Poster Sessions: Poster Abstracts - Journal of Dental Education

206 Journal of Dental Education ■ Volume 68, No. 2

Poster Sessions: Poster Abstracts

BLOCK I, Monday, March 8

12:00 noon to 1:30 pm

1. Dental School Websites: A Follow-Up Study

Callie, Vassilakis, UMDNJ-New Jersey Dental School, Panagakos,Fotinos, UMDNJ-New Jersey Dental School, Mina, Ranzurmal,UMDNJ-New Jersey Dental School, DeCastro, Jeanette, UMDNJ-New Jersey Dental School

Purpose: In 2000, we conducted a review of U.S. dental schoolwebsites to determine the presence of key “student-related” content.This work was presented at the 2001 ADEA Annual Session. Thispast summer we proceeded to repeat the evaluation of dental schoolwebsites using the same criteria and compared the results obtainedin 2003 with the results obtained in 2000. Our hypothesis was thatdental schools would have improved the offering of “student-related”content over the past 36 months.

While the Internet’s role as a critical communication tool forschools of higher education has grown, so does the importance ofmaking the right information accessible to students, whether current,incoming, or prospective. In 2000, our group evaluated the qualityand quantity of “student-related” content present on U.S. dental schoolwebsites. The University of Puerto Rico website was not evaluateddue to language limitations of the student researcher. An assessmentlist was developed based on the topics available for students on fivedental school websites. A dental student used this list to survey U.S.dental school’s websites. Among the items evaluated were:accessibility (number of clicks) of the dental school page from theuniversity’s main page; the availability of links for prospective,incoming, and current students; and links for other departments suchas financial aid or administrative departments within the dental school,class pages, course catalogs, student handbook-type information,school calendars, class schedules, lecture notes, and syllabi. Alongwith the quality and quantity of information presented, the studentalso rated the sites for ease of navigability. In 2000, while there wasnear uniformity in the presence of a few items, there was definiteinconsistency in the existence of links for current students and mosttopics and in the type of links that had access restricted by passwords.In 2003, the same survey was repeated. The results from this repetitionindicated that there was improvement in the overall quality andquantity of the websites posted by dental schools. The informationpresented on these sites was more comprehensive and addressed theneeds of all three student groups: current, incoming, and prospective.

In summary, our study from this past summer, when comparedto the results obtained in 2000, indicates that schools have improvedthe quantity and quality of “student-related” content on their websites.It is expected that this trend will continue, as the use of the web as acritical means of communicating with current and prospective studentswill only increase in importance in the future.

2. Career Plans of Dental Hygiene Students

Solly, Jennifer, East Tennessee State University, Barnes, W. Gail, EastTennessee State University

Purpose: To ascertain the career plans of dental hygiene seniorsenrolled in a small program in the Southeast.

The last journal article you read could alter your opinion of adental hygiene shortage. Is there a shortage, or do dental hygienestudents have career aspirations other than working in a general dentaloffice? To determine the career aspirations of senior dental hygienestudents, a survey was developed and administered to summer 2003registrants (N=26) via a course’s assessment section of a Blackboardsite. The survey consisted of sixteen items, qualitative open-endedquestions, and closed-ended questions. The data sample consisted of

sixteen usable responses (62 percent response rate). Students wereinstructed to logon to the Blackboard site and complete the survey.Blackboard provided an analysis for the survey, which included themean and a list of the qualitative responses. The results indicatedthat the students’ five to ten-year career plans after graduation wereto “work in a private/group dental practice” (88 percent) and tobecome “employed as a dental sales representative” (38 percent).Becoming an “educator in a dental hygiene program” and “other”were the career plans for 19 percent of the respondents. The qualitativeresponse for “other” category included working as a volunteer with amission agency and earning a dental degree. Only 25 percent of therespondents planned to pursue another degree after graduation. Ofthose mentioned, the most prevalent degree was a masters degree(44 percent). Sixty-three percent of the respondents indicated thatthey would consider a Dental Hygiene Masters Online degreeprogram. However, only 13 percent stated they would “not consideran online masters program.” Their qualitative response indicated thatthey did not feel “you get the attention needed to succeed in theprogram.”

According to the result of the present study, the Class of 2004at this southeastern dental hygiene program aspires to work in thetraditional dental setting. Unfortunately, few aspire to further theireducation to become dental hygiene educators, which is a professionthat is truly experiencing a paucity of qualified applicants.

3. Comparison of Examinations Required for DentalLicensure in Japan and the United States

Komabayashi, Takashi, University of California, San FranciscoSchool of Dentistry, Bird, William, University of California, SanFrancisco School of Dentistry

Purpose: To illustrate the differences of examinations requiredfor dental licensure in Japan and the United States.

Materials and Methods: Guides for candidates, old examreprints, and other published data for Japan National Examinationfor Dentists (JP-NED) and U.S. National Board of DentalExamination (US-NBDE) were used for statistical analysis of examspecifications including timetables and outlines to be licensed. Resultsand Discussion: Dental education in Japan consists of a six-yearprogram, including liberal arts for undergraduate level after highschool graduation, while the U.S. counterpart is usually a four-yearprogram at graduate level after bachelor degree. JP-NED, whichconsists of 330 questions for 600 minutes, is a single all-importanttest that immediately grants dental licensure to practice dentistry allover Japan. No examination to evaluate technical skills is currentlyoffered in Japan. On the other hand, the US-NBDE, which consistsof 900 questions for 1,050 minutes in Parts I and II total, is acomponent of licensure. A technical skill exam, such as the state board,is required to practice within a state. Due to the differences in licensuresystems in two countries, for example, questions in JP-NED are moreemphasized on clinical applications, while those in US-NBDE aremore focused on basic sciences and clinical reasoning. For instance,there are 400 test items in US-NBDE Part I; however, the number oftest items equivalent in JP-NED is thirty, about one-thirteenth of thosein US-NBDE.

Outcomes of this study are important to help comprehendinternational comparison of standards and useful implications forcurriculum development in U.S. dental programs for foreign dentists.

4. Treating Disadvantaged Patients in the Future:Analyzing Dental Students’ Behavioral Intentions

Larson, Craig, University of Michigan School of Dentistry, Bagramian,Robert, University of Michigan School of Dentistry, Inglehart, Marita,University of Michigan School of Dentistry

February 2004 ■ Journal of Dental Education 207

Poster Sessions: Poster Abstracts (cont.)

Purpose: To explore which first- and second-year dental studentsintend to treat disadvantaged patients once they enter the dentalprofession.

In the year 2000, the U.S. Surgeon General published the firstever report on oral health. This report pointed to the importance ofproviding dental care to underprivileged and special needs patients.The objective of this research project was to explore which factorsdetermine whether first- and second-year dental students intend totreat these patients once they enter the dental profession.Questionnaire data were collected at the end of the first and secondyear of dental school from 101 dental students. The results showedthat women (N=49) intend more strongly than men (N=51) (meanson 5 point scale: women 4.31 vs. men 4.02; p=.10) and non-whitestudents (N=28) more strongly than white students (N=72) (non-whitestudents 4.64 vs. 3.97; p=.000) to treat underserved patients in theirprofessional life. The more the students intend to treat underservedpatients, the more they agree that: they have a great education at theUniversity of Michigan (r=.28; p=.004); they are well prepared fortheir professional life (r=.34; p=.001); community service learningis a valuable part of their education (r=.37; p=.000); they like thedental profession because they want to treat patients (r=.41; p=.000);they like to interact with patients from different backgrounds (r=.55;p=.000); and they will volunteer their services to underserved patientsin the future (r=.50; p=.000).

This research shows that dental students differ in the degree towhich they intend to treat underserved patients once they enter theirprofessional lives. Furthermore, the more students plan to treatunderserved patients, the more interested they are in patient-centeredcare.

5. The Effect of Problem-Based Learning on Students’Attitude Toward Teaching and Learning

Kim, Min Kang, Seoul National University College of Dentistry, Lee,Jae Il, Seoul National University College of Dentistry, Kim, KackKyun, Seoul National University College of Dentistry

Purpose: To examine whether the experience of problem-basedlearning changes students’ attitude toward teaching, learning, andassessment.

Perry’s model (Perry, 1970) has been admitted as the mostconvincing theory that conceptualizes the development of collegestudents. According to his model, college students move from adualistic (right versus wrong) view of the universe to a morerelativistic view. Moreover, students in higher positions can formrules to develop reasonable and likely solutions through their ownindependent thought rather than depending on the instructor. Thisstudy was conducted to examine whether PBL could change students’attitude toward their learning and encourage their independentthought. Second-year prep students (N=112, eight students in eachof fourteen groups) participated in the PBL course, which was aimedto introduce generals of dental medicine. During the course, studentshad to find out their own learning issues of and discuss their findingswith other students. At the end of the last tutorial of each case, studentsshould write journal and fill out self assessment forms. Those materialswere designed to facilitate the students’ reflection on their ownlearning and problem solving. Especially, Learning EnvironmentPreference (LEP) test (eighty-five items, five areas=contents ofteaching, role of teacher, role of student, instructional method,assessment method) was conducted before and after the course inorder to measure students’ attitude change. The data demonstratedthat there was significant difference between pre- and post-test(p<.05). Examination of the score of each area reveals that morestudents think that not all knowledge taught in class is absolutelyright. Also, their perception of the role of teacher and student slightlychanged. That is, more students think the professor is one who helps

students’ own problem solving, and they prefer diversity of learningtask.

Those results show that PBL encourages students to movebeyond their current positions in Perry’s development model. Suchgrowth is necessary to be a good professional and should beencouraged through proper learning environment of dental school.Consequently, the curriculum of dental school should provide studentswith various learning experiences, especially including self-directedlearning, discussion, or writing.

6. Assessment of PREPassistant and Class IIPreparations

Lamb, Daniel, Case Western Reserve University School of Dentistry,Price, Erin, Case Western Reserve University School of Dentistry,Kacer, Kurtis, Case Western Reserve University School of Dentistry,Nelson, Jasinevicius, T. Roma, Case Western Reserve UniversitySchool of Dentistry, Jasinevicius, T. Roma, Case Western ReserveUniversity School of Dentistry

Purpose: The PREPassistant (KaVo Germany) uses patterns oflight to scan intra- and extra-coronal preparations and restorationsand reformats the information into a 3-D image. It is marketed as atool for objective grading in dental education. The goal of this projectwas to determine whether the PREPassistant (PPA) accurately scansintracoronal preparations. The specific aims were to determine 1)whether there were differences between an “Instructor” scan and“Students” scans, and 2) if the scans were affected by axial depth(AxD), gingival depth (GvD), walls of the proximal box (DCW),width of the proximal box (BXW), and positioning/repositioning ofthe preps in the template.

Methods: Sixteen Class II (MO) preparations on typodont tooth#19 (KaVo America) were prepared. Only the proximal box differed:depth (1 mm, 2 mm), facial/lingual width (3mm, 4mm), wallangulations (divergent, convergent), and axial depth (1mm, 2mm).The sixteen preps were scanned ten times (n=160) resulting in“Student” scans (SS). Half were removed and then reinserted intothe template prior to scanning; the others were not removed betweenscans. An additional scan of each prep was used as the “Instructor”scan (IS). Scans were assessed for ghosting and artifacts prior to theplacement of the two evaluation planes: mesial/distal (MD) planeand facial/lingual (FL) plane through the proximal box. The planeswere chosen in areas where ghosting (voids in the 3-D image) andartifacts were minimal. On each plane, six points, three distances,and three angles were arbitrarily selected to evaluate the scans. ThePPA software records the difference (mm or degrees) between IS andSS. Results: One preparation was eliminated due to improperpositioning in the template, resulting in the final evaluation of fifteenpreparations of ten scans each (n=150). The measurements obtainedbetween the IS and SS scans varied. The designated points on theMD plane of the occlusal floor varied from the IS the least (meandifference of 0.043 ± 0.037 mm, range 0.00 – 0.11 mm), while theaxiofaciogingival point of the SS varied from the IS the most (meandifference of 0.067 ± 0.048 mm, range 0.00 – 0.29 mm). Majordifferences in the positions of the six distances and angles of IS andSS were also found. For example, the mean difference between theIS and SS for the axial box depth was 0.09 ± 0.10 mm (range 0.00 –0.38). The results of stepwise regression suggest that the above axialbox depth differences were significantly (p<0.001) influenced byAxD, GvD, DCW, BXW.

Extracoronal preparations (which were evaluated in anotherstudy by the authors) appeared to scan completely (without ghosting);however, the 3-D images of the intracoronal preparations in this studywere often incomplete with artifacts and ghosting. While thePREPassistant can be used for crown and onlay preps, at this time itis of limited use for the objective grading of Class II preparations.



7. Qualities of a Good Teacher: The Dental StudentPerspective

Shih, Weilin, University of California at Los Angeles School ofDentistry, Talwar, Diya, University of California at Los AngelesSchool of Dentistry, Hsiao, Grace, Ryn, Karen E., University ofCalifornia at Los Angeles School of Dentistry

Purpose: To explore the factors that dental students considerimportant in making a faculty member an effective teacher.

