100 Years of ADEA: Dr. Sandra Andrieu

Sandra Andrieu

Sandra Carlin Andrieu, Ph.D.

Professor and Associate Dean for Academic Affairs
Louisiana State University Health New Orleans School of Dentistry

Dr. Sandra Carlin Andrieu’s profile is our final entry in the 100 Years of ADEA Profile series, acknowledging many of those who have made their mark on ADEA as an organization and on the profession of dental education over the past 100 years. Dr. Andrieu not only served as ADEA President, championing interprofessional education during her term, but she also weathered many challenges as Associate Dean for Academic Affairs at Louisiana State University Health New Orleans School of Dentistry (LSUSD), from Hurricane Katrina to the COVID-19 pandemic. In her Q&A, she shares her experiences transitioning from a dental hygienist to a dental educator and academic leadership and the many things she learned along the way.

We thank her for her contributions, along with the 11 other dental educators we profiled!

Q. You started in dental hygiene but made the transition to dental education. What was the impetus for that change?

I wish I had an exciting story to tell, but I have always enjoyed learning. I never stray too far from my roots, so if you look up the definition of the term, “Bloom where you are planted,” you should see my name listed, and I am proud of that. Mine is a story of continued growth and expansion of my world, fueled by curiosity and a desire to contribute and do more, combined with a willingness to put in the work, a huge dose of persistence and many blessings along the way.

Born to parents of the Greatest Generation, who wanted more for their children than they could have dreamed for themselves, I knew from a young age that my “job” was to earn a college degree. My parents wanted their daughters to be good people, never afraid of hard work, and able to support themselves. I grew up with the naïve belief that a combination of hard work, persistence and a positive attitude—sprinkled with the fortune of good timing—was the key to success. But what I learned was that you could work hard and have a positive attitude and still not reach the goals you set. However, I also learned that my naïve belief wasn’t such a bad thing—the lessons learned by following that belief served me well and gave me a solid foundation for each next part of my journey. I learned it is not the goal that is the most important, rather it’s who you become along the journey that makes the difference in the whole of your life. I also learned that the destination might change, but it is often better than expected!

So, dental hygiene to dental education . . . Why? How? Well, mine is a good example of a journey where the original goal, the destination, changed more than once, and the journey was truly better than expected. College degree—check! Private practice—check! Then an arbitrary turn in the road, a truly surprise detour as a clinical instructor intended to be a very temporary one-semester experience, changed the course of my career. As a faculty member, I thrived on collaborating with colleagues, working toward a common goal and helping others fulfill their dreams. I wanted to learn more and help more. Master’s degree—check! I was appointed as director of the Program in Dental Hygiene, and I thought that was the new destination. My world expanded.

Again, my roots were firmly planted, but I was reaching and itching to learn more, to contribute more to larger school efforts, and to be more. I saw in my new world dental faculty who had opportunities to grow, in rank, to professor. I investigated what was required. I was informed that a dental hygienist could not be considered for promotion to professor. Not understanding why, I naïvely persisted. I studied the promotion guidelines and made certain that I met all the criteria expected of a dental faculty member—even earning a Ph.D. to have the required advanced degree. When it was time to request promotion, there was no choice but to consider my application and I was promoted. My destination had changed again. My world expanded.

I learned all I could about the school of dentistry—all programs. I said yes to every committee opportunity and any chance to engage with colleagues from and with whom I could learn, and I was blessed with that sprinkle of good timing. A new dean arrived, saw a spark of potential, and promoted me to Associate Dean for Academic Affairs. My destination changed again. My world expanded. That was the year I met ADEA (then the American Association of Dental Schools [AADS]) and my world has never been the same since.

Q. During Hurricane Katrina, when flooding caused LSUSD to relocate from New Orleans to Baton Rouge, you played a key role in re-creating the curricula for the programs in dentistry, dental hygiene and dental laboratory technology—allowing the class of 2006 to graduate on time. What did this experience teach you about leadership during a crisis? Were you able to adapt those skills during the COVID-19 pandemic?

Hurricane Katrina (Katrina) and COVID-19 presented us with unique challenges, but, with each one, we faced an uphill battle of epic proportions. Hurricanes and pandemics require preparedness and response tactics, but they are different in their impact and duration. Hurricanes and other natural disasters are sudden and limited to certain locations, but pandemics are ongoing and global disasters. Leadership and agility proved critical to survival in each.

During Katrina, in the middle of a city that had survived over 286 years of hurricanes, there was a complete breakdown of communication and infrastructure. The almost 800 faculty, staff and students of LSUSD were displaced, so locating and relocating each person was extremely difficult. There was no school to return to, as it was underwater. Cell phone and computer servers were all down. We had no internet access, no files, no schedules, no equipment, much less course syllabi or books. Many students, faculty and staff lost everything—even the lives of family and beloved pets.

