the same work. The most dominant theme emerging from qualitative analysis of barriers the respondents experienced was the difficulty women in dental education have in a traditionally male-dominated profession. The results confirmed that women faculty members are "leaning in" to seek administrative/leadership roles in academic dentistry. However, pay equity remains an issue, and faculty development and mentoring are needed for the advancement of academic dentistry and ultimately the dental profession.

Flipping the Classroom: Assessment of Strategies to Promote Student-Centered, Self-Directed Learning in a Dental School Course in Pediatric Dentistry.

The aim of this study was to explore student and course director experiences with the redesign of a traditional lecture-based course into a flipped classroom for teaching didactic content in pediatric dentistry to second-year dental students. The study assessed student satisfaction, extent of student engagement, overall course grades, and course director satisfaction. The students enrolled in a flipped classroom pediatric dentistry course (spring semester 2014; SP14) were asked to complete pre- and post-course questionnaires to assess their perceptions of active learning, knowledge acquisition, and course satisfaction. The process was repeated with the class enrolled in the same course the following year (SP15). Responses for SP14 and SP15 resulted in an overall response rate of 95% on the pre questionnaire and 84% on the post questionnaire. The results showed that the greatest perceived advantage of the flipped classroom design was the availability and access to online content and course materials. Students reported enhanced learning due to heightened engagement in discussion. The results also showed that students' overall course grades improved and that the course director was satisfied with the experience, particularly after year two. Many calls have been made for educational strategies that encourage critical thinking instead of passive learning environments. This study provides one example of a course redesign and demonstrates the need for both faculty and student development to ensure success when a flipped classroom methodology is introduced.