Teaching Cultural Competence in Dental Education: A Systematic Review and Exploration of Implications for Indigenous Populations in Australia

Abstract

Indigenous and other minority populations worldwide experience higher rates of disease including poor oral health than other populations. Cultural competence of practitioners is increasingly being recognized as fundamental to health care and quality of life in addressing these disparities. The aims of this study were to conduct a systematic review of the literature about teaching cultural competence in dental education and to explore the particular relevance of that teaching for the oral health care of Indigenous populations in Australia. A systematic review employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was conducted of published studies that explored cultural competency interventions in dental curricula. A total of 258 studies from 2004 to 2015 were identified; after removing duplications and applying criteria for exclusion, 12 were selected for analysis, involving 1,360 participants. The principal themes identified in the qualitative analysis of these studies were curriculum content, curriculum delivery, community service-learning, reflective writing, and evaluation. Students need knowledge of health disparities and community health to better understand the perspectives of culturally diverse populations and to communicate effectively with people from various cultures. The principal strategies that improved cultural competence in the articles examined in this study were educational seminars, community service-learning, and reflective writing. These findings suggest that integration of cultural competency curricula using a combination of didactic or online training, community engagement, and reflective writing may increase the cultural knowledge and skills of dental students.

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

“…Didactic lectures were often included with other teaching approaches, such as experiential learning, discussion seminars, problem‐based learning, and community‐based rotations . Scenario‐ and problem‐based learning that use simulations of situations and case studies, respectively, were used to address various topics of interest .…”

“…Three studies discussed the role of interdisciplinarity in teaching cultural competency, in addition to a variety of pedagogical approaches . Studies have also used the concept of person‐centered care as a means to teach and increase cultural competency in dental education .…”

Knowledge and behaviours related to oral health among underserved older adults

“…Notwithstanding these limitations, this qualitative study provides novel evidence of the central importance of the mouth to the physical and social body as explicated by racial/ethnic minority older adults. A recent report in the literature emphasised that dental students need knowledge of health disparities and community health to better understand the perspectives of culturally diverse populations and to communicate effectively with people from various cultures . It has also been argued in the literature, as well as illustrated by this study, that oral health professionals need to become culturally and linguistically proficient in communicating with and caring for all patients …”

Strengthening Indigenous cultural competence in dentistry and oral health education: Academic perspectives

“…11,12 Mandatory accreditation requirements provide incentives to increase Indigenous cultural competence within all dentistry and oral health programmes in Australia, however as scant evidence for integration of Indigenous culture into dentistry curricula is available, dental and oral health educational providers struggle to effectively incorporate Indigenous knowledge into curricula. 13,14 A systematic review of the literature was conducted in 2016 to identify specific cultural competence curriculum interventions in dentistry and oral health education. 14 Likewise, an online survey involving academics and students within the DMD and BOH programmes at the University of Sydney School of Dentistry was conducted, to provide a baseline analysis of Indigenous cultural competence curricula practices.…”