We divided into small groups of faculty and staff and tackled major areas of need. Yes, a group of us literally re-created course schedules and courses from memory. We reached out to friends, the LSU community and alumni. We found classroom space, created laboratory space and reached out to practitioners who shared their clinics with our students. For two solid years, our network of extraordinary, reliable, trustworthy and effective colleagues became an interdependent and unstoppable force. Individuals were experiencing tragedy, death, loss and grief beyond what is describable; and through it all, we carried each other. When you could not stand any longer, someone carried you and then you did the same for the next person. We needed each other and we knew it. We knew that none of us could survive alone, but we could all survive if we stayed together. Our dean made the decision that we would stay together. We cared for each other. We joined hands and hearts and worked as a team. The students in each of programs graduated on time, and the entire senior dental class passed state and national board examinations. It was a miraculous feat after an unimaginable disaster.

The crisis of COVID-19 wasn’t as destructive to our LSUSD family—but it was equally as epic to the larger population, and it reached past LSUSD to our colleagues across the country and the globe. While the damages of a natural disaster are sudden and more predictable, the challenges presented by a pandemic like COVID-19 are slow, prolonged and ongoing. COVID-19 has a long-term impact on public health, thus health education. During COVID-19, we didn’t have as much direct control over our recovery, but we did make the decision to follow national public health guidelines and remain on track to graduate our students on time—and we did.

Successful leadership in crisis is important. The expected skillset includes a vision and a plan that is clearly communicated with measured goals along the way. The key to rising from a crisis better than you were before is dependent upon collaboration and buy-in from the whole team. Respect for and trust in each other is equally as important as support for the leader. The value of demonstrated effective leadership is the foundation it provides for the next challenge. When the challenge of COVID-19 arose, there was a sense of comfort among those who worked together to meet the challenge of Katrina because trust in each other to work as a team had already been established.

Q. During your years as ADEA President, you championed interprofessional education (IPE). You also were a lead contributor to the Core Competencies for Interprofessional Collaborative Practice Report. How do you think IPE has evolved in dental education, and where do you see it going in the future?

It is true that what propelled my urgent appeal in 2010 to the ADEA community to support IPE was desperation to help my husband as he battled Parkinsonism and Lewy body dementia. Shortly after that appeal, I was grateful, in my role as President of ADEA, to be appointed to the IPEC national panel that prepared the report on core competencies for interprofessional practice. My lived experience brought home to me the need for us to prepare health professionals to provide collaborative care. Learning from, with and about representatives from six national education associations of schools of the health professions gave me hope for the future of health practice and patient care. Knowing that others realized the need encouraged me to invest my professional and personal energy in moving the effort forward one step at a time.

Through a grassroots effort with colleagues at Louisiana State University Health Sciences Center New Orleans (LSUHSC-NO), we established a working group that became, in 2011, a formal health sciences center-wide IPE Committee. The initial goal was to give each health professions student at least one IPE experience while enrolled at LSUHSC-NO. In 2014, we hosted our first LSUHSC-NO IPE event and now, almost 10 years later, we are in our seventh year of TEAM UP COMPASSION, COMMUNICATION, COLLABORATION® (TEAM UP™), a two-year longitudinal interprofessional education experience integrated within the curriculum of all six LSU Health Sciences Center Schools for first- and second-year students.

IPE continues to evolve in dental education and, more importantly, in health professions education as a whole. IPE at LSUHSC-NO has moved forward and so has IPEC, which now represents 21 national health professions associations. Accrediting bodies have moved IPE forward by creating required interprofessional education standards for health professions programs.

I believe our students are learning to appreciate the value of IPE while in the dental education environment; however, I still see areas of need. I will mention two: 1) the value placed on IPE in our educational programs from a financial perspective, and 2) the extent to which our graduates’ knowledge and appreciation of IPE will translate to interprofessional practice (IPP) for the primary goal of improved patient care.

Regarding the value placed on IPE in our programs, most IPE programs/experiences/efforts are, from my viewpoint, the responsibility of faculty who have a personal interest in promoting IPE. But their efforts are basically voluntary. They contribute to the IPE effort because they believe it in, but many faculty spend time on IPE activities in addition to their already full-time workload. IPE, in many of our schools, is still viewed as a “soft skill.” So, the value of it isn’t easily assessed, as in the impact of compassion, or translated to an investment from a financial perspective. Even dedicated faculty who are volunteering to support IPE will burn out if time is not carved out of their schedules to accommodate their contribution. We need to give thought to how to best support the critical IPE effort for the person who stands to benefit most: the patient.

Regarding the translation of IPE into IPP: again, I think we have to be realistic about some challenges and I will speak to one—a public health challenge. Collaboration in dental schools is making progress. Dental and dental hygiene students in our health sciences centers are learning with students in so many other professional programs but leave school to practice primarily in small group or larger corporate practice environments. Though most will do their best to care for the overall health of their patients, the fact remains that one of the primary reasons that individuals miss work and children miss school is because of dental pain. And many of those individuals still go to the ER or urgent care centers for relief. How can the ever-changing health system address this issue from an IPP perspective? One approach would be to have oral health practitioners educating medical practitioners in the ER and the urgent care centers. We can teach our dental and dental hygiene students about IPE all day long, but if we truly care about impacting the overall health of the patient, we should give more thought to what we, as oral health practitioners, can do to educate the other health professional practitioners about oral health and disease.