A teaching skills survey with questions pertaining to didactic,bench, and clinical instructor characteristics was given to second-,third-, and fourth-year UCLA dental students. Students were askedto rate the importance of several teaching traits within the above threecategories on a scale of 1 to 4. Completed surveys were returned by167 of the 277 full-time dental students surveyed (60 percent). Studentresponse rates were: fourth years, thirty-nine of ninety-two (42percent); third years, forty-nine of ninety-seven (51 percent); secondyears, seventy-nine or eighty-eight (90 percent). Data from all dentalstudents, independent of year and gender, showed that basic lecturingskills were most important for didactic teaching, effectivedemonstration of procedures was most significant for benchinstruction, and punctuality/availability was most needed for clinicalteaching. Data organized by year independent of gender showed thatsecond-, third-, and fourth-year students felt basic lecturing skills(audibility, visibility, and language) were the most important didacticskills and perceived effective demonstration of procedures to be themost important bench instructor skills. There were, however,differences between classes regarding clinical instructor skills:second-year students perceived the most important teaching skill tobe effective demonstrations, third-year students perceived appropriateallocation of time among students as most significant, and fourth-year students believed punctuality and availability were key. Datacollapsed by gender independent of year showed that, for didacticteaching skills, both males and females felt basic lecturing skills werethe most important aspect. For bench instruction, both males andfemales rated effective demonstration of procedures the highest. Forclinical instruction, male and female responses differed. Both malesand females believed punctuality/availability was most important,but females felt constructive feedback and criticism were equallyimportant to excel. The most significant gender difference was seenin the second-year class, regarding the importance of effectivedemonstration of procedures in the preclinical lab (t=2.003).

In conclusion, students consider different teaching skillsimportant depending on the academic setting, year in school, andgender. Instructors must recognize these differences in order tomaximize effective teaching.

8. ADEA Council of Faculties Review of Promotion andTenure Documents to Identify Content of ExpandedScholarship

Rockwood, Jeffrey, University of Missouri-Kansas City School ofDentistry, Killip, John, University of Missouri-Kansas City Schoolof Dentistry, Haden, Karl, American Dental Education Association,Overman, Pam, University of Missouri-Kansas City School ofDentistry

Purpose: To evaluate U.S. dental school promotion and tenurestandards on the basis of Boyer’s expanded definition of scholarshipand identify and extract wording that will ultimately contribute tothe development of a model promotion and tenure document by theCouncil of Faculties in conjunction with the Council of Deans andrepresentatives from the American Association for Higher Education.

Method and Materials: Literature review of promotion andtenure documents from forty-eight dental schools and subject-relatedjournal articles. Discussion: The previously reviewed promotion and

tenure documents from forty-eight of the fifty-five U.S. dental schoolswere categorized into “Boyer” and “non-Boyer” types. The fifteendocuments that were found to include expanded Boyer principles forfaculty roles and reward programs were further reviewed, and specificphrases and wording were extracted and placed within Boyer’s newlydefined headings: The Scholarship of Teaching and Learning,Discovery, Integration, and Community Engagement. This poster willillustrate examples that may be used in the development of a modelpromotion and tenure document for possible adoption by dentalschools throughout the nation.

The specific passages that include Boyer principles taken fromthe fifteen promotion and tenure documents show the paradigm shiftthat is taking place throughout the community of higher education. Itis anticipated that this trend will eventually facilitate a shift in thedental education community.

9. Using GIS to Educate Policymakers About DentalWorkforce Issues

Krause, Denise, University of Mississippi Medical Center, Mosca,Nicholas, Mississippi State Department of Health

Purpose: To share experience with Geographic InformationSystem technology in the analysis of state population-level dentalworkforce information for policymakers.

State policymakers have been faced with the worst budget crisesin years and will continue to face budget shortfalls that could diminishfunding to state-funded dental and dental hygiene programs. Statelegislators will need informative data on the state’s health workforcewhen making policy decisions about educational needs and objectives.Such data should be presented clearly for maximum effectiveness.Geographic Information Systems (GIS) technology is useful fordeveloping dental workforce profile information for policymakers.GIS provides graphical representation of data contained in underlyingdatabases and presented in the form of presentation-quality maps.This poster reviews how GIS was used to present workforce profileinformation to the Governor’s Task Force on Oral Health inMississippi in July 2003. Multiple data sets were coded and mappedusing ESRI geospatial analysis. A survey assessment of task forcemembers concluded that GIS was an effective approach to presentingdental workforce analysis information. Geographic informationsystems will be presented that include: high/mid/low distributions ofMississippi dentists by county and shifts of the dental workforce overfour decades; population-to-dentist ratios by county and shifts overtime; distribution of the dental workforce in relation to children livingin poverty; and how dental professional shortage areas (DHPSAs)can be reported graphically and the distribution of dental schoolgraduates into these areas.

GIS provides very informative and visual presentations of thedental workforce that improve the understanding of policymakersabout dental workforce issues.

10. Dental Hygienists’ Oral Cancer Knowledge andScreening Practices

Bailey, Meredith, Case Western Reserve University School ofDentistry, Pyle, Marsha, Case Western Reserve University School ofDentistry, Vendemia, Maureen, Youngstown State University, Sawyer,Danny, Case Western Reserve University School of Dentistry

Purpose: To determine oral cancer knowledge and screeningpractices of U.S. dental hygienists.

The oral cancer knowledge and screening practices of dentalhygienists are important factors impacting the diagnosis of risks anddisease. A mail survey including demographic and practiceinformation and a ten-item knowledge questionnaire of oral cancerfacts were sent to 2,000 licensed dental hygienists. Thirteen responses



were returned undeliverable, while 575 completed surveys werereturned for a response rate of 29 percent. A similar survey had beencompleted in a sample of 171 Midwestern dentists previously. Mosthygienists held associate degrees, worked in one general practiceoffice, and were nonsmokers. Fifty-three percent complete head andneck soft tissue examinations on all patients, and 50.6 percent do theexams either once per year or at each recall visit. The longer ahygienist was out of school, the more likely they were to perform ahead and neck examination (x2 = 35.6, p = 0.002). A majority ofrespondents select patients for oral soft tissue exam on criteria suchas age, tobacco, and alcohol use. Seventy-six percent of respondentsask patients about tobacco use, while only 47.8 percent ask aboutalcohol use. Only 31.6 percent counsel patients about alcohol use,and 82 percent report counseling tobacco users. Seventy-three percentfelt it was important to offer tobacco cessation information ormedication to patient users; however, 79 percent of respondentsworking in one office report that cessation information and productsare not offered. The average score on knowledge items was 58.6percent with a range of 0 to 90.9 percent. Hygienists who graduatedin the last three years had the highest scores compared to previousgraduates by decade (p=0.025). Only one respondent correctlyidentified all risk factors for the development of oral cancer. Yet theirscores were higher than a sample of dentists responding to the samesurvey. Hygienist tobacco use was associated with less likelihood tovalue providing cessation products and information to patients(x2=9.4, p=0.009), and the more important the value of providingproducts and information to patients, the more likely hygienists wereto complete head and neck examinations (x2=35.1, p<0.001).

This information is important for dental and allied educatorswho may modify curricula to place greater emphasis on screeningand prevention information for both tobacco and alcohol use.

11. Evaluation of Junior Dental Students as PreclinicalFaculty in Occlusion

Nimmo, Arthur, University of Florida College of Dentistry, Mitchell,Gail, University of Florida College of Dentistry, Penfield, Randall,University of Florida College of Education, Hall, Alana, Universityof Florida College of Dentistry

Purpose: To mentor students as future academicians, providehigher learning experiences for student teachers, and determine thefeasibility of using junior dental students as instructors for a preclinicaldental course in occlusion.

Dental schools will need to be innovative in their educationalmethodologies at the same time they are facing a shortage of facultymembers. One possible approach would be to utilize junior dentalstudents as faculty in the preclinical courses. In the summer term of2003, two students completing the junior year (3DN) along with fivefull-time faculty were assigned as faculty for the DEN 5213Fundamentals of Occlusion preclinical course. This course haspreviously been conducted with a total of seven full-time faculty fora first-year class (1DN) of eighty students. Two types of outcomeassessment were accomplished: 1) standardized evaluation by the1DN students of full-time faculty and student teachers using a 1 (poor)to 5 (excellent) scale, and 2) a brief survey of student teachers usinga scale of 1 (most negative) and 5 (most positive). The overall meanvalues from the 1DN evaluation of faculty were 4.18 for full-timefaculty and 4.53 for student teachers. The difference observed in thesample means was found to be statistically significant at α = 0.05using an independent samples t-test. The two student teacherscompleted a survey about their experience. Means were determinedfor the following questions: 5.00 for the overall experience, 5.00 foracceptance by the 1DN students, and 4.00 for acceptance by full-time faculty. An increased interest in an academic career was noted.Both respondents found their student teaching experience to bepositive.

The utilization of junior dental students as preclinical facultyin occlusion appears to be a viable approach to mentor students incareers in academics, provide student teachers with higher learningexperiences, and supplement the efforts of full-time faculty.

12. Effects of Dietary Supplements on Oral Health

Collins, Jake, University of Missouri-Kansas City School of Dentistry,Glaros, Alan, University of Missouri-Kansas City School of Dentistry,McQueen, Cydney, University of Missouri-Kansas City School ofDentistry

Purpose: Dietary supplements are substances with minimalregulations by the FDA and are presumed to have beneficial healtheffects. However, supplements may complicate dental treatmentbecause of their side effects and interactions with other drugs andsupplements. The goal of this study was to assess supplement use inpatients presenting to a dental school clinic and to determine theincidence of oral and general physical health problems in thesepatients.

Dietary supplements are substances with minimal regulationby the FDA and are presumed to have beneficial health effects.Supplements may complicate dental treatment because of their sideeffects and interactions with other drugs. People who use supplementsmay have a higher probability of various oral and non-oral side effects.Method: 216 patients at the University of Missouri-Kansas CitySchool of Dentistry completed a questionnaire assessing supplementuse, demographic characteristics, and other medication use. Dietarysupplements surveyed were those with known or possible effects onoral tissues or physical systems that could impact dental care.Information regarding oral and general physical health was obtainedfrom their records. The sample was split into those who currentlyused and those who never used dietary supplements; t-tests were usedto examine differences between the groups. Results: 36.7 percent ofthe sample used one or more dietary supplements. Of the thirty-fiveproducts surveyed, the following were taken in decreasing frequency:garlic, glucosamine, ginko biloba, echinacea, ginger, ginseng,chamomile, and chondroitin. Users did not differ from nonusers inage, education, gender, ethnic/racial category, or income. However,users were significantly more likely to be taking prescription drugsas well as supplemental vitamins and minerals than nonusers. Userssignificantly differed from nonusers in the number of non-oralsystemic conditions, but did not differ on oral effects.

There is no evidence that the dietary supplements taken by thissample of patients affected their oral health. However, the proportionof patients using dietary supplements was considerable, and thosewho used dietary supplements also had higher rates of prescriptiondrugs, vitamins, and mineral use. Providers need to be aware of naturalproduct use in patients and to assess the likelihood of interactions inthose taking dietary supplements and prescription medications.

13. Final Impressions for Complete DentureProsthodontics

Robl, Megan, University of Missouri-Kansas City School of Dentistry,Petrie, Cynthia, University of Missouri-Kansas City School ofDentistry, Walker, Mary, University of Missouri-Kansas City Schoolof Dentistry, Williams, Karen, University of Missouri-Kansas CitySchool of Dentistry

Purpose: To survey members of the American College ofProsthodontists and department chairs of prosthodontics in the NorthAmerican dental schools regarding the materials and methods usedfor final impressions of complete dentures.

Materials and Methods: A questionnaire was sent to all 1,762active members and fellows of the American College ofProsthodontists (ACP) and to all fifty-four dental schools in North



America. The participants were asked to answer a short series ofquestions regarding the materials and methods they use for finalimpressions for complete denture prosthodontics. Results: Thirty-nine of the fifty-four dental schools (72 percent) returned thecompleted questionnaires, whereas 528 of 1,762 questionnaires sentto the ACP members (30 percent) were returned. Both preliminaryand final impressions are usually performed by 94.9 percent of thedental schools and by 93 percent of the prosthodontists. For the finalimpression, a custom tray is used by the majority of dental schools(92.3 percent) and by 91.7 percent of the prosthodontists. Modelingcompound is the most popular material used for border moldingprocedures for a complete denture by dental schools (94.9 percent)and by prosthodontists in practice (66.9 percent). For the finalimpression of a complete denture, polysulfide and polyvinylsiloxanewere the materials used most often. Polysulfide is used by 66.1 percentof the dental schools and 32.2 percent of the prosthodontists.Polyvinylsiloxane is used by 25.6 percent of the dental schools and37.5 percent of the prosthodontists.

Overall, there appears to be a close correlation between themethods and materials taught in the dental schools for finalimpressions for complete denture prosthodontics and those utilizedby prosthodontists in practice.

14. Development and Evaluation of a PediatricDentistry CE Course for Pediatricians and Dentists

Nickoles, Eleisha, West Virginia University School of Dentistry,Gangaram, Balram, West Virginia University School of Medicine,Hornbrook, Robert, West Virginia University School of Dentistry,Ngan, Stanley, West Virginia University School of Dentistry, Wearden,Stanley, West Virginia University School of Medicine, Kohli, Kavita,Columbia University School of Dental and Oral Surgery, Crout,Richard, West Virginia University School of Dentistry

Purpose: The purpose of this joint West Virginia UniversitySchools of Dentistry and Medicine research project was to developand evaluate a pediatric dentistry CE course for pediatricians anddentists.

Early childhood caries continues to be a problem in WestVirginia. Since it has been suggested that pediatricians may be ableto help in this area, a needs assessment was sent out to all thepediatricians in our state. Results of those responding indicated thatthere was a considerable need for updated information with 85 percentbeing interested in participating in a proposed CE course (JDR2002;81:103). Methods included the development of a full-day CEcollaborative course with the Department of Pediatrics entitled“Pediatric Oktoberfest: Current Topics in Child Oral Health.”Presentations included overall pediatric dentistry information as wellas pediatric periodontal, orthodontic, oral pathological considerations,along with identifying potential effects of the mother’s oral health onher baby. Evaluations included the administration of a twenty-sixitem pre-test of which eleven were Likert style followed by anidentical post-test. The questions included items such as knowledgeof fluoride levels and the time for a child’s first dental visit, whichwere covered in the presentations. The Office of Continuing MedicalEducation (CME) also conducted a separate evaluation. Resultsrevealed that ninety-four attended, including thirty-three physicians,twenty-eight dentists, eleven hygienists, nine nurses, practical nurses,or nurse practitioners, and ten students. Of those responding, sixty-four (68 percent) submitted pretests followed by fifty-two (55 percent)providing posttests. Information increased with six out of the elevenLikert style questions and two out of the five multiple choice questionsshowing a statistically significant (p≤0.05) improvement inknowledge. Evaluation by the CME office from the respondentsutilizing 1 (poor) through 5 (excellent) resulted in a median score of4.58.

