1 Preparing Dental Students for Community- Based Education Margot Stein, Ph.D. UNC School of Dentistry CCPH Consultancy Network June 21, 2005

2 How to maximize student learning and a community mindset? An integrated dental curriculum: –Pre-clinical –Social –Behavioral –Community

3 The curriculum UNC: 4-year required and elective curriculum in social, community, behavioral, and ethical issues First Year, Fall: Social and Ethical Issues in Dental Practice First Year, Spring: Health Care Systems First Year, Summer: 1 months elective (DISC)

4 The curriculum Second Year, Fall: Behavior, Communication & Culture-Child Second Year, Spring: Behav., Commmun. & Culture; Adolescent/Adult/Cultural Competence and Communication Skills Second Year, Summer: Behav., Commun. & Cult.-The Elderly Second Year, Summer: DISC elective 1 mo.

5 The curriculum Third Year, Spring: Geriatric Dent. Third Year, Summer: DISC 2 months required Fourth Year,Fall: DISC 1 mo. Elective Fourth Year: Clinical Geriatric Dentistry 1 week Fourth Year, Fall: Legal and Ethical Aspect of Dental Practice Fourth Year, Spring: DISC Capstone 4-5 wk

6 Behavior, Communication, and Culture 2-credit course that is part of behavioral sciences curriculum in 2 nd year of dental school Examines how dental students & their patients interact How these interactions are shaped by individual differences, society, culture

7 Explicitly teaches (verbal and nonverbal) communication skills Awareness of individual differences Respect for individual differences Ways to educate dental patients in preventive care using appropriate educational materials

8 Communication Skills Conflict negotiation skills How to present bad news Dealing with difficult people Communication on a dental team

9 Cultural Awareness Awareness is a step towards cultural competence: What is culture? What is the student’s individual culture? What is the culture of dentistry?

10 Towards Cultural Competence What is cultural competence? How does one compare different cultures? What are stereotypes? Generalizations? Is there one “Hispanic/Latino” culture? African-American culture?“Asian” culture? What is the relationship between class and culture?

11 Behavior Communication & Culture This course also addresses: Adolescent Development, Transition to adulthood Dental Fear and Anxiety Mental Health issues in Dentistry

12 Interactive Teaching Strategies Break-out discussion groups of 8 for problem based learning, projects, presentations to larger group Videos of real/simulated dental provider/patient interactions to analyze communication and problem- solving strategies

13 Interactive Teaching Strategies Role-plays of specific issues Students conduct observations of interactions between 4 th year dental students and patients according to established criteria. Students then write 2-page essay describing behavior and reflecting on what they saw in terms of course content Students create their own videos of simulated dental provider/patient interactions

14 Interactive Teaching Strategies Communication skills survey given on 3 different occasion to both dental student and his/her patient that day. –Answers entered on laptop in interview of patient into electronic survey database –Students compare own and patient’s answers –Write an essay on observations with reflections on what saw and learned

15 Summary of Critical Elements For students: Learning to listen Observation Reflection, reflection, reflection Interaction Critical thinking/ Group learning/teamwork

16 Summary of Critical Elements For teachers: STRUCTURE Clear expectations Clear and explicit instructions for exercises, grading criteria Provide climate of tolerance and support Insist on respect and accountability Listen to and observe dynamics and individuals and learn from it

17 THANK YOU! MUCHAS GRACIAS!