Changes in Dental Students’ Attitudes About Treating Underserved Populations: A Longitudinal Study

Abstract

The aim of this study was to assess changes in a group of dental students' feelings about, willingness to treat, and perceived responsibility in treating underserved populations as they progressed through their predoctoral education. A questionnaire was developed to assess the first-through fourth-year (D1-D4) students' attitudes about treating 13 underserved populations after graduation. Surveys were distributed from 2008 to 2014, resulting in longitudinal data from three graduating classes (D1 year: N=240; eligible D4 participants: N=221). A total of 132 students from the three classes (Class of 2012 N=41; 2013 N=46; 2014 N=45; adjusted response rate 60%) completed all surveys (D1-D4). The results showed that changes in students' feelings about treating and willingness to treat underserved populations were population-specific rather than universal. Compared to the D1 year, the students in later years anticipated feeling more negatively towards treating low-income, frail elderly, homebound, homeless, other ethnic groups, and non-English-speaking patients, while their feelings were more positive towards treating known drug users and HIV/AIDS populations. Across the four years, students' willingness to treat low-income, frail elderly, homebound, and non-English-speaking populations after graduation became more negative, while their willingness to treat medically complex populations, known drug users, and HIV/AIDS populations became more positive. The students also became less likely to strongly agree that it is their responsibility as dentists to treat underserved populations as they progressed through school. These respondents reported that clinical and faculty interactions had impacted their likelihood to treat underserved populations. These findings may point to specific types of interventions and faculty mentoring to bring about change.

A scoping review on social justice education in current undergraduate dental curricula

“…Community‐based education and community service‐learning are examples of experiential learning that were discussed. These “hold the potential to instill awareness of others, foment curiosity, and catalyze self‐reflection, process that may subsequently foster empathy and human compassion.” Such experiences often alleviate the stress associated with the credit and requirements‐focused weight of most dental curricula, which can impact students’ educational experiences …”

“…This definition of school environment is also expanded to include exposure of students through externships and community experiences . Another study discussed the stressful school environment perpetrated by a heavy curriculum and how this affects students’ empathy levels, which already undergo a natural decrease throughout dental school …”

“…Learning in dental school is influenced by the teaching approaches and the learning theories that are adopted by educators . Within a healthcare field like dentistry, community‐based education plays a large role in shaping students’ social skills and in increasing their exposure to multiple cultures and life experiences .…”

Homeless adults' access to dental services and strategies to improve their oral health: a systematic literature review

“…Dental services provided by students were well-received by the homeless population. However, there is evidence that dental student attitudes' towards treating homeless people worsen as they progress through their dental course (Major et al 2016) and that despite working with underserved populations as part of their university training, dentists were unlikely to treat homeless people as part of their everyday practice (McQuistan et al 2010). Dental service providers should not operate in isolation, but work collaboratively with other homeless service providers.…”

Dental Students' Intent to Practice in Rural Communities Before and After Community‐Based Rotations in a Rural Area

“…A recent longitudinal study evaluated changes in dental students' attitudes to treat underserved populations. 16 Over a six-year period, 132 dental students responded to a survey distributed at the beginning of the D1, D2, and D3 academic years and the end of the D4 year. That study found that students' feelings became more negative in the D2, D3, and D4 years about treating low-income patients, frail elderly, homebound, homeless, other ethnic groups, and non-English-speaking patients, but more positive towards treating drug users and HIV/AIDS populations.…”