Implementing Standardized Patient Caregivers to Practice Difficult Conversations in a Pediatric Dentistry Course.

INTRODUCTION: Standardized patient (SP) methodology has been used in health professional education to help students develop communication, deeper diagnostic reasoning, and critical thinking skills. Few examples demonstrate the use of SPs to practice difficult conversations with pediatric caregivers in the pediatric dentistry literature. The objective of this educational activity was to describe the implementation of three SPs in a pediatric dentistry course for second-year dental students. METHODS: We developed three SP encounters covering interactions with caregivers of an infant with severe early childhood caries, an adolescent on the path to gender affirmation, and a child with autism and dental caries whose caregiver was resistant to fluoride- and silver-containing dental materials. We describe the case design process, rubric construction and calibration, student debriefing, and pandemic modifications. We evaluated the effectiveness of the implementation by thematic analysis of student reflections following each encounter using a qualitative descriptive framework. RESULTS: Eighty-three students completed each encounter. Qualitative analysis showed that students preferred a more realistic encounter by having a child or other distraction present. Students relied on different elements of motivational interviewing depending on the objective of each encounter and the age of the patient. Overall, the SP encounters were well received by students and faculty as an alternative or supplement to traditional student evaluation methods. DISCUSSION: We noted a number of lessons learned about implementing SP methodology in pediatric dental education. With these experiences now in place, future evaluations should measure student performance in the SP encounters against student performance during clinical care.

Preparing for implementation of an entrustable professional activity assessment framework.

Following the adoption of competency-based education in dentistry in the 1990s, entrustable professional activities (EPAs) were introduced in the field of medicine in the mid-2000s to help educators better determine the competence of trainees. More recently, the field of dental education has begun exploring EPAs as a framework for assessing competence while ensuring compliance with accreditation standards. This paper explores one dental school's process of preparing for implementation of a major curriculum change using an EPA assessment framework, shifting away from the use of singular assessments for competency determination to a global and longitudinal approach using a constellation of data to determine practice readiness. This paper describes how the EPA framework was developed, including the complementary capacities, assessment tool development and programming, and data reporting to follow learner progression and determine practice readiness. We discuss lessons learned leading up to implementation, and we position this perspective as a space to describe opportunities and complexities to consider when using a longitudinal assessment system. We attend to the tension between the current language of Commission of Dental Accreditation Standards as "competencies" and the evolving conversation of operationalizing EPAs while addressing accreditation Standards. To do this, we describe the process of finalizing our EPA framework and preparing for initial implementation in a new curriculum.

How to create a faculty-centered curriculum support system: Launching the Academic Support Center (ASC) to inspire excellence in curriculum change.

PURPOSE: To define faculty needs and services requested for the implementation of a faculty-centered curriculum support system (i.e., Academic Support Center [ASC]) to assist curriculum redesign. METHODS: Faculty and students were invited to participate in 60-min, one-on-one interviews to describe pain points in teaching and identify possible support services needed. Benchmarking through surveys of academic deans was also conducted to determine what services other institutions offer. Qualitative memos from interviews and survey data were analyzed to identify salient challenges and outline possible services that could benefit the school. This information was used to create a strategic plan for the ASC. Full-time faculty were requested to evaluate the ASC 6 and 12 months following the launch of the center in 2019. RESULTS: Fifty interviews were conducted with department chairs (n = 10), full-time faculty (n = 36), and students (n = 4). Six pain points identified by participants were time, resources, knowledge, confidence, organizational structure, and organizational culture. Participants generated solutions related to supporting teaching and learning, enhancing faculty experience, and assisting educational evaluation. Twenty-two schools responded to the benchmarking survey-approximately half acknowledged a centralized curriculum support service (n = 12, 54.5% of respondents). Services often focused on instructional design, education technology, and faculty onboarding to education. Faculty feedback following the ASC launch was generally positive and demonstrating progress toward the three priorities. CONCLUSION: Needs assessment and benchmarking data can inform the design and implementation of centers that offer faculty-centered support structures around teaching, educational scholarship, and curriculum change.

Introducing legislative advocacy into the dental school curriculum: A mixed-methods evaluation.

The aim of this project was to evaluate a legislative advocacy exercise in pediatric dentistry at 1 North American dental school. A mixed-methods approach was employed using focus groups and questionnaires. All third-year dental students (n = 84) participated in an exercise as part of the pediatric dentistry course. Participation in the program evaluation was voluntary. Questionnaires were administered to assess students' advocacy beliefs, behaviors, self-efficacy, and knowledge 1 week before and 1 week after the exercise. Six months later, a focus group with questionnaire non-respondents (n = 9) was conducted to explore participants' attitudes and beliefs about oral health advocacy within the dental school curriculum. The focus group followed a semi-structured guide, and transcripts were analyzed using thematic content analysis. Questionnaires were returned from 27 students before (33% response rate) and 23 students (28% response rate) following the advocacy exercise. Students' advocacy beliefs, behaviors, and knowledge showed no change, whereas self-efficacy improved following the advocacy exercise. Students enjoyed the advocacy exercise and viewed it as a positive addition to the curriculum; however, they requested more exposure to advocacy across the curriculum. Students described the power of their collective voice rather than a single person as a major driver of policy change. These findings suggest that curricular changes should incorporate experiential advocacy activities more frequently to help students learn about and gain advocacy skills.