Abstracts for Posters Presented at the 2012 ADEA Annual Session & Exhibition
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2012 ADEA Annual Session: Poster Abstracts Abstracts for Posters Presented at the 2012 ADEA Annual Session & Exhibition Note that the posters in all categories (Educational Research, New Program, and Work in Progress) appear here in numerical order. For Work in Progress posters, only the titles and authors are published. A schedule of poster presentations at the 2012 ADEA Annual Session & Exhibition appears on pages 264–7. 501. Engaging Students by Creating Curriculum confidence necessary to treat children with behavior management Grounded in Interprofessional Education Through issues once they begin their own dental careers. Service-Learning with a Diabetes Education Health Care Team 504. Evaluation of Admission Criteria to Predict Sheryl L. Sloshower, Nicole M. Aylward, Laura L. MacDonald, Performance Among Non-U.S.-Trained Dentists at the University of Manitoba VCU School of Dentistry Work in Progress Preeti K. Sastry, Riki Gottlieb, Virginia Commonwealth University Work in Progress [Poster 502 was withdrawn.] 505. Health Professions Programs Student Attitudes 503. Dentists’ Perceptions of Predoctoral Pediatric About Hookah Use Dental Training Regarding Children with Attention Jill M. Loewen, Mathew Savaya, Basam Shamo, Swati Chitre, Span Disorders Michelle Wheater, University of Detroit Mercy Tedi H. Fladhammer; Ashley Ray; Janet Head Work in Progress Educational Research Over the last twenty-five years, educators, physicians, dentists, and 506. Teaching the Chronic Care Model in General parents have become progressively more aware of the increased Dentistry prevalence of uncooperative behavior in children and teens. There have Julia Kazimiroff, Nanice E. Regis Blay, Kevin D. Oh, Montefiore been many factors in the lives of children that have been suggested Medical Center to be the cause of this increase, including changes in parenting styles New Program such as permissive parenting, changes in education styles, increased numbers of children with psychological disorders including attention The Chronic Care Model (CCM) is a tool designed by Improving span and hyperactivity disorders, and an increased prevalence of video Chronic Illness Care Organization for correcting the many deficiencies games and watching television in American households. Dentists who in current management of diseases such as diabetes, heart disease, have treated numerous children over the past two decades have become depression, asthma, and others. The Montefiore Medical Center’s U.S. increasingly aware of the change in the relationship among the child, Health Resources and Services Administration (HRSA)-sponsored parent, and dentist and its potential impact on dental treatment. The Dental Resident Training Project aims to train dentists in the use of objective of this research was to explore general dentists’ perceptions CCM to improve oral health outcomes for persons with diabetes. The of their predoctoral education in the management and treatment of project consisted of four parts. First, outreach included oral health children with attention span disorders/hyperactivity issues. General promotion to patients and medical primary care providers (PCPs) at dentists who serve as clinical rotation site faculty for fourth-year community-based programs including PCP waiting rooms, health students at the Arizona School of Dentistry and Oral Health were fairs, senior centers, and dental staff communication with medical staff surveyed. Bivariate and multivariate analyses were used to analyze by means of handouts, oral presentations, and oral health education the data. Results indicated that dentists who have been in practice classes. Second, interventions included a diabetes collaborative to more than ten years have seen a significant increase in the number train residents in management, monitoring, and analysis of cytokines of children with attention span/hyperactivity issues since they first in diabetic and overweight/obese patients as oral health indicators. started practicing (p=0.045). Additionally, the majority (70.3 percent) Third, for evaluation, practice teams (GP and dental faculty) became of dentists surveyed did not feel they had enough training while in familiar with the Assessment of Chronic Illness Care (ACIC) and dental school to effectively manage children with attention span/ Patient Assessment of Chronic Illness Care (PACIC) and completed hyperactivity issues while in the dental office. Dentists indicated the ACIC for one chronic condition (e.g., how well they are providing they would like to have received more education in pharmacologic oral health care for diabetes). Adherence to the CCM was evaluated interactions, conscious sedation, general anesthesia, and hospital quantitatively by a numerical score given by the respondents (teams, orientation. With the prevalence of attention span disorders on the rise, patients) in which they rated the degree to which each component dental schools need to increase the amount of exposure predoctoral (e.g., partnerships with community organizations, patient treatment students receive in the treatment of children with complex behavior plans) is being implemented for that chronic condition, using a management issues. This will provide a more complete learning scale ranging from 0 (not at all) to 11 (fully). When we started the experience. Students can then gain the exposure, techniques, and enhanced program, the scores ranged over 85 percent between 0 These abstracts were peer-reviewed following established criteria. The abstracts published here are the property of their authors. No transfer of copyright to the Journal of Dental Education has occurred. ADEA makes no claims, express or implied, with respect to the accuracy, completeness, usefulness, ownership, or adequacy of the information presented. 218 Journal of Dental Education ■ Volume 76, Number 2
2012 ADEA Annual Session: Poster Abstracts (cont.) and 2=limited support for chronic illness care, and the six-month Phase 1 results reveal the following positive attributes of the developed average moved to between 3 and 5=basic support for chronic illness case studies: relative advantage of active learning and modeling; care. To improve the results, we will use systems-based practice and compatibility with a variety of courses; ability to observe case-related practice-based learning and improvement for team development to knowledge and skills; independent learning; and ability to be modified achieve between 6 and 8=reasonably good support for chronic illness for use with other oral-systemic health issues. In Phase 2, the case care and between 9 and 11=fully developed chronic illness care. studies were filmed to create live-action videos. Videos were used to The enhanced dental curriculum will provide new dentists with the model communication by dentists or dental hygienists with diverse tools necessary to communicate with patients regarding oral health patients (i.e., male, female, adult, and pediatric), who present with a implications of chronic illness; perform interventions in the various variety of clinical findings and are determined to be at varying stages dental settings (community-based, hospital-based, private practice); of readiness to address their underlying issues. Phase 3 results from and establish relationships with their medical counterparts to allow the pretesting