The development and implementation of this pediatric dentistryCE program increased knowledge and was well received by theparticipants. Similar courses may be beneficial in other populations.

15. Antibiotic Resistance of Endodontically RecoveredMicrobes in Appalachia Compared to a NationalElectronic Surveillance Network

Edmonds, Scott, West Virginia University School of Dentistry,Fletcher, Robert, West Virginia University School of Dentistry,Thomas, John, West Virginia University School of Dentistry,Gochenhour, Lori, West Virginia University School of Dentistry

Purpose: To analyze susceptibility of endontically involvedmicrobes representative of Appalachia to a panel of commonlyprescribed antibiotics at the West Virginia University School ofDentistry, comparing the susceptibility results to the SurveillanceNetwork Database.

Oral bacteria are composed of a complex community ofcultivable and noncultivable species. They can accumulate to form alayer of protection as well as act as a potential reservoir for invasiveoral pathogens. Identifying antibiotic sensitivity of these oral bacteriais a way to better understand the action of these pathogens and enablebetter treatment for the patient. The objective of this project was tocollect samples from root canal patients at the WVU School ofDentistry and analyze the antibiotic resistance of those bacteriarecovered. This information was compared to a National SurveillanceNetwork to better understand the resistance level differences ofpathogens in Appalachia as to a national reference. Each specimengathered was cultured against six antibiotics (Penicillin VK,Ampicillin, Clindamycin, Metronidazole, Erythromycin, andCefoxitin). The specimens were analyzed for antibiotic susceptibilityand later compared to the electronic database. Results indicated mixedcolony forming units and different degrees of efficacy for sixantibiotics. Based on patient data, of the antibiotics tested,Clindamycin yielded the least resistant patterns. These results weresupported by the national electronic database. Metronidazole,however, revealed the most resistance of antibiotics tested. Theseresults were in contrast with the national electronic database. Thisproject provided useful data to expand our research to betterunderstand antibiotic resistance of endodontically involved microbesin Appalachia compared to the rest of the nation. This may led todifferent antibiotic use in Appalachia and help to prevent further toothloss and oral disease. It also shows that testing antibiotic resistanceis important because susceptibility is not universal.

With the increased concern about the widespread resistance ofhuman pathogens in conjunction with antimicrobial treatment, ourdata may help clinicians to decrease inappropriate use of antibiotics.This will lead to less microbial resistance patterns developing in thefuture.

16. Pediatric Primary Oral Health Access: A DentalProgram Expansion Update

Sheka, Sreedevi, Columbia University School of Dental and OralSurgery, Davis, Martin, Columbia University School of Dental andOral Surgery, Surattanont, Farisa, Columbia University School ofDental and Oral Surgery, Chussid, Kavita, Columbia UniversitySchool of Dental and Oral Surgery, Kohli, Kavita, ColumbiaUniversity School of Dental and Oral Surgery

Purpose: To increase access to oral health care for the pediatricpopulation of Northern Manhattan, which has been designated as adental health professions shortage area (DHPSA), and to address theshortage of pediatric dentists with an emphasis on recruitment ofminority trainees.



Research supported by HRSA Title VII Grant. Methods: TheColumbia University School of Dental and Oral Surgery-Children’sHospital of New York (SDOS–CHONY) was awarded a Title VIIgrant to expand the pediatric dental residency from two to five traineesand to recruit minority trainees. The goals of the program includeproviding access to oral health care for an underserved pediatricpopulation, training an increased number of pediatric dentists,providing the opportunity to serve in a variety of settings, developingrisk assessment programs to identify children susceptible to earlychildhood caries, and increasing trainee experience in caring for HIVpositive children as part of Columbia’s Ryan White center. Residentsrotate to an intermediate school, a dental van, Blythedale Children’sHospital, and hospital-based clinics. Results: In the second year ofthe expanded program, there has been a significant increase in thenumber of patients registered and treated at all dental sites. Thisincrease is greater than the increase seen after the first year of theprogram. This indicates that the community is better served with theincrease in the number of residency positions and that the initialincrease in the number of visits was not an aberration. Five residentsare enrolled in each class. Cultural competency training was attainedfor all residents through collaboration with the National Center forCultural Competence. CHONY/Presbyterian Hospital has agreed tocontinue the new resident positions utilizing GME funding.

Expansion of the program has resulted in an increase in accessto oral health care for the pediatric population of Northern Manhattan.This program can serve as a model for metropolitan areas designatedas DHPSA. The achievements made in the past two years havedemonstrated that the project is successful and suggest that the successcan be sustained for the foreseeable future.

17. A Comparison of Panoramic and Cross-SectionalRadiography in the Evaluation of Implant Selectionand Placement

Shumate, Dana, West Virginia University School of Dentistry,Ghareeb, Steven, West Virginia University School of Dentistry, Reed,Harold, West Virginia University School of Dentistry, Razmus,Michael, West Virginia University School of Dentistry, Bagby,Michael, West Virginia University School of Dentistry

Purpose: The use of cross-sectional radiography as the “Standardof Care” for treatment planning the placement of endosseous dentalimplants has been questioned by many clinicians, and it consequentlyremains an underutilized procedure. The purpose of this study was todetermine if the information gained from the addition of conventionaltomography to the radiographic analysis affected the treatmentdecisions based on the information from the panoramic analysis alone.

The radiographs of forty-nine implant sites from fourteendifferent patients were examined. The patients had both cross-sectional surveys by conventional tomography and anterior-posteriorsurveys by panographs with a radiological stent in place.Measurements were then obtained from each patient’s radiographsand corrected for any distortion by using the radiographic markers ofthe known dimentions from the stent. The implant length, diameter,and path of insertion was initially determined by using the panograph.The same site was then evaluated for the same parameters by usingthe tomograph. Variations in implant diameter of path of insertiondue to anatomical considerations of magnification distortion werenoted. It was found that 19 percent of the implants initially selectedwould require a change in dimention to avoid vital structures orcortical perforation due to anatomical variations. An additional 56percent required changes in length or diameter of the implants due tononuniform horizontal magnification distortion or positioning errorsof the panograph even with correction factors calculated with aradiological stent.

The results of this project revealed that 75 percent of theimplants selected from the panographic evaluation required changesin either length or diameter after comparison with a tomograph ofthe same site. The results lead us to conclude that cross-sectionalimagery should be the standard of care for placing endosseous dentalimplants in their optimal position.

18. Do You Practice What You Preach?

DeCaria, Alene, University of Pittsburgh School of Dental Medicine,Close, John, University of Pittsburgh School of Dental Medicine,Etzel, Kenneth, University of Pittsburgh School of Dental Medicine

Purpose: To determine the degree to which students incorporatenutrition information into their lifestyles and to determine ifdifferences exist between two health science schools regardinglifestyle choices.

The role of nutrition in the maintenance of oral and overallhealth is receiving greater emphasis in the dental curriculum. Despitethe fact that students are presented with dietary information, the degreeto which it is utilized on a daily basis is uncertain. A twenty-sevenitem survey was distributed to faculty and students in the School ofPharmacy (PS) and School of Dental Medicine (DS) at the Universityof Pittsburgh. In addition to faculty, students from the FirstProfessional and Dental Hygiene program were included in the Schoolof Dental Medicine survey. The questions pertained to dietary andoral hygiene habits that are associated with optimal oral and systemichealth. Two hundred and seventy-one dental/hygiene students andfaculty and 104 pharmacy students and faculty responded to thesurvey. Results of the survey reveal that, in general, those habitsassociated with optimal oral health are practiced more consistentlyby dental students compared to their pharmacy counterparts: brushingbetween meals, DS=33.6 percent, PS=15.4 percent (p=.0008); dailyflossing, DS=53.1 percent, PS=22.1 percent (p=.0004); mouth rinsing,DS=37.3 percent, PS=30.8 percent (p=.2923). Dietary choices thathave a negative impact on oral health are more likely to be practicedby pharmacy students compared to dental students: carbonatedbeverage consumption, DS=42.8 percent, PS=54.8 percent (p=.0498);sugared gum chewing DS=14.8 percent, PS=31.7 percent(p=.0005).

These results suggest that nutritional information is utilized bystudents in their daily lives and suggests that presentation of thisinformation in the curricula of other health professions would bebeneficial.

19. Evaluation of Health History Demographics of aDental School Patient Sample

Pruner, Jerald, Case Western Reserve University School of Dentistry,Kwong, Jeffrey, Case Western Reserve University School of Dentistry,Pyle, Marsha, Case Western Reserve University School of Dentistry,Sawyer, Danny, Case Western Reserve University School of Dentistry

Purpose: To evaluate patient history demographics from a panelof patients attending a Midwestern school of dentistry.

Changing demographics of the United States indicate that thepopulation is aging. Data suggest that current cohorts of the agingpopulation experience more medical illnesses and have moremedications than earlier groups of the aged. It could be expected thatthe dental school patient pool would therefore reflect these nationalpopulation demographics emphasizing the importance in physicalevaluation and patient assessment instruction for current dentalstudents. In this study, 503 current patient files from a private schoolof dentistry were reviewed for health history and demographicinformation. Fifty-five percent were female, with a slight majorityof African American ethnicity. Forty-two percent of this patient groupwere over the age of 62 years, and 71 percent were self-pay. Themean age of the sample was 49.4 years. The mean number of



prescription medications was 1.4 with an average of 0.1 OTCmedications, as well. These patients had an average of onehospitalization, 22.3 teeth, and an ASA Risk Status Classification of1.7. Variations were noted by age and payment level (p<0.001), ageby the number of prescription and OTC medications (p<0.001), ageby the number of surgeries, number of remaining teeth, and ASARisk Status Classification. Race was associated with variation in ASARisk status (p=0.038), with African Americans having a greaterproportion of patients categorized as ASA III. Gender was associatedwith variation in payment method with females having a greaterpercentage of public assistance payment methods. When comparedby age, the older the patients were above sixty-five years, the greaternumbers of prescription and OTC medications, the greater numberof diagnoses, surgeries, and the higher the ASA Classification. Theaverage number of remaining teeth of patients >65 years was 15.2,while that of patients over 85 years was 12.2. Ensuring that studentsare prepared to treat the aging and medically complex patients seekingdental care in dental schools and private practices today will providethem with the skills they require for the future.

This information supports instruction in aging, patient physicalevaluation, and correlation of medical and dental science, as asignificant proportion of this sample were older than sixty-five years.

20. Attitudes of Dental School Clinic Patients TowardTobacco Cessation Promotion

Zakariasen Victoroff, Kristin, Case Western Reserve University Schoolof Dentistry, Ellis, Eric, Case Western Reserve University School ofDentistry, Ntragatakis, Milton, Case Western Reserve UniversitySchool of Dentistry, Williams, Kristin A., Case Western ReserveUniversity School of Dentistry

Purpose: Patient resistance is frequently cited as a barrier todentists’ promotion of tobacco cessation. Dental school curriculaencourage students to counsel patients regarding tobacco use, yetstudents may share practitioners’ concerns about patient resistance.To address these concerns, a better understanding of patient attitudesis needed. The purpose was to determine dental school clinic patients’attitudes toward tobacco cessation promotion in the dental clinicsetting.

Methods: Patients attending the general dental clinic of a singleMidwestern dental school during a three-week period (N=389) wereasked to complete a twenty-five item written survey. Results:Response rate was 76 percent. Of respondents who returned usablesurveys, 24 percent (N=61) reported that they currently use tobacco.Tobacco users were 54 percent female, 67 percent Caucasian, and 33percent African American, with a mean age of 48±15 years. Seventy-three percent of tobacco users agreed that the student dentist shouldask each patient if he/she uses tobacco, 61 percent agreed that thestudent dentist should advise patients who use tobacco to quit, and80 percent agreed that the student dentist should offer quit tobaccoassistance to patients who want to quit. Sixty-seven percent reportedthat they are considering quitting or are currently trying to quit. Sixty-three percent were not aware of community resources available tohelp tobacco users quit. Forty-eight percent reported that their primarycare physician had not talked with them about tobacco use at theirmost recent visit.

These results suggest that the majority of dental school clinicpatients who use tobacco are positive in their attitudes toward studentdentists asking about tobacco use, advising tobacco users to quit,and offering assistance to those who want to quit. Based on the highnumber of tobacco users considering or trying to quit, the low levelof awareness of community resources to help them quit, and the factthat nearly one-half had not recently discussed their tobacco use withtheir primary care physician, these results also suggest that studentdentists have a significant opportunity to deliver a needed service.

21. General Dentists and Their Special Needs Patients:Does Education Matter?

Bouwens, Thomas, University of Michigan School of Dentistry, daFonseca, Marcio, University of Michigan School of Dentistry,Inglehart, Marita, University of Michigan School of Dentistry

Purpose: To explore the role of undergraduate dental educationon general dentists’ decisions to treat dental patients with specialneeds and their attitudes towards treating these patients.

