Abstracts for Posters Presented at the 2012 ADEA Annual Session & Exhibition
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
2012 ADEA Annual Session: Poster Abstracts
Abstracts for Posters Presented at the
2012 ADEA Annual Session & Exhibition
Note that the posters in all categories (Educational Research, New Program, and Work in Progress) appear here in numerical
order. For Work in Progress posters, only the titles and authors are published. A schedule of poster presentations at the 2012
ADEA Annual Session & Exhibition appears on pages 264–7.
501. Engaging Students by Creating Curriculum confidence necessary to treat children with behavior management
Grounded in Interprofessional Education Through issues once they begin their own dental careers.
Service-Learning with a Diabetes Education Health
Care Team 504. Evaluation of Admission Criteria to Predict
Sheryl L. Sloshower, Nicole M. Aylward, Laura L. MacDonald,
Performance Among Non-U.S.-Trained Dentists at the
University of Manitoba VCU School of Dentistry
Work in Progress Preeti K. Sastry, Riki Gottlieb, Virginia Commonwealth University
Work in Progress
[Poster 502 was withdrawn.]
505. Health Professions Programs Student Attitudes
503. Dentists’ Perceptions of Predoctoral Pediatric About Hookah Use
Dental Training Regarding Children with Attention Jill M. Loewen, Mathew Savaya, Basam Shamo, Swati Chitre,
Span Disorders Michelle Wheater, University of Detroit Mercy
Tedi H. Fladhammer; Ashley Ray; Janet Head Work in Progress
Educational Research
Over the last twenty-five years, educators, physicians, dentists, and 506. Teaching the Chronic Care Model in General
parents have become progressively more aware of the increased Dentistry
prevalence of uncooperative behavior in children and teens. There have Julia Kazimiroff, Nanice E. Regis Blay, Kevin D. Oh, Montefiore
been many factors in the lives of children that have been suggested Medical Center
to be the cause of this increase, including changes in parenting styles New Program
such as permissive parenting, changes in education styles, increased
numbers of children with psychological disorders including attention The Chronic Care Model (CCM) is a tool designed by Improving
span and hyperactivity disorders, and an increased prevalence of video Chronic Illness Care Organization for correcting the many deficiencies
games and watching television in American households. Dentists who in current management of diseases such as diabetes, heart disease,
have treated numerous children over the past two decades have become depression, asthma, and others. The Montefiore Medical Center’s U.S.
increasingly aware of the change in the relationship among the child, Health Resources and Services Administration (HRSA)-sponsored
parent, and dentist and its potential impact on dental treatment. The Dental Resident Training Project aims to train dentists in the use of
objective of this research was to explore general dentists’ perceptions CCM to improve oral health outcomes for persons with diabetes. The
of their predoctoral education in the management and treatment of project consisted of four parts. First, outreach included oral health
children with attention span disorders/hyperactivity issues. General promotion to patients and medical primary care providers (PCPs) at
dentists who serve as clinical rotation site faculty for fourth-year community-based programs including PCP waiting rooms, health
students at the Arizona School of Dentistry and Oral Health were fairs, senior centers, and dental staff communication with medical staff
surveyed. Bivariate and multivariate analyses were used to analyze by means of handouts, oral presentations, and oral health education
the data. Results indicated that dentists who have been in practice classes. Second, interventions included a diabetes collaborative to
more than ten years have seen a significant increase in the number train residents in management, monitoring, and analysis of cytokines
of children with attention span/hyperactivity issues since they first in diabetic and overweight/obese patients as oral health indicators.
started practicing (p=0.045). Additionally, the majority (70.3 percent) Third, for evaluation, practice teams (GP and dental faculty) became
of dentists surveyed did not feel they had enough training while in familiar with the Assessment of Chronic Illness Care (ACIC) and
dental school to effectively manage children with attention span/ Patient Assessment of Chronic Illness Care (PACIC) and completed
hyperactivity issues while in the dental office. Dentists indicated the ACIC for one chronic condition (e.g., how well they are providing
they would like to have received more education in pharmacologic oral health care for diabetes). Adherence to the CCM was evaluated
interactions, conscious sedation, general anesthesia, and hospital quantitatively by a numerical score given by the respondents (teams,
orientation. With the prevalence of attention span disorders on the rise, patients) in which they rated the degree to which each component
dental schools need to increase the amount of exposure predoctoral (e.g., partnerships with community organizations, patient treatment
students receive in the treatment of children with complex behavior plans) is being implemented for that chronic condition, using a
management issues. This will provide a more complete learning scale ranging from 0 (not at all) to 11 (fully). When we started the
experience. Students can then gain the exposure, techniques, and enhanced program, the scores ranged over 85 percent between 0
These abstracts were peer-reviewed following established criteria. The abstracts published here are the property of their authors. No transfer of copyright to
the Journal of Dental Education has occurred. ADEA makes no claims, express or implied, with respect to the accuracy, completeness, usefulness, ownership,
or adequacy of the information presented.
