Current proposals to solve the dental access problem probably will be insufficient until barriers identified by caregivers are addressed.

Dental schools are challenged to develop new learning methodologies and experiences to better prepare future dental practitioners. The purpose of this study was to gain insight into the community-based experiences of dental students as documented in their critical incident essays and explore what learning outcomes and benefits students reported. Following two required community-based clinical rotations, each student wrote a reflection essay on a self-defined critical incident that occurred during the rotations. Rotations took place in settings such as a public health clinic, special needs facility, hospital, or correctional institution. Essays for two classes of students were content-analyzed for recurring themes and categories. Students were confronted in their rotations with a wide range of situations not typically encountered in dental academic settings. Their essays showed that, as a result of these rotations, students developed increased self-awareness, empathy, communications skills, and selfconfidence. Critical incidents challenged assumptions and stereotypes, enhanced awareness of the complexities of dental care, and raised complex ethical dilemmas. The essays also illustrated a heightened sense of professional identity and enabled students to appreciate the role dentistry can play in impacting patients' lives. We concluded from the study that community-based dental education that includes a process for reflection holds promise as an educational strategy to facilitate the personal and professional development of future dentists.

Background: Contrary to international guidelines recommending family presence during cardiopulmonary resuscitation (CPR), allowing family members to be present remains a matter of debate in many countries. The purpose of this study was to determine the opinions of healthcare providers from a Muslim setting concerning family-witnessed resuscitation (FWR). Methods: The sample population consisted of CPR responders in four teaching hospitals in Tehran. These centres have no policy regarding the presence of family members during resuscitation. We developed and circulated a questionnaire gathering opinions, and collated their comments. Results: From 200 respondents, 77% opposed FWR. We found that gender, age, experience, previous exposure to FWR or specialty (except for emergency physicians) did not predict opinion towards family presence during CPR. The most common reasons given for opposition to family presence were fear of psychological trauma to family members, possible interference with patient care/ decision-making, and a perceived increase in staff stress. Conclusion: In a largely Muslim community, and contrary to general guidelines, our survey suggested that the majority of CPR responders do not favour the presence of relatives during cardiopulmonary resuscitation. Any counter to this opinion would need to be based on educating team members about the possible benefits of relatives being present during resuscitation. Public education surrounding CPR would also be a fundamental element for implementing any formal programme encouraging family-witnessed CPR in hospitals such as ours.

Tailored, theory-based interventions are needed to improve communication between EHS staff and families. Clear policies on the application of Head Start oral health performance standards to EHS are warranted. Educational activities should address the needs and suggestions of EHS participants.

Learners gain additional value from community-based education when they are guided through a reflective process. The purpose of this article is to describe how structured reflection assignments and methods are incorporated in the University of North Carolina School of Dentistry's community-based DISC (Dentistry in Service to Communities) program. The following strategies are described as ways to enrich community-based learning experiences for dental students: photographic documentation; written narratives; critical incident reports; and mentored post-experiential small group discussions. Fieldwork and courserelated examples are drawn from community-based dental experiences to illustrate how reflective teaching approaches can enhance student learning. A directed process of reflection is suggested as a way to increase the impact of the community learning experience.