Faculty diversity, equity, and inclusion in academic dentistry: Has dental education missed the call of #MeToo?

Faculty, students, and staff experience sexual harassment in the workplace and educational environment. Frequently, the victim takes no action either due to a lack of understanding of their rights or concern about retaliation or adverse outcomes if an incident is reported. The #MeToo movement has enhanced awareness of sexual harassment and its impact on victims. However, dental institutions vary in their approach to creating an environment free from harassment and supportive of individuals subject to inappropriate or illegal behaviors. In this article, four vignettes provide examples of harassment, mistreatment, or bias. Common themes and critical issues within the vignettes are then identified, discussing the potentially illegal, unethical, inappropriate, and unprofessional behaviors and comments. Strategies to address the issues identified are described. Recommendations are also provided to assist dental institutions and educators in evaluating their current practices and policies and implementing change.

Stress and anxiety in orthodontic residents during the coronavirus disease 2019 pandemic.

INTRODUCTION: The coronavirus disease 2019 pandemic has had far-reaching effects on health care providers and health professional students; however, little is known about the factors related to stress and anxiety levels, specifically among orthodontic residents during this time. METHODS: A 2-part questionnaire, which included modified stress and anxiety inventories, was disseminated electronically to U.S. orthodontic residents between June and July 2020. Descriptive and comparative statistics were used to analyze the data. RESULTS: Overall, 261 participants responded (56% female), representing a response rate of 26.8%. Significant gender differences were found in 18 stress items, with female respondents expressing more stress than their male counterparts. Only 1 stress item (ie, fear of being unable to catch up if behind) varied as a function of the difference on the basis of respondents' stage in the program. First-year residents reported more stress in relation to this than more senior residents. Responses to all anxiety items but 1 item varied by gender, with females reporting higher scores. Residents in the middle stages of their program responded with higher anxiety scores with significant differences on 3 anxiety items. CONCLUSIONS: Although financial responsibilities and travel plans were the most stressful and anxiety-inducing items for orthodontic residents during the early aspect of the coronavirus disease 2019 pandemic, multiple items contributed to their stress and anxiety. In addition, both gender and stage of progress in a residency program impacted the level of stress and anxiety reported by respondents.

Dental faculty well-being amid COVID-19 in fall 2020: A multi-site measure of burnout, loneliness, and resilience.

PURPOSE/OBJECTIVES: This study aimed to understand the impact of the COVID-19 pandemic on dental school faculty's self-reported burnout, loneliness, and resilience. METHODS: A 34-item questionnaire composed of three previously validated scales - adapted Copenhagen Burnout Inventory, the brief resilience scale, and a short loneliness scale - and demographic information was sent by email to dental school faculty in four dental schools across the US during the sixth and seventh months of the COVID-19 pandemic. RESULTS: Two-hundred sixteen (19.63%) of faculty invited to participate completed the survey. On a scale of five, with five indicating extreme burnout and one indicating no burnout, the average personal burnout was 2.7 (SD = 0.83), and work-related burnout (WRB) was 2.8 (SD = 0.83). Personal and WRB decreased with increasing age. WRB was significantly higher among full-time faculty, females, and those living alone. Faculty who lived alone experienced more loneliness than those who lived with others. Resilience was not a statistically significant difference across demographic groups. Regarding the impact of COVID-19 pandemic on their burnout, loneliness, and resilience on a scale ranging from "Never" (scored as 1) to "A great deal" (scored as 5), the average response for burnout was 3.3 (SD = 1.01), loneliness was 2.6 (SD = 1.10), and resilience was 2.8 (SD = 0.99). CONCLUSION(S): While self-reported burnout and resilience scores did not show a significant increase during the pandemic, the rates of burnout and loneliness remain higher than the public. Dental education has real challenges and opportunities to explore individual and organizational interventions to combat burnout and loneliness and enhance resilience among faculty.

Should attendance for preclinical simulation and clinical education be mandatory?

Mandatory attendance, particularly in didactic settings, is a highly debated topic in higher education, including dental education. Within dental education, a large portion of education occurs in preclinical laboratories and clinical environments. There is little to no research on attendance in these settings in dental schools. This point/counterpoint paper examines the pros and cons of mandatory attendance in these highly specialized educational settings. With the backdrop of the COVID-19 pandemic that began in March 2020 and continues to impact dental education at the time of publication, this topic has become even more relevant. Viewpoint 1 claims that attendance should be mandatory because a greater exposure to preclinical and clinical environments helps foster better clinical hand skills, critical thinking, decision-making, problem-solving skills, and an overall sense of professional identity. It goes on further to suggest that there may be a link between attendance and performance in exams and that attendance is part of the dental school's responsibility. Viewpoint 2 argues that the rationale for attendance is complex, and that creating learning environments that are psychologically safe will incentivize students to attend, even without mandatory attendance policies. Furthermore, it explains that technological advances have allowed dental schools to think creatively about asynchronous learning, which by its very nature does not require attendance at a given time. The authors of both viewpoints conclude that the preclinical and clinical education and experience are critical dental education and that dental school leaders should focus on improving the quality of these experiences.

High depressive symptom prevalence in dental students associated with lifestyle and well-being characteristics.