revealed that the following positive attributes were met for a holistic approach to patient treatment. The project was funded by the case studies: relative advantage of active learning; compatibility by HRSA Grant Award No. D88HP20119-01-00. with a variety of courses; case-related knowledge could be observed; material could be communicated; and time saved in class by assigning 507. Development and Evaluation of Interactive, cases for homework. Addressing identified adoption attributes are Web-Based Case Studies: Application of Diffusion of expected to increase the likelihood that dental and dental hygiene faculty members will adopt the web-based case studies for use in Innovations the curriculum. Diffusion of Innovation adoption themes identified Rita D. DeBate; Herbert H. Severson; Deborah C. Cragun; Ashley A. in this study could be applied to the development of future case Gallentine; Tracy S. Shaw studies and may provide broader insight that might prove useful for Educational Research exploring differences in case study use across oral health curricula. Calls for change regarding the future direction of dental and dental Study results provided valuable and practical information that was hygiene curricula include increasing students’ exposure to patients’ used to inform the development of four interactive, web-based case oral-systemic health issues throughout their entire training and studies on patient-provider communication on sensitive oral-systemic increasing the use of computer and web-based information technology. health issues. The use of the Diffusion of Innovations model allowed Web-based interactive case studies may provide the opportunity us to capitalize on positive attributes of case studies that may increase for students’ exposure to oral-systemic health issues they may not the likelihood that oral health faculty members would incorporate encounter in their clinical training, thereby increasing students’ them into existing courses. Identified adoption themes can also be experiences in differential diagnosis, patient/provider communication, applied to the development of future web-based case studies. (NIH and patient-specific treatment plans. The purpose of the study was to 1RC1DE020274-01) apply the Diffusion of Innovations (DOI) conceptual framework to identify characteristics of web-based case studies that would increase 508. “Domestic Abuse” Versus “Intimate Partner their adoption among dental and dental hygiene faculty; develop Violence/Abuse”: Dental and Dental Hygiene Students’ four interactive web-based case studies on patient communication Educational Experiences, Knowledge, Attitudes, and of sensitive oral/systemic health issues; and evaluate how well the case studies addressed the identified adoption characteristics. DOI Behavior is the process by which an innovation (web-based case study) is Rachel A. Sheridan, Marita R. Inglehart, University of Michigan diffused into a population (dental and dental hygiene curricula) and Educational Research is ultimately adopted by its members (dental and dental hygiene Approximately 1.3 million women and 835,000 men are physically faculty). According to DOI, certain innovation attributes (e.g., assaulted by an intimate partner in the United States annually, and relative advantage, compatibility, complexity) increase the likelihood one out of three women in the United States reports being physically that an innovation will be adopted by a targeted population. This abused by a boyfriend or spouse in her lifetime. Research has mixed-methods study spanned three phases: 1) identification of shown that the majority of these women would like their health care adoption characteristics among dental and dental hygiene faculty; providers to inquire about abuse. Dentists and dental hygienists in 2) translation of adoption characteristics into four web-based case particular have a unique chance to identify evidence of domestic studies; and 3) evaluation of translation. Methods for Phase 1 entailed violence, because head, neck, and facial injuries are so common in soliciting input from potential innovation adopters (dental and dental domestic violence cases that they are considered markers for abuse. hygiene faculty members) regarding attributes of web-based case However, most dentists never screen their patients for domestic studies. Eight ninety-minute focus groups (three dental, five dental violence (DV). A lack of education regarding DV identification and hygiene) representing six universities/colleges were conducted with a reporting could be the major reason. The purpose of this study is convenience sample of dental and dental hygiene faculty members at therefore to explore dental and dental hygiene students’ educational collaborating dental and dental hygiene schools. Methods for Phase experiences, knowledge, attitudes, and behaviors related to DV. In 2 entailed translating identified themes into case study development. addition, this project explored whether the term “intimate partner Scripts for the case studies were written, edited, and evaluated by the violence/abuse” (IPV/A) elicits different responses from the term research team with collaboration from an expert panel. Questions “domestic violence.” Data were collected with two versions of an were written about the case studies to assess knowledge and skills anonymous self-administered paper-and-pencil survey. The first on patient-provider communication regarding sensitive oral-systemic version used the term “domestic violence” throughout the survey, health issues. These questions were interspersed throughout the case and the second version used the term “intimate partner violence/ studies. Pictures were taken, an audio recording of the script was abuse.” A total of 522 surveys were returned from dental and dental made, and the prototype was developed. Methods for Phase 3 entailed hygiene students (Version 1: N=294; Version 2: N=228). While 54 pretesting the developed case studies. Participants were provided with percent of the students indicated that they had learned about DV, only a link to the case study prototype for review prior to the interview. 17 percent reported to have learned about IPV/A (p
2012 ADEA Annual Session: Poster Abstracts (cont.) behavioral science classes. Students agreed more strongly that they ADEA Foundation Knowledge and Skills for the New General should have more education about addressing IPV/A concerns with Dentist (2011). The Commission on Dental Accreditation (CODA) their patients than addressing DV concerns (on a five-point scale requires demonstration of competence in this area for the graduating from 1=disagree strongly to 5=agree strongly: 3.79 vs. 3.61; p=.043). dentist of 2013. Institutions must demonstrate compliance including However, the students did not differ in the degree to which they wanted explicit discussion of the meaning, importance, and application of to have more education about either one of these issues in general critical thinking. The ADEA critical thinking toolbox and similar (3.88 vs. 3.87; p=.920) nor in their assessment of the effects of the publications have outlined explicit definitions of critical thinking as lack of education on their professional behavior. When the students conceived by authors of educational and/or philosophical scholarship. were assessing their knowledge concerning DV and IPV/A, it became Most definitions of critical thinking in the dental literature, however, clear that they thought they had more knowledge about DV than are implicitly defined by the author, taking the form of the author’s about IPV/A (knowledge about symptoms of DV vs. IPV/A: 3.28 personal interpretations and assumptions of the meaning. These vs. 2.68; p
