The development and implementation of an online applied biochemistry bridge course for a dental hygiene curriculum.

This article describes a curricular change project designed to improve instruction in biochemistry. After years of unsatisfactory outcomes from a dental hygiene biochemistry course, a decision was made to change the traditional lecture-based course to an online format. Using online technology and principles of educational pedagogy, a course was developed that fosters application of biomaterials principles to dental hygiene practice and provides a bridge between prerequisite chemistry coursework and biochemistry in a health professions program. Members of the dental hygiene graduating Classes of 2007 and 2008 participated in the revised course. The outcome measures used to assess the effectiveness of the revised course were student end-of-semester course evaluations, graduating senior survey results, student course performance, and National Board examination performance. While the results are based on only two classes, the positive outcomes suggest that the revision was a worthwhile endeavor. The use of technology in teaching holds the potential for solving many of the curriculum and instruction issues currently under discussion: overcrowding of the curriculum, lack of active learning methods, and basic sciences taught in isolation from the rest of the curriculum. It is hoped that the results of this change will be helpful to other faculty members seeking curricular change and innovation.

A qualitative study of limited access permit dental hygienists in Oregon.

Many states have adopted alternative oral health care delivery systems that include expanded roles for dental hygienists. This qualitative study was designed to evaluate the impact of the Limited Access Permit (LAP) legislation in Oregon and to understand the relationship between dental hygienists and dentists within this delivery system. The snowball sampling technique was used to identify LAP dental hygienists and collaborating dentists. The snowball sampling technique begins with the identification of a known expert in the field who serves as the initial "sampling unit." Subsequent individuals are then recommended, or nominated, to the investigator by the initial study participant and are selected based upon the need to fill in or extend information. The final sample consisted of seven LAP dental hygienists and two collaborating dentists. Interviews, field observations, and document analysis were utilized for data collection. Factors that led to the creation of LAP dental hygiene practice, current LAP practice, personal characteristics, relationships between LAP dental hygienists and dentists, and the impact that LAP dental hygienists have had on access to oral health care were explored. Data revealed that the Oregon legislature twice expanded the LAP scope of practice to increase access to oral health care services. LAP dental hygienists practice in community and school-based settings. Common characteristics of LAP dental hygienists include entrepreneurship, lifelong learning, and a commitment to underserved populations. The findings from this study indicate that LAP dental hygienists and collaborating dentists have positive relationships. No evidence of lower quality of care in unsupervised dental hygiene practices was found. However, the impact of the LAP legislation is still unknown due to the limited numbers of LAP dental hygienists and the early nature of the LAP practice.

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.

Identifying Needs to Ensure a Humanistic Academic Dental Environment: A Multi-Site Survey of Dental Students' Perspectives.

Dental school academic environments, whether the overall environment or the smaller environments of the classroom, lab, clinic, or community, are critical to student learning and professional development. The aims of this study were to assess dental students' experiences in the overall academic environment related to discrimination, destructive communication, belittlement, and isolation and to explore the relationships between students' emotional health and such experiences. Dental students in all four years at five U.S. dental schools were invited to participate in an electronic survey in April 2017. A total of 358 students responded for a 19.4% response rate. These students reported a total of five cases of discrimination that had been formally reported to their schools. Among these respondents, 24% had experienced destructive communication, 33% had experienced belittlement, and 33% reported feeling a sense of isolation. Non-males and students with disabilities were more likely to experience belittlement and isolation. Both destructive communication and feeling belittled increased with program year (relative to year 1)-spiking in year 3. Destructive communication and isolation were associated with behavior changes such as weight change, increased alcohol or over-the-counter medication use, and consultation with a health professional. To improve overall academic environments, dental educators should create learning environments to foster development of professional relationships, and schools should continue to provide student support services. Identifying and acknowledging shared issues across dental education might stimulate a national discussion that could lead to concerted approaches to address these issues. Identifying the proportions of students with feelings of isolation or loneliness along with experiences of belittlement and destructive communication could provide schools with a useful picture of their academic environment.