218 Journal of Dental Education ■ Volume 76, Number 22012 ADEA Annual Session: Poster Abstracts (cont.)
and 2=limited support for chronic illness care, and the six-month Phase 1 results reveal the following positive attributes of the developed
average moved to between 3 and 5=basic support for chronic illness case studies: relative advantage of active learning and modeling;
care. To improve the results, we will use systems-based practice and compatibility with a variety of courses; ability to observe case-related
practice-based learning and improvement for team development to knowledge and skills; independent learning; and ability to be modified
achieve between 6 and 8=reasonably good support for chronic illness for use with other oral-systemic health issues. In Phase 2, the case
care and between 9 and 11=fully developed chronic illness care. studies were filmed to create live-action videos. Videos were used to
The enhanced dental curriculum will provide new dentists with the model communication by dentists or dental hygienists with diverse
tools necessary to communicate with patients regarding oral health patients (i.e., male, female, adult, and pediatric), who present with a
implications of chronic illness; perform interventions in the various variety of clinical findings and are determined to be at varying stages
dental settings (community-based, hospital-based, private practice); of readiness to address their underlying issues. Phase 3 results from
and establish relationships with their medical counterparts to allow the pretesting revealed that the following positive attributes were met
for a holistic approach to patient treatment. The project was funded by the case studies: relative advantage of active learning; compatibility
by HRSA Grant Award No. D88HP20119-01-00. with a variety of courses; case-related knowledge could be observed;
material could be communicated; and time saved in class by assigning
507. Development and Evaluation of Interactive, cases for homework. Addressing identified adoption attributes are
Web-Based Case Studies: Application of Diffusion of expected to increase the likelihood that dental and dental hygiene
faculty members will adopt the web-based case studies for use in
Innovations the curriculum. Diffusion of Innovation adoption themes identified
Rita D. DeBate; Herbert H. Severson; Deborah C. Cragun; Ashley A. in this study could be applied to the development of future case
Gallentine; Tracy S. Shaw studies and may provide broader insight that might prove useful for
Educational Research exploring differences in case study use across oral health curricula.
Calls for change regarding the future direction of dental and dental Study results provided valuable and practical information that was
hygiene curricula include increasing students’ exposure to patients’ used to inform the development of four interactive, web-based case
oral-systemic health issues throughout their entire training and studies on patient-provider communication on sensitive oral-systemic
increasing the use of computer and web-based information technology. health issues. The use of the Diffusion of Innovations model allowed
Web-based interactive case studies may provide the opportunity us to capitalize on positive attributes of case studies that may increase
for students’ exposure to oral-systemic health issues they may not the likelihood that oral health faculty members would incorporate
encounter in their clinical training, thereby increasing students’ them into existing courses. Identified adoption themes can also be
experiences in differential diagnosis, patient/provider communication, applied to the development of future web-based case studies. (NIH
and patient-specific treatment plans. The purpose of the study was to 1RC1DE020274-01)
apply the Diffusion of Innovations (DOI) conceptual framework to
identify characteristics of web-based case studies that would increase 508. “Domestic Abuse” Versus “Intimate Partner
their adoption among dental and dental hygiene faculty; develop Violence/Abuse”: Dental and Dental Hygiene Students’
four interactive web-based case studies on patient communication Educational Experiences, Knowledge, Attitudes, and
of sensitive oral/systemic health issues; and evaluate how well the
case studies addressed the identified adoption characteristics. DOI
Behavior
is the process by which an innovation (web-based case study) is Rachel A. Sheridan, Marita R. Inglehart, University of Michigan
diffused into a population (dental and dental hygiene curricula) and Educational Research
is ultimately adopted by its members (dental and dental hygiene Approximately 1.3 million women and 835,000 men are physically
faculty). According to DOI, certain innovation attributes (e.g., assaulted by an intimate partner in the United States annually, and
relative advantage, compatibility, complexity) increase the likelihood one out of three women in the United States reports being physically
that an innovation will be adopted by a targeted population. This abused by a boyfriend or spouse in her lifetime. Research has
mixed-methods study spanned three phases: 1) identification of shown that the majority of these women would like their health care
adoption characteristics among dental and dental hygiene faculty; providers to inquire about abuse. Dentists and dental hygienists in
2) translation of adoption characteristics into four web-based case particular have a unique chance to identify evidence of domestic
studies; and 3) evaluation of translation. Methods for Phase 1 entailed violence, because head, neck, and facial injuries are so common in
soliciting input from potential innovation adopters (dental and dental domestic violence cases that they are considered markers for abuse.
hygiene faculty members) regarding attributes of web-based case However, most dentists never screen their patients for domestic
studies. Eight ninety-minute focus groups (three dental, five dental violence (DV). A lack of education regarding DV identification and
hygiene) representing six universities/colleges were conducted with a reporting could be the major reason. The purpose of this study is
convenience sample of dental and dental hygiene faculty members at therefore to explore dental and dental hygiene students’ educational
collaborating dental and dental hygiene schools. Methods for Phase experiences, knowledge, attitudes, and behaviors related to DV. In
2 entailed translating identified themes into case study development. addition, this project explored whether the term “intimate partner
Scripts for the case studies were written, edited, and evaluated by the violence/abuse” (IPV/A) elicits different responses from the term
research team with collaboration from an expert panel. Questions “domestic violence.” Data were collected with two versions of an
were written about the case studies to assess knowledge and skills anonymous self-administered paper-and-pencil survey. The first
on patient-provider communication regarding sensitive oral-systemic version used the term “domestic violence” throughout the survey,
health issues. These questions were interspersed throughout the case and the second version used the term “intimate partner violence/
studies. Pictures were taken, an audio recording of the script was abuse.” A total of 522 surveys were returned from dental and dental
made, and the prototype was developed. Methods for Phase 3 entailed hygiene students (Version 1: N=294; Version 2: N=228). While 54
pretesting the developed case studies. Participants were provided with percent of the students indicated that they had learned about DV, only
a link to the case study prototype for review prior to the interview. 17 percent reported to have learned about IPV/A (p2012 ADEA Annual Session: Poster Abstracts (cont.)
behavioral science classes. Students agreed more strongly that they ADEA Foundation Knowledge and Skills for the New General
should have more education about addressing IPV/A concerns with Dentist (2011). The Commission on Dental Accreditation (CODA)
their patients than addressing DV concerns (on a five-point scale requires demonstration of competence in this area for the graduating
from 1=disagree strongly to 5=agree strongly: 3.79 vs. 3.61; p=.043). dentist of 2013. Institutions must demonstrate compliance including
However, the students did not differ in the degree to which they wanted explicit discussion of the meaning, importance, and application of
to have more education about either one of these issues in general critical thinking. The ADEA critical thinking toolbox and similar
(3.88 vs. 3.87; p=.920) nor in their assessment of the effects of the publications have outlined explicit definitions of critical thinking as
lack of education on their professional behavior. When the students conceived by authors of educational and/or philosophical scholarship.
were assessing their knowledge concerning DV and IPV/A, it became Most definitions of critical thinking in the dental literature, however,
clear that they thought they had more knowledge about DV than are implicitly defined by the author, taking the form of the author’s
about IPV/A (knowledge about symptoms of DV vs. IPV/A: 3.28 personal interpretations and assumptions of the meaning. These
vs. 2.68; p2012 ADEA Annual Session: Poster Abstracts (cont.)