PURPOSE: Studies show health professional students have a high prevalence of depression. Dental students are especially susceptible due to the burden of the highest debt, exposure to bloodborne pathogens and chronic pain frequency. However, few studies on depression among U.S. dental students exist. This study aims to determine: (1) the difference in depression prevalence between U.S. dental students, the general population, and medical students; and (2) demographic and lifestyle characteristics associated with depressive symptoms in dental students. METHODS: Researchers surveyed dental students in California in 2018 using a 36- item questionnaire. The Patient Health Questionnaire (PHQ-9), a validated diagnostic screening tool, measured depressive symptoms suggesting clinically significant moderate to severe depression. Additionally, participants answered demographic and lifestyle characteristics questions. Data analysis included bivariable chi-square tests and multivariable logistic regression. RESULTS: The response rate was 19.1%. The crude depressive symptom prevalence (27.7%) was similar to that of depression in medical students (27.2%) and higher than the U.S. population (7.7%). Bivariable analysis indicated several characteristics significantly associated (P ≤ 0.05) with moderate to severe depressive symptoms in dental students, including experience of injury/pain, financial insecurity, self-reported minority status, perception of meaningful work, and year in school. Multivariable logistic regression modeling estimated 5 well-being categories as significantly associated with higher odds of not having major depressive symptoms. CONCLUSIONS: Prevalence of depressive symptoms among California dental students is similar to depression in medical students and higher than the general population. Results suggest a significant proportion of dental students experience moderate to severe depression and require accessible resources.

Evidence-Based Education: Faculty Development Workshop to Promote Critical Thinking Skills in Dental Education.

INTRODUCTION: The Commission on Dental Accreditation emphasizes the importance of teaching critical thinking. If faculty are expected to change the way they teach, training resources that employ the methods of promoting critical thinking must be made available to provide guidance on how to teach critical thinking. A search of MedEdPORTAL showed no peer-reviewed active learning resources for faculty development in the domain of critical thinking. METHODS: This 90-minute workshop is designed to provide preclinical and clinical dental faculty with strategies to promote critical thinking skills in their students. It includes a presentation on foundational knowledge about critical thinking and knowledge organization, followed by small- and large-group activities. Videos of real teaching encounters are reviewed so that different teaching styles can be seen and discussed. RESULTS: This workshop was given at the 2014 American Dental Education Association Annual Session, receiving an overall rating of 3.67 on a Likert-type scale of 1-4, with 4 being the highest score. It was repeated at the University of California, San Francisco School of Dentistry, where it received an overall rating of 4.7 on a Likert scale of 1-5, with 5 being the highest score. DISCUSSION: For faculty who learned in teacher-centered curricula, training may be necessary to provide them with skills for contemporary teaching in this new domain of competence. This workshop offers such training.

Building Resilience for Wellness: A Faculty Development Resource.

Introduction: The National Academy of Medicine recently published "A Multifaceted Systems Approach to Addressing Stress Within Health Professions Education and Beyond," which calls for greater attention to the wellness of health care providers, students, and educators. Suggested actions include "creating and training positive role models." In order for faculty to role-model behaviors of wellness, they need to understand what this means and how to incorporate it into their lives. At present, there is only one other MedEdPORTAL resource on wellness and resilience that includes faculty as audience members. Methods: This 60-minute workshop is designed to provide faculty with a basic framework for wellness, with an emphasis on the emotional process aspect of resilience. Strategies for stress and anxiety management are reviewed. The workshop is interactive, with large- and small-group discussions, as well as a guided meditation. Results: This workshop was given at the 2017 Council of Faculties Business Meeting at the American Dental Education Association Annual Session, with 40 participants. Workshop evaluations, completed by 34 (85%) attendees, showed an overall rating of 4.0 on a 5-point Likert scale, with 5 = excellent. The workshop was repeated at the School of Dentistry at the University of California, San Francisco, with 11 attendees; there, the overall rating was 4.7. Discussion: In order to contribute to a culture of wellness and resilience in their organization, faculty need training on the concepts, as well as practical skills for implementation. This workshop provides introductory-level knowledge and skills.

Toothbrushing barriers for people with developmental disabilities: a pilot study.

PURPOSE: The aims of this study were: (1) to determine which step in tooth brushing is most difficult for individuals with developmental disabilities and (2) to determine if oral hygiene instruction improves technique. MATERIAL AND METHODS: Once per week for 6 weeks, disclosing solution was applied to the teeth of 14 subjects who were observed individually in their tooth brushing technique. Fourteen distinct steps were measured on a 4-point Likert scale. Plaque score was measured after brushing. RESULTS: The step causing greatest difficulty was "able to brush off residual, identified plaque." Steps that showed greatest improvement were "open toothpaste" and "place toothpaste on brush." The change in plaque score from the initial visit to the final visit was not statistically significant. CONCLUSION: Oral hygiene instruction in a group and individual setting increased compliance in the initial steps of tooth brushing.

Which factors influence students' selection of advanced graduate programs? One institution's experience.

The reasons that students choose certain specialties may be integral to the quality of specialty programs and the future of those specialties. The Harvard School of Dental Medicine (HSDM) has a high percentage (87.6 percent) of students who enroll in postgraduate programs. The goals of this study were to establish a baseline of factors that affect postgraduate program selection at HSDM and to determine if there was a significant difference in factor selection by gender, relationship status, graduation year, or choice to specialize versus choice to pursue advanced training in general dentistry. As a pilot study, we asked HSDM graduates from the classes of 2005 to 2007 to rank the importance of forty-two factors in selecting a field of dentistry and a particular program or institution within a specialty. Overall, students felt that intellectual content, challenging diagnostic problems, and possessing a special skill or talent unique to a specialty were the most important factors in choosing a field of dentistry. Influence of family members in dentistry was ranked as least important. In choice of a certain program or institution within a given field, clinical training and philosophy of training were ranked most highly. Students felt that the opportunity to moonlight was least important. Significant differences (p<0.05) were found regarding gender, relationship status, and students who chose to specialize versus those pursuing advanced general dentistry training. No significant differences were found among the students in different graduating classes.