Teaching Dental Students About Incarceration and Correctional Dentistry: Results from a National Survey

Abstract

People who are incarcerated or have a history of incarceration have high rates of dental disease, but access to dental treatment is often a challenge during and after incarceration. Dental students' exposure to this population is unknown: no data exist regarding the number of schools that provide didactic and clinical training in correctional dentistry. The aim of this study was to assess the extent of instruction in correctional dentistry and clinical opportunities at correctional facilities for dental students in the U.S. A survey was distributed to the academic deans at all 66 U.S. dental schools in 2017. Respondents were asked if their institutions had curricular content on correctional health and if they provided clinical opportunities in the correctional setting. Respondents from 30 schools completed the survey, for a response rate of 45%. Nearly two-thirds of the respondents said their institutions offered didactic instruction on the impact of incarceration on health, and eight schools offered a clinical experience at a correctional facility. The most common format was a community-based dental externship involving fourth-year dental students. Oral exams, prophylaxis, and extractions were the most common procedures performed. Respondents from schools that offered a clinical experience agreed more strongly than those that did not that exposure to correctional health care was important and that their students believed incarceration to be a social determinant of health. This study found that a substantial proportion of dental schools offered didactic education on correctional health, but a much smaller number offered student rotations in correctional facilities.

Qualitative exploration of the medical learner’s journey into correctional health care at an academic medical center and its implications for medical education

“…However, our study provides an important caveat to the previously reported positive outcomes of other studies in correctional health settings (Applebaum et al 2002;Alemagno et al 2004;Weiskopf 2005;Dhawan et al 2007;Haley et al 2009;Rich et al 2012;Filek et al 2013;Diaz et al 2014;Bouchaud and Swan 2017;Simon et al 2017;van de Mortel et al 2017;Brooker et al 2018;Candamo et al 2018). Our data suggests a more cautionary approach may be required before immersing medical trainees (or their proctors) in correctional healthcare settings.…”

“…Reflective of other studies (Alemagno et al 2004;Kuthy et al 2007;Brooker et al 2018) and the rationale behind greater AMC involvement in correctional care (Raimer and Stobo 2004;Wakeman and Rich 2010;Pelletier 2015;Trestman et al 2015), our findings suggest that correctional care training-singular among other traditional care settingsprovides a unique opportunity to engage with the personhood of the patient by challenging prevailing stereotypes of the incarcerated and potentially other vulnerable communities. Here, we find some synergy with the aims of AMCs to create clinical experiences for medical learners that foster favorable attitudes to providing health care in prisons and reduce stigma towards those who are in custody or recently released (Faulkner and McCurdy 2000;Littlewood et al 2005;Wakeman and Rich 2010;Min et al 2012;Brooker et al 2018;Candamo et al 2018).…”

Clinician Experiences of Care Provision in the Correctional Setting: A Scoping Review

“…Only one publication focused on the correctional experience of health professions trainees, although these experiences, if positive, can represent an opportunity to cultivate and recruit a future correctional workforce as well as train community providers aware of the health hazards associated with incarceration (Candamo et al, 2018; Simon & Tobey, 2019).…”

“…Such issues may be partly responsible for the difficulty many facilities face in recruiting and retaining providers (Kalra et al, 2016). Indeed, there is limited exposure to correctional settings for health trainees (Candamo et al, 2018; Simon & Tobey, 2019) and a lack of standardized competencies specific to correctional clinicians (Haley et al, 2009).…”

Evaluation of an Interprofessional Student–Faculty Collaborative Clinic in a Jail

“…To our knowledge, this report represents the first description of lessons learned from a student clinic in a correctional facility. Given that a substantial number of health professional schools offer some correctional exposure, programs may find value in the lessons learned and educational results detailed herein (Candamo, Tobey, & Simon, 2018).…”