In the year 2000, the first U.S. Surgeon General Report on OralHealth stressed the importance of providing oral health care to specialneeds patients. The objective of this research project was to explorewhether dental education about special needs patients affected whethergeneral dentists actually treated dental patients with special needsand their attitude towards this patient population. Data were collectedwith a survey mailed to a random sample of 500 members of theMichigan Dental Association (MDA) (response rate: 30.2 percent;N=151). A substantial number of the respondents indicated that theydid not treat special needs patients (33.8 percent) nor patients withmental retardation (38.5 percent), Attention Deficit HyperactivityDisorder (ADHD) (38.1 percent), or Autism (65.9 percent). Overall,66 percent of the respondents indicated that their undergraduate dentaleducation had not prepared them at all or only very little to treat totreat special needs patients, 71.6 percent that they had not beeneducated to manage patients with mental retardation, 79.1 percent tomanage patients with ADHD, and 86.4 percent to treat patients withautism. The more the respondents indicated that dental school hadprepared them well to treat autistic patients, the more they liked totreat autistic patients (r=.15; p=.078), the more they would like totake continuing education programs about this topic (r=.17; p=.049),and the more comfortable (r=.27; p=.002) and knowledgeable (r=.27;p=.001) they reported that their staff had been.

In conclusion, this research showed that not all general dentiststreat special needs patients and that the majority of general dentistsindicate that their dental undergraduate education had not preparedthem well to provide care to the special needs population. The resultspoint to the significance of curriculum development efforts in thisarea.

22. Application of Computer Animation, OptoelectronicLimb Segment Tracking, and Virtual Reality inTeaching and Learning Dental Ergonomics

Jamal, Rahim, University of British Columbia Faculty of Dentistry,Pau, Clifford, University of British Columbia Faculty of Dentistry,Coil, Jeff, University of British Columbia Faculty of Dentistry, Rucker,Lance, University of British Columbia Faculty of Dentistry, Hodgson,Anthony, University of British Columbia Faculty of Dentistry,Chehroudi, Babak, University of British Columbia Faculty ofDentistry

Purpose: To enhance the student-centered approach to teachingand learning dental ergonomics by utilizing computer-based virtualreality (VR), movie animation, and optoelectronic localization.

Incorrect body posture of an operator during performance ofdental procedures can result in serious work-related injuries(Lalumandier J et al., Gen Dent 2001;49:160-6). Dental students alsodevelop musculoskeletal disorders, even within educational programs(Sunell S, Maschak M, Probe 1996;30:216-9). The integration ofclinical ergonomics into dental education demands increased clinictime, ergonomically sophisticated instructors, specializedmannequins, and/or additional patients. To create a computer-simulated ergonomics program, digital images from direct and indirectviews of mandibular and maxillary teeth were recorded in operatorright and left back tilt movement simulation (20˚ each side) using amannequin head custom-fitted to the Magellon 2500 Object-Rig. In



addition, operator intraoral views (both direct and indirect) of teethwere recorded with a head-mounted video camera simulating the fieldof vision using a 2.5 X magnification telescope. The body posture ofthe operator was recorded simultaneously using a Northern DigitalPolaris optoelectronic localizer while the operator performed 20˚ left-right tilt movements. The relative inclination of the head and torsowas computed. All multimedia information was imported andorganized onto a composite screen using Live Stage Pro software.The results indicated that both simulated and direct recording methodsprovided clear animated images of teeth and corresponding operatorpostures. The Polaris system provided quantitative data on bodysegment movements in space that can be used to create animatedstick figures or to perform muscular fatigue analysis. The preliminaryquestionnaire data indicated that students favor the VR-ergonomicsoftware as an important adjunct to their program. Supported by theUniversity of British Columbia Teaching & Learning EnhancementFund #14S35950.

VR imaging techniques and live digital animation can replicateimages of the oral cavity that students are expected to see when theirbodies (head, neck, shoulders) are postured in an ergonomicallycorrect position. Students can study the concepts at their own paceand initiative, minimizing the need for additional clinic time, patients,and instructors. Real-time comparisons of images of the oral cavityand body postures will assist students in understanding theseinvaluable concepts and in preventing future work-related injuries.

23. Interdisciplinary Summer Externship Program:Rural Community Dental Experience in Warsaw, NewYork

Stansbury, Christopher, University at Buffalo School of DentalMedicine, Gleason, James, University at Buffalo School of DentalMedicine, Brewer, John, University at Buffalo School of Medicineand Biomedical Sciences, Munro, Meghan, Western New York RuralArea Health Education Center, Perinpanayagam, Meghan, Universityat Buffalo School of Dental Medicine, Bernat, Joseph, University atBuffalo School of Dental Medicine

Purpose: To offer dental students the opportunity to experiencea rural dental practice and to interact with students and health careprofessionals in other health care disciplines.

Access to medical care is in high demand for the underservedrural areas of the United States. Access to dental care is in even higherdemand. The University at Buffalo School of Dental Medicinepartnered with the Western New York Rural Area Health EducationCenter (R-AHEC) to pilot a dental program to offer dental studentsthe experience of a dental practice in rural underserved areas. Thegoal of R-AHEC is to educate and place health professionals in theunderserved areas where they are needed most. This externshipincluded interdisciplinary seminars by which the dental studentsdiscussed patient and rural public health issues with medicine, nursing,pharmacy, speech therapy, and physical therapy students. Methods:The program accepted four first-year dental students and one third-year dental student. Dental students were placed in rural dental offices(general or pediatric dentistry) and had the opportunity to rotatethrough an orthodontic office and an oral surgery office. Dentalstudents were asked their views of rural dentistry and kept a journalof their daily observations, experiences, and thoughts/attitudes aboutrural dentistry. Results: This program allowed the dental students toobserve dentists working with patients in rural dental offices. Theywere able to gain educational experiences in a comfortable andprofessional clinical setting. Each dental student’s attitudes aboutdental practices in a rural community changed significantly. Theyalso gained valuable information on the delivery of health care servicein a rural setting. Funding for this program was provided by the

Western New York Rural Area Health Education Center (R-AHEC)through a grant from the Community Foundation for Greater Buffalo.

This externship allowed dental students to engage ininterdisciplinary discussions on public health, to learn why dentistslive and practice in rural areas, and to change preconceived attitudesabout practicing in rural New York.

24. Demographics of 512 Pediatric Patients Attendinga University Clinic Related to Caries Experience

Mercandetti, Mindy, State University of New York at Stony BrookSchool of Dental Medicine

Purpose: To present certain demographics from a pediatricpopulation and target groups with high caries experience that maybenefit from an outreach program.

The Children’s Dental Care Center at the State University ofNew York at Stony Brook utilizes an intake record to determinemultifactorial risks to pediatric oral health through the use of thePediatric Oral Health Concerns Record (POHCR), a comprehensivequestionnaire that includes an interview with the primary caregiverand clinical findings. The purpose of this study was to present certaindemographics from a pediatric population in the period September1999 to July 2002 to target a population with an increased risk forcaries experience. The sample consisted of 512 pediatric patients withan age range of three to seventeen years and a mean carious surface(MCS) of 3.98. Of the 512 caregivers answering the POHCR, 50percent reported a payment method of self-pay, 28 percent Medicaid,and 22 percent insurance. The sample was divided into individualssix years of age or older (n=444) and individuals less than six yearsof age (n=68). The MCS for the six and older group was 3.34 whilethe MCS for the less than six group was 8.13, more than twice that ofthe older group. Payment distribution for the less than six years ofage group was 44 percent Medicaid, 32 percent insurance, and 24percent self-pay. In addition, the MCS for individuals less than sixyears of age with Medicaid was 10.57, for self-pay 6.25, and insurance5.9. The less than six years of age group was categorized by zip code/town. Of the sixty-eight individuals who were less than six years ofage, 63.23 percent (n=43) had an MCS significantly greater than theMCS for the entire sample. Of those forty-three subjects, 55.8 percent(n=24) reported having Medicaid. The zip codes with a marked MCSwere plotted on a map of Long Island indicating cluster areas of highcaries experience. In conclusion, individuals in these areas may benefitfrom an outreach program.

Individuals less than six years of age with Medicaid living in atarget area on Long Island have a high caries experience.

25. Dental Education and General Dentists’ Treatmentof Pediatric Dental Patients

Inglehart, Marita, University of Michigan School of Dentistry, Shelton,Deirdre, University of Michigan School of Dentistry, Feigal, Robert,University of Minnesota School of Dentistry

Purpose: To explore the role of undergraduate education aboutpediatric dentistry on general dentists’ treatment of pediatric dentalpatients.

The objective of this research project was to explore whetherdental education about pediatric dentistry affected how generaldentists treated pediatric dental patients. Data were collected with asurvey mailed to a random sample of 500 general dentists who weremembers of the Michigan Dental Association (MDA) (thirty-threesurveys were returned due to mailing problems; response rate: 40percent; N=185). Most of the respondents were male (81.5 percent),white (88.6 percent), and practiced in a solo practice (69.7 percent),a group practice (10.3 percent), or a partnership (9.7 percent). Therespondents treated on average approximately sixty-five patients per



week of which 12.63 were children. Approximately 12 percent ofthese children displayed behavior problems. Overall, 42.4 percent ofthe respondents indicated that their undergraduate dental educationhad prepared them well to treat pediatric dental patients, while 21.7percent indicated that they had not been prepared well and the restanswering in a neutral way. The more the respondents indicated thatdental school had prepared them well to treat pediatric patients, themore they liked to treat child patients (r=.28; p=.000), the more theyused positive ways to shape the children’s behavior such as behavioralshaping with rewards (r=.15; p=.04) and positive reinforcements withwords (r=.18; p=.017), and the less they used physical restraints (r=-.20; p=.000).

In conclusion, this research showed that undergraduateeducation on pediatric dentistry affected how general dentists treatedpediatric dental patients. The results point to the significance ofcurriculum development efforts in this area.

26. Teaching Head and Neck Anatomy UsingReconstructive Modeling

Adams, Brent, University of Nevada, Las Vegas School of DentalMedicine, Allman, Casey, University of Nevada, Las Vegas Schoolof Dental Medicine, Rawson, Raymond, University of Nevada, LasVegas School of Dental Medicine, Davenport, William D., Universityof Nevada, Las Vegas School of Dental Medicine

Purpose: To conserve valuable curriculum time while improvingthe long-term understanding and functional application of head andneck anatomy.

A thorough understanding of head and neck anatomy is crucialto the practice of clinical dentistry. Traditionally, dental students arefirst introduced to this information through cadaver dissection. Thiswell-accepted method of teaching is expensive in terms of dedicatedspace; cadaver acquisition, preparation, and storage; and curriculumcontact hours. One of the goals of the UNLV SDM integratedcurriculum is the conservation of contact hours so that students mayengage in enrichment opportunities and have adequate time forindependent study. Based on empirical data from the Dental HygieneProgram at the Community College of Southern Nevada (CCSN),UNLV SDM decided to adopt the college’s method of reconstructivemodeling for teaching head and neck anatomy. Hygienists haveexpanded duties in Nevada; thus, their need for a thoroughunderstanding of this information rivals that of most dental schools.We were confident that this would be an effective and efficientteaching methodology. Dr. Raymond Rawson, who developed theprogram for CCSN, is the director of our Head and Neck Course andhas expanded it to meet dental student needs. Each student is issueda medical grade skull model, instruments, waxes, and other materialswith which to work. Each student must model a required set ofstructures as well as choose a specific individual project. Completionof the skull model requires the student to research the informationand to pay particular attention to relative size of modeled structuresto the issued skull. Students are evaluated through daily quizzes andmajor examinations on the didactic content. Skulls are evaluated oncompleteness (required structures), individual project innovation,anatomical accuracy, and modeling detail.

It is our premise that this approach to teaching head and neckanatomy will provide the student with an equivalent amount ofworking knowledge didactically. We also feel that the student timespent in this endeavor provides a better and more long-termunderstanding of anatomical relationships as well as making a bettercontribution to the development of those hand skills critical to thepractice of clinical dentistry than traditional dissection. This methodrequires a more intimate understanding of the structures of the headand neck beyond simple identification and memorization. Theeffectiveness of this approach will not be fully realized until we have

one or two cycles of National Board scores (the first class will nottake Boards until July 2004) and grades in the preclinical and clinicalcourses and clinical competency evaluations. However, we feel thatthe conservation of curriculum time and the novelty of this approachmake it worthy of initial note. Follow-up reports with morequantitative data will be forthcoming.

27. Recruitment and Retention of UnderrepresentedPopulation Groups in Dental Hygiene

Moved to Monday, 4:00-5:00 pm

Bezak, Teresa, University of Pittsburgh School of Dental Medicine,Etzel, Kenneth, University of Pittsburgh School of Dental Medicine

Purpose: To identify how many students of underrepresentedpopulation groups complete their dental hygiene program, thedetermining factors of those who do not complete, and what methodsare being used for their recruitment and retention.

The U.S. Surgeon General’s Report (2000) states thatunderrepresented population groups (UPGs) are unable to obtainmuch-needed oral health care due in part to the minimal number ofminority health care professionals. These UPGs include poor children,the elderly, and a large number of ethnic and racial minority groups.Research further states that patients generally go to medicalprofessionals of similar race and ethnicity as themselves. Researchsuggests that if there is an increase in the number of health careprofessionals from these UPGs, then access to oral health care willbe increased. This research reflects a national survey of dental hygieneprograms’ recruitment and retention efforts of UPGs. A questionnairewas developed to address the reasons for nonretention and recruitmentand mentoring strategies. A ten-item survey was mailed to 265accredited entry-level dental hygiene program directors in May 2003.Analysis includes identification of recruitment programs, mentoringstrategies, and retention rates of UPG students. This research willalso differentiate in proportions the predictor groups and retention.Results of survey respondents thus far (currently 18 percent) indicatethat 1) UPG students have a lower retention rate than non-UPGstudents (88.6 percent of all UPG students complete the programwhile 93.1 percent of non-UPG group students complete); 2) there isa significant relationship between UPG student dropout rate andfinances (67.3 percent dropped out due to financial concerns); 3) ofall UPG students, 33.33 percent dropped out due to other reasons(12.3 percent were unable to continue due to academic or professionalperformance; 7.5 percent dropped out due to family concerns); and4) recruitment strategies and retention/mentoring programs are notspecifically designed for UPGs.