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.

Access to care and the allied oral health care workforce in Kansas: perceptions of Kansas dental hygienists and scaling dental assistants.

Access to oral health care continues to be a problem in the United States. Research has called for innovative approaches to improve access to oral health care and reduce oral health care disparities. Successful alternate approaches have been reported. In 1998 the Kansas Legislature passed a proposal to enhance access to care and manpower needs by allowing dental assistants to provide supragingival scaling, a service traditionally assigned to dental hygienists. In 2000, Mitchell et al. investigated the perceptions of Kansas dental hygienists and scaling dental assistants in relation to House Bill 2724 (HB 2724), which allows dental assistants to perform coronal scaling. The intent of the study was to collect baseline data in relation to HB 2724. The purpose of the present study was to follow up on the impact of HB 2724 six years after legislation. Both groups report satisfaction with their professions: scaling dental assistants believe the delivery of care in Kansas has changed, and areas of Kansas previously noted as dental health professional shortage areas are now served by either a registered dental hygienist or scaling dental assistant.

Program Evaluation of a Distance Master's Degree Dental Hygiene Program: A Program Effectiveness Study.

Purpose: The purpose of this study was to conduct a program evaluation of the University of Missouri-Kansas City Master of Science in Dental Hygiene Education Program (MSDH). This evaluation examined long-term outcomes in the context of stakeholders (the profession, the student, and the degree-granting institution).Methods: A mixed-methods approach was used to gather data from the 28 graduates from the MSDH program. An electronic questionnaire included both open- and closed-ended questions including demographic and practice data, and data related to alumni preparedness to reach their career goals. Virtual focus groups provided valuable insight into whether the program has achieved its goals, and prepared the graduates to meet their program competencies and future goals.Results: Out of a total of 28 individuals who have successfully completed the distance program (2001-2011), 19 participated in an online survey (67.8%). The majority of the participants (73.7%) participated in one of 3 focus groups. Sixty-three percent of the graduates are currently employed in dental hygiene education. Eighty-four percent of the respondents have published their research conducted while in the program, thereby contributing to the dental hygiene body of knowledge. Sixty-eight percent indicated that had the distance option not existed, they would not have been able to obtain their advanced degree in dental hygiene. Twenty-one percent of the respondents report either being currently enrolled in a doctoral program, or having completed a doctoral degree.Conclusion: These results suggest that the University of Missouri-Kansas City Master of Science in Dental Hygiene Education Program is meeting its goals from the perspective of all stakeholders and providing its graduates with access to education and educational resources to meet the program competencies and ultimately achieve their career goals.

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.

Faculty Development at One Midwestern Dental School: A Program Evaluation.

Most dental school faculty members arrive on campus with a wealth of clinical experience but little to no teacher training. For the past two decades, there has been a call for schools to educate their faculty on a wide variety of topics including educational methodology and cutting-edge educational techniques through faculty development programs. Drawing on theories of general program evaluation as well as evaluation specific to educational programming, the aim of this study was to investigate outcomes of the Faculty Development Program at the University of Missouri-Kansas City School of Dentistry between 2007 and 2014. A mixed-methods research design gathered quantitative data via email survey sent to all eligible teaching faculty members; it received an overall response rate of 54% (N=51). Qualitative data came from open-ended survey questions and a focus group with seven volunteer faculty participants. The survey data suggested that the stated outcomes of faculty development were being met for all stakeholder groups with varying degrees of success. Focus group results indicated a need for a more formal new faculty orientation and better communication with all about the specific charge of faculty development within the school. Evaluation of faculty development activities in academic dental institutions is a necessary component of the ongoing improvement of dental education. Suggestions for future evaluations include the idea of collaborating with other dental schools to increase sample sizes, which would increase participants' perception of the level of confidentiality and make statistical analyses more robust.

ADEA/AAL Institute for Allied Health Educators: Program Evaluation.

