A cross-sectional survey of attitudes and barriers toward pharmacist services at predoctoral academic dental institutions.

BACKGROUND: The pharmacy profession continues to evolve through novel practice settings and collaborations. Recent reports have highlighted services provided by pharmacists in academic dental settings. OBJECTIVES: This study aimed to measure attitudes and barriers to pharmacist services at academic dental institutions via a survey of dental school administrators. METHODS: A survey was circulated in summer 2019 to all accredited dental schools in the United States through the American Dental Education Association clinic dean listserv. The survey consisted of Likert scale questions pertaining to barriers and attitudes regarding pharmacist services in dental education programs and clinics. The survey was open from July 2019 to December 2019. Responses were analyzed with descriptive statistics and Spearman rank correlation. RESULTS: Complete attitude and barrier responses were received from 30 of 66 accredited institutions. Responding schools showed a generally positive attitude toward pharmacist services. Respondents identified funding as the barrier with greatest impact on program development and expansion. CONCLUSION: Attitudes among dental education program administrators regarding pharmacists are generally positive. Barriers remain to fully incorporating pharmacists into dental institutions in the United States. Increased funding and reimbursement for pharmacy services would support universal pharmacist integration to this practice setting.

Evaluating the impact of interprofessional forums on dental medicine students' collaborative practice skill perception.

PURPOSE: This study evaluates third-year dental medicine students' perceived competencies related to interprofessional collaborative practice (IPCP) after completing two exposure level experiences with students from other professions across a large academic health center. METHODS: Two cohorts of D3 dental medicine students (2018-2019 and 2019-2020) completed the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) after participating in in-person 2.5-h Interprofessional (IP) Forums in the Fall and Spring semesters. Self-reported competencies were compared between pre-and post-IP Forum ratings and between Fall and Spring. RESULTS: Prior to the IP Forums, dental medicine students (n = 185) reported perceived skill in the interprofessional competencies to be from Good to Very Good using the ICCAS. After participation in the Fall IP Forum, students' ICCAS scores increased in all ICCAS subscales with large effect sizes. Students reported a perceived decline in these skills in the four months between Fall and Spring IP Forums and restoration of IP skill levels after participating in a second IP Forum (Spring). CONCLUSIONS: Participation in IP Forums has a positive impact on students' IPCP skill perception. Our data suggest that perceived skill level requires repeated IP learning experiences. If dental medicine students are expected to embrace collaborative practice to enhance patient outcomes, then dental school educators must provide opportunities for students to engage in collaborative practice experiences at all levels of their training.

An environmental scan of pharmacists supporting pre-doctoral dental education institutions.

PURPOSE/OBJECTIVES: Reports have described pharmacists providing services within academic dental settings. The full scope of these activities and where they exist is unreported. This environmental scan was performed to identify and summarize the levels in which pharmacists provide support to predoctoral dental education programs. METHODS: A survey was circulated in summer 2019 to all CODA accredited dental schools through the American Dental Education Association (ADEA) clinical dean listserv. The IRB approved survey consisted of 23 questions pertaining to the pharmacist's role in predoctoral dental education programs. Institutions were asked whether pharmacists were used and what kinds of services pharmacists provided. Pharmacist roles were classified into standard pharmacy services, clinical pharmacy services, medication inventory, education, and administration/research. Univariate analysis was performed on responses and reported using descriptive statistics. RESULTS: A response rate of 59.1% from 66 institutions was achieved. Of those responding, 28.21% reported utilizing a pharmacist at their institution. Of the institutions responding positively to utilizing a pharmacist, the most common standard pharmacy services used were patient counseling regarding a disease state (50%), and medication errors/adverse event reporting (60%). Some clinical pharmacy services provided were medication history collection (70%), advising antimicrobial selection (50%), and treatment plan consultation (60%). Pharmacists were also found to be active in education, school administration, and research. CONCLUSION: Pharmacists are utilized at just over a quarter of responding CODA accredited predoctoral dental education institutions in the United States. Where deployed, pharmacists provide a wide array of services.