18.96 with a standard deviation of 0.988; the mean GPA was 3.547 In June 2010, two of the CWRU-DM student organizers (BC, NB)
with a standard deviation of 0.127; and the mean science GPA was visited the Lamay Health Clinic and inspected the facilities. There
3.474 with a standard deviation of 0.142. Graphically, each variable is was adequate electricity and facilities. The initiative also had strong
represented as a normal distribution. The correlation between science support from the mayor of Lamay. Additionally, the students met with
GPA and DAT academic average (0.44) was found to be larger than the regional health minister (Cuzco, Peru) and received permission to
the correlation between cumulative GPA and DAT academic average perform humanitarian dental work under the supervision of licensed
(0.38). The correlation between PAT score and science GPA (0.42) dentists. The Cuzco Dental School was also contacted, and several
was found to be larger than the correlation between PAT score and of their students agreed to assist the effort with Spanish-Quechua-
cumulative GPA (0.39). Strong correlations were found between DAT English translations. Since only a few of the volunteers spoke Spanish
academic average score and PAT score (0.82) as well as between and some patients spoke only Quechua, these language skills were
cumulative GPA and science GPA (0.97). Variance between mean critical for communicating with the patients. Step 4: fundraising
scores in individual dental schools was found to be 0.2304 for DAT and supplies. We were fortunate to receive most of the requisite
academic averages, 0.4696 for PAT scores, 0.003415 for cumulative supplies from the CWRU faculty and local dentists. We borrowed
GPAs, and 0.004444 for science GPAs. Nationwide, variance of mean portable operatory units and dental chairs. We purchased anesthesia,
DAT academic average was 1.3393, 0.9761 for mean PAT average, needles, etc. in Cuzco because of customs restrictions. Finding a
0.0162 for mean cumulative GPA, and 0.0203 for mean science GPA. dental supply company in our destination city was crucial. We did
Science GPA has a stronger correlation with DAT academic average not obtain nonprofit status in time for this year’s trip, which would
and PAT score than cumulative GPA. Individual schools tend to have made monetary donations easier. Step 5: recruiting students and
maintain a small variance in mean scores for mean DAT academic faculty volunteers. Humanitarian outreach programs offer unique
average, PAT score, GPA, and science GPA; however, nationwide opportunities to give service and to be exposed to different cultures.
variance is much greater for DAT academic average and PAT while We found no difficulty in recruiting students and licensed faculty
much smaller for cumulative GPA and science GPA among dental members to participate. In fact, upon our return, faculty members and
schools. Graphically, dental school admission criteria scores maintain students have begun inquiring whether they could assist next year.
similar averages between years and do not appear to be increasing Step 6: scheduling and organizing the logistics of the trip. Multiple
or decreasing. meetings were held throughout the year with all volunteers. Step 7:
announcing dental services to the target population. New programs
515. Eight Steps for Developing and Implementing a require significant marketing. Because the director of the Lamay
Student-Organized International Outreach Program Clinic made several announcements prior to and the weekend of our
arrival, we expected more patients. We then posted flyers in local
Benjamin H. Cope, Nathan B. Buckner, Michael D. Gillins, T. Roma businesses, announced our intentions at a town gathering, and ran
Jasinevicius, Lisa A. Lang, Case School of Dental Medicine an advertisement on the government-sponsored radio station that
New Program broadcasts to underserved communities. During the first week of
Case Western Reserve University School of Dental Medicine (CWRU- August 2011, CWRU-DM students (n=13) and faculty members
DM) dental students have a history of volunteering for international (n=4) treated 304 patients. For every patient triaged, we recorded his
outreach programs to provide dental care to underserved populations. or her name, gender, age, proposed treatment, and treatment provided
Recently, the Cleveland Clinic Lerner College of Medicine and and its date. Step 8: debriefing sessions. It is critical to review and
CWRU School of Medicine (CWRU-MedS) initiated a medical reassess throughout. In Peru, debriefing sessions were held daily;
outreach program in Peru. In a discussion with other health care we reviewed what worked and which aspects could be changed/
professionals, the medical students noted that one of the chief improved. For example, the dates of the program will be changed
complaints of the patients was related to dental decay. This discussion since the Peruvian Independence Day celebrations caused some minor
initiated the organization of a dental outreach program in Lamay, complications. Also, we are considering weekend sessions to allow
Peru. Preparation, both legal and material, began in August 2009. The men to take off from work.
organizational process will be described in eight steps with supporting
information related specifically to the Lamay Outreach Program. Step 516. Results of a Student-Organized International
1: picking a site for the humanitarian outreach program. Generally Humanitarian Dental Outreach Program
the needs of a population are complex; therefore, for programs to be
Nathan B. Buckner, Benjamin H. Cope, Michael D. Gillins, T. Roma
successful interprofessional collaboration is required. Hence, working
Jasinevicius, Lisa A. Lang, Case School of Dental Medicine
with existing contacts and facilities, such as the contacts with CWRU-
MedS and those in Lamay, should improve the comprehensiveness of New Program
care. The observation that dental decay is a problem is supported by The objectives of this first Case Western Reserve University School
a 2009 study that found Peruvian children living in poor households of Dental Medicine (CWRU-DM) outreach effort (August 2011) were
are 2.25 times more likely to have dental caries than children living to 1) provide basic dental treatment to an underserved population
in non-poor households. Given that 54 percent of the Peruvian (Lamay, Peru, and surrounding communities), 2) assess the dental
population lives in poverty, there is a definite risk to the oral health needs to determine the future direction of the program, and 3) provide
of this population. We felt that CWRU dental students could help dental students opportunities to practice their clinical skills. During
address this need. Step 2: support from the home institution. This was our investigative visit, we were introduced to several patients who
crucial for our trip because we anticipated that the majority if not all had generally poor oral health and obvious lack of professional dental
the volunteers would be students and faculty members. Permission care. The resident dentist indicated such patients were typical in the
to initiate the program was granted by the CWRU-DM dean; the Lamay clinic. Therefore, we anticipated much of our patient base
clinic director also sanctioned the program. At the suggestion of the would exhibit similar oral health problems (rampant decay, poor
dean, we consulted with the CWRU legal team and subsequently oral hygiene, periodontal disease, etc.). The town of Lamay has a
modified the application packet for the study abroad program to small health clinic, which was our base of operations. We used three
fit our circumstances. This ensured that our group would fall under unoccupied rooms approximately 10x20. Each room, managed by
the protection of CWRU. Step 3: support from Peruvian officials. fourth-year students, was designated a specific type of procedure:
February 2012 ■ Journal of Dental Education 2212012 ADEA Annual Session: Poster Abstracts (cont.)