Revised accreditation standards for dental and dental hygiene education programs have increased emphasis on faculty development that can improve teaching and learning, foster curricular change including use of teaching and learning technologies, and enhance retention and satisfaction of faculty. The American Dental Education Association (ADEA) and Academy for Academic Leadership (AAL) established the Institute for Allied Health Educators (IAHE) in 2007 to address faculty development needs for allied dental and allied health educators. In 2009, it was transitioned to an online program, which resulted in increased enrollment and diversity of participants. After seven years, a comprehensive program evaluation was warranted. The authors developed an online questionnaire based on Kirkpatrick's four-level model of training evaluation; for this study, levels one (satisfaction), two (knowledge and skill acquisition), and three (behavior change) were examined. Of the 400 program participants invited to take part in the study, a 38% response rate was achieved, with the majority indicating full-time faculty status. Nearly all (95-97%) of the respondents agreed or strongly agreed the program contributed to their teaching effectiveness, and 88-96% agreed or strongly agreed it enhanced their knowledge of educational concepts and strategies. In addition, 83% agreed or strongly agreed the program helped them develop new skills and confidence with technology, with 69% agreeing or strongly agreeing that it helped them incorporate technology into their own educational setting. Nearly 90% were highly positive or positive in their overall assessment of the program; 95% indicated they would recommend it to a colleague; and 80% agreed or strongly agreed they had discussed what they learned with faculty colleagues at their home institutions who had not attended the program. Positive findings from this evaluation provide evidence that the IAHE has been able to meet its goals.

Validity and reliability of portfolio assessment of competency in a baccalaureate dental hygiene program.

This study examined the validity and reliability of portfolio assessment using Messick's unified framework of construct validity. Theoretical and empirical evidence was sought for six aspects of construct validity. Seven faculty raters evaluated twenty student portfolios using a primary trait analysis scoring rubric. A significant relationship (r = .81-.95; p < .01) between the seven subscales in the scoring rubric demonstrates measurement of a common construct. There was a significant relationship between portfolios and GPA (r = .70; p < .01) and the NBDHE (r = .60; p < .01). The relationship between portfolios and the Central Regional Dental Testing Service (CRDTS) examination was both weak and nonsignificant (r = .19; p > .05). A fully crossed, two-facet generalizability (G) study design was used to examine reliability. ANOVA demonstrated that the greatest source of variance was the scoring rubric itself, accounting for 78 percent of the total variance. The smallest source of variance was the interaction between portfolio and rubric (1.15 percent). Faculty rater variance accounted for only 1.28 percent of total variance. A phi coefficient of .86, analogous to a reliability coefficient in classical test theory, was obtained in the decision study by increasing the subscales to fourteen and decreasing faculty raters to three. In conclusion, the pattern of findings from this study suggests that portfolios can serve as a valid and reliable measure for assessing student competency.

Information-seeking behaviors of U.S. practicing dental hygienists and full-time dental hygiene educators.

PURPOSE: This study compared the frequency and variety of information-seeking behaviors used by dental hygiene practitioners and dental hygiene educators to answer practice-related questions. Personal demographic characteristics also were compared between the two groups to determine the characteristics of those with a high level of computer-based information-seeking behaviors. METHODS: A self-administered questionnaire was sent to a national computer generated random sample of 300 practicing dental hygienists and 300 dental hygiene educators. Responses were received from 63% of the practicing dental hygienists and 78% of the educators. RESULTS: Dental hygiene practitioners and dental hygiene educators both used traditional methods of seeking information. However, dental hygiene educators used a higher frequency and wider variety of sources than dental hygiene practitioners, including innovative sources such as the Internet, computer databases and online discussion groups. Dental hygiene educators almost universally reported some use of the Internet and computer databases--97% and 91%, respectively. Meanwhile, 50% of dental hygiene practitioners used the Internet and 25% used computer databases at least once for practice information. Online discussion groups were used by 50% of dental hygiene educators but by only 13% of dental hygiene practitioners. Level of education was the demographic characteristic that was most associated with use of computers to answer practice-related questions. CONCLUSIONS: Since use of computer sources for information were defined as innovative, more dental hygiene educators were classified in early adopter categories, while greater numbers of dental hygiene practitioners were classified in later adopter categories. Group demographics were examined to determine variables that predicted adoption. Level of education predicted the majority of variation and as a whole, showed the strongest statistical differentiation between adopter categories.