2012 ADEA Annual Session: Poster Abstracts (cont.) 18.96 with a standard deviation of 0.988; the mean GPA was 3.547 In June 2010, two of the CWRU-DM student organizers (BC, NB) with a standard deviation of 0.127; and the mean science GPA was visited the Lamay Health Clinic and inspected the facilities. There 3.474 with a standard deviation of 0.142. Graphically, each variable is was adequate electricity and facilities. The initiative also had strong represented as a normal distribution. The correlation between science support from the mayor of Lamay. Additionally, the students met with GPA and DAT academic average (0.44) was found to be larger than the regional health minister (Cuzco, Peru) and received permission to the correlation between cumulative GPA and DAT academic average perform humanitarian dental work under the supervision of licensed (0.38). The correlation between PAT score and science GPA (0.42) dentists. The Cuzco Dental School was also contacted, and several was found to be larger than the correlation between PAT score and of their students agreed to assist the effort with Spanish-Quechua- cumulative GPA (0.39). Strong correlations were found between DAT English translations. Since only a few of the volunteers spoke Spanish academic average score and PAT score (0.82) as well as between and some patients spoke only Quechua, these language skills were cumulative GPA and science GPA (0.97). Variance between mean critical for communicating with the patients. Step 4: fundraising scores in individual dental schools was found to be 0.2304 for DAT and supplies. We were fortunate to receive most of the requisite academic averages, 0.4696 for PAT scores, 0.003415 for cumulative supplies from the CWRU faculty and local dentists. We borrowed GPAs, and 0.004444 for science GPAs. Nationwide, variance of mean portable operatory units and dental chairs. We purchased anesthesia, DAT academic average was 1.3393, 0.9761 for mean PAT average, needles, etc. in Cuzco because of customs restrictions. Finding a 0.0162 for mean cumulative GPA, and 0.0203 for mean science GPA. dental supply company in our destination city was crucial. We did Science GPA has a stronger correlation with DAT academic average not obtain nonprofit status in time for this year’s trip, which would and PAT score than cumulative GPA. Individual schools tend to have made monetary donations easier. Step 5: recruiting students and maintain a small variance in mean scores for mean DAT academic faculty volunteers. Humanitarian outreach programs offer unique average, PAT score, GPA, and science GPA; however, nationwide opportunities to give service and to be exposed to different cultures. variance is much greater for DAT academic average and PAT while We found no difficulty in recruiting students and licensed faculty much smaller for cumulative GPA and science GPA among dental members to participate. In fact, upon our return, faculty members and schools. Graphically, dental school admission criteria scores maintain students have begun inquiring whether they could assist next year. similar averages between years and do not appear to be increasing Step 6: scheduling and organizing the logistics of the trip. Multiple or decreasing. meetings were held throughout the year with all volunteers. Step 7: announcing dental services to the target population. New programs 515. Eight Steps for Developing and Implementing a require significant marketing. Because the director of the Lamay Student-Organized International Outreach Program Clinic made several announcements prior to and the weekend of our arrival, we expected more patients. We then posted flyers in local Benjamin H. Cope, Nathan B. Buckner, Michael D. Gillins, T. Roma businesses, announced our intentions at a town gathering, and ran Jasinevicius, Lisa A. Lang, Case School of Dental Medicine an advertisement on the government-sponsored radio station that New Program broadcasts to underserved communities. During the first week of Case Western Reserve University School of Dental Medicine (CWRU- August 2011, CWRU-DM students (n=13) and faculty members DM) dental students have a history of volunteering for international (n=4) treated 304 patients. For every patient triaged, we recorded his outreach programs to provide dental care to underserved populations. or her name, gender, age, proposed treatment, and treatment provided Recently, the Cleveland Clinic Lerner College of Medicine and and its date. Step 8: debriefing sessions. It is critical to review and CWRU School of Medicine (CWRU-MedS) initiated a medical reassess throughout. In Peru, debriefing sessions were held daily; outreach program in Peru. In a discussion with other health care we reviewed what worked and which aspects could be changed/ professionals, the medical students noted that one of the chief improved. For example, the dates of the program will be changed complaints of the patients was related to dental decay. This discussion since the Peruvian Independence Day celebrations caused some minor initiated the organization of a dental outreach program in Lamay, complications. Also, we are considering weekend sessions to allow Peru. Preparation, both legal and material, began in August 2009. The men to take off from work. organizational process will be described in eight steps with supporting information related specifically to the Lamay Outreach Program. Step 516. Results of a Student-Organized International 1: picking a site for the humanitarian outreach program. Generally Humanitarian Dental Outreach Program the needs of a population are complex; therefore, for programs to be Nathan B. Buckner, Benjamin H. Cope, Michael D. Gillins, T. Roma successful interprofessional collaboration is required. Hence, working Jasinevicius, Lisa A. Lang, Case School of Dental Medicine with existing contacts and facilities, such as the contacts with CWRU- MedS and those in Lamay, should improve the comprehensiveness of New Program care. The observation that dental decay is a problem is supported by The objectives of this first Case Western Reserve University School a 2009 study that found Peruvian children living in poor households of Dental Medicine (CWRU-DM) outreach effort (August 2011) were are 2.25 times more likely to have dental caries than children living to 1) provide basic dental treatment to an underserved population in non-poor households. Given that 54 percent of the Peruvian (Lamay, Peru, and surrounding communities), 2) assess the dental population lives in poverty, there is a definite risk to the oral health needs to determine the future direction of the program, and 3) provide of this population. We felt that CWRU dental students could help dental students opportunities to practice their clinical skills. During address this need. Step 2: support from the home institution. This was our investigative visit, we were introduced to several patients who crucial for our trip because we anticipated that the majority if not all had generally poor oral health and obvious lack of professional dental the volunteers would be students and faculty members. Permission care. The resident dentist indicated such patients were typical in the to initiate the program was granted by the CWRU-DM dean; the Lamay clinic. Therefore, we anticipated much of our patient base clinic director also sanctioned the program. At the suggestion of the would exhibit similar oral health problems (rampant decay, poor dean, we consulted with the CWRU legal team and subsequently oral hygiene, periodontal disease, etc.). The town of Lamay has a modified the application packet for the study abroad program to small health clinic, which was our base of operations. We used three fit our circumstances. This ensured that our group would fall under unoccupied rooms approximately 10x20. Each room, managed by the protection of CWRU. Step 3: support from Peruvian officials. fourth-year students, was designated a specific type of procedure: February 2012 ■ Journal of Dental Education 221
