RESUMEN
There is a continuing shortage of academic dentists due to myriad factors. However, each graduating class of dental students includes a select group who choose to explore academic positions. It is this group of potential academic dentists that a four-year R25 initiative, funded by the National Institute of Dental and Craniofacial Research, has targeted with the intent of increasing their numbers and mentoring them for success in a future faculty position. The aims of the program at the School of Dentistry, University of California, Los Angeles, are to target and recruit potential clinician-scientists and to design and implement an Academic Track (AT) that complements existing clinical and research training with the comprehensive skill set of pedagogical, organizational, and personal strategies necessary to be successful in an academic career. Recruitment to the AT targeted candidates from a variety of sources including those enrolled in the dual D.D.S./M.S. and D.D.S./Ph.D. programs, dental residents, Ph.D. candidates in other disciplines, and predental students. Through a variety of professional development activities in the AT, selected students receive teaching, leadership, and mentoring experiences. Outcomes and lessons learned related to specific activities and lessons learned are presented in this article, and a model that recognizes the diverse paths to an academic career in dentistry is recommended.
Asunto(s)
Docentes de Odontología , Mentores , Modelos Educacionales , Selección de Personal , Desarrollo de Programa , Selección de Profesión , Humanos , Liderazgo , Los Angeles , National Institute of Dental and Craniofacial Research (U.S.) , Evaluación de Programas y Proyectos de Salud , Facultades de Odontología , Enseñanza , Administración del Tiempo , Apoyo a la Formación Profesional , Estados UnidosRESUMEN
Several Archstone Foundation funded projects developed and implemented training curricula on elder abuse for mandated reporters such as dentists, adult protective services workers, paramedics, and coroner investigators. Common education and training issues emerged, including the need to provide basic content on normal aging and the need for creating standardized trainings. Strategies include integrating elder abuse and neglect content into existing courses, building relationships with stakeholders, and customizing content and delivery to student needs and preferences. Projects developed relevant, practice-based content, decided on curriculum delivery methods, engaged learners, and provided feedback to them. A main outcome is the permanent institution of elder abuse content in training curricula.
Asunto(s)
Abuso de Ancianos , Notificación Obligatoria , Anciano , Evaluación Geriátrica , Necesidades y Demandas de Servicios de Salud , Humanos , Modelos Organizacionales , Desarrollo de ProgramaRESUMEN
Dentists are in a unique position to detect elder abuse and neglect. Approximately 75 percent of all physical domestic violence results in injuries to the head, neck, and/or mouth area, clearly visible to the dental team during examinations and treatment. The goal of this project was to gather a comprehensive understanding of predoctoral dental students' perceptions of the culture of abuse and neglect and their level of fluency regarding their rights and responsibilities as mandated reporters. This article aims to inform dental educators of dental students' level of awareness of elder abuse and neglect in order to highlight content areas to be addressed in dental school curricula and clinical training. A twenty-four-item survey was administered to 291 predoctoral dental students at the University of California, Los Angeles School of Dentistry. The results are organized into three general areas: prior training and education; perceptions of the culture of abuse and neglect; and knowledge of mandated reporter legal responsibilities and protections. Overall, this study found that most students do not feel adequately trained to report a case of elder abuse. Data from this study suggest that dental students need education on the psychosocial aspects of older adulthood, as well as training in detecting and reporting elder abuse.
Asunto(s)
Abuso de Ancianos , Conocimientos, Actitudes y Práctica en Salud , Notificación Obligatoria , Estudiantes de Odontología , Anciano , Cultura , Curriculum , Educación en Odontología , Abuso de Ancianos/diagnóstico , Abuso de Ancianos/psicología , Humanos , Los Angeles , Encuestas y CuestionariosRESUMEN
As part of a U.S. Health Resources and Services Administration-funded evaluation of the impact of federal funding on postgraduate general dentistry programs, a random sample of 6,725 dentists graduating in 1989, 1993, and 1997 were surveyed regarding practice patterns, advanced training, populations served, services provided, and their position on a mandatory fifth year of training. Responses (1,965) showed 48 percent supporting a mandatory year and 52 percent not supportive. Open-ended comments were provided by 1,626 respondents. The main reasons for supporting a mandatory fifth year were the need for more instructional time and need for a transition year. Individual choice, no value in a fifth year of dental school, mentoring available elsewhere, and cost were cited in opposition. The following respondents were significantly more likely than other respondents to support a mandatory fifth year: individuals who had completed an AEGD, GPR, or specialty program; were Asian; held salaried positions in a community clinic, nursing home, or hospital; or described themselves as a consultant. Graduates in 1993 and 1997 were less supportive of a mandatory fifth year than were 1989 graduates. Significant differences in the reasons offered in support of respondents' positions on the issue were observed among AEGD, GPR, specialists, and nonspecialists and the three cohort years.