Overall, there is a lack of recruitment and mentoring programsspecifically designed for UPG students, and there is a great need forincreased financial support to reduce their dropout rate.

28. Sealant Presence in Reducing Caries AmongChildren Below Poverty Level

Neibaur, Ben, Case Western Reserve University School of Dentistry,Nelson, Suchitra, Case Western Reserve University School ofDentistry

Purpose: To compare the extent of caries in children with (S)and without (NS) sealants, stratified according to low socioeconomic(poverty income ratio ≤ 100 percent) and moderate to highsocioeconomic (PIR > 100 percent) status.

Dental sealants’ role in reducing caries in a lower socioeconomicgroup is not well understood. Methods: The sample consisted of 5,217children from the NHANES III database. Predictor variables includedpresence of sealants (yes/no), demographic variables (gender,ethnicity, census region, household education), frequency of dental



visits, blood lead, and body mass index. Outcome variables weredecayed and filled surfaces (DFS) for six to eleven year olds (withsealants n = 407, without sealants n = 2526); DFS and decayed,missing, and filled surfaces (DMFS) for twelve to sixteen year olds(with sealants n = 276, without sealants n = 1587). Results: T-testanalyses indicated that there was no significant difference in the meanDFS scores for six to eleven year old children below poverty (S mean:0.55 ± 0.22; NS mean: 1.01 ± 0.18) and above poverty (S mean: 0.78± 0.12; NS mean: 0.84 ± 0.08), according to sealant status. For twelveto sixteen year olds, below poverty, there was no significant differencein either DFS (S mean: 4.42 ± 0.78, NS mean 4.12 ± 0.38) or DMFS(S mean: 4.49 ± 0.78, NS mean: 4.41 ± 0.41) scores. But for childrenaged twelve to sixteen years above poverty, there was a significantreduction (p<0.05) in both DFS (S mean: 2.55 ± 0.40, NS mean: 3.71± 0.27) and DMFS (S mean: 2.84 ± 0.43, NS mean: 3.90 ± 0.30)scores. Linear regression revealed that the presence of sealants wasnot significant in predicting DFS in both socioeconomic categoriesfor six to eleven year olds. For twelve to sixteen year old childrenabove poverty, sealants significantly lowered DFS and DMFS scores,but not for children below poverty. The most consistent variables inthe prediction of dental caries were household education andfrequency of dental visits.

In conclusion, cross-sectional data indicates that, for childrenbelow poverty level, caries experience cannot be reduced with sealantpresence alone. School-based/linked programs should also considerother preventive approaches together with sealants to reduce cariesrates in lower socioeconomic groups. Educational programs shouldhighlight the importance of a risk-based approach to prevention andtreatment for high-risk children.

29. Prevalence and Severity of Caries by School

Bingham, Michael, Case Western Reserve University School ofDentistry, Lalumandier, James, Case Western Reserve UniversitySchool of Dentistry, Nelson, Suchitra, Case Western ReserveUniversity School of Dentistry, Gill, Gary, Case Western ReserveUniversity School of Dentistry

Purpose: To prioritize the delivery of care of the school sealantprogram to those in greatest need.

The Surgeon General’s Report on the Oral Health of the Nation,which was released in May 2000, indicated that oral health in theUnited States has improved greatly over the last fifty years, but “thereis a silent epidemic of oral disease affecting poor children, the elderly,and many members of racial and ethnic minorities.” To improve theoral health of poor children in Cleveland, the Case Dental Schoolwith funding for the St. Lukes Foundation of Cleveland instituted adistrict-wide sealant program in 2001. By the 2003-04 school year itis anticipated that all 101 elementary and middle schools will bevisited, and all second and sixth grade children with a signed consentwill be examined and treated. However, if the targeted goal of 101schools is not reached, the prevalence and severity of dental carieswill be incorporated to determine the priority of care. To be able torank order severity of disease, we established a scale from 0-5 with 0indicating no caries present on permanent or deciduous, 1 indicatingcaries only on deciduous, 2 indicating caries on only one permanenttooth, 3 indicating caries present on one permanent tooth and one ormore deciduous teeth, 4 indicating the presence of decay on two orthree permanent teeth with or without carious deciduous teeth, and 5indicating four or more decayed permanent teeth with or withoutcarious deciduous teeth. The mean score for second graders was asfollows: 0=22 percent, 1=43 percent, 2=2 percent, 3=12 percent, 4=14percent, and 5=7 percent. For sixth graders the mean scores were0=22 percent, 1=20 percent, 2=7 percent, 3=10 percent, 4=21 percent,and 5=19 percent. Selecting schools with the greatest severity ofdisease ensures that the children in the greatest disease category areprioritized in treatment.

30. Oral Oncology: Knowledge, Attitudes, Beliefs, andPractices of Community-Based Health Care Providers

Hadden, Katie, University of California, Los Angeles School ofDentistry, Parker, Ira, University of California, San Diego School ofMedicine, Spolsky, Vladimir, University of California, Los AngelesSchool of Dentistry

Purpose: To examine the level of knowledge and the practicebehaviors of health care providers in the area of oral oncologic,medically necessary dental care.

The five-year survival rate of head and neck cancer patients isless than 50 percent. Associated morbidity is significant, and qualityof life is drastically impacted for those affected and their families. Alarge number of patients continue to be initially diagnosed at advanceddisease stages, significantly decreasing treatment success. The trainingof community-based providers is a necessary component of an overallstrategy targeting the enhanced prevention and management of headand neck cancer. Methods: Data was collected from 439 attendees ofthe American Cancer Society’s (ACS) [Border/Sierra Region] 2001Annual Head and Neck Conference who completed a two-page,confidential survey. Descriptive statistics were analyzed using SPSS.Results: The primary population responding to the survey weredentists, dental hygienists, and dental assistants providing care inprivate practice settings. Physicians, nurses, and other community-based providers also contributed. Results indicate a difference inopinion on who should provide comprehensive oral cancer exams,as well as the need for continued oral cancer screenings for recallpatients. While most providers felt competent providing care topatients receiving radiation, they did not feel competent caring forpatients receiving chemotherapy or bone marrow transplantation. Ofthese “competent” providers, many did not feel that this symposiumcontributed to their level of competency. However, a large numberfelt that if they had not received additional training at previous ACSHead and Neck Symposiums, they would not have felt competent.

Continuing education courses focusing on oral oncology provideworthwhile benefits to community-based health care providers andtheir patients. In addition, there is a need for advanced training inoral oncology, as well as the enhanced availability of continuingeducation programs in this area.

31. The Genetic Components That Determine FamilialHypodontia

Briscoe, Patrick, University of Missouri-Kansas City School ofDentistry, Trimmell, Justin, University of Missouri-Kansas CitySchool of Dentistry, Kula, Katherine, University of Missouri-KansasCity School of Dentistry, Lu, Yongbu, University of Missouri-KansasCity School of Dentistry, Feng, Jerry, University of Missouri-KansasCity School of Dentistry

Purpose: Understanding the genetic components of hypodontiacould lead to future gene replacement therapy to prevent this disorder.Gene therapy will provide a significant monetary savings and animprovement in the patient’s esthetics and occlusion.

One of the most common anomalies in the dentition ishypodontia, congenitally missing teeth. It occurs in approximately2-20 percent of various populations. The purpose of this study isthreefold. We plan to: 1) determine the mode of inheritance bydeveloping pedigrees of families with a tooth agenesis anomaly; 2)compare phenotypes of affected family members with unaffectedfamily members using cephalometric analysis and clinicalexaminations; and 3) analyze DNA samples of affected and unaffectedfamily members to find the genes responsible for hypodontia. Thepatient’s medical charts will be used to locate a family ofapproximately ten people that contain both affected and unaffectedmembers. Each member will undergo a clinical examination and a



buccal cheek swab. The clinical examination consists of charting allerupted and unerupted teeth, along with recording abnormal size ofteeth, hypoplasia, and quality of skin, nails, and hair. Panoramic andcephalometric radiographs will be included as part of the clinicalexamination. The cheek swab provides the genetic information neededfor the study. The DNA is extracted and exposed to a polymerasechain reaction (PCR) in order to amplify the DNA. The amplifiedDNA is purified, sequenced, and then genotyped. The final step is alinkage analysis to determine the relationship between the locus andthe phenotype. Sequence analysis revealed possible changes in theamino acid coding sequence of exon 3 in the PAX 9 gene. There wasa missence mutation that changed alanine to proline (Ala240Pro).Although alanine and proline are neutral non-polar amino acids, theyare quite different. The phi and psi values for alanine facilitate theformation of an alpha helix. Proline has severely restricted phi andpsi values, which tend to significantly distort an alpha helix.Preliminary results indicated homogynicity of the missence mutation,suggesting that the mutation is carried in both parents.

Knowing that PAX 9 plays an important role in the initiation ofthe tooth bud, one can infer that by understanding the certain mutationsthat occur within PAX 9, health care professionals will be able tomanipulate the expression of the mutated gene in order to control theproper development of teeth. Although the discovery of this mutationis very encouraging, there are still many steps that need to be takento verify the significance of the mutation. Preliminary results indicatethat the mutation is homozygous, which suggests that both parentscarry this mutation. Therefore, analysis of the DNA of other familymembers will be performed in an attempt to locate the same mutationthroughout the affected family members. Studies of the MSX 1 genewill be performed to determine what role, if any, it might have inhypodontia. By carrying out these final steps, we hope to determinethe frequency of this mutation, and that should allow for identificationof a major genetic component of hypodontia.

32. Mentoring Program Focused on Minorities

Bitar, Leena, Tufts University School of Dental Medicine, Alva,Aurora, Tufts University School of Dental Medicine, Herman, Aidee,Tufts University School of Dental Medicine

Purpose: To increase the number of minorities in the dentalprofession by establishing a mentoring program that motivates highschool minority students to pursue various careers in the dental field.

Methods: From 1996 to the present, minority dentists and dentalstudents have been serving as mentors to students enrolled in thedental assisting program at Madison Park Technical Vocational HighSchool. The minority dentists and dental students encourage thesestudents to continue pursuing a career in the dental field by motivatingthem through inspirational talks given at their high school. The highschool students also gain confidence in their abilities and build theirself-esteem during their visits to Tufts Dental School, where theyassist dental students in the clinic. Results: The enrollment of highschool students in the dental assisting program at Madison ParkTechnical Vocational High School increased 142 percent from sevenstudents in 1996 to seventeen students in 2002.

The mentoring program has played a vital role in increasingthe number of high school minority students pursuing a career in thedental profession.

33. Characteristics of Top Dental School FeederInstitutions

Mentasti, Lauren, University of Connecticut School of DentalMedicine, Thibodeau, Edward, University of Connecticut School ofDental Medicine

Purpose: To facilitate enrollment and recruitment strategies byidentifying and characterizing feeder colleges and universities thatare the major source of applicants to U.S. dental schools.

Feeder school information was obtained from AADSAS for the2002-03 admissions cycle. The reports identified the degree status,institution, and demographic information of each applicant. Feederschools were defined as any school with five or more applicants.Minority-feeder schools were those with two or more applicants.Schools were ranked based on the total number of applicants(Category 1) and, to minimize the effects of school size, the applicantto total undergraduate enrollment ratio (Category 2). The top fiftyfeeder schools in both categories were compared using total schoolenrollment, degree status, geographic distribution, religious affiliation,and numbers of minority applicants. At the time of application, 6,947dental applicants reported attending 1,149 colleges and universities.The top fifty Category 1 schools had average enrollments of over19,000, while Category 2 schools had average enrollments of 8,000students. California and Utah had the greatest number of applicantsfollowed by Florida and New York, all together accounting for 28percent of total applicants. Seventeen of the top twenty-five Category2 schools had religious affiliations, including the Seventh-DayAdventist Church with six institutions followed by Roman Catholic(three), Methodist (three), Mormon (three), Lutheran (one), andJewish (one). The majority of black and Hispanic applicants attendedschools in the southeast (Florida, Tennessee, Louisiana), Puerto Rico,and California.

Results from this study indicate that the majority of dental schoolapplicants are from colleges and universities with large studentenrollments. However, many smaller schools, often affiliated withreligious groups, have better applicant-to-enrollment ratios than largerinstitutions. Overall- and Hispanic-feeder schools are concentratedin heavily populated states while black-feeder schools are moreregional.

34. Early Childhood Caries Prevention: A NeedsAssessment in Progress

Dixon, Jennifer, University of Missouri-Kansas City School ofDentistry, McCunniff, Michael, University of Missouri-Kansas CitySchool of Dentistry, Williams, Karen, University of Missouri-KansasCity School of Dentistry

Purpose: To propose a theory-based needs assessment in orderto elicit parents’ attitudes, social norms, and perceived control asthey relate to their children’s oral health.