2012 ADEA Annual Session: Poster Abstracts (cont.) prophylaxis, operative, and oral surgery. Triage was conducted in The Dental Admissions Enhancement Program, funded solely the hallway adjoining the three rooms, while oral hygiene instruction by the Missouri state legislature’s Caring for Missourians Act, is was presented in Spanish in the clinic’s main waiting area. The oral unique in its delivery. The six-week online component incorporates surgery room was equipped with straight-backed chairs supplied by the University of Missouri-Kansas City (UMKC)’s excellence in the Lamay clinic. Three patients could be treated simultaneously. distance education with a comprehensive review of foundational The prophy and operative rooms were equipped with two reclining knowledge in quantitative reasoning, chemistry, organic chemistry, chairs (manufactured by DNTLworks and loaned to our program and biology. The online curriculum is directed by the same faculty by CWRU’s community outreach sealant program); two portable members who conduct the national Web CE Dental Admission Test operative units (manufactured by DNTLworks) were placed in (DAT) preparatory course and is complemented by daily interaction the operative room. Instruments and materials were donated by with UMKC supplemental instruction (SI) leaders. Tablet technology manufacturers or private dentists or purchased using funds raised and Wimba sessions enabled SI leaders to instruct students in any for the project. CWRU supplied amalgam and disposables. Cold area of weaknesses. The program begins and ends with an on-site sterilization using a gluteraldehyde solution was implemented with component designed to engage students in academic and professional a typical turnaround time of approximately half an hour. Anesthetic development in combination with enrichment activities targeting (2 percent lidocaine with 1:80:000 epi), needles, and gluteraldehyde skills training, experience in the dental school labs and clinics, concentrate were purchased in Peru at a local dental supplier. The one-on-one mentoring for the dental school application essay, mock triage area was managed by the faculty advisors and consisted of a interviews, financial aid, and other admissions-related topics. The long bench upon which two patients could be triaged simultaneously. twelve participants chosen for the inaugural class were given tips The main waiting area (our OHI area) was outfitted with three long and overviews on how to strengthen their knowledge on topics benches facilitating the instruction of several patients at once. Each covered by the DAT. Academic skills training in the form of study patient received a toothbrush and a small tube of toothpaste (donated skills, test taking, reading, writing, time management, and critical by Crest and Colgate) in conjunction with this instruction. Patients thinking skills were also included. Panel discussion forums that were from Lamay and from the Quechua communities surrounding the included professionals from dental research, dental public health, town. Despite the fact that many patients had signs of past competent and academia took place. A survey was sent to all participants at the dental care, most were still experiencing oral pain. Over three hundred conclusion of the enhancement program via an electronic survey. individuals were treated over the course of four days. This treatment Preliminary results indicate overall satisfaction with the program. The consisted of 241 prophylactic cleanings, 136 amalgam and composite applicants report that while the online material was difficult, it has restorations, and 138 extractions. Roughly two-thirds of the patients helped them prepare for the DAT. In addition, post-DAT scores have were female. The average patient age was 22.7 years. Thirteen dental risen in comparison to pre-DAT scores. Based on early feedback from students were involved in the project, supervised by four faculty the surveys, the UMKC School of Dentistry will continue to follow members from CWRU. We hope to improve the program to provide these twelve initial participants and plans to maintain the program care to a greater number of people, especially Quechua natives. in the summer of 2012. One shortfall in our planning was the time of year we were there. Our excursion occurred at the end of July, mere days following the 518. Engaging Dental School Faculty and Students in Peruvian Independence Day. The festivities may have contributed to Evidence-Based Decision Making a decreased number of patients the first two days we were in town. We performed our work from Monday to Thursday. Since the men work Andrew B. Schenkel, New York University; Ivy D. Peltz; Silvia E. during the week, few were available to receive the care we offered. Spivakovsky, New York University; Analia Veitz-Keenan, New York Another concern is reaching our target population. By working in University the clinic in Lamay itself, we saw fewer Quechua natives than we Work in Progress had originally anticipated. Too much of our effort was spent treating patients who clearly had already received adequate to excellent dental 519. Neck of the Condyle Directed Gow-Gates Injection care. Lastly, we would like to address the issue of providing more Technique specialized care. This trip, the depth of our treatment was limited due to a lack of radiographic equipment and the inability to treat young, Karen A. Edwards, Alan W. Budenz, University of the Pacific Arthur uncooperative patients because of a lack of experience in pediatrics. A. Dugoni School of Dentistry CWRU’s dental school has made great strides developing an outreach New Program program in Peru, yet we recognize areas needing improvement. First, Achieving mandibular nerve block anesthesia using the Gow-Gates we will return in May to avoid the summer festivals, scheduling our technique is used and taught worldwide. There are two known treatment days over a weekend to accommodate the working male techniques in use: the original Gow-Gates technique and the modified population. Second, we will travel directly to the outlying Quechua Gow-Gates technique as recommended by Malamed. A new technique communities. Third, we hope to acquire a Nomad portable radiograph for the delivery of the Gow-Gates taught to first-year dental students unit. Fourth, we will recruit pediatric residents to aid in treating at the University of the Pacific Arthur A. Dugoni School of Dentistry children. Moving forward, we will continue to assess the program, is introduced here and is believed to be safer and more predictable tailoring it as needed to provide the greatest good to those with the than the traditional Gow-Gates and Malamed’s modified Gow-Gates greatest need. technique because the deposition site is individually determined as being below the head of the condyle of the mandible and the 517. The Development of an Innovative Hybrid Dental temporomandibular joint. Finding the extraoral landmark of the Admissions Enhancement Program bulging head of the condyle, the operator can aim for the neck of the condyle and the medial side of the ramus to reach the target area. This Carrie L. Hanson; Geralyn D. Crain, East Carolina University; modified technique is considered to be a safe injection for the everyday Rachael J. Maerz; Cynthia C. Gadbury-Amyot, University of clinician to use for the mandibular block because the landmarks are Missouri-Kansas City determined individually. New Program 222 Journal of Dental Education ■ Volume 76, Number 2