prophylaxis, operative, and oral surgery. Triage was conducted in The Dental Admissions Enhancement Program, funded solely
the hallway adjoining the three rooms, while oral hygiene instruction by the Missouri state legislature’s Caring for Missourians Act, is
was presented in Spanish in the clinic’s main waiting area. The oral unique in its delivery. The six-week online component incorporates
surgery room was equipped with straight-backed chairs supplied by the University of Missouri-Kansas City (UMKC)’s excellence in
the Lamay clinic. Three patients could be treated simultaneously. distance education with a comprehensive review of foundational
The prophy and operative rooms were equipped with two reclining knowledge in quantitative reasoning, chemistry, organic chemistry,
chairs (manufactured by DNTLworks and loaned to our program and biology. The online curriculum is directed by the same faculty
by CWRU’s community outreach sealant program); two portable members who conduct the national Web CE Dental Admission Test
operative units (manufactured by DNTLworks) were placed in (DAT) preparatory course and is complemented by daily interaction
the operative room. Instruments and materials were donated by with UMKC supplemental instruction (SI) leaders. Tablet technology
manufacturers or private dentists or purchased using funds raised and Wimba sessions enabled SI leaders to instruct students in any
for the project. CWRU supplied amalgam and disposables. Cold area of weaknesses. The program begins and ends with an on-site
sterilization using a gluteraldehyde solution was implemented with component designed to engage students in academic and professional
a typical turnaround time of approximately half an hour. Anesthetic development in combination with enrichment activities targeting
(2 percent lidocaine with 1:80:000 epi), needles, and gluteraldehyde skills training, experience in the dental school labs and clinics,
concentrate were purchased in Peru at a local dental supplier. The one-on-one mentoring for the dental school application essay, mock
triage area was managed by the faculty advisors and consisted of a interviews, financial aid, and other admissions-related topics. The
long bench upon which two patients could be triaged simultaneously. twelve participants chosen for the inaugural class were given tips
The main waiting area (our OHI area) was outfitted with three long and overviews on how to strengthen their knowledge on topics
benches facilitating the instruction of several patients at once. Each covered by the DAT. Academic skills training in the form of study
patient received a toothbrush and a small tube of toothpaste (donated skills, test taking, reading, writing, time management, and critical
by Crest and Colgate) in conjunction with this instruction. Patients thinking skills were also included. Panel discussion forums that
were from Lamay and from the Quechua communities surrounding the included professionals from dental research, dental public health,
town. Despite the fact that many patients had signs of past competent and academia took place. A survey was sent to all participants at the
dental care, most were still experiencing oral pain. Over three hundred conclusion of the enhancement program via an electronic survey.
individuals were treated over the course of four days. This treatment Preliminary results indicate overall satisfaction with the program. The
consisted of 241 prophylactic cleanings, 136 amalgam and composite applicants report that while the online material was difficult, it has
restorations, and 138 extractions. Roughly two-thirds of the patients helped them prepare for the DAT. In addition, post-DAT scores have
were female. The average patient age was 22.7 years. Thirteen dental risen in comparison to pre-DAT scores. Based on early feedback from
students were involved in the project, supervised by four faculty the surveys, the UMKC School of Dentistry will continue to follow
members from CWRU. We hope to improve the program to provide these twelve initial participants and plans to maintain the program
care to a greater number of people, especially Quechua natives. in the summer of 2012.
One shortfall in our planning was the time of year we were there.
Our excursion occurred at the end of July, mere days following the 518. Engaging Dental School Faculty and Students in
Peruvian Independence Day. The festivities may have contributed to Evidence-Based Decision Making
a decreased number of patients the first two days we were in town. We
performed our work from Monday to Thursday. Since the men work Andrew B. Schenkel, New York University; Ivy D. Peltz; Silvia E.