Asunto(s)
Actitud del Personal de Salud , Odontólogos , Educación en Odontología , Internado y Residencia , Programas Obligatorios , Estudios de Cohortes , Odontología Comunitaria , Intervalos de Confianza , Consultores , Costos y Análisis de Costo , Curriculum , Servicio Odontológico Hospitalario , Educación en Odontología/economía , Educación en Odontología/normas , Educación de Posgrado en Odontología , Etnicidad , Humanos , Internado y Residencia/economía , Internado y Residencia/normas , Modelos Lineales , Modelos Logísticos , Programas Obligatorios/economía , Programas Obligatorios/normas , Mentores , Análisis Multivariante , Casas de Salud , Oportunidad Relativa , Autoimagen , Estadística como Asunto , Estados UnidosRESUMEN
We compared the funding granted by the federal government between 1985 and 1997 to stimulate the growth of AEGD and GPR programs across HRSA regions, states, and populations. Information regarding the number, size, and location of programs available during the time period of 1985 to 1997 was collected. During this period, although the number of programs remained constant, the composition of the programs changed, with AEGD programs increasing by 113 percent and GPR programs decreasing by 13 percent. HRSA Regions 2, 3, and 5 combined offered over 50 percent of all programs. The number of residency positions rose by 28 percent in civilian programs and dropped by 11 percent in Veterans and Military (VA/M) positions. Overall growth in AEGD positions increased 208 percent, while the civilian GPR positions remained constant and the number of VA/M GPR positions dropped by 30 percent. A higher percentage increase in programs occurred in cities of greater than 500,000 population than in less densely populated areas. HRSA spent dollar 41,254,501 in the thirteen-year time frame, and funding by region varied by over a hundredfold. Programs in the least dense population groups were often the least funded. There was great variability in the amount of HRSA money received by state, with fifteen states receiving no funding during the thirteen years. Without HRSA dollars, it is apparent that the postgraduate general dental training program would not have gained the vitality it currently offers. However, attention must be paid to developing programs among states with a lack of infrastructure in dental education and training.
Asunto(s)
Educación en Odontología/economía , Financiación Gubernamental , Internado y Residencia/economía , Costos y Análisis de Costo , Odontología General/economía , Odontología General/educación , Humanos , Odontología Militar , Desarrollo de Programa , Asignación de Recursos/economía , Población Rural , Estados Unidos , United States Department of Veterans Affairs , United States Health Resources and Services Administration/economía , Población UrbanaRESUMEN
To address concerns about the growing shortage of dental educators, the UCLA School of Dentistry initiated an elective course to introduce fourth-year students to issues in academic dentistry and to provide an apprentice teaching experience. Participants in the elective (referred to as student teachers) developed a microcourse entitled "Welcome to Dental Anatomy," presented to incoming first-year students during orientation week. Under the guidance of faculty mentors, the student teachers were responsible for development of course content, teaching aids, and evaluation methodology. Two cycles of the elective have been completed reaching a total of twenty-one fourth-year students to date. The positive impact on student teachers and incoming first-year students indicates that this approach has great potential for encouraging more graduates to pursue careers in academic dentistry. In addition, the program has the potential to be expanded by adaptation to other foundational courses in the dental and dental hygiene curricula.
Asunto(s)
Educación en Odontología , Docentes de Odontología , Mentores , Estudiantes de Odontología , Enseñanza/métodos , Anatomía/educación , Actitud , Cognición , Curriculum , Retroalimentación , Predicción , Humanos , Aprendizaje , Los Angeles , Satisfacción Personal , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Estadística como Asunto , Materiales de Enseñanza , Recursos HumanosAsunto(s)
Atención Odontológica , Educación de Posgrado en Odontología , Odontología General/educación , Atención Primaria de Salud , Educación de Posgrado en Odontología/economía , Educación de Posgrado en Odontología/tendencias , Financiación Gubernamental , Odontología General/economía , Odontología General/tendencias , Humanos , Evaluación de Necesidades , Apoyo a la Formación Profesional , Estados UnidosRESUMEN
In 1999, HRSA contracted with the UCLA School of Dentistry to evaluate the postgraduate general dentistry (PDG) training programs. The purpose of this article is to compare the program characteristics of the PGD training programs sponsored by the Armed Services (military) and VA. Surveys mailed to sixty-six VA and forty-two military program directors in fall 2000 sought information regarding the infrastructure of the program, the program emphasis, resident preparation prior to entering the program, and a description of patients served and types of services provided. Of the eighty-one returned surveys (75 percent response rate), thirty were received from military program directors and fifty-one were received from VA program directors. AEGDs reported treating a higher proportion of children patients and GPRs more medically intensive, disadvantaged and HIV/AIDS patients. Over half of the directors reported increases in curriculum emphasis in implantology. The program directors reported a high level of inadequate preparation among incoming dental residents. Having a higher ratio of residents to total number of faculty predicted inadequate preparation (p=.022) although the model was weak. Although HRSA doesn't financially support federally sponsored programs, their goal of improved dental training to care for medically compromised individuals is facilitated through these programs, thus making military and VA general dentistry programs a national resource.