2012 ADEA Annual Session: Poster Abstracts (cont.) 520. Providing Special Care in a Mobile Dental Unit 522. Gender Issues in Clinical Dental Education David E. Cohen, University of Missouri-Kansas City Karen K. Tiwana New Program Educational Research One hundred and five clients from the Johnson County Developmental Prior to the early 1970s, dental professionals were almost exclusively Supports (JCDS) were examined. The JCDS is an agency of the male. A combination of legal and social changes in the 1960s and Johnson County, KS, government that facilitates career and personal 1970s made dental school more accessible to women. Today more development for county residents with developmental disabilities. The than 40 percent of dental students are women. The presence of gender OHOW mobile truck dental services provided included oral screening, bias or discrimination and sexual harassment in the educational periodontal assessment, restorative evaluation, selective scaling and environment is a potential concern in dental education. There is root planing, oral prophylaxis, topical fluoride, patient-specific oral little in the literature that addresses this topic and even less that hygiene instruction, and necessary digital radiographs. The dentist specifically addresses the presence or magnitude of gender issues in wrote up treatment recommendations for the dental problems clinical settings in dental education. A pilot study at the University identified. Scripts were given for adjunct oral health care items and of North Carolina at Chapel Hill School of Dentistry was initiated to antibiotic premedication if indicated. Patient management practices investigate the presence and magnitude of gender issues in the clinical included taking time, speaking the patient’s language, show, tell, do, components of dental education. Initially, four focus groups consisting and presenting a relaxed atmosphere. Evaluation tools included the of ten randomly selected faculty members and ten randomly selected following: 1) the basic screening survey to identify demographics as students from the sophomore, junior, and senior classes were utilized well as dental disease, and 2) a self-administered student feedback to identify any potential gender issues. Based on reports from the survey that was completed by twenty-six dental hygiene students. literature and the themes identified from the focus group discussions, This survey evaluated the degree to which students’ OHOW rotation two surveys (a student and a faculty version) were developed and increased their awareness, clinical judgment, skills, and ethical patient approved by the Biomedical Institutional Review Board. Only full- care of this underserved population. Special needs patients gained time faculty members with clinical attending responsibilities were trust and compliance with consistent management strategies. This included in the faculty panel. All sophomore, junior, and senior dental population is at an increased risk for dental disease. From 2009 to students were surveyed. E-mails with a cover letter explaining the 2010, the range for untreated caries was 42 to 47 percent. Early dental study and obtaining consent were sent to each potential participant care needs were 26 to 32 percent. Urgent care was 26 to 27 percent. with a weblink to the group-specific Qualtrics survey. The student Special needs individuals need early identification of oral problems survey consisted of twenty-three questions, and the faculty survey and a proactive approach to their treatment. Frequent preventive consisted of eighteen questions covering the recurring themes maintenance visits ranging from two up to, in rare exceptions, six and domains from the focus groups. Bivariate data analysis was will serve to identify new carious lesions and emerging periodontal performed using Fisher’s exact test and chi-square test. Of the 236 problems. Dental hygiene students reported significant satisfaction, surveys sent, eighty-six students responded (36.4 percent response personal growth, and appreciation in treating patients with intellectual, rate): twenty-eight sophomores, thirty-four juniors, and twenty-four emotional, and physical disabilities. seniors. Fifty-one of the respondents were female, and thirty-five were male. Fifty-six percent of female and 35 percent of male students 521. Beauty Is in the Eye of the Beholder: Old Age Is reported personally experiencing or witnessing prejudice in action or Not a Deterrent to Esthetic Dentistry treatment based on gender. Less than 10 percent of males and females reported any personal experience of witnessing sexual advances Mihaela Michele Harutunian; Angela M. De Bartolo, Normandale from faculty. In general, a greater proportion of female than male Community College; David Hershkowitz, NHTI, Concord’s students perceived that issues related to gender affected the clinical Community College; Denise J. Estafan; Mark S. Wolff, New York training environment. Approximately two-thirds of both male and University female students reported no gender difference in faculty mentorship. New Program However, the remaining female students reported mentorship was less Historically, dental schools have treated the geriatric population as available and less in content for females while the remaining male patients with dentures. This solves the basic functions for patients students perceived mentorship was less for males (p
2012 ADEA Annual Session: Poster Abstracts (cont.) was not appropriate awareness (p=0.02). Further, in response to the and Recall appointments. The student dentists all indicated they question of whether there was a difference in respect shown towards were able to deliver the splint at the Delivery appointment. Student female versus male faculty by the students, 56 percent of female but dentists reported that 92 percent of the splints had cuspid guidance only 8 percent of male faculty members perceived that female faculty which dis-occluded the posterior teeth. This value increased to 96 received less respect than male faculty (p=0.007). Thirty-eight percent percent after the Recall appointment. When asked if protrusive of the faculty respondents felt female students showed more empathy guidance was shared among the front teeth, the student dentists towards patients. No faculty respondent felt male students were more reported 79 percent at the Delivery appointment and 96 percent empathetic. Unlike the student respondents, the faculty respondents at the Recall appointment. Following the Recall appointment, 100 did not perceive any difference between the male and female students percent of the student dentists reported that they were able to improve