during the week, few were available to receive the care we offered. Spivakovsky, New York University; Analia Veitz-Keenan, New York
Another concern is reaching our target population. By working in University
the clinic in Lamay itself, we saw fewer Quechua natives than we Work in Progress
had originally anticipated. Too much of our effort was spent treating
patients who clearly had already received adequate to excellent dental 519. Neck of the Condyle Directed Gow-Gates Injection
care. Lastly, we would like to address the issue of providing more Technique
specialized care. This trip, the depth of our treatment was limited due
to a lack of radiographic equipment and the inability to treat young, Karen A. Edwards, Alan W. Budenz, University of the Pacific Arthur
uncooperative patients because of a lack of experience in pediatrics. A. Dugoni School of Dentistry
CWRU’s dental school has made great strides developing an outreach New Program
program in Peru, yet we recognize areas needing improvement. First, Achieving mandibular nerve block anesthesia using the Gow-Gates
we will return in May to avoid the summer festivals, scheduling our technique is used and taught worldwide. There are two known
treatment days over a weekend to accommodate the working male techniques in use: the original Gow-Gates technique and the modified
population. Second, we will travel directly to the outlying Quechua Gow-Gates technique as recommended by Malamed. A new technique
communities. Third, we hope to acquire a Nomad portable radiograph for the delivery of the Gow-Gates taught to first-year dental students
unit. Fourth, we will recruit pediatric residents to aid in treating at the University of the Pacific Arthur A. Dugoni School of Dentistry
children. Moving forward, we will continue to assess the program, is introduced here and is believed to be safer and more predictable
tailoring it as needed to provide the greatest good to those with the than the traditional Gow-Gates and Malamed’s modified Gow-Gates
greatest need. technique because the deposition site is individually determined
as being below the head of the condyle of the mandible and the
517. The Development of an Innovative Hybrid Dental temporomandibular joint. Finding the extraoral landmark of the
Admissions Enhancement Program bulging head of the condyle, the operator can aim for the neck of the
condyle and the medial side of the ramus to reach the target area. This
Carrie L. Hanson; Geralyn D. Crain, East Carolina University;
modified technique is considered to be a safe injection for the everyday
Rachael J. Maerz; Cynthia C. Gadbury-Amyot, University of
clinician to use for the mandibular block because the landmarks are
Missouri-Kansas City
determined individually.
New Program
222 Journal of Dental Education ■ Volume 76, Number 22012 ADEA Annual Session: Poster Abstracts (cont.)
520. Providing Special Care in a Mobile Dental Unit 522. Gender Issues in Clinical Dental Education
David E. Cohen, University of Missouri-Kansas City Karen K. Tiwana
New Program Educational Research
One hundred and five clients from the Johnson County Developmental Prior to the early 1970s, dental professionals were almost exclusively
Supports (JCDS) were examined. The JCDS is an agency of the male. A combination of legal and social changes in the 1960s and
Johnson County, KS, government that facilitates career and personal 1970s made dental school more accessible to women. Today more
development for county residents with developmental disabilities. The than 40 percent of dental students are women. The presence of gender
OHOW mobile truck dental services provided included oral screening, bias or discrimination and sexual harassment in the educational
periodontal assessment, restorative evaluation, selective scaling and environment is a potential concern in dental education. There is
root planing, oral prophylaxis, topical fluoride, patient-specific oral little in the literature that addresses this topic and even less that
hygiene instruction, and necessary digital radiographs. The dentist specifically addresses the presence or magnitude of gender issues in
wrote up treatment recommendations for the dental problems clinical settings in dental education. A pilot study at the University
identified. Scripts were given for adjunct oral health care items and of North Carolina at Chapel Hill School of Dentistry was initiated to
antibiotic premedication if indicated. Patient management practices investigate the presence and magnitude of gender issues in the clinical
included taking time, speaking the patient’s language, show, tell, do, components of dental education. Initially, four focus groups consisting
and presenting a relaxed atmosphere. Evaluation tools included the of ten randomly selected faculty members and ten randomly selected
following: 1) the basic screening survey to identify demographics as students from the sophomore, junior, and senior classes were utilized
well as dental disease, and 2) a self-administered student feedback to identify any potential gender issues. Based on reports from the
survey that was completed by twenty-six dental hygiene students. literature and the themes identified from the focus group discussions,
This survey evaluated the degree to which students’ OHOW rotation two surveys (a student and a faculty version) were developed and
increased their awareness, clinical judgment, skills, and ethical patient approved by the Biomedical Institutional Review Board. Only full-
care of this underserved population. Special needs patients gained time faculty members with clinical attending responsibilities were
trust and compliance with consistent management strategies. This included in the faculty panel. All sophomore, junior, and senior dental
population is at an increased risk for dental disease. From 2009 to students were surveyed. E-mails with a cover letter explaining the
2010, the range for untreated caries was 42 to 47 percent. Early dental study and obtaining consent were sent to each potential participant
care needs were 26 to 32 percent. Urgent care was 26 to 27 percent. with a weblink to the group-specific Qualtrics survey. The student
Special needs individuals need early identification of oral problems survey consisted of twenty-three questions, and the faculty survey
and a proactive approach to their treatment. Frequent preventive consisted of eighteen questions covering the recurring themes
maintenance visits ranging from two up to, in rare exceptions, six and domains from the focus groups. Bivariate data analysis was
will serve to identify new carious lesions and emerging periodontal performed using Fisher’s exact test and chi-square test. Of the 236
problems. Dental hygiene students reported significant satisfaction, surveys sent, eighty-six students responded (36.4 percent response
personal growth, and appreciation in treating patients with intellectual, rate): twenty-eight sophomores, thirty-four juniors, and twenty-four
emotional, and physical disabilities. seniors. Fifty-one of the respondents were female, and thirty-five were
male. Fifty-six percent of female and 35 percent of male students
521. Beauty Is in the Eye of the Beholder: Old Age Is reported personally experiencing or witnessing prejudice in action or
Not a Deterrent to Esthetic Dentistry treatment based on gender. Less than 10 percent of males and females
reported any personal experience of witnessing sexual advances
Mihaela Michele Harutunian; Angela M. De Bartolo, Normandale from faculty. In general, a greater proportion of female than male
Community College; David Hershkowitz, NHTI, Concord’s students perceived that issues related to gender affected the clinical
Community College; Denise J. Estafan; Mark S. Wolff, New York training environment. Approximately two-thirds of both male and
University female students reported no gender difference in faculty mentorship.
