Working Together to Access Dental Care for Young Underserved Children: A Problem-Based Learning Approach to Increase Health Professional Students Awareness
|Case, Evaluation Tool, Video||9380||1||March 26, 2013|
The course uses a problem-based learning (PBL) approach to introduce students to the process of critical thinking and its application to clinical problem solving in a public health context. Students are expected to critically evaluate a dental public health case involving biological, behavioral, social, ethical, and cultural elements; seek resources and information to develop an understanding of patient needs; develop hypotheses regarding the nature and complexity of the problem; prioritize goals and objectives relevant to the problem; and develop a solution. The centerpiece of this curriculum is a novel video case scenario that highlights the real-world consequences of the lack of parental knowledge and dental community cultural awareness on the oral health of young Hispanic children from lower socioeconomic families in rural communities. The mother is well-meaning and concerned. The dentist is well-meaning and accommodating. Yet problems emerge. Immediate issues such as clinical hours that are conducive to hourly rate farm worker’s, to longer range issues such the fact that the older daughter, who had her dental needs treated in an emergency room situation acts as the interpreter for her non-English speaking mother are portrayed. Important consequences of other facilities and services not communicating clearly and not attending to cultural sensitivities are also able to be presented effectively. The video case scenario has successfully been used to teach dental students about oral health disparities.
Pickrell J, Spector G, Chi D, Riedy C. Working Together to Access Dental Care for Young Underserved Children: A Problem-Based Learning Approach to Increase Health Professional Students Awareness. MedEdPORTAL; 2013. Available from: www.mededportal.org/publication/9380
- Attain an awareness and understanding of dental public health principles and problems in rural United States, including how oral health problems affect particular vulnerable subgroups (e.g.,racial/ethnic minorities, low-income) and communities.
- To describe the associations between early childhood caries and parental access to education.
- Identify and discuss alternative points of view about a public health problem involving dentistry.
- Be able to suggest strategies physicians might use to implement early oral health intervention programs within a medical setting.
- Illustrate ways that physicians can partner with dentists to provide consistent nutrition messaging to parents of young children.
- Prepare a coherent presentation of the public health problem and offer potential solutions using resource materials supplemented with electronic media.
- Vulnerable Subgroups, Minority, Low-Income, Caries, Building Oral Health Capacity (BOHC) Collection
- Family Medicine
- Public Health
- Assessment, Diagnosis & Treatment
- Dental Public Health
- Establishment & Maintenance of Oral Health
- Health Promotion
- Pediatric Dentistry
- Preventive Dentistry
- Preventive Medicine
- Interpersonal & Communication Skills
- Medical Knowledge
- Patient Care
- Practice-based Learning & Improvement
- Basic Sciences
- Psychology/Behavioral Science
- Clinical Sciences
- Clinical Skills/Doctoring
- Communication Skills
- Community Health
- Cultural Diversity/Cultural Competency
- Health Education
- Healthcare Systems
- Public Health Sciences
- Professional School
- Dental Student
- Medical Student
- Nursing Student
- Public Health Student
- Problem-based Learning
Authors & Co-Authors
Jacqueline Pickrell, PhD
University of Washington
Gary Spector, MD
Christine Riedy, PhD, MPH
University of Washington
Donald Chi, DDS, PhD
University of Washington
Sponsorship or Funding Source
University of Washington, Department of Oral Health Sciences -- Regional Initiative in Dental Education (RIDE).
This project is also sponsored in part by funding from the Health Resources and Services Administration/Maternal Child Health Bureau grant #U44MC20223.
Effectiveness and Significance
Disparities in early childhood caries disproportionately affect racial/ethnic minorities and low-income individuals. By focusing on the prevention and management of nutritional and self-care behaviors among new parents using an innovative video-based case scenario, the curriculum will train medical students how to approach these issues during well baby visits in clinical settings. This is significant because children visit their pediatrician or family physician far more frequently and at earlier ages than they do a dental care provider, which highlights the need to equip future physicians with the tools they need to combat this problem. In addition to fact-based modules, self-reflective modules encourage medical students to think about how they would implement such practices in a clinical setting and ways they can strengthen interdisciplinary working relations with dentists.
Until last year, the content on oral health in a public health framework was provided in a paper-based format. In order to inject new life into the content, we developed this video-based scenario that would provide both experiential and didactic learning. The course is centered on a problem-based learning approach but mainly focuses on students’ ability to think critically when examining complex issues that have societal implications. When we compared the student ratings of the course prior to last year (paper-based format) with last year (video-based format) we found that students rated several indices higher for the video-based format. They gave a higher mean rating for whether the course met its educational objective, a higher rating for the instructor’s effectiveness, reported they had spent more hours per week on the course materials, and felt that a greater percentage of those hours were valuable for advancing their education. This increased level of engagement, we believe, will lead to improved memory when faced with similar situations in years to come. Based on the analysis we did of the students’ ratings of the course, we felt that the transition from a paper-based to a video-based format was very effective in engaging the students and impacting their desire to learn. We have manipulated group size and have found that smaller group sizes (< 12 students) work better for engaging the students in meaningful interactions. Additionally, we have used other dental public health problem scenarios to allow for this approach to be used with an entire dental school class (> 50 students).
Special Implementation Guidelines or Requirements
This curriculum is based on a video case scenario so there would need to be a laptop (with internet access) and projector available for the course instructor or group facilitator. Since the video is still one we use in our first year dental curriculum we ask that the video is held with the course instructor and not given to the students. The suggested course length is 8 weeks with 6 weeks of working sessions approximately one and a half hours long. The suggested group number is 8-10 students with no more than 12 students as a larger group makes the interaction unmanageable. The instructor guide, facilitator guide, and list of articles and guidelines provide the necessary preparatory background information/readings and course structure. The PBL introduction PowerPoint presentation and course syllabus provide direct materials to the students. The main evaluation for the course is the final presentation by the students (40 points); however, the course instructor can also evaluate the students’ weekly research summaries (4 summaries at 15 points each; total of 60 points) both for the presence and quality of the summary.
This video-based case scenario highlights a young Hispanic family without easy access to dental care who rely on government programs for both education and health care needs. This video scenario allows the student to “experience” situations from numerous points of view and based on the analysis we did of the students’ ratings of the course, we felt that the transition from a paper-based to a video-based format was very effective in engaging the students and impacting their desire to learn. If the curriculum is used in the online version (no physical contact hours with students and students are working alone) we recommend following the facilitator guidelines document, such that the insertion of the listed didactic material throughout strategic areas of the video will replace the need to have students interact with other students in their search for information. These instructive “prompts” enhance its effectiveness and success among students in understanding the complex issues that underserved families face in accessing and receiving care. When facilitating a small group, the instructive prompts may be employed when necessary to guide the focus of discussions.
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