with respect to their confidence level relative to their classmates. the fit, function, or comfort of the splint. One hundred percent also reported that this had been a good learning experience. The student 523. Engaging Students in a Recall Appointment patients were asked if their splint fit securely around the upper teeth, Improves Their Performance Adjusting the Fit, and 96 percent responded yes after the Delivery followed by 100 percent after the Recall appointment. When asked if they were able Function, and Comfort of an Occlusal Stabilization to smoothly slide their lower teeth side-to-side and forward onto the Splint ramps at the front of the splint, 88 percent responded yes after the Richard H. White, Lawrence Gardner, Gitta Radjaeipour, Chi D. Delivery. This increased to 100 percent after the Recall. When asked Tran, Mark Macaoay, University of the Pacific Arthur A. Dugoni if their back teeth separate when their lower teeth slide onto any of School of Dentistry the ramps, 92 percent responded yes after the Delivery appointment. New Program This increased to 100 percent after the Recall appointment. When the Teaching occlusion to dental students at the University of the questionnaires for individual splints were tracked from start to finish, Pacific Arthur A. Dugoni School of Dentistry is a key part of the it was noted that following Delivery of their splint, 45 percent of the curriculum. A series of exercises involving the fabrication and student patients were unable to wear their splint all night. Of these, delivery of an occlusal stabilization splint teaches valuable lessons 100 percent indicated that the difficulties/issues that had prevented in taking records, mounting casts in centric relation, and adjusting them from wearing the splint were corrected or improved during the occlusion. This study was designed for the twenty-four students in Recall appointment. Following the Recall appointment, 95 percent the International Dental Student class. It was approved by the chair of of all student patients indicated that their splint felt better than it had the Restorative Department and also received IRB approval. Consent immediately after the Delivery appointment. was obtained from the participants, and each participant received a Research Identification Number to ensure that the records would 524. Engaging Dental Students and Faculty in be anonymous. The students formed groups of two or three and Providing Smoking Cessation Services Through the Use identified who would be the student patient for each student dentist. of a PDA/Web-Based Clinical Decision Support System It was planned so that each student would have the experience of Andrew B. Schenkel, New York University; Theresa Montini; David being the student dentist. Each student prepared for the clinical A. Albert splint delivery by obtaining clinical records from his or her student Work in Progress patient. The records included high-quality maxillary and mandibular impressions, a facebow record, and a centric relation bite record. Two sets of casts were made. The students mounted the best quality 525. Engaging Today’s Students in State-of-the-Art maxillary and mandibular casts using the facebow transfer and centric CAD/CAM Dentistry Through Use of the LED Bluecam relation bite record and prepared them to be sent to a professional James J. Apltauer, New York University; Kay T. Oen, New York dental laboratory for fabrication of dual-layered maxillary splints University; Angela M. De Bartolo, Normandale Community College; with centric contact on all teeth and discluding ramps in working Denise J. Estafan; Mark S. Wolff, New York University and protrusive. The dual-layered construction of the splint consists New Program of a hard occlusal surface made of methylmethacrylate and an inner surface of ethylmethacrylate, which is slightly thermoplastic. The next Traditional training in the fabrication of indirect restorations consists step was for each student to mount the second set of models from his of numerous tedious steps, such as learning how to take and pour or her student patient using the facebow transfer and centric relation impressions; trim dies, prepare, invest, and burn out wax patterns; bite record. Then, in the preclinic laboratory, the students fabricated cast inlays, onlays, and crowns; and finally, finish these for placement a practice splint on the articulator and practiced adjusting the splint in patients’ mouths. Every step had the possibility of introducing to have proper function. Later, when the clinical splints arrived from errors. Even with the introduction of technical advances, errors the professional laboratory, each student dentist delivered the splint still persisted. The explosion of computer-generated methodologies he or she had fabricated to the student patient. Each student patient and the accompanying new materials has largely eliminated the was then asked to attempt wearing the splint all night (as long as tedium and inaccuracies. We at New York University College of it was not causing too much discomfort). This provided a patient’s Dentistry (NYUCD) successfully introduce our students to one of perspective on wearing the splint to the student patient and engaging these technologies (the CEREC CAD/CAM unit) beginning in their empathy for a patient receiving dental care. The student patients were second year as part of an esthetic dentistry course. The CEREC challenged to make mental notes of the fit, function, or comfort of (ceramic reconstruction) system constructs crowns, onlays, and the splint so they would be able to accurately describe to their student inlays out of ceramic or composite blocks. We teach the students to dentist any difficulty/issue they were having. One week later, at the prepare and fabricate indirect restorations on typodont teeth, using Recall appointment, the student dentists were challenged to engage the Bluecam impression technique. Each student is trained to take their patients and carefully listen to their descriptions of wearing an optical impression and use his or her own computer to design their splints, then to assess the cause of any complaints and adjust different types of restorations. Students are required to complete the splints to correct the problems. The student dentist and student additional assignments using the most recent software available. The patient filled out questionnaires immediately following the Delivery students also gain invaluable experience by preparing, designing, and 224 Journal of Dental Education ■ Volume 76, Number 2