New Program However, the remaining female students reported mentorship was less
Historically, dental schools have treated the geriatric population as available and less in content for females while the remaining male
patients with dentures. This solves the basic functions for patients students perceived mentorship was less for males (p2012 ADEA Annual Session: Poster Abstracts (cont.)
was not appropriate awareness (p=0.02). Further, in response to the and Recall appointments. The student dentists all indicated they
question of whether there was a difference in respect shown towards were able to deliver the splint at the Delivery appointment. Student
female versus male faculty by the students, 56 percent of female but dentists reported that 92 percent of the splints had cuspid guidance
only 8 percent of male faculty members perceived that female faculty which dis-occluded the posterior teeth. This value increased to 96
received less respect than male faculty (p=0.007). Thirty-eight percent percent after the Recall appointment. When asked if protrusive
of the faculty respondents felt female students showed more empathy guidance was shared among the front teeth, the student dentists
towards patients. No faculty respondent felt male students were more reported 79 percent at the Delivery appointment and 96 percent
empathetic. Unlike the student respondents, the faculty respondents at the Recall appointment. Following the Recall appointment, 100
did not perceive any difference between the male and female students percent of the student dentists reported that they were able to improve
with respect to their confidence level relative to their classmates. the fit, function, or comfort of the splint. One hundred percent also
reported that this had been a good learning experience. The student
523. Engaging Students in a Recall Appointment patients were asked if their splint fit securely around the upper teeth,
Improves Their Performance Adjusting the Fit, and 96 percent responded yes after the Delivery followed by 100
percent after the Recall appointment. When asked if they were able
Function, and Comfort of an Occlusal Stabilization
to smoothly slide their lower teeth side-to-side and forward onto the
Splint ramps at the front of the splint, 88 percent responded yes after the
Richard H. White, Lawrence Gardner, Gitta Radjaeipour, Chi D. Delivery. This increased to 100 percent after the Recall. When asked
Tran, Mark Macaoay, University of the Pacific Arthur A. Dugoni if their back teeth separate when their lower teeth slide onto any of
School of Dentistry the ramps, 92 percent responded yes after the Delivery appointment.
New Program This increased to 100 percent after the Recall appointment. When the
Teaching occlusion to dental students at the University of the questionnaires for individual splints were tracked from start to finish,
Pacific Arthur A. Dugoni School of Dentistry is a key part of the it was noted that following Delivery of their splint, 45 percent of the
curriculum. A series of exercises involving the fabrication and student patients were unable to wear their splint all night. Of these,
delivery of an occlusal stabilization splint teaches valuable lessons 100 percent indicated that the difficulties/issues that had prevented
in taking records, mounting casts in centric relation, and adjusting them from wearing the splint were corrected or improved during the
occlusion. This study was designed for the twenty-four students in Recall appointment. Following the Recall appointment, 95 percent
the International Dental Student class. It was approved by the chair of of all student patients indicated that their splint felt better than it had
the Restorative Department and also received IRB approval. Consent immediately after the Delivery appointment.
was obtained from the participants, and each participant received a
Research Identification Number to ensure that the records would 524. Engaging Dental Students and Faculty in
be anonymous. The students formed groups of two or three and Providing Smoking Cessation Services Through the Use
identified who would be the student patient for each student dentist. of a PDA/Web-Based Clinical Decision Support System
It was planned so that each student would have the experience of Andrew B. Schenkel, New York University; Theresa Montini; David
being the student dentist. Each student prepared for the clinical A. Albert
splint delivery by obtaining clinical records from his or her student
Work in Progress
patient. The records included high-quality maxillary and mandibular
impressions, a facebow record, and a centric relation bite record.
Two sets of casts were made. The students mounted the best quality 525. Engaging Today’s Students in State-of-the-Art
maxillary and mandibular casts using the facebow transfer and centric CAD/CAM Dentistry Through Use of the LED Bluecam
relation bite record and prepared them to be sent to a professional James J. Apltauer, New York University; Kay T. Oen, New York
dental laboratory for fabrication of dual-layered maxillary splints University; Angela M. De Bartolo, Normandale Community College;
with centric contact on all teeth and discluding ramps in working Denise J. Estafan; Mark S. Wolff, New York University
and protrusive. The dual-layered construction of the splint consists
New Program
of a hard occlusal surface made of methylmethacrylate and an inner
surface of ethylmethacrylate, which is slightly thermoplastic. The next Traditional training in the fabrication of indirect restorations consists
step was for each student to mount the second set of models from his of numerous tedious steps, such as learning how to take and pour
or her student patient using the facebow transfer and centric relation impressions; trim dies, prepare, invest, and burn out wax patterns;
bite record. Then, in the preclinic laboratory, the students fabricated cast inlays, onlays, and crowns; and finally, finish these for placement
a practice splint on the articulator and practiced adjusting the splint in patients’ mouths. Every step had the possibility of introducing
to have proper function. Later, when the clinical splints arrived from errors. Even with the introduction of technical advances, errors
the professional laboratory, each student dentist delivered the splint still persisted. The explosion of computer-generated methodologies
he or she had fabricated to the student patient. Each student patient and the accompanying new materials has largely eliminated the
was then asked to attempt wearing the splint all night (as long as tedium and inaccuracies. We at New York University College of
it was not causing too much discomfort). This provided a patient’s Dentistry (NYUCD) successfully introduce our students to one of
perspective on wearing the splint to the student patient and engaging these technologies (the CEREC CAD/CAM unit) beginning in their
empathy for a patient receiving dental care. The student patients were second year as part of an esthetic dentistry course. The CEREC
challenged to make mental notes of the fit, function, or comfort of (ceramic reconstruction) system constructs crowns, onlays, and
the splint so they would be able to accurately describe to their student inlays out of ceramic or composite blocks. We teach the students to
dentist any difficulty/issue they were having. One week later, at the prepare and fabricate indirect restorations on typodont teeth, using
Recall appointment, the student dentists were challenged to engage the Bluecam impression technique. Each student is trained to take
their patients and carefully listen to their descriptions of wearing an optical impression and use his or her own computer to design
their splints, then to assess the cause of any complaints and adjust different types of restorations. Students are required to complete
the splints to correct the problems. The student dentist and student additional assignments using the most recent software available. The
patient filled out questionnaires immediately following the Delivery students also gain invaluable experience by preparing, designing, and
