Recent shifts in treatment and care perspectives are leading dental schools to rethink their programs and curricula. The focus of dental education has traditionally been reactive—responding to incidents of oral disease as they presented. Changes
in the Commission on Dental Accreditation (CODA) standards and recommendations from the Institute of Medicine (IOM) have forced changes toward a more proactive and holistic approach that considers patients' social and environmental variables.
One institution taking a new approach to curricula and training is the
University of California, Los Angeles, School of Dentistry (UCLA SOD). A recent study published in the
December 2014 issue of the Journal of Dental
Education outlines this methodology for teaching pediatric dental residents that prepares them for unique and complex cases. UCLA SOD’s new program, Community Health and Advocacy Training in Pediatric Dentistry (CHAT-PD), aims to close the gap between traditional dental education and IOM
recommendations that focus on early intervention, treatment plans and disease management. This program encourages pediatric dentists to have an impact beyond the traditional office setting by involving students directly in the community.
University of California, Los Angeles
School of Dentistry
Los Angeles, CA
Dean: No-Hee Park, D.M.D., Ph.D.
Year opened: 1964
Doctoral dental degree(s) offered: D.D.S.
Total predoctoral enrollment: 375
Rooted in the principles of community-based education (CBE), the program’s goal is to develop a team—dentists, other health professions and community partners—to treat and care for underserved, vulnerable populations. As a result of new curricula, training and research, the advanced
education program trains pediatric dental residents to get more involved with local patients and organizations. The goals fit in with the CODA standard of 2013 requiring dental education programs to have a component of CBE.
CHAT-PD was developed in advance of the new CODA standard, introducing eight courses not traditionally in pediatric residency programs. The topics run the gamut from interprofessional education to research methods, ethics, community-focused studies and quality improvement. These courses
encourage new ways of thought and practice, laying a foundation for understanding and navigating the dental care delivery system.
In addition to curricula changes, clinical training and research projects are woven into the program. Applied learning experiences are central to the CHAT-PD clinical
training component. Participants complete two community-based
clinical rotations, including one through the Infant Oral Care Program. Two separate practicum activities are required in which they partner with local organizations to plan and participate in an activity around dental care. Residents
are also required to complete a research project around a topic of their choice.
As this program continues to take root at UCLA SOD, aspects are continuously monitored. Performance measurement takes two distinct paths: the efficacy of the curriculum and the influence of the program on postgraduate practice placement. The evaluation process references competencies set forth by the Pediatrics Milestones Project. In addition, exit interviews and expression of plans to practice, or not to practice, in community clinics, will be used in the analysis.
Since its inception in 2006, CHAT-PD has undergone significant development and change. Leadership training, interprofessional education and service in underserved communities have improved the cross-cultural effectiveness of graduates. Graduates found themselves working with patients who receive Medicaid, an experience that many students do not have the opportunity to share. Pediatric dental residents in particular have gained valuable experience in policy and advocacy activities and in long-term disease management and treatment plans. However, the program has not had more than a slight influence on residents’ intentions to work with low-income populations.
Programs such as CHAT-PD at UCLA SOD will continue to chip away at significant gaps in access to dental care. With continued encouragement from institutions and dental educators, students at all levels will benefit from service in their communities as much as those they serve.