Dental caries is the single most common chronic childhooddisease. Low-income minority populations are differentially affectedby caries. Early childhood caries (ECC) is a form of severe andrampant decay that occurs in infants and toddlers. Untreated cariesresults in pain, weight loss, premature tooth loss, and malocclusion.Method and Materials: A convenience sample of all available children,ages six months to five years, enrolled in the WIC Program at theKansas City Health Department and the Swope Parkway HealthCenter in Kansas City, MO, and their parent(s)/guardian are beingrecruited for this study. A convenience sample of all available children,ages six months to five years, enrolled in the Maternal and InfantClinic and the Community Health Center in Pittsburg, KS, a ruralcommunity, and their parent(s)/guardian are also being recruited forthis study. A written questionnaire, based on the Theory of PlannedBehavior (TPB), will elicit information on the parents’ demographics,knowledge, attitude, behavior, social norms, and perceived controlrelated to ECC. Items will use Likert-type and categorical responsescales. For the analysis, descriptive, cross-sectional, and correlationalanalyses will be conducted to examine the relationship ofdemographics to domain scores. Data will be analyzed in aggregate



form. Results: This information will be used for subsequent programplanning at WIC sites in Kansas.

The goal of this project is to implement the needs assessmenton ECC prevention and the WIC dental survey to serve as a templatefor next year’s Summer Scholars students to follow.

35. Survey of Behavioral Science Practicum Programsin U.S. Dental Schools

Shamloo, Shahram, Temple University School of Dentistry, Paharia,Indira, Temple University School of Dentistry, Fornatora, Maria,Temple University School of Dentistry

Purpose: The practice of dentistry relies on communication skillsand technical proficiency. Similar to technical training,communication training requires didactic and practical instruction.The opportunity to practice communication skills may be achievedthrough a behavioral science practicum (BSP). “Practicum” is definedas an experiential method of training that gives students an opportunityto apply theory in a clinical setting. The implementation andstandardization of BSP programs have been limited in Americandental education. The purpose of this study was to identify existingBSP programs at U.S. dental schools and to obtain informationregarding the design and resources used in developing and maintainingthese programs. A survey of twenty-two close-ended questions wassent to each of the fifty-four dental schools. Multiple choice answerswere provided for all of the questions, including an “other” categoryto allow for written responses. Surveys were collected throughstandard and electronic mail. The response rate was 81 percent (forty-four of fifty-four). Of the responding schools, only 27 percent (twelveof forty-four) report the existence of a BSP in the curriculum.

From the information offered by the twelve schools with a BSP,the following results were compiled. Most schools use a group format(75 percent) and conduct the practicum in a school-based clinic (75percent). A majority of the BSP programs use psychologists asinstructors (83 percent). There is high consistency amongst BSPprograms with respect to topics covered in the practicum, such asuse of empathy and active listening skills. The data reveal the mostconsistent teaching methodology to be case presentation withvideotaping (67 percent), followed by the use of role-play (58 percent).All of the schools indicate that the practicum is a requirement. Mostoften BSP programs are multi-semester courses (58 percent).Placement within the predoctoral curriculum varies widely betweeninstitutions, but often includes the junior year (75 percent). Of thefew schools (33 percent) that are aware of their annual BSP budgets,a range of zero to nine thousand dollars is reported. There isinconsistency among institutions regarding which clinics are utilizedfor practicum training and which departments are responsible for itsadministration. Evaluation methods and remediation processes alsovary significantly between institutions. In addition, there appears tobe no correlation between class size and number of instructors.

This study has implications for the development of BSPprograms at dental schools throughout the country. The survey resultsindicate that few schools utilize this type of experiential trainingprogram and there is little standardization for its development.According to the American Dental Association, graduates must becompetent in the application of the fundamental principles ofbehavioral science and have the interpersonal and communicationskills to function successfully. Without ample opportunity for practicaltraining, there cannot be certainty that dental students are achievingcompetency in these areas. Therefore, appropriate guidelines areneeded for the development and implementation of BSP programs inpredoctoral dental education. The establishment of these guidelinesmay encourage more dental schools to provide such programs byfacilitating their development.

36. Increasing the Utilization of Medicaid by ChildrenAges 0-5: Needs Assessment in Progress

Choy, Andrew, University of Missouri-Kansas City School ofDentistry, Williams, Karen, University of Missouri-Kansas CitySchool of Dentistry, McCunniff, Michael, University of Missouri-Kansas City School of Dentistry

Purpose: To conduct a needs assessment regarding Medicaidutilization as well identifying what elements are needed for aneducational intervention targeted at the parents of low income childrenin a rural community.

The need for increasing the utilization of Medicaid by childrenhas been identified as an objective in Healthy People 2010. Reformin the Medicaid program and educational interventions are necessaryto bring about changes that will increase the level of Medicaid use.Materials and Methods: The literature on current Medicaid programsand current educational and preventive programs related to Medicaidutilization was critically reviewed to identify focus issues for planninga needs assessment. Based on this literature, a proposal was developedto assess parental attitudes/beliefs, social norms, perceived control,and knowledge of oral health care as they related to Medicaidutilization. A questionnaire based on the Theory of Planned Behaviorwas developed to assess a low-income parent’s baseline level ofknowledge so that specific topics can be subsequently identified foran educational intervention. Items will use Likert type and categoricalresponse scales. A convenience sample of English-proficient parents/primary caregivers of children attending WIC clinics in a ruralcommunity will be used. Demographics will be analyzed in aggregateform. A cross-sectional analysis will be used to examine relationshipsbetween parental attitudes and behaviors and those of their children.Results: A needs assessment for a rural community regardingincreasing the utilization of Medicaid will be conducted using theproposed methodology. Information collected will be used to guidethe creation of an educational intervention and to determine if thereis a relationship between a parent/caregiver’s attitudes and beliefstowards oral health and their Medicaid-eligible dental-seekingbehaviors for their children.

The creation of an educational intervention directed at parentsof Medicaid children could be beneficial in increasing the usage ofMedicaid benefits.

BLOCK II, Monday, March 8

2:00 pm to 3:30 pm

Additional Poster during this Block: 132. StudentBenefits from a Summer Preparatory Course in DentalHistology (see page 249).

37. Career Status and Job Satisfaction: A Pilot SurveyAmong African American Dental Hygienists in theUnited States

Miller, Faith, Southern Illinois University-Carbondale

Purpose: The first purpose was to develop an instrument tocollect data concerning black dental hygienists. The second purposewas to collect data that could be used as a recruitment tool for blacksand other minority groups.

A thirty-two item pilot questionnaire was developed and mailedto seven dental hygienists in seven states whose names and addresseswere obtained from a list of participants to recent annual sessions ofthe American Dental Hygienists’ Association (ADHA) or via personalcontact. Colleagues reviewed the researcher-designed instrument, and



appropriate corrections were made before mailing. Four of sevensurveys were returned for a 57.14 percent response rate. Descriptivedata was compiled in table form by respondent and separated intothe sections that corresponded with those from the questionnaire:Demographics, Practice Setting/Career Status, Membership/Affiliations, and Career Satisfaction. Participants shared lifelongexperiences from practicing as dental hygienists that could possiblybe encouraging to future minority students. Participants ranged inage from thirty-five to fifty-nine. All were female. The highest earneddegree reported was the baccalaureate, with one having earned anassociate degree, and two held licenses in two states. Self-reportedsalary range was $31,000-60,000. The number of years in theprofession ranged from 1 to 30+ years. All but one of the participantswere members of ADHA while two were National Dental Hygienists’Association (NDHA) members. All reported having provided eitherdirect patient care in private offices, military installations, and mentalhealth facilities or in education or other dental-related field. Jobsatisfaction lent itself to having convenient hours, providing care forthree generations of family members, and being economicallyrewarding. Other comments challenged black dental hygienists tobecome more involved and visible, while one stated the need forblacks to market themselves more so than their white peers.

Further research is needed in this area to determine whether ornot job satisfaction has an effect on blacks entering into dentalhygiene.

38. Choosing an Online, School-Wide, StudentAssessment of Instruction System

Johnson, Lynn, University of Michigan School of Dentistry, Green,Thomas, University of Michigan School of Dentistry, Lantz, Marilyn,University of Michigan School of Dentistry, Katcher, Patricia,University of Michigan School of Dentistry

Purpose: Good curriculum management and accreditationstandards require a school-wide system of student assessment ofinstruction. The distribution of forms, collection of data, analysis ofdata, and the return of information to faculty can be a very labor-intensive task, particularly in a large school. To streamline the process,an online system was envisioned.

Our aspirations for the system were that it: 1) could be used forevaluation of clinical, preclinical, lecture (large group), and seminar(small group) courses; 2) was easy to use for students, faculty, andsupport staff; 3) would require minimal support from the school’sinformation technology staff; 4) would facilitate student compliance;5) would guaranteed privacy of all student and faculty information;6) would accommodate both Likert-scale questions and open-endedcomments; and 7) would meet the school’s reporting needs to thefaculty, the school, and the university. A product, CoursEval,developed by Academic Management Systems was the productreviewed that matched our criteria the best. A pilot of the system wasconducted with twenty randomly chosen first-year students. Feedbackwas gathered during the follow-up focus group. While a few problemsdid occur during the pilot, they were resolved. Students liked theconvenience of the online forms, the time flexibility in completingthe assessments, and the ease of writing comments. During thesummer of 2003, the system was expanded to include three classesof students (n=317). One question was asked of all students: “Theseonline surveys allowed me to provide information necessary forimprovement of the curriculum?” Of 299 responses on a five-pointscale, 70 percent agreed or strongly agreed, and 11 percent disagreedor strongly disagreed. When asked a similar question about the paperversion of this system last year, responses on a two-point scale byclass and by form ranged from 72 to 96 percent agreement and 6 to28 percent disagreement.

Our conclusion is that an IT solution to course and facultyassessment is feasible.

39. A Look at Dental Hygiene and Dental AssistingWorkforce and Graduates in the United States

Schaid Wagner, Karen, American Dental Association, Brown, L,American Dental Association, Mikkelsen, Matthew, American DentalAssociation, Munson, Bradley D., American Dental Association

Purpose: The American Dental Association (ADA) conductsannual surveys of educational programs in dental hygiene and dentalassisting. The Survey of Allied Dental Education gathers data fromallied dental education programs in the United States accredited bythe ADA’s Commission on Dental Accreditation (CDA).

Methods: Government statistics on population and workforceof dental hygienists and dental assistants are compared with graduatestatistics from the Survey of Allied Dental Education. The survey iscompleted by program directors of dental hygiene and dental assistingeducation programs. Their response is mandatory for continuedaccreditation by the CDA. Results: In the United States in 1998, theproportion of dental hygienists to 100,000 residents varied greatlyby state. The states with the highest proportion of hygienists per100,000 were mostly in the north central and New England states.The states with the lowest proportion of hygienists per 100,000 weremostly in the central and southern United States. Among those states,some have dramatically increased the annual number of dentalhygienist graduates since 1998. In 1998 the proportion of dentalassistants to 100,000 residents also varied greatly by state. Stateswith the highest proportion of dental assistants per 100,000 werelocated mostly in the mountain and Pacific states. States with thelowest proportion of dental assistants per 100,000 were located mostlyin the southeastern United States. Among those states, four haveincreased the annual number of dental assistant graduates since 1998.

Results from these surveys assist in addressing the concerns ofthe public and the profession regarding the issue of national allieddental workforce levels. While statistics vary by state, at the nationallevel consistent or increasing numbers of dental hygiene and dentalassisting graduates continue to supply office personnel to supportthe delivery of dental care.

40. Senior Dental and Dental Hygiene StudentsFunctioning as Teaching Assistants in a Dental HygieneDental Materials Course

McClure, Beverly, The Ohio State University College of Dentistry

Purpose: To facilitate learning in a laboratory dental materialscourse and to provide senior dental and dental hygiene (DH) studentsthe opportunity to gain teaching experience. Hopefully, this newprogram would encourage students to pursue careers in academicdentistry.

Senior DH students are required to complete a practicum thelast quarter of their educational experience. Three senior DH studentschose to complete their practicum by serving as teaching assistants(TAs) in the course. Two senior dental students who had completedclinical requirements agreed to become TAs. The students contributedsuggestions concerning course content, and they were asked todetermine the topics and methods they would like to teach. Theycould choose to conduct small group or entire class demonstrations,construct quizzes and evaluations, construct practical exams, evaluateand grade required assignments, or provide one-on-one instructionand evaluation. All teaching methods were guided by mentoringfaculty. The DH students (N=31) enrolled in the dental materialscourse were given a Likert-like survey regarding the perceivedeffectiveness of the TAs. One hundred percent of the enrolled studentseither strongly agreed or agreed to the following: 1) the senior dentaland DH student contributed to their learning in the course; 2) thesenior dental students were interested and willing to help; 3) the DHstudents were prepared for each lab session; and 4) the quizzes



prepared and graded by the TAs covered the appropriate material. Astudent provided the following comments concerning the TAs: “Theywere a great help. It is good to get guidance and input from differentaspects to better understand the material covered.” The teachingassistants (N=4) were given a Likert-like survey regarding theirperceived effectiveness as teachers in the course. One hundred percentof the TAs either strongly agreed or agreed that they were usedeffectively as a teaching assistant, they felt prepared for the dailyactivities, and they contributed to student learning.

The TAs contributed to the learning of the beginning studentsand would recommend this experience to future students. The teachingassistants gained experience in teaching, and three of the four surveyedindicated a desire to become a dental educator.

41. Fluid Consumption Habits of Adolescents Attendinga National Youth Sports Program

Scheidel, Donal, University of South Dakota, Nelson, Robert,University of South Dakota

Purpose: To determine the amounts of various fluids consumedby ten to sixteen year olds and to compare these data with accepteddietary recommendations.