224 Journal of Dental Education ■ Volume 76, Number 22012 ADEA Annual Session: Poster Abstracts (cont.)
cementing CAD/CAM restorations on their patients when indicated. her fellow students that there is a Code Blue. This begins the team
The NYUCD program introduces its students to a methodology of approach for managing the emergency. This student is called the team
constructing permanent, high-quality, durable restorations during leader and stays with the patient at all times. Fellow classmates, who
only one clinic visit. This allows them to complete their clinical are treating patients in adjacent cubicles, should immediately stop
requirements. It engages our students in the use of a new technology patient care and assist the team leader. As students appear to lend
that results in greater efficiency and less stress to both the patient assistance, they are assigned a number from 1 to 6. Each assigned
and the clinician. Training the students in preclinical CAD/CAM number has a predetermined responsibility. The first student who
techniques enables them to perform today’s dentistry both as presents to help, called student 1, is instructed by the team leader to
student clinicians and when entering into practice. The students gain locate a faculty member and/or group practice director (GPD). Upon
invaluable experience by preparing, designing, and cementing CAD/ arrival, the faculty/GPD will assess the emergency and determine if
CAM restorations on their patients when indicated. the emergency system should be activated. At NYUCD the system is
activated by calling our security office with the location of the Code
526. Engaging and Training Our Students in Medical Blue. Security then contacts our Oral Surgery Code Blue Team. The
Emergency Preparedness: A Student-Led Medical faculty or GPD will also decide if a call to 911 emergency services
is indicated. Student 2 is responsible for finding the GPD if he or
Emergency Protocol for the Dental School Setting she is not initially present and informing him or her that a team alert
Morey J. Gendler, Scott W. Podell, David Hershkowitz, Mark S. Wolff, has occurred and its location. Student 3 is responsible for bringing
New York University the oxygen tank and medical emergency box from the supply area.
New Program Student 4 goes directly to the Oral Surgery Clinic to help guide the
It is of the highest importance that a dental student receives in-depth emergency responders to the emergency location. Student 5 will wait
training for managing medical emergencies. New York University at the front entrance to the Treatment Center and ensure that the aisles
College of Dentistry (NYUCD) has implemented a medical and doorways are clear. Student 6 will be the primary assistant to the
emergency protocol that encompasses a scenario- and case-based team leader. This student is responsible for assisting the team leader,
model and a student-led team approach. This model encourages reviewing the patient’s history, and creating a timeline for the patient
team-oriented learning and also helps develop a student’s leadership including periodic vital signs, the patient’s medication list, and any
skills. The first line of care in managing any medical emergency is medications that are administered to the patient. This information is
trying to prevent it from happening in the first place. Our students made readily available to any emergency responder who may arrive.
are trained to initially evaluate their patient as they greet and escort
him or her from the reception area to the treatment setting, looking 527. The Well-Being of University Students and
for any possible signs of an imminent medical problem. An initial Employees
evaluation is made of the patient’s appearance, gait, and speech Janet L. Woldt, Arizona School of Dentistry and Oral Health;
pattern, observing for signs of breathing difficulty, abnormal body Bernadette Mineo; Patricia Sexton; Timothy D. Hodges
movement, or excessive perspiration. If any deviation from a normal
New Program
appearance is evident, the student is trained to ask the appropriate
questions and make subsequent decisions based on the responses. A.T. Still University (ATSU), a graduate health science university
Once the patient is seated, a current and detailed medical history with campuses in Missouri and Arizona, has partnered with the
is completed at the initial visit, and the medical history is reviewed nationally known Gallup organization as an inaugural member of its
at every appointment. As health care providers, dentists may be the Well-Being Consortium to study the well-being of university students
first to detect signs and symptoms of diseases such as hypertension and employees (including faculty and staff) for the next five years. All
and diabetes. Medical consults are obtained for patients who have incoming first-year residential students and all full-time employees at
incomplete medical histories or who require referral due to the initial ATSU are being asked to participate in the study. Schools/programs
data obtained from our screening questions. The scenario- and case- within ATSU participating in this study include the Arizona School of
based emergency training program consists of two phases. During Dentistry and Oral Health (ASDOH), School of Osteopathic Medicine
Phase 1, students demonstrate their ability to work as a team by in Arizona, Arizona School of Health Sciences, and Kirksville College
knowing the responsibilities of each team member and understanding of Osteopathic Medicine. The definition of well-being used for this
how the collective response of the team contributes to the successful study comes from Rath and Harter’s The Five Elements of Well-
management of a medical emergency. Phase 2 includes the use Being: “Well-being is about the combination of our love for what
of simulation drills. Students are asked to diagnose and render we do each day, the quality of our relationships, the security of our
emergency care for various medical emergencies. Students receive finances, the vibrancy of our physical health, and the pride we take in
both didactic and practical training and then demonstrate proficiency what we have contributed to our communities. Most importantly, it’s
in several emergency response skills including the administration about how those five elements interact.” Initial data collection for this
of oxygen, glucose paste, and patient ventilation. These case-based study includes the use of the Gallup Well-Being Finder, which study
scenarios assist our students in becoming skilled at recognizing participants were asked to complete during an initial fielding period
and treating several medical emergencies including vaso-vagal conducted September 19 to October 10, 2011, and will complete at
syncope, orthostatic hypotension, hypoglycemia, asthmatic crisis, other designated times during the five-year study. The Well-Being
latex allergy, angina, myocardial infarction, and/or epileptic seizure. Finder is designed to collect data on participant well-being and has
Students receive case-based narratives that include the symptoms the potential to help students and employees measure and manage
that their patient is experiencing and are asked to make a differential their well-being over time. Additionally, data will be collected with
diagnosis and answer questions related to the patient’s condition. the Gallup Daily Tracker, which participants are asked to complete
The objective of these exercises is to have our students develop on a daily (or regular) basis. The Daily Tracker is designed to give
their critical thinking skills so they are proficient at diagnosing and participants immediate feedback, helping them to manage their
treating medical emergencies. Our students are trained to act as a team well-being. Throughout the course of this study and subsequent to it,
and each member has individualized responsibilities. The student various curricular, student service, and human resource interventions
who is treating the patient with the medical emergency alerts his or will be integrated into campus life, academics, and daily operations
February 2012 ■ Journal of Dental Education 2252012 ADEA Annual Session: Poster Abstracts (cont.)