2012 ADEA Annual Session: Poster Abstracts (cont.) cementing CAD/CAM restorations on their patients when indicated. her fellow students that there is a Code Blue. This begins the team The NYUCD program introduces its students to a methodology of approach for managing the emergency. This student is called the team constructing permanent, high-quality, durable restorations during leader and stays with the patient at all times. Fellow classmates, who only one clinic visit. This allows them to complete their clinical are treating patients in adjacent cubicles, should immediately stop requirements. It engages our students in the use of a new technology patient care and assist the team leader. As students appear to lend that results in greater efficiency and less stress to both the patient assistance, they are assigned a number from 1 to 6. Each assigned and the clinician. Training the students in preclinical CAD/CAM number has a predetermined responsibility. The first student who techniques enables them to perform today’s dentistry both as presents to help, called student 1, is instructed by the team leader to student clinicians and when entering into practice. The students gain locate a faculty member and/or group practice director (GPD). Upon invaluable experience by preparing, designing, and cementing CAD/ arrival, the faculty/GPD will assess the emergency and determine if CAM restorations on their patients when indicated. the emergency system should be activated. At NYUCD the system is activated by calling our security office with the location of the Code 526. Engaging and Training Our Students in Medical Blue. Security then contacts our Oral Surgery Code Blue Team. The Emergency Preparedness: A Student-Led Medical faculty or GPD will also decide if a call to 911 emergency services is indicated. Student 2 is responsible for finding the GPD if he or Emergency Protocol for the Dental School Setting she is not initially present and informing him or her that a team alert Morey J. Gendler, Scott W. Podell, David Hershkowitz, Mark S. Wolff, has occurred and its location. Student 3 is responsible for bringing New York University the oxygen tank and medical emergency box from the supply area. New Program Student 4 goes directly to the Oral Surgery Clinic to help guide the It is of the highest importance that a dental student receives in-depth emergency responders to the emergency location. Student 5 will wait training for managing medical emergencies. New York University at the front entrance to the Treatment Center and ensure that the aisles College of Dentistry (NYUCD) has implemented a medical and doorways are clear. Student 6 will be the primary assistant to the emergency protocol that encompasses a scenario- and case-based team leader. This student is responsible for assisting the team leader, model and a student-led team approach. This model encourages reviewing the patient’s history, and creating a timeline for the patient team-oriented learning and also helps develop a student’s leadership including periodic vital signs, the patient’s medication list, and any skills. The first line of care in managing any medical emergency is medications that are administered to the patient. This information is trying to prevent it from happening in the first place. Our students made readily available to any emergency responder who may arrive. are trained to initially evaluate their patient as they greet and escort him or her from the reception area to the treatment setting, looking 527. The Well-Being of University Students and for any possible signs of an imminent medical problem. An initial Employees evaluation is made of the patient’s appearance, gait, and speech Janet L. Woldt, Arizona School of Dentistry and Oral Health; pattern, observing for signs of breathing difficulty, abnormal body Bernadette Mineo; Patricia Sexton; Timothy D. Hodges movement, or excessive perspiration. If any deviation from a normal New Program appearance is evident, the student is trained to ask the appropriate questions and make subsequent decisions based on the responses. A.T. Still University (ATSU), a graduate health science university Once the patient is seated, a current and detailed medical history with campuses in Missouri and Arizona, has partnered with the is completed at the initial visit, and the medical history is reviewed nationally known Gallup organization as an inaugural member of its at every appointment. As health care providers, dentists may be the Well-Being Consortium to study the well-being of university students first to detect signs and symptoms of diseases such as hypertension and employees (including faculty and staff) for the next five years. All and diabetes. Medical consults are obtained for patients who have incoming first-year residential students and all full-time employees at incomplete medical histories or who require referral due to the initial ATSU are being asked to participate in the study. Schools/programs data obtained from our screening questions. The scenario- and case- within ATSU participating in this study include the Arizona School of based emergency training program consists of two phases. During Dentistry and Oral Health (ASDOH), School of Osteopathic Medicine Phase 1, students demonstrate their ability to work as a team by in Arizona, Arizona School of Health Sciences, and Kirksville College knowing the responsibilities of each team member and understanding of Osteopathic Medicine. The definition of well-being used for this how the collective response of the team contributes to the successful study comes from Rath and Harter’s The Five Elements of Well- management of a medical emergency. Phase 2 includes the use Being: “Well-being is about the combination of our love for what of simulation drills. Students are asked to diagnose and render we do each day, the quality of our relationships, the security of our emergency care for various medical emergencies. Students receive finances, the vibrancy of our physical health, and the pride we take in both didactic and practical training and then demonstrate proficiency what we have contributed to our communities. Most importantly, it’s in several emergency response skills including the administration about how those five elements interact.” Initial data collection for this of oxygen, glucose paste, and patient ventilation. These case-based study includes the use of the Gallup Well-Being Finder, which study scenarios assist our students in becoming skilled at recognizing participants were asked to complete during an initial fielding period and treating several medical emergencies including vaso-vagal conducted September 19 to October 10, 2011, and will complete at syncope, orthostatic hypotension, hypoglycemia, asthmatic crisis, other designated times during the five-year study. The Well-Being latex allergy, angina, myocardial infarction, and/or epileptic seizure. Finder is designed to collect data on participant well-being and has Students receive case-based narratives that include the symptoms the potential to help students and employees measure and manage that their patient is experiencing and are asked to make a differential their well-being over time. Additionally, data will be collected with diagnosis and answer questions related to the patient’s condition. the Gallup Daily Tracker, which participants are asked to complete The objective of these exercises is to have our students develop on a daily (or regular) basis. The Daily Tracker is designed to give their critical thinking skills so they are proficient at diagnosing and participants immediate feedback, helping them to manage their treating medical emergencies. Our students are trained to act as a team well-being. Throughout the course of this study and subsequent to it, and each member has individualized responsibilities. The student various curricular, student service, and human resource interventions who is treating the patient with the medical emergency alerts his or will be integrated into campus life, academics, and daily operations February 2012 ■ Journal of Dental Education 225
