Despite the crucial role oral health care providers can have in the early identification of eating disorders and the referral and case management of patients with these disorders, little is known concerning their knowledge of oral complications of these disorders. The purpose of this study was to determine the knowledge among dentists and dental hygienists concerning the oral and physical manifestations of eating disorders. Employing a randomized cross-sectional study, data were collected from 576 dentists and dental hygienists randomly selected from the American Dental Association and the American Dental Hygienists' Association. Results indicated low scores concerning knowledge of oral cues, physical cues of anorexia, and physical cues of bulimia among study participants. More dental hygienists than dentists correctly identified oral manifestations of eating disorders (p=.001) and physical cues of anorexia (p=.010) and bulimia (p=.002). As the first health professional to identify oral symptoms of eating disorders, the most important task of the dental care provider when identifying oro-dental signs of eating disorders is to ensure that the patient receives treatment. Implications for education include the addition of conceptual, procedural, and skillbased curricula objectives addressing etiologic assessment and patient communication-thus increasing behavioral capacity for delivery of restorative care and patient referral.

Often the first to observe overt health effects of eating disorders, dentists and dental hygienists play a fundamental role in the secondary prevention of eating disorders. The purpose of this study was to explore readiness and capacity for integration of oral health and mental health services. Employing a randomized cross-sectional study based upon the Transtheoretical and Health Belief Models, data were collected from 378 dental hygienists. Results reveal that the majority do not currently engage in secondary prevention practices. Only 18% of respondents indicated referring patients exhibiting oral manifestations of eating disorders to treatment. Significantly increasing the likelihood of assessment, referral, and case management included modifying factors regarding greater perceived self-efficacy, and knowledge of oral cues of disordered eating, as well as the individual's perception pertaining to severity of eating disorders. Implications for bridging dental care to mental health services include increasing behavioral capacity among dental hygienists via consciousness raising and improved self-efficacy.

The objective of this study was to explore how dental hygiene programs in the United States educate their students about treating patients with special needs. Data were collected from 102 U.S. dental hygiene programs (response rate=49 percent) with a web-based survey. Nearly all programs (98 percent) reported that they present this material in lectures. However, only 42 percent of the programs required students to gain clinical experiences with patients with special needs. Most programs covered the treatment of patients with physical/sensory impairments such as hearing impairments (93.1 percent), psychopathologies (89.2 percent), and adult onset neurological disorders (89.2 percent). Outcome assessments were usually done in a written exam (97.1 percent), while objective structured clinical examinations (OSCEs) (9.8 percent) and standardized patient experiences (4.9 percent) were less frequently used. Respondents identified "curriculum overload" as the biggest challenge to addressing special patient needs. Nevertheless, 29.4 percent of the respondents indicated that they support an increase in clinical experiences for students to give them increased opportunities to work with patients with special needs. Recent changes in accreditation standards require graduating dental hygiene students to be competent in assessing the treatment needs of special needs patients. Based on the program directors' responses, recommendations can be made to increase the opportunities for students to have clinical experiences with patients with special needs and to address the needs of patients with special needs more comprehensively in dental hygiene curricula.Ms. Dehaitem is a dental hygiene graduate student,

Program evaluation is a necessary component of curricular change and innovation. It ascertains whether an innovation has met benchmarks and contributes to the body of knowledge about educational methodologies and supports the use of evidence-based practice in teaching. Education researchers argue that rigorous program evaluation should utilize a mixed-method approach, triangulating both qualitative and quantitative methods to understand program effectiveness. This approach was used to evaluate the University of Michigan Dental Hygiene Degree Completion E-Learning (online) Program. Quantitative data included time spent on coursework, grades, publications, course evaluation results, and survey responses. Qualitative data included student and faculty responses in focus groups and on surveys as well as students' portfolio relections. The results showed the program was academically rigorous, fostering students' ability to connect theory with practice and apply evidence-based practice principles. These results also demonstrated that the students had learned to critically relect on their practice and develop expanded professional identities; going beyond the role of clinician, they began to see themselves as educators, advocates, and researchers. This evaluation model is easily adaptable and is applicable to any health science or other professional degree program. This study also raised important questions regarding the effect of meta-relection on student conidence and professional behavior.

Distance education offers an opportunity to catalyze sweeping curricular change. Faculty members of the University of Michigan Dental Hygiene Program spent eighteen months researching best practices, planning outcomes and courses, and implementing an e-learning (online) dental hygiene degree completion program. The result is a collaborative and portfolio-integrated program that focuses on the development of relective practitioners and leaders in the profession. A team-based, systems-oriented model for production, implementation, and evaluation has been critical to the program's success. The models and best practices on which this program was founded are described. Also provided is a framework of strategies for development, including the utilization of backward course design, which can be used in many areas of professional education. Prof. Gwozdek is Clinical Lecturer and