With mounting concerns related to dietary choices America’syouth are making and the subsequent impact these choices have onoral and general health, a voluntary survey was administered to 227ten to sixteen year olds (120 boys and 107 girls) participating in aNational Youth Sports Program summer session in Vermillion, S.D.to evaluate their daily fluid consumption habits. The children weresurveyed regarding their daily consumption of soda, sports drinks,bottled water, tap water, milk, and juice using a look-back surveyinstrument. The data reported represents the combined responses ofboys and girls in all age groups. Of the respondents, 55.5 percentstated that they consumed at least one can/bottle of sugared sodadaily, and 17.6 percent admitted to drinking at least two to three cans/bottles of soda daily. Also, 33.9 percent of those surveyed stated theydrank at least one sports drink daily, with 24.2 percent indicatingthey don’t drink sports drinks. In addition, 48.4 percent of the surveyparticipants indicated they drank at least two bottles of water daily,reflecting a shift from consumption of primarily tap water to bottledwater. Of those surveyed, 63.9 percent stated that they drank at leastthree glasses of tap water daily. Of the children surveyed, 61.2 percentreplied they drank two glasses of milk a day or less. Finally, 70.9percent of the respondents admitted drinking at least one glass ofjuice daily. The results of this research illustrate the fluid consumptiontrends of children and adolescents, including consuming largeamounts of simple carbohydrates in the form of soda, sports drinks,and juices. The majority of respondents aren’t consuming therecommended three glasses of milk daily, thus increasing theprobability of developing a calcium deficiency. Finally, the surveygroup is drinking nonfluoridated bottled water instead of fluoridatedtap water.

The results of this research identify some of the contributoryfactors of childhood obesity, adolescent osteoporosis, and thecontinuing problem of dental decay in children and adolescents.

42. The Benefits of Mentoring AEGD Residents asLocal Anesthesia Faculty

Dower, James, University of the Pacific School of Dentistry, Wong,Allen, University of the Pacific School of Dentistry, Park, Jun,University of the Pacific School of Dentistry, Hanson, Nhi, Universityof the Pacific School of Dentistry, Nguyen, Nhi, University of thePacific School of Dentistry, Kuo, Jane, University of the Pacific Schoolof Dentistry

Purpose: To train AEGD residents to excel in local anesthesia,mentor AEGD residents as local anesthesia instructors, and inspireAEGD residents to be dental educators in the local anesthesiacurriculum and other teaching positions.

There is a documented shortage of faculty in U.S. dental schools.An excellent way of reducing the shortage of instructors is to mentorresidents from the Advanced Education in General Dentistry programas instructors in the dental school curriculum. The director of thelocal anesthesia program and the director of the AEGD program haveworked synergistically to have the chief resident as an understudy ofthe director of local anesthesia courses. The objectives of thementoring program are building a positive relationship between theone being mentored and the mentor, transference of the knowledgeand skills in local anesthesia, and transference of the art and scienceof being an educator. The residents progress through the followingactivities in being mentored: being taught individually by the director;observing the director in the yearlong curriculum composed of twolocal anesthesia blocks and three rotations in local anesthesia; havingthe resident demonstrate to the director how they would instruct thestudents; having the director observe the resident while he or she istraining the dental students; having the chief resident assume fullresponsibility of the instruction and then meeting at the end of eachday’s session with the course director; and having the trained residentas a faculty member in the local anesthesia director’s continuingeducation courses. In two years, this has resulted in two chief residentsbecoming faculty members: Dr. Jun Park three days/week and Dr.Nhi Nguyen one day/week.

This collaborative endeavor has impacted dentistry and theSchool of Dentistry by training clinicians who have a high level ofexpertise in local anesthesia and producing educators who areproficient in mentoring students.

43. Dental Student Evaluation of an Online Textbookin Pediatric Dentistry

Peterson, Devereaux, University of Washington School of Dentistry,Kaakko, Tarja, University of Washington School of Dentistry, Smart,Erika, University of Washington School of Dentistry, Jorgenson,Michael, University of Washington School of Dentistry, Herzog,Christopher, University of Washington School of Dentistry

Purpose: To evaluate dental student perceptions regarding onlineeducation using the Atlas of Pediatric Dentistry as the textbookresource during a comprehensive course in pediatric dentistry.

The Atlas of Pediatric Dentistry is a comprehensive textbookof pediatric dentistry that is web-based. The atlas was designed as anonline resource, rather than as a traditional textbook that was copiedand pasted to a disk or website. It is a stand-alone textbook withapproximately 3,000 frames and 2,500 images and includes end-of-chapter quizzes, laboratory manuals, photobanks, and a scrollableindex. The atlas is the sole textbook used at the University ofWashington for courses in pediatric dentistry. Dental studentperceptions regarding online education were assessed at thecompletion of the major undergraduate course in pediatric dentistryvia a survey of the students. The specific aims of the study were toassess the effectiveness of online education, compare perceptions ofonline training vs. traditional forms of instruction, and describe howthe online program was utilized (i.e., patterns of use). Relationshipsbetween several individual demographic and academic variables ofthe students with their perceptions and use of online instruction alsowere evaluated. Eighty-four percent of the class responded (n=46).Eighty-three percent of the respondents preferred the online textbookto traditional textbooks. Ninety-six percent rated the educationalcontent of the atlas as good or excellent, and all respondents indicatedthey would rate the textbook highly to a colleague. Positive



perceptions were associated with the scope of content, numerousimages (especially color images), and ease of use. The most negativeperceptions involved technical problems associated with online bycomputers with obsolete browser software. Thirteen percent of therespondents did not have access to a computer at home, and fifteenpercent used printouts of the text material.

Students strongly preferred the online textbook to a traditionaltext. Faculty who are planning to develop a comprehensive onlinetext are advised to emphasize an atlas format using numerous imagesin order to gain broad acceptance. There continue to be a small numberof students who do not have access to computers at home and whosecomputers are equipped with obsolete software. It is important toplan for students to be able to access computers at the university andto program any online resource so that it is compatible with olderbrowser software.

44. Domain Specification and Validity: National BoardDental Hygiene Examination Practice Analysis

Kramer, Gene, American Dental Association, Neumann, Laura,American Dental Association

Purpose: To specify the content domain associated with theNational Board Dental Hygiene Examination Practice Analysis.

For examinations involved in licensing decisions, content-related validity can be demonstrated by showing a strong relationshipbetween content specifications and clinical practice. To demonstratethis relationship for the National Board Dental Hygiene Examination,a practice analysis was conducted. The content domain for the practiceanalysis was specified by a set of fifty-six competencies. A surveywas conducted to determine the importance of the competencies todental hygiene patient care. The survey directed participants to ratethe competencies on a 5-level scale of uniformly increasingimportance, with 1 indicating unimportant and 5 indicating critical.The actual content of the examination would involve the knowledgeand problem-solving skill necessary to support the successfulacquisition of the competencies. The extent of content devoted toeach competency would be in accordance with the overall rating.The findings were expected to confirm the existing contentspecifications or to support adjustments. The survey was distributedto a sample of 3,941 dental hygienists. Of these, 1,841 responded,and 1,284 were full-time practitioners. A principal componentsanalysis of the ratings showed one primary factor and ten minorfactors. Forty-seven of the fifty-six competencies loaded on theprimary factor, which might be best characterized as dental hygienepatient care. The average ratings ranged from a high of 4.93 to a lowof 2.80. Participants tended to rate most competencies as highlyimportant. The ratings were converted to numbers of items based ona test length of 350 items. The greatest number of items (twelve) wasdevoted to the competency “Obtain medical histories,” and no itemswere devoted to “Participate in community service activities.”

The competencies synthesized from two sources adequatelydefined the domain of dental hygiene practice and are appropriatefor use as the basis for the practice analysis. The number ofexamination items devoted to each competency will adequately reflectdental hygiene patient care.

45. Quality Assurance: An Assessment of InfectionControl Curriculum, Occupational Exposure Incidents,and Reporting Compliance

Stewart, Carol, University of Florida College of Dentistry, Grimaudo,Nicholas, University of Florida College of Dentistry

Purpose: To assess students’ perceptions of their infectioncontrol curriculum, the occupational exposure incidents, and reportingcompliance.

In response to CDC guidelines, OSHA requirements,accreditation standards, and concerns for health and asepsis, all dentalschools have integrated principles of infection control andmanagement of occupational exposures into the curriculum. At theUF College of Dentistry, numbers of occupational exposures aretracked anonymously, in aggregate fashion, by the Division of QualityAssurance through assistance from the Shands Hospital OccupationalHealth Department. Through trending analysis, it was noted that therate of occupational exposures for the college had decreased duringthe years 1999-2002, from 5.9 exposure incidence density rate to3.1. To gain a clearer understanding of the potential factors responsiblefor this decline, students’ perceptions of their instruction and issuesassociated with occupational exposures were assessed via aquestionnaire. A survey was administered to rising junior and seniordental students that included questions pertaining to the quality oftheir infection control education, faculty modeling of infection controlbehaviors, the process of reporting occupational exposures, numbersof exposures and reasons for protocol noncompliance. Someunexpected findings included underreporting of exposures and reasonsfor protocol noncompliance. Nine exposures were not reported bythis cohort during a two-year period. The most frequent response fornot reporting was a lack of concern regarding risk of diseasetransmission. The second most frequent response was the timeinvolved to report the incident, and the third reason was perceivedembarrassment associated with informing the patient and reportingthe incident. The detailed analysis of the survey will be providedplus implications for possible curricular and procedural modifications.

An routine review of the effectiveness of an infection controlcurriculum and occupational exposure protocol can provide importantinformation regarding trends and possible indications formodifications.

46. Assessing Teacher Beliefs: The Teacher BehaviorPreferences Survey

Behar-Horenstein, Linda, University of Florida College of Dentistry,Dolan, Teresa, University of Florida College of Dentistry, Mitchell,Gail, University of Florida College of Dentistry, Anusavice, SandyH., School Board of Alachua County

Purpose: The Teacher Behavior Preferences Survey (TBPS), aresearch-constructed instrument, assesses educators’ beliefs aboutinstructional practice.

The instrument is comprised of two parts. Part I consists ofthirty statements that describe teaching behaviors. Using a 5-pointLikert scale, respondents indicate their level of agreement with eachstatement. Fifteen items represent teacher-centered or traditionalteaching behaviors; fifteen represent student-centered orcontemporary teaching behaviors. Scores reveal a preference forteacher- or student-centered practices and provide information aboutpreferences for methods of instruction, questions, student feedback,and structure of the learning environment, student communication,grouping, assessment of, and expectations for student learning. PartII is comprised of forty-two items representing teaching models.Respondents mark an “X” preceding each item that describes theirteaching. Items correspond to one of the four families of teachingmodels (Joyce & Weil, 1996). Scores indicate preferences for ateaching model family. Participants (N=109) were eighty-two dentaland medical educators in higher education and 27 educators in variedschool settings. Items in Part I were selected from a review of theliterature on teaching effectiveness. Items in Part II were synthesizedfrom a review of literature on teaching models. Data from Part I hasbeen analyzed using paired samples T-test. Data from Part II isanalyzed using descriptive statistics. Only an analysis of data forPart I is reported here. Respondents reported a significant differenceamong paired items including a preference for two teacher-centered



practices and eleven student-centered practices. Additionally, theyreported a preference for student-centered rather than teacher-centeredpractices, significant at the p<.005 level.

The findings suggest that the instrument can discriminate amongindividuals in their preferences for teacher- or student-centered pairedpractices and among the total teacher- and student-centered practices.Assessing instructional beliefs can help individuals reflect about theways in which they think they teach.

47. Evaluation of Senior Dental Students as PreclinicalFaculty in Prosthodontics

Nimmo, Arthur, University of Florida College of Dentistry, Mitchell,Gail, University of Florida College of Dentistry, Penfield, Randall,University of Florida College of Education

Purpose: This study was designed to mentor students as futureacademicians, provide higher learning experiences for the studentteachers, and determine the feasibility of using senior dental studentsas instructors for preclinical dental courses in prosthodontics.

Dental schools need to be innovative in their educationalmethodologies at the same time they are facing a shortage of facultymembers. One possible approach would be to utilize senior dentalstudents (4DN) as faculty in the preclinical courses. In the springterm of 2003, three student teachers and four full-time faculty wereassigned as faculty for the DEN 6412 Fixed Prosthodontics III andDEN 6460 Treatment of the Edentulous Patient preclinical courses.These courses have previously been conducted with a total of sevenfull-time faculty for a second year class (2DN) of eighty students.Three types of outcome assessment were accomplished: 1)standardized evaluation by the 2DN students of full-time faculty andstudent teachers using a 1 (poor) to 5 (excellent) scale; 2) a briefsurvey of student teachers using a scale of 1 (most negative) to 5(most positive); and 3) a routine course debriefing with selected 2DNstudents. The overall mean values from the 2DN evaluation of facultywere 4.37 for full-time faculty and 4.52 for student teachers. A two-way ANOVA determined this difference was not significant at the α= 0.05 level. Each of the six student teachers completed a surveyabout their experience. Means were determined for the followingquestions: 4.50 for the overall experience, 4.83 for acceptance by the2DN students, and 4.33 for acceptance by full-time faculty. Anincreased interest in an academic career was also noted. Commentsfrom the 2DN students in the debriefing sessions were positive abouthaving student teachers.

The utilization of senior dental students as preclinical facultyin prosthodontics appears to be a viable approach to mentor studentsin careers in academics, provide student teachers with higher learningexperiences, and supplement the efforts of full-time faculty.

48. Tobacco Use Intervention Program

Monajem, Sara, Forsyth School for Dental Hygienists

Purpose: To study the feasibility of implementing a tobaccouse cessation clinical activity (TUCCA) in the students’ clinic.

