Assessing Dental Students’ Readiness to Treat Populations That Are Underserved: A Scoping Review

Abstract

In North America, all dental schools have adopted some form of community-based dental education (CBDE) or service-learning, but little is known about the areas being researched and reported in published studies. The aim of this study was to conduct a scoping review to determine what areas of research had been conducted to determine the effects of CBDE on dental students' readiness to treat populations that are underserved. A systematic search of articles published in English or French since 2000 was performed on July 29, 2015, and combined quantitative and qualitative synthesis of data was conducted. Of the 32 studies evaluated, 23 (72%) were quantitative, seven (22%) were qualitative, and two were multi-method. The majority (66%) used self-report methods, most frequently surveys. Participants in 50% of the studies were fourth-year dental students; the others assessed third- and fourth-year (13%), first- and second-year (6%), and first-year (13%) students. Dentists were the participants in three studies (9%), with dentists and students in one study (3%). Either the types of populations receiving care were unspecified or four or more groups were pooled together in 25 studies (78%), while two focused on children, one on rural populations, one on elderly populations, two on persons with special health care needs, and one on low-income populations. The study areas were wide-ranging, but generally fell into three categories: student performance (37.5%), teaching approaches and evaluation methods (37.5%), and perceptions of CBDE (25%). This review identified many research gaps for determining whether students are prepared to treat populations that are underserved. The disparate nature of CBDE research demonstrates a compelling argument for determining elements that define student readiness to care for patients who are underserved and for research that includes the voices of patients, curriculum development, and more comprehensive and rigorous evaluation methodologies.

Reflective Learning Outcomes of Community‐Based Experiences: A Qualitative Study

“…Some of them noted that insights from the students would be hard to attain via classroom experience alone 2, 3,6,11, 20 . Furlini et al conducted a systematic review of studies published from 2000 to 2015 that investigated the effects of CBDE on dental students' readiness to treat populations that are underserved 21 . They found 12 studies that focused on pedagogical approaches; of the 12, only six were qualitative.…”

“…Students' reflections suggest an active role, rather than a passive role, as experience is often required for learning in the affective domain. Students' ability to focus on an experience and analyze the process and outcome of actions taken, as well as the assumptions that led them to their conclusions, is critical to developing a professional identity that is communityminded 2 – 7, 9,11,13,14,17, 18 – 21 . Instructional strategies aimed at attaining these outcomes are an important and necessary part of health professions curricula 18 – 20 …”

Universally funded oral health care and oral health outcomes

“…However, either system has to yet fully eliminate inequity and oral health disparities -utilization rather than access remains a personal choice mediated by life circumstances, choices and perceived benefits. Moreover, Leake (3) highlights that "unless an alternative direction is taken, dentistry will lose its relevance as a profession working for the public good and this will be followed by further erosion of public support for dental education and research" regardless of undergraduate dental education attempting to address dental public health (19), community services (46,47) and social responsibility (48) Inclusion and exclusion criteria for the literature search strategy…”

A review on oral health care in four different health care systems

“…However, neither system has yet to fully eliminate oral health disparities -utilization rather than access remains a personal choice mediated by life circumstances, choices, and perceived benefits. Moreover, Leake (3) highlights that "unless an alternative direction is taken, dentistry will lose its relevance as a profession working for the public good and this will be followed by further erosion of public support for dental education and research" regardless of undergraduate dental education's attempt to address dental public health (20), community services (47,48), and social responsibility 49 given their inherit epidemiological disadvantages. This study did not gather data on the many other factors that are known to influence service utilization including age, gender, educational level, and so on.…”