at ATSU. This integration will include individualized student and for, and writing of a white paper in conjunction with the Bellevue
employee assessment, action step planning, and other interventions Medical Program. Just as those of us in dentistry have realized that
relating to the five elements of well-being. For ASDOH, the first- the elimination of diseases we treat is more important than the repair
year dental students (Class of 2015) will be followed longitudinally of the damage they cause, we at the NYUCD Program for Survivors
for four years across the curriculum and one year after graduation. of Torture have come to realize that the mere restoration of dentition
Additionally, the well-being of predoctoral dental students will and dignity to those tortured by agents of their government is
be compared to other graduate health science students within the inadequate. Unless we take steps politically to eliminate the worldwide
university. Study progress and initial data collected will be presented problem, our mission remains unfulfilled. Our new program engages
in this poster. our students in advocacy dedicated to legislate against professional
involvement in torture and wrongful imprisonment of children with
528. Engaging Students in Advocacy: The NYUCD adults in our nation’s immigration prisons.
Program for Survivors of Torture—Seeking Torture
Elimination While Dealing with Its Ravages 529. Engaging the Geriatric Patient
Steven J. Resnick, June Weiss, New York University Marjan Moghadam, Michael B. Ferguson, Paul Zhivago, New York
New Program University
Work in Progress
The New York University College of Dentistry (NYUCD) Program
for Survivors of Torture (PSOT), established in September 2008,
is the first program in the United States to provide comprehensive 530. A Model for Cultivating Faculty Development
dental care to survivors of political torture from around the world Within a Community of Practice
who have sought refuge and asylum in our country. We have a team Cara L. Tax, Nancy R. Neish, Heather Doucette, Peggy J. Maillet,
of twenty dedicated student doctors in our elective who treat patients Dalhousie University
every Friday. Political torture is documented to occur in over ninety Educational Research
countries. Over 400,000 torture victims reside in the United States.
Our program partners with the Bellevue/NYU PSOT founded in 1995 To address the lack of theory in faculty development research, the
by its present director, Allen Keller, M.D. The Bellevue PSOT provides School of Dental Hygiene at Dalhousie University applied social
comprehensive medical care and psychiatric and social services to this learning theory to a clinical dental hygiene faculty development
unique population. Until NYUCD became involved, these patients program. Social learning theory examines how people learn from
had no source of comprehensive dental care, and treatment was others, and in this case, learning within the unique community of
limited to surgical pain relief by the oral surgery program at Bellevue clinical instructors provided an informal mentorship in which the
Hospital. This year, in addition to the intense dental, medical, and flow of knowledge was not in the traditional mentor/mentee approach
psychological training our students receive that enables them to treat but in more of a shared learning experience among all community
this unique patient population, we have developed a new program members. The purpose of the study was to determine if participation
designed to engage the students in political advocacy. We are now in in the community of practice of clinical instructors resulted in
our fourth year of treating this population and have come to realize actual change in teaching practices and if the level of participation
that while we have been restoring both the dentitions and the dignity of instructors in the community changed over time. The faculty
of our patients and while we have focused NYU and national media development program consisted of three components: attendance at
attention on the issue, our new patient population keeps growing. We a series of seminars aimed at effective teaching strategies, application
have done little to eliminate the problem of politically based torture. of new teaching strategies in the clinic, and attendance at a thirty-
The program is being developed with Dr. Keller and the NYU School minute meeting (called a “huddle”) prior to each assigned dental
of Medicine Center for Health and Human Rights. He has chaired hygiene clinic to share teaching strategies and problem-solve with
the Advisory Board of Physicians for Human Rights, chaired the other instructors. The clinic huddle became a forum for dialogue and
Policy Committee of the National Consortium of Torture Treatment problem-solving, and it served as a constant reminder for instructors
Programs, and served on the American College of Physicians Ethics to implement newly learned teaching strategies. A retrospective self-
and Human Rights Committee. At the present time, certain biological assessment questionnaire consisting of four open-ended questions
markers are being used to determine the age of immigrants seeking was administered to fourteen clinical dental hygiene instructors at the
asylum. We suspect that possible biological variances in different end of the 2010 academic year. Twelve clinical instructors responded
cultures may lead to the improper placement of child immigrants to the questionnaire. The narrative data were analyzed thematically
within adult prisons, where medical and dental care is poor. In order using qualitative methodology. Analysis of the data indicated all
to effectively involve the students in advocacy for a bill before the participants had incorporated new teaching strategies into practice.
New York State Legislature, we took a six-pronged approach: study of The data suggested that participation in the community of practice
the history of the problem and the details of the legislation; a lecture supported their learning and helped them make effective changes in
by Dr. Keller on the art and science of advocacy; a presentation by their teaching. The responses revealed that participation within the
an expert from a major New York public relations firm on gaining community of practice increased as instructors began to feel more
support and media coverage for advocacy; a presentation by an elected confident and comfortable in the community as a whole. Research
government official on what politicians view as effective advocacy; grounded in educational theory is important because it helps us
the advocacy itself; and a presentation to our college on the process, understand how people learn. In this study, the community of practice
actions, and results. The research/white paper portion of the advocacy became the framework for social learning, and it provided ongoing
program dedicated itself to study of the problem of placing children support for instructors as they tried to implement new teaching
in adult immigration prisons, review of the literature on biological strategies in the clinic setting. The value of this model extended
(often dental) age determination, assessment if the present practice beyond the acquisition and implementation of new knowledge. It also
of age determination by government authorities is consistent with the contributed to a more collegial work environment that, in turn, could
evidence-based research, exploration of the literature to see if genetic contribute to the recruitment and retention of future faculty members.
variation through different world populations has been accounted
226 Journal of Dental Education ■ Volume 76, Number 2You can also read