Q.  In 2008, you were selected to receive special leadership training offered through the Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program for Women. How do you view the increase of women leaders in the health professions? What unique perspectives, if any, do you think you bring to dental education as a women leader?

How fortunate I was to receive the training from ELAM. But the truth is important, and the truth is: the timing was not best for me. Unfortunately, we were relocated because of Hurricane Katrina, as I mentioned earlier, and our lives were upside down; my experience was greatly encumbered by that. I tried my best to soak in what I could, but my mind and life were already soaked from the great flood. I wish I could go back now for a refresher. Not only could I learn more, but I also think that, now—this many years later—I would have a lot of practical experience to bring to the discussions.

To your question, how can one not view the increase in women leaders without saying, “YES, it’s about time! And why not women?” I see no downside to exemplary leadership—no matter the gender. Do women bring unique perspectives to dental education when in leadership roles? Of course, I think we would all agree they do. Do I believe I bring a unique perspective to leadership in dental education? Yes, there is no doubt in my mind that I do, and I say that with all humility.

I could go on and expound on the literature showing us what women bring to leadership roles. But we all know what those things are. I think that ship has sailed and the outcomes are notable. But what I can do is be perfectly honest and say that we need women leaders so that the following questions/statements are NEVER stated or asked again. Were these statements or questions ever spoken to or asked of me? Yes, these and more:

  • “Once a hygienist, always a hygienist. Why are you working so hard?” (As if being a hygienist was less than.)
  • “You do not need to be going back to school; you should be having babies.”
  • With regard to departmental raises being decided: “You’re married; your husband should be able to make enough money to take care of you.”
  • With regard to trying to attend an AADS conference: “There is no need for hygienists to attend the meetings.”
  • Then, when more hygienists were asking to attend: “Okay, you FOUR can go, but you have to share one room.” (While the men each had their own hotel rooms.)
  • “You are wasting your time getting that Ph.D., a hygienist will never have my job.”

And those are just a few. I could go on for days.

Do I think there remain issues in women’s advancement? Yes. What is it that I have always wanted as a woman in the workplace? Simple: Equal opportunity for selection for a position when I meet all the search criteria. Do I want to be chosen just because I am a woman, even if I have not earned the appointment? No. Putting a person in a role that he or she or has not earned or does not meet the criteria stated, just to check a box, is doing that person a disservice. I have always felt that way and continue to do so.

But I will end on the most positive note. Again, being at the same school for decades, I have taught so many dental students. Two leaders I work closest with every single day happen to be male dental students I once taught. They knew nothing other than having men and women as course directors and they grew up seeing this woman, me, advance in my career. That generation of men serving as leaders today can hardly believe the stories I tell them. They just respect any woman or man who earns their place.

Q. Which of your accomplishments in relationship to ADEA and/or dental education, in general, are you most proud of?

It’s always been hard for me to talk about my accomplishments. But with respect to ADEA, my favorite association in the entire world (as I always say), I have to speak up. I have to speak up because ADEA invested in ME. Being part of the leadership of the association that allowed me to grow as an individual and as a leader has been the gift that keeps on giving. I had no real mentor up to 1993 in dental education. I had colleagues I learned with, but we were all “in the same place,” so I had no guidance. I was on my own. Then, 15 years after I became a faculty member, a dean was hired that not only afforded me the opportunity to participate in AADS, but encouraged it. That was the turning point in my professional life and, quite honestly, something that impacted my personal life in so many amazing ways. I blossomed and I never looked back. My world expanded beyond anything I ever expected.

In general, I would say that I am proud of many things I have done—things that, to some, would be insignificant. I never considered myself very brave. I always stretched and reached to learn and do more, but I always held on tightly to the past. I needed that security. But it took all I had to be brave enough to run for Chair-elect of the ADEA Board of Directors. Recently, it took all I had to apply for the position of Vice Chancellor for Academic Affairs, a role I did not get. But I considered that effort a triumph because I was brave enough to try.

I am also proud of the way I have traversed my career. Mine was a slow journey, but it was a steady one and I always felt prepared for the next position. Some people are comfortable playing leapfrog as they move through their careers. I had to go step by step. But the fact is that I did keep moving forward and, all the while, maintained my self-respect. I have learned so much. I have met the nicest people and the best of friends and, I hope, made all those who held me up, in any way, proud. Regret isn’t worth much, but I would say to my younger self, “You are ready, you are capable, you are qualified—try the next thing sooner”. Had I done that, I would have squeezed more exciting things into this incredible life!!