Asunto(s)
Educación de Posgrado en Odontología , Odontología General/educación , Odontología Militar/educación , United States Department of Veterans Affairs , Adulto , Distribución de Chi-Cuadrado , Niño , Atención Odontológica Integral , Factores de Confusión Epidemiológicos , Curriculum , Atención Dental para Niños , Atención Dental para Enfermos Crónicos , Atención Dental para la Persona con Discapacidad , Servicios de Salud Dental/clasificación , Servicios de Salud Dental/organización & administración , Implantación Dental Endoósea , Servicio Odontológico Hospitalario , Educación de Posgrado en Odontología/organización & administración , Servicios Médicos de Urgencia , Docentes de Odontología , Odontología General/organización & administración , Infecciones por VIH , Recursos en Salud , Humanos , Internado y Residencia/organización & administración , Modelos Logísticos , Odontología Militar/organización & administración , Evaluación de Programas y Proyectos de Salud , Estadística como Asunto , Estados Unidos , United States Department of Veterans Affairs/organización & administración , United States Health Resources and Services AdministrationRESUMEN
In 1999 HRSA contracted with the UCLA School of Dentistry to evaluate the impact of federal funding on postgraduate general dentistry programs. Part of that evaluation analyzed curriculum emphasis and preparation of incoming residents in advanced general dentistry programs over a five-year period. Directors of 208 civilian AEGD and GPR programs were surveyed about the curriculum content of their programs, increased or decreased emphasis in thirty subject areas, and resident preparation and quality (GPA and National Board scores). Results indicate that curriculum changes in AEGD and GPR programs over the time period have been responsive to the changing nature of general practice. At least half of all program directors reported that their residents were less than adequately prepared in fourteen curriculum areas. Sub-analyses were conducted for AEGD/GPR programs and HRSA-funded versus nonfunded programs. Multivariate regression identified lower student quality as the most important program variable in predicting a perceived need for resident remediation. Logistic regression showed that programs with higher resident GPA and National Board Part I scores had less difficulty filling resident positions.
Asunto(s)
Curriculum , Educación de Posgrado en Odontología , Odontología General/educación , Internado y Residencia , Adolescente , Anciano , Certificación , Distribución de Chi-Cuadrado , Niño , Preescolar , Competencia Clínica , Curriculum/tendencias , Cuidado Dental para Ancianos , Atención Dental para Niños , Atención Dental para Enfermos Crónicos , Atención Dental para la Persona con Discapacidad , Evaluación Educacional , Financiación Gubernamental , Predicción , Humanos , Seguro Odontológico , Modelos Logísticos , Análisis Multivariante , Evaluación de Programas y Proyectos de Salud , Educación Compensatoria , Estados Unidos , United States Health Resources and Services AdministrationRESUMEN
U.S. civilian (non-VA/non-military) Advanced Education in General Dentistry (AEGD) and General Practice Residency (GPR) programs were identified (n=208) and surveyed. The assessment evaluated infrastructure support, populations served, services provided, and trainee stipends. One hundred thirty-one programs responded (thirty-two AEGD, 64 percent/ninety-nine GPR, 63 percent). Sixty-nine programs were HRSA-funded (53 percent), and sixty-three (47 percent) were nonfunded. One hundred and five responses identified hospital/medical center resources; fifty-six indicated dental school support. Mean faculty support was similar regardless of program type or HRSA funding. Mean first-year positions in AEGDs were greater than GPRs. Mean first-year GPR positions were greater in funded than in nonfunded programs. A comparison of AEGD and GPR programs showed that residents in GPRs treated more children, medically intensive, economically/socially disadvantaged, and in-patient/same-day surgery patients (p<0.05). Residents in AEGDs treated more healthy adults (p<0.05). GPRs treated more lower fee (no pay, Medicaid, welfare/general relief, Medicare, and capitation/HMO) patients. AEGDs treated more insurance/private pay patients (p=.0001). No differences existed in comprehensive care and emergency visits between AEGDs and GPRs. GPRs treated more hospital-based patients. The mean stipends for GPRs ($32,055) and AEGDs ($22,403) were different.
