No abstract

In this report, selected results are presented from the 1987 Kentucky Oral Health Survey, which acquired statewide data on the oral health status and practices of the noninstitutionalized population of Kentucky. In the 1987 epidemiological survey, information about persons who were homebound was also gathered through telephone and in-person interviews. The results of that survey provided a relatively accurate estimate of the number of persons homebound in the state of Kentucky. Although the majority of this population was older than age 60, almost 21% were between the ages of 35 and 59. Household income for persons who are homebound and the amount of money spent on dental care is significantly less than in households not reporting the presence of a person who is homebound. These findings provide baseline data for dentists and health planners interested in serving this population. Also, this data is pertinent to the formation of health policies to create accessible, affordable care for this growing segment of the population.

Several initiatives have been introduced over the years to address the maldistribution of health care professionals and to improve access to care for underserved rural populations. One of these is the sponsorship of community-based, service-oriented teams comprised of students from various health disciplines. This study investigated extramural training as a complement to traditional hospital-based experiences. The specific objective of the study was to determine the extent to which the nation's medical schools combine training with a rural community-based experience in the form of an interdisciplinary student health team program. In the fall of 1994, a 32-item questionnaire was mailed to the chief academic or clinical affairs administrators of the nation's 126 allopathic medical schools. A total of 104 (82.5%) medical schools responded to the survey. Eighty-six of the respondents (82.7%) reported some type of rural training or public service activity; 22 (21.2%) acknowledged the sponsorship of an interdisciplinary student health team program. Small rural communities, those with populations of 5,000 or fewer, were the focus of 76 percent of the reporting programs. Nearly two-thirds of the reporting programs were located in the South, the region with the nation's lowest physician-to-population ratio. The nursing and medical professions were most frequently represented, although a wide range of disciplines were identified as participating on the student health teams. Activities of the teams included both ambulatory care and community outreach services. The majority of the programs used team-building exercises to enhance team effectiveness. Extramural training programs offer students a realistic examination of the social, cultural, economic, and political forces that influence both individual and community health. Rural community-based programs, such as interdisciplinary student health teams, should be valued because they can strengthen the link between the sponsoring institution's educational mission and its public service obligation.

The purpose of this study is to evaluate the effect of an extramural rotation on dental hygiene student self‐perceptions of competence in specific clinical areas. Dental hygiene students attending one midwestern university from 1992 through 1998 rated their perceived level of competence on nineteen dimensions of dental hygiene practice prior to beginning a four‐week extramural rotation and again at the completion of the rotation. Results indicated that student perceptions of competence improved significantly on six of the nineteen dimensions in each of the study years. Study results suggest that an extramural rotation is a valuable component of a dental hygiene curriculum to enhance student self‐perceptions of clinical competence.

Dentistry is confronting rapid changes in its environment. Technological advancements, innovations in the traditional delivery system, and epidemiological and demographic changes are all factors that have a direct and very powerful effect on today's practicing dentist.I While virtually all components of the health care system are faced with similar changes, it has been proposed that, within dentistry, the challenges are perhaps the most dramatic.2If the profession is to be responsive to the factors that influence it, the educational systems that prepare its members for the practice of dentistry must reflect these societal and clinical changes. These systems include not only undergraduate and graduate dental education, but continuing educa- 29