Our plan to apply tobacco-related didactic teachings in clinicalsettings began with the creation of a data collection instrument. Thedecision to monitor tobacco use cessation clinical activities (TUCCA)independent of routine clinical care was born out of three necessities:1) to ensure the absolute privacy of the smoking clients; 2) to prepareand calibrate a clinical faculty who were largely unfamiliar withtobacco use interventions; and 3) to solidify referral partnerships withkey tobacco counseling and cessation organizations. The eleven-iteminstrument followed the National Cancer Institute’s training program(then 4A Model). Under the ASK and ADVISE categories, studentsrecorded the history of tobacco use among their smoking clients aswell as the smokers’ levels of interest in cessation. The determination

of the latter guided students’ subsequent courses of action—either toASSIST with cessation and ARRANGE for quitting time or to designstrategies to further motivate. The data collection instrument waspilot-tested recording TUCC activities during three consecutivetrimesters, and the findings revealed that students were successful insetting quit dates including referrals for 19 percent of the 155 smokers,the latter representing 33 percent of the clinic population. The analysisof the data collected during process evaluation demonstrated a highrating assigned to the facility and utility of the data collectioninstrument by faculty (97 percent) and students (94 percent).Moreover, both groups recognized the supremacy of the NationalCancer Institute’s model. While 96 percent of the faculty judged theintervention program to be a valuable learning experience for students,65 percent of the graduating students agreed strongly that they wouldconsider replicating the model in their practice.

The results of this feasibility study clearly point to the positiveinternal impact of the program and the significant role of the datacollection instrument in its success. The feedback offered by theclinical faculty and students is enhancing our plan toward furtherintegration of tobacco-related education into all levels of curriculum,training, and testing.

49. Student Evaluation Skills in a Preclinical OperativeTechnique Course

Louie, Kenneth, University of the Pacific School of Dentistry, Kenyon,Brian, University of the Pacific School of Dentistry, Woodson, Russell,University of the Pacific School of Dentistry, Dower, James S. Jr.,University of the Pacific School of Dentistry

Purpose: To compare the tooth preparation evaluation skills ofstudents at the beginning and end of a preclinical operative techniquecourse.

The Preclinical Operative Dentistry course at Pacific not onlyteaches students to develop hand-eye coordination but also evaluationskills. In addition to faculty, students grade their own preparationsafter every practical exam. The purpose of this study was to comparethe evaluation skills of students at the beginning and end of the course.Nine typodont teeth with Class II amalgam preparations wererandomly selected from previous practical exams. The teeth weremounted in stone with adjacent teeth and assigned a number. Forty-one students graded the preparations for criteria and refinement (thetwo marks given each practical exam in the course) at two times. Thefirst evaluation was after the third practical exam and the secondfour months later. The grades at times one and two were comparedwith the average of the fourteen faculty grades for each preparation.Accuracy, defined as the proportion of student grades within onestandard error of measurement of faculty grades, decreased for criteria(50 percent to 45 percent) but increased for refinement (41 percent to47 percent), from the beginning to the end of the course. At timesone and two, 40-42 percent gave lower grades than the faculty (bygreater than one standard error of measurement) for criteria, and 45percent gave lower grades for refinement. The low percentage (50percent or less) of students accurately grading preparations for criteriaand refinement, the decreasing criteria accuracy of the students duringthe course, and the high percentage (>40 percent) of students gradingmore harshly than the instructors demonstrate the need to improvethe tooth preparation evaluation skills of our students. Only ninegrading experiences during practical examinations may beinsufficient. More grading experiences will be given to the studentsin the future.

This study demonstrates the need to improve the toothpreparation evaluation skills of our students. Only nine gradingexperiences during practical examinations may be insufficient. Moregrading experiences will be given to the students in the future.



50. Is There a Dental Hygiene Faculty Shortage inCanada?

Mitchell, Terry, Dalhousie University School of Dental Hygiene,Lavigne, Salme, University of Manitoba School of Dental Hygiene

Purpose: To establish whether or not there is a current shortageof qualified dental hygiene faculty in Canada and to provide baselinedemographic data enabling the projection of future shortages.

The American Dental Education Association recently identifiedthe growing shortage of faculty in dental education programs to havereached a crisis situation. It is anticipated that further aging of facultyand the enhanced monetary enticements of clinical practice willfurther complicate the situation. Upon a review of the literature, wefound no studies investigating Canadian dental hygiene facultyshortages. The investigators hypothesized there are currently notenough qualified candidates to fill teaching positions in Canadiandental hygiene schools. A descriptive survey consisting of twenty-three questions was mailed to the director of each school of dentalhygiene in Canada (N=31). The survey and letter were translatedinto French for the francophone schools. Follow-up telephone callswere made to those programs from which a response had not beenreceived. Survey results were analyzed using descriptive statisticalmethods. The response rate was 84 percent. Results revealed 19percent of schools seeking faculty within the year and that 46 percentof full-time faculty are forty-nine years or older. Within the next twoyears, 23 percent of dental hygiene programs in Canada will havefull-time faculty positions available, growing to 43 percent withinthe next four years. Currently, twenty-three schools offer a diplomain dental hygiene, but ten schools will be converting to a baccalaureatedegree program within five years, further impacting the qualificationsof dental hygiene educators. Although some schools are constrainedby union agreements, it was reported that 81 percent of schools wouldprefer either a baccalaureate or Masters degree as the credential forteaching full- or part-time. Other qualifications required includeprevious teaching experience, current clinical experience, andeligibility for licensure in the province.

Clearly, this study verifies a shortage of qualified Canadiandental hygiene educators and projects this shortage will reach a crisiswithin five years. More baccalaureate and Masters-level programsin dental hygiene are required to address this growing demand foreducators. Now is the time to be proactive and to mentor studentsand colleagues to consider teaching as a career choice.

51. Male and Female Enrollment in Advanced DentalEducation Programs, 1985 to 2001

Ostermeier, Kendra, American Dental Association, Mikkelsen,Matthew, American Dental Association, Schaid Wagner, Karen,American Dental Association

Purpose: To examine male and female enrollment in advanceddental education programs from 1985 to 2001.

Each year the American Dental Association (ADA) conductsthe Survey of Advanced Dental Education to gather information onprogram characteristics, resident demographics, enrollment levels,and stipends and fees for advanced dental education programsaccredited by the ADA’s Commission on Dental Accreditation. Ascompleting of this survey is required for accreditation, a 100 percentresponse rate is obtained each year. Using the enrollment data fromthe advanced dental education survey, we examined male and femaleenrollment levels in general dentistry and specialty dental programs.Male and female enrollment was calculated as a percentage of thetotal enrollment in each program per year. General Practice Residencyand Advanced Education in General Dentistry programs werecombined to form “General Dentistry.” The remaining programs madeup “Specialties.” In 1985, males accounted for 80.7 percent of the

enrollment in all advanced dental education programs. In 2001, theyrepresented 66.6 percent of advanced students, a decrease of 14.1percentage points. Conversely, women comprised 19.3 percent ofthe enrollment in 1985, but by 2001 accounted for 33.4 percent ofthe advanced dental students. Female enrollment increased the mostbetween 1985 and 1994 (9.9 percentage points). In general dentistry,female enrollment increased from 20.8 percent in 1985 to 42.0 percentin 2001, more than doubling their share of the enrollment total. Inthe specialty programs:• Men dominated enrollment in 1985, accounting for 81.5 percent

of all students. In 2001, their enrollment dropped to 71.0 percent,a decrease of just 10.5 percentage points.

• Male enrollment in Oral and Maxillofacial Surgery programsdeclined just 6.1 percent between 1985 and 2001.

• In 1985, women accounted for 41.1 percent of all PediatricDentistry students. In 2001, female enrollment (52.5 percent) washigher than male enrollment (47.5 percent).

Enrollment in advanced dental education programs increased30.7 percent between 1985 and 2001. Men once dominated the field,but since 1985, their enrollment has decreased 14.1 percentage pointswhile female enrollment has increased. Males continue to dominatethe specialty programs, but female enrollment in Pediatric Dentistryhas exceeded males in recent years. Other than Pediatric Dentistry,females experienced their largest growth in General Dentistryprograms, more than doubling their share of the enrollment total.The proportion of males and females enrolled in advanced dentalprograms is expected to stabilize since the numbers have begun tolevel off in the past five years.

52. A Comparison of Community-Based and School-Based Clinical Evaluations at Harvard School of DentalMedicine

Ferguson, Michael, Harvard School of Dental Medicine, Raygada,Susana, Harvard School of Dental Medicine, Carpio, Lillian, HarvardSchool of Dental Medicine, Sobel, Carole, Harvard School of DentalMedicine, Chase, Carole, Harvard School of Dental Medicine,Ojimba, Jacqueline, Harvard School of Dental Medicine, Shah-Hosseini, Neda, Harvard School of Dental Medicine

Purpose: To compare clinical evaluations of similar dentalprocedures performed by fourth-year dental students at theircommunity-based sites with those performed “in-house” at Harvard’spredoctoral student clinic.

Dental schools are challenged with providing a variety of clinicalexperiences to students. Many dental schools have supplemented theirtraditional curricula with educational opportunities off-site. This “real-world” experience is invaluable to the dental student as well as to thesurrounding communities by increasing access to affordable dentalcare. It should be noted that all faculty at our extramural sites havefaculty appointments at our institution and receive yearly calibrationof our grading system and teaching/learning objectives and goals.After reaching a certain level of competency, at Harvard, fourth-yeardental students provide dental care at various community healthcenters or VA Hospital-based dental facilities for three months. Thegrades of clinical procedures performed by students at their extramuralsites were evaluated using the same system as in our in-house clinic.We have restructured our grading system to better reflect the students’clinical skills using a 5-point grading system. We compared theaverage grades for similar procedures in both settings. From the datacollected, it is apparent that the grades are similar to in-house gradesor slightly higher at their extramural sites. We can hypothesize thatthe results may be due to the following: an improved promotionsprocess at Harvard School of Dental Medicine, which screens ourstudents based on their clinical competencies for the order of theirscheduled extramural rotations; increased skill level of the student;



the added student experience gained at the community-based site;students’ increased levels of clinical confidence; and a more efficientand improved callibration system of our off-site faculty.

In conclusion, the extramural evaluations of dental students’perceived competencies should be explored further, as well as theirimpact on the community dental care system. Our study suggeststhat the diverse clinical experiences and skills gained by the studentdentists improve with their participation in community-based clinics.

53. Knowledge Retention

Fielding, Allen, Temple University School of Dentistry, Feinstein,Bernard, Temple University School of Dentistry, Haber-Cohen, Andrea

Purpose: The goal of this study was to compare the testing ofstudents’ knowledge from exam questions prepared by in-houseinstructors to questions from the “Dental Decks.”

With increasing pressure continually being placed on educatorsto prove teaching outcomes objectively, scores on the National Boardof Dental Examiners have gained greater importance. “Teaching forthe Boards” is a much-debated topic in professional schools. Theideal curriculum prepares students for high-quality practice with asound and full scope of knowledge of the basic and clinical sciences.The “hit or miss” testing of the boards inspires overemphasis on afew favored topics rather than a comprehensive understanding ofdental medicine and in particular oral and maxillofacial surgery.Studies in 2001 by K Vasker from Tufts and in 2002 by M Brody etal. from West Virginia University show the need for schools to developbetter methods of preparation. Students rely heavily on the released“Dental Decks” National Board questions to study for their NationalBoards. Yet the Temple University in-house questions written fordidactic and clinical testing of the students’ knowledge of oral andmaxillofacial surgery are felt to be equal to, if not better than, thosecontained in the Dental Decks. A comparison of the testing of thestudents’ knowledge provided insight as to the future preparation ofin-house questions. Two exams are prepared each semester for theoral and maxillofacial surgery course. The exams consist of fiftyquestions, of which 50 percent are from the Dental Decks. Thequestions chosen from the Dental Decks were specific to the materialcovered by the textbook and classroom lectures to allow for anunbiased comparison. Incorrect information from the Dental Deckswas corrected, and the dental students were informed of theinaccuracies. The results showed that the in-house questions betterreflected the students’ overall retained knowledge by 12 percent. Thestatistics further showed the distracters by the in-house instructors tohave an approximately 19 percent choice of the first distracter with a3 to 5 percent of the second and third distracter. The fifth distracterwas chosen less than 1 percent, indicating that an in-house fifthdistracter was not necessary. The Dental Deck questions were foundto have a 24 percent choice of the first distracter with an evendistribution of 5 to 7 percent for the second, third, and fourthdistracters.

The results indicated that the in-house questions were found tobetter reflect the students’ overall retained knowledge. This may bedue to the subjective emphasis placed on the material delivered bythe presenter. The distracters on the Dental Decks were found to havemore relevance to the material as a higher percentage of across-the-board choices were made by the students.

54. Clinical Experiences in Dentistry: Preparing theDental Hygiene Student, Part 2

Keselyak, Nancy, University of Missouri-Kansas City School ofDentistry, Mitchell, Tanya, University of Missouri-Kansas City Schoolof Dentistry

Purpose: This study evaluated the impact of a project in itssecond year to expand experiences in dentistry for dental hygienestudents.

Alumni and employer surveys indicated a need for graduatesto know more about dentistry in general. Students were required tocomplete an activity in various aspects of dentistry including chairsideassisting, preparation of materials, and observations. Three years ofboard scores were compared to evaluate the educational experience.Descriptive statistics analyzed data from questionnaires to determinestudent perceptions and confidence before and after participation inthe project. Student journal entries were analyzed using the ConstantComparative Method to discover recurring themes. Data obtainedfrom 2002 and 2003 were analyzed separately and compared. Whilemost students perceived little benefit from the project in preparingfor the board exam, students scored higher, moving from decile 5 todecile 8 in 2002 and to decile 10 in 2003. Students in 2003 weremore positive about the project than students in 2002. Studentsindicated they were generally more confident immediately followingthe biomaterials lab course than at the end of the project. Comfortratings for discussing procedures with patients generally increasedby the end of the program in all areas except periodontal surgery.While overall comfort decreased slightly for periodontal surgery, thepercentage of students feeling very comfortable by the end of theproject