The impact of Kansas House Bill 2724: perceptions of Kansas dental hygienists and dental assistants.

PURPOSE: Kansas House Bill 2724 (HB 2724), which allows dental assistants to perform coronal scaling, was passed by the Kansas legislature in the spring of 1998. This bill was the legislature's way of addressing access to care and manpower issues, in relation to oral health care in Kansas. The intent of this study was to collect baseline data related to HB 2724. Specific purposes of this study were to, 1) compare overall perceptions of dental hygienists and scaling assistants related to HB 2724, 2) compare perceptions of dental hygienists and scaling assistants on how HD 2724 has addressed access to care and manpower issues, and 3) examine the impact of HB 2724 on the delivery of preventive care in underserved areas in Kansas. METHODS: This study employed a nonexperimental descriptive survey research design. Two survey instruments were developed consisting of Likert scale questions, demographic information, and closed and opened-ended questions. All registered Kansas dental hygienists, and dental assistants who had completed the training course approved by the Kansas Dental Board to perform coronal scaling of teeth, were chosen to participate. RESULTS: A total response rate of 38% for dental hygienists, and 42% for scaling assistants was achieved. Analyses were conducted to ensure validity and reliability of the two survey instruments, including factor analysis and internal reliability measures. In relation to overall satisfaction with career choices, both dental hygienists and scaling assistants reported being happy in their professions and respected by their dentist employers. The majority of dental hygiene respondents (79%) did not see HB 2724 addressing either access to care or manpower issues in the state, while in contrast a majority (89%) of scaling assistants believed that this was the best answer for Kansas in relation to access to care and manpower. In examining the impact of HB 2724 on delivery of preventive care in underserved areas of Kansas, this study found that the majority of scaling assistants reported practicing in metropolitan areas, as opposed to identified oral health care shortage areas in the state. CONCLUSIONS: While both dental hygienists and scaling assistants are satisfied with their career choices, this legislation does not appear to be addressing its main objectives-access to care and increased manpower in dentally underserved areas in Kansas.

Teaching with technology: learning outcomes for a combined dental and dental hygiene online hybrid oral histology course.

Among the challenges leaders in dental and allied dental education have faced in recent years is a shortage of well-qualified faculty members, especially in some specialty areas of dentistry. One proposed solution has been the use of technology. At the University of Missouri-Kansas City School of Dentistry, the departure of a faculty member who taught the highly specialized content in oral histology and embryology provided the opportunity to implement distance delivery of that course. The course is taught once a year to a combined group of dental and dental hygiene students. Previous to spring semester of 2009, the course was taught using traditional face-to-face, in-class lectures and multiple-choice examinations. During the spring semesters of 2009, 2010, and 2011, the course was taught using synchronous and asynchronous distance delivery technology. Outcomes for these courses (including course grades and performance on the National Board Dental Examination Part I) were compared to those from the 2006, 2007, and 2008 courses. Students participating in the online hybrid course were also given an author-designed survey, and the perceptions of the faculty member who made the transition from teaching the course in a traditional face-to-face format to teaching in an online hybrid format were solicited. Overall, student and faculty perceptions and student outcomes and course reviews have been positive. The results of this study can provide guidance to those seeking to use technology as one method of curricular delivery.

Development and implementation of online National Board Dental Examination Review Courses.