Should the U.S. Adopt a National Dental Clinical Licensure Examination? Two Viewpoints: Viewpoint 1: National Licensure Would Provide Multiple Advantages for Practitioners and the Profession and Viewpoint 2: Licensing Authority Should Remain Under State Dental Boards' Jurisdiction.

This Point/Counterpoint article examines the need for and potential impact of implementing a national clinical examination for initial licensure in dentistry. Viewpoint 1 supports a national licensure exam that meets the clinical exam's credentialing requirement for licensure in every state. According to this viewpoint, a national exam will reduce costs, enhance portability of graduates, simplify the transition from dental school to practice or specialty training programs, and standardize requirements for licensure between states. Viewpoint 2 opposes a national licensure exam. This viewpoint supports individual states' dental board decision making process, which is based on identifiable state-specific criteria. The ability to prioritize needs at the state level allows for higher exam standards, easier modifications, more focused requirements, and better calibration in specific exam areas. Viewpoint 2 argues that the delicate balance between licensure agencies and organized dentistry in each state, as well as the involvement of dental schools in the licensure process, must be preserved. This Point/Counterpoint concludes with a joint statement about the prospects for adoption of a national licensure exam.

Nursing and Dental Students' Reflections on Interprofessional Practice After a Service-Learning Experience in Appalachia.

Nowhere is the discrepancy between good and poor oral health status more pronounced in the U.S. than in the Appalachian region, where there is a high incidence of dental problems related to non-flouridated water, limited access to care, and tooth loss. To address these disparities, in 2016 University at Buffalo dental and nurse practitioner faculty members led a group of dental and nursing students on a two-day service-learning experience in rural Tennessee. The aim of this study was to assess the dental and nursing students' reflections on this interprofessional service-learning experience in Appalachia. After the program, all 36 students who took part in it were invited to complete a survey with open-ended questions about the experience and their attitudes about interprofessional practice. Of the students, 34 (94.4%) returned the surveys, and 23 completed all the questions. Thematic analysis was used to code and analyze the student comments, which were then organized into themes. Five themes emerged: facilitating care through teamwork, gaining mutual respect, gaining confidence, understanding dental role in overall health, and relieving suffering. The overarching pattern was the link among all the themes: that everyone has a part to play in ensuring that patients get the best care. The themes and overarching pattern corresponded to the Interprofessional Education Collaboration (IPEC) competencies and the overall goal of delivering patient-centered care to a population that is underserved. These findings suggest that exposure to patients who lack dental care and have severe oral health problems can impact developing nursing and dental professionals in ways that can increase their appreciation of interprofessional practice and their future willingness to provide care in underserved settings.

The Buffalo Model: Shifting the Focus of Clinical Licensure Exams in Dentistry to Address Ethical Concerns Regarding Patient Care.

Most jurisdictions grant dental licensure to graduating students following successful completion of a clinical exam. Testing agencies, which are independent of dental schools, nevertheless conduct their exams at school facilities. Patient participation in these exams raises ethical concerns regarding such issues as unlicensed providers' performing irreversible procedures with minimal supervision and graduates' limited accessibility to provide follow-up treatment. To address these concerns, a collaborative effort between University at Buffalo School of Dental Medicine faculty and testing agency personnel was launched. The aims of this article are to describe the development and implementation of the resulting Buffalo Model, to highlight ethical advantages in its application, and to identify areas of improvement to be addressed in future iterations. With the Buffalo Model, modifications were made to the traditional exam format in order to integrate the exam into the school curriculum, enabling candidates to take it at various points during their fourth year. In addition, after calibration of school faculty members, 98.5% of cases verified by faculty were accepted by the Commission on Dental Competency Assessments for use in the exam. In two cases, restorative treatment completed during the exam did not meet the school's competency standard. This new approach ameliorates ethical concerns associated with clinical licensure exams because treatment is provided only to patients of record within a sequenced treatment plan and timely and appropriate treatment is provided to all patients. The results of this first year of implementation also suggest that calibrated faculty members will not show bias in the selection of lesions or competency evaluations of candidates.