Asunto(s)
Educación de Posgrado en Odontología , Odontología General/educación , Adulto , Procedimientos Quirúrgicos Ambulatorios , Distribución de Chi-Cuadrado , Niño , Atención Dental para Niños , Atención Dental para Enfermos Crónicos , Servicios de Salud Dental/clasificación , Servicio Odontológico Hospitalario , Educación de Posgrado en Odontología/economía , Docentes de Odontología , Financiación Gubernamental , Odontología General/economía , Recursos en Salud , Hospitalización , Humanos , Seguro Odontológico , Internado y Residencia/economía , Asistencia Médica , Facultades de Odontología , Clase Social , Estadísticas no Paramétricas , Apoyo a la Formación Profesional , Atención no Remunerada , Estados Unidos , United States Health Resources and Services Administration/economíaRESUMEN
This study compares the practice patterns of general dentists with and without formal advanced training in AGED or GPR programs. The UCLA School of Dentistry surveyed a random selection of dentists from graduating years 1989, 1993, and 1997 as part of a Health Resources Services Administration (HRSA)-supported evaluation of the impact of federal funding on postgraduate general dentistry (PGD) programs. Using a sample drawn by the American Dental Association (ADA), 6,725 dentists were surveyed about their practice, advanced training, patients served, and services provided. Of the 2,029 dentists (30 percent) who responded, 49 percent were practicing dentists with no formal advanced training in general dentistry or one of the eight ADA specialties; 7 percent had Advanced Education in General Dentistry (AEGD) experience; 20 percent trained in a General Practice Residency (GPR); and 24 percent were specialists. Additionally, 7 percent of respondents had PGD training and a clinical specialty. GPR-trained dentists were significantly more likely to be on a hospital staff and to treat medically compromised patients even after ten years of practice. PGD dentists were less likely to seek specialty training. Major reasons for seeking PGD training were increasing treatment speed, learning to treat medically compromised patients, and wanting hospital experience. Primary reasons for not selecting training were starting a practice and having a great practice opportunity. Our conclusion is that PGD training has an enduring impact on practice patterns and improves access to dental care for underserved populations.
Asunto(s)
Educación de Posgrado en Odontología/estadística & datos numéricos , Odontología General/estadística & datos numéricos , Pautas de la Práctica en Odontología/estadística & datos numéricos , Análisis de Varianza , Selección de Profesión , Distribución de Chi-Cuadrado , Estudios de Cohortes , Atención Dental para Enfermos Crónicos/estadística & datos numéricos , Educación de Posgrado en Odontología/economía , Femenino , Financiación Gubernamental , Odontología General/economía , Humanos , Masculino , Grupos Minoritarios/estadística & datos numéricos , Administración de la Práctica Odontológica/estadística & datos numéricos , Mecanismo de Reembolso/estadística & datos numéricos , Factores Sexuales , Encuestas y Cuestionarios , Estados Unidos , United States Health Resources and Services AdministrationRESUMEN
This study compares differences by gender in the practice patterns and professional activities of general dentists, specialists, and dentists with Advanced Education in General Dentistry (AEGD) or General Practice Residency (GPR) training. The UCLA School of Dentistry surveyed a random sample of 6,725 dentists graduating from dental school in 1989, 1993, and 1997 as part of an evaluation of the impact of federal funding on postgraduate general dentist (PGD) programs. The survey asked about current practice, services referred and provided, and professional activities. Of the 2,029 dentists (30 percent) who responded, 49 percent were general dentists with no specialty training; 7 percent had AEGD training; 20 percent had GPR training; and 24 percent had specialty training. General dentists were more likely to be in private practice (p < 0.05). AEGDs, specialists, and females were more likely to report faculty positions as a secondary occupation. General dentists were more likely to be practice owners than AEGD- or GPR-trained dentists. The mean number of patients seen was highest for specialists. Females reported fewer patients than males, and this difference was significant for GPR-trained dentists. With respect to services, GPR-trained dentists reported significantly more biopsy procedures, conscious sedation, periodontal surgery, and implants than general dentists. AEGD-trained dentists reported more conscious sedation than general dentists. GPR dentists were more likely to volunteer time than general dentists without specialty training. PGD training appears to result in different types of employment and specific practice patterns that strengthen primary care dentistry. We further conclude that there are gender differences in the types of practice, patients seen, and services provided. These findings occur in addition to training differences.