2012 ADEA Annual Session: Poster Abstracts (cont.) at ATSU. This integration will include individualized student and for, and writing of a white paper in conjunction with the Bellevue employee assessment, action step planning, and other interventions Medical Program. Just as those of us in dentistry have realized that relating to the five elements of well-being. For ASDOH, the first- the elimination of diseases we treat is more important than the repair year dental students (Class of 2015) will be followed longitudinally of the damage they cause, we at the NYUCD Program for Survivors for four years across the curriculum and one year after graduation. of Torture have come to realize that the mere restoration of dentition Additionally, the well-being of predoctoral dental students will and dignity to those tortured by agents of their government is be compared to other graduate health science students within the inadequate. Unless we take steps politically to eliminate the worldwide university. Study progress and initial data collected will be presented problem, our mission remains unfulfilled. Our new program engages in this poster. our students in advocacy dedicated to legislate against professional involvement in torture and wrongful imprisonment of children with 528. Engaging Students in Advocacy: The NYUCD adults in our nation’s immigration prisons. Program for Survivors of Torture—Seeking Torture Elimination While Dealing with Its Ravages 529. Engaging the Geriatric Patient Steven J. Resnick, June Weiss, New York University Marjan Moghadam, Michael B. Ferguson, Paul Zhivago, New York New Program University Work in Progress The New York University College of Dentistry (NYUCD) Program for Survivors of Torture (PSOT), established in September 2008, is the first program in the United States to provide comprehensive 530. A Model for Cultivating Faculty Development dental care to survivors of political torture from around the world Within a Community of Practice who have sought refuge and asylum in our country. We have a team Cara L. Tax, Nancy R. Neish, Heather Doucette, Peggy J. Maillet, of twenty dedicated student doctors in our elective who treat patients Dalhousie University every Friday. Political torture is documented to occur in over ninety Educational Research countries. Over 400,000 torture victims reside in the United States. Our program partners with the Bellevue/NYU PSOT founded in 1995 To address the lack of theory in faculty development research, the by its present director, Allen Keller, M.D. The Bellevue PSOT provides School of Dental Hygiene at Dalhousie University applied social comprehensive medical care and psychiatric and social services to this learning theory to a clinical dental hygiene faculty development unique population. Until NYUCD became involved, these patients program. Social learning theory examines how people learn from had no source of comprehensive dental care, and treatment was others, and in this case, learning within the unique community of limited to surgical pain relief by the oral surgery program at Bellevue clinical instructors provided an informal mentorship in which the Hospital. This year, in addition to the intense dental, medical, and flow of knowledge was not in the traditional mentor/mentee approach psychological training our students receive that enables them to treat but in more of a shared learning experience among all community this unique patient population, we have developed a new program members. The purpose of the study was to determine if participation designed to engage the students in political advocacy. We are now in in the community of practice of clinical instructors resulted in our fourth year of treating this population and have come to realize actual change in teaching practices and if the level of participation that while we have been restoring both the dentitions and the dignity of instructors in the community changed over time. The faculty of our patients and while we have focused NYU and national media development program consisted of three components: attendance at attention on the issue, our new patient population keeps growing. We a series of seminars aimed at effective teaching strategies, application have done little to eliminate the problem of politically based torture. of new teaching strategies in the clinic, and attendance at a thirty- The program is being developed with Dr. Keller and the NYU School minute meeting (called a “huddle”) prior to each assigned dental of Medicine Center for Health and Human Rights. He has chaired hygiene clinic to share teaching strategies and problem-solve with the Advisory Board of Physicians for Human Rights, chaired the other instructors. The clinic huddle became a forum for dialogue and Policy Committee of the National Consortium of Torture Treatment problem-solving, and it served as a constant reminder for instructors Programs, and served on the American College of Physicians Ethics to implement newly learned teaching strategies. A retrospective self- and Human Rights Committee. At the present time, certain biological assessment questionnaire consisting of four open-ended questions markers are being used to determine the age of immigrants seeking was administered to fourteen clinical dental hygiene instructors at the asylum. We suspect that possible biological variances in different end of the 2010 academic year. Twelve clinical instructors responded cultures may lead to the improper placement of child immigrants to the questionnaire. The narrative data were analyzed thematically within adult prisons, where medical and dental care is poor. In order using qualitative methodology. Analysis of the data indicated all to effectively involve the students in advocacy for a bill before the participants had incorporated new teaching strategies into practice. New York State Legislature, we took a six-pronged approach: study of The data suggested that participation in the community of practice the history of the problem and the details of the legislation; a lecture supported their learning and helped them make effective changes in by Dr. Keller on the art and science of advocacy; a presentation by their teaching. The responses revealed that participation within the an expert from a major New York public relations firm on gaining community of practice increased as instructors began to feel more support and media coverage for advocacy; a presentation by an elected confident and comfortable in the community as a whole. Research government official on what politicians view as effective advocacy; grounded in educational theory is important because it helps us the advocacy itself; and a presentation to our college on the process, understand how people learn. In this study, the community of practice actions, and results. The research/white paper portion of the advocacy became the framework for social learning, and it provided ongoing program dedicated itself to study of the problem of placing children support for instructors as they tried to implement new teaching in adult immigration prisons, review of the literature on biological strategies in the clinic setting. The value of this model extended (often dental) age determination, assessment if the present practice beyond the acquisition and implementation of new knowledge. It also of age determination by government authorities is consistent with the contributed to a more collegial work environment that, in turn, could evidence-based research, exploration of the literature to see if genetic contribute to the recruitment and retention of future faculty members. variation through different world populations has been accounted 226 Journal of Dental Education ■ Volume 76, Number 2
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