Failure on the National Board Dental Examination (NBDE) Parts I and II has troubling consequences for dental students, faculty members, and school administrators. Since the NBDE is a high-stakes exam for all involved, it is important to determine effective strategies to help students prepare. The purpose of this article is to describe the development and implementation of online NBDE Parts I and II Review Courses by the faculty and administration at the University of Missouri-Kansas City School of Dentistry. The courses are taught by faculty members who are content experts. By utilizing distance technology, students in any geographic location can review the material at the time, place, and pace that are most convenient. Early outcomes show that 592 students from thirty-two states have participated in the courses since they were first offered in 2010-11. In post-course evaluations, students report that participation in the courses encouraged them to spend more time preparing for the exam and that the associated PowerPoint slides/handouts provided structure for their review. The literature suggests that multiple modalities are most effective in preparing for the NBDE. These online review courses can serve as a beneficial component of a student's preparation regimen.

Academic integrity violations: a national study of dental hygiene students.

The purpose of this study was to identify the prevalence of academic integrity violations reported by a national sample of dental hygiene students as compared to general undergraduate students. This study also examined the influence of student variables such as gender, age, and level of education, along with honor codes and other contextual factors, on academic integrity. A total of 2,050 surveys were mailed to a random selection of the schools with dental hygiene degree programs in each of the twelve American Dental Hygienists' Association (ADHA) districts. A total of 794 usable surveys were returned for an overall response rate of 39 percent. The respondents were predominantly twenty to twenty-nine years of age (85 percent), and 97.7 percent were female. The largest percentage of respondents (38.5 percent) had completed four or more years of undergraduate education at the time of the survey, with the majority of the coursework taken in a community college setting (39 percent). Approximately 53 percent were from associate programs and 47 percent from baccalaureate programs. Of those responding, 11.3 percent reported cheating during their dental hygiene program, and 30.2 percent were aware of someone cheating in their program. A comparison of academic violations for dental hygiene students to students in other undergraduate programs reveals that a smaller proportion of dental hygiene students report violations.

Examining clinical assessment practices in U.S. dental hygiene programs.

Competency-based education (CBE) in dental hygiene education is intended to measure learned skills that prepare students to independently provide services for the public. A variety of standardized clinical assessment techniques (SCATs) are available to substantiate the competence of health care professionals, including, but not limited to, objective structured clinical examinations (OSCEs), triple jump exams, standardized patients, and simulations. Standardized clinical examinations test students' abilities to treat diverse patients in a consistent, controlled setting. SCATs help prepare clinicians to safely treat patients of various complexities. The objectives of this study were to examine the variety of techniques used to assess clinical competence in U.S. accredited dental hygiene programs and to obtain program directors' attitudes regarding clinic assessment, with a focus on how SCATs are used. An online survey collected data from 125 directors (48 percent response rate). Approximately 97 percent of the responding programs used observation-type assessments followed by case studies (90 percent), self-assessment (85 percent), and mock boards (75 percent), with SCATs being the least used. The majority of responding directors (74 percent) indicated an interest in learning more about these SCATs. A chi-square test identified no significant difference between the use of SCATs by associate and baccalaureate degree programs, with program location also being irrelevant.

Articaine: a new alternative in dental hygiene pain control.

PURPOSE: Local anesthesia administration is integral to pain control in dental hygiene. As of 2006, 40 licensing jurisdictions in the United States include local anesthesia administration in the scope of dental hygiene practice. While the risks associated with use of intraoral local anesthesia are not great, careful attention to recommended practices helps foster patient safety. As new products are introduced, it is important to study their advantages and limitations to see where they fit into dental hygiene practice. An amide local anesthetic agent, articaine, that has been available in Europe for over 20 years, was approved for US distribution in 2000. METHODS: The purpose of this article is to review the current peer reviewed literature on the characteristics of articaine so it can be incorporated into dental hygiene practice when indicated. RESULTS: Rather than simply using one agent for all procedures, patient care is enhanced when local anesthetics are selected based on the unique needs of the procedure, the patient and with safety and effectiveness in mind.