Community-based education and attitudes and behavior related to underserved patients

Objectives:  The US Surgeon General Report on Oral Health from the year 2000 showed that certain groups of patients in the US face challenges when seeking dental care services. The objectives were to explore how dentists who graduated before 2001 vs. after 2001 differ in (a) evaluations of the role of community-based education for their clinical practice, and (b) attitudes and behavior related to treating underserved patients.

Methods: Data were collected with web-based surveys from 267 alumni/ae of a Midwestern dental school. One third graduated before 2001 (= older cohorts) when community-based education was largely unstructured, and the other respondents graduated after 2000 when a well developed community-based outreach program was in place.

Results: The evaluations of community-based dental education of older cohorts differed significantly from the evaluations of younger cohorts. For example, younger cohorts were more likely to agree that they preferred treating patients in outreach clinics compared to dental school clinics (5-point scale with 1=disagree strongly: 3.15 vs. 3.73; p<.001), that they improved their clinical skills in the outreach clinics (3.62 vs. 4.28; p<.001), and that they were exposed to different techniques and materials in the community clinics (3.45 vs. 5.04; p<.001) than older cohorts. Younger cohorts also had a more positive attitude concerning how the community-based education had shaped their professional behavior concerning treating underserved patients, and had a more positive attitude towards treating  patients on Medicaid (3.00 vs. 2.17; p<.001) than older cohorts. Younger cohorts were more likely to treat patients on Medicaid (52% vs. 15%; p<.001) and with developmental disabilities (7% vs. 4%; p<.001) than older cohorts.

Conclusions: Well structured community-based education can introduce future dentists to providing care for underserved patients and thus shape their attitudes and professional behavior concerning  underserved patients such as patients with SHCN, on Medicaid or from socio-economically disadvantaged backgrounds.