Reforming dental workforce education and practice in the USA

Abstract

The USA dental education programmes are facing challenges similar to those confronting countries around the globe, particularly amongst the industrialised nations. The purpose of this study was to evaluate the educational programmes of 15 USA dental schools to determine their impact on improving workforce diversity and oral health care access. The study investigates the predictors of public service plans of dental school seniors in Pipeline and non-Pipeline Program dental schools. We analysed baseline and post-intervention data collected in the American Dental Education Association (ADEA) Annual Survey of Dental School Seniors and a set of contextual variables. Public service plans (dependent variable) was predicted by four types of independent variables: intervention, contextual, community-based dental education (CBDE), and student characteristics. Findings from the study show that access to a state or federally sponsored loan repayment program was the most significant predictor of public service plans and that increasing educational debt was the most significant barrier. In the short-term we may be able to sustain the USA loan repayment programs to motivate senior dental students to provide public service to address the oral health care access crisis. However, in the long-term, a new workforce development initiative will be required to transform dental education and practice, modelled after the well-respected licensure programmes for Physician Assistants and/or Advanced Practice Registered Nurses, to expand oral health care access, particularly amongst vulnerable population subgroups, such as low-income children and families.

Comparisons between the attitudes of medical and dental students toward the clinical importance of gross anatomy and physiology

“…To contextualize this project, and the hypotheses to be tested, it is necessary to provide an account of the changes that have recently been instigated to “modernize” medical and dental training. This account is based on experiences in the United Kingdom but similar restructuring has occurred worldwide (Cooke et al, ; Davidson et al, ; Virdi, ).…”

The relationship between education debt and career choices in professional programs

“…Results from another study showed that education debt has only a small overall effect on specialty choice. 19 Investigators also have analyzed the potential of dental school debt to influence dentists' career choices, [20][21][22][23] including Medicaid participation or practice ownership. 24, 25 Nicholson and colleagues 26 concluded that dentists with high education debt were more likely to enter private practice and work longer hours.…”

Who Will Serve? Assessing Recruitment of Underrepresented Minority and Low‐Income Dental Students to Increase Access to Dental Care

“…[6][7][8][9][10][11][12] In our previous research, we conducted a baseline and impact analysis to investigate the significant factors associated with plans to care for more underserved minority patients using ADEA senior survey data from 2002-03 and 2006-07. 7,8,13,14 Race/ethnicity and parental income both increased the odds that senior dental students planned to care for minority patients. Specifically, compared to white graduating seniors, URMs were three times more likely (OR=3.23, p<.001) to plan to care for minorities, and Asian/Pacific Islanders were almost two times (OR=1.88, p<.001) more likely to plan to care for minorities.…”

“…Increasing access to loan repayment programs through better financing is an incremental policy approach to improve short-term access and should be examined more closely in a cost-effective analysis to quantify the gain in access. 14 More worry about debt upon graduation was associated with increased likelihood that students planned to serve minorities. Those planning to provide more care to minority patients may be especially concerned that their choice of service will make it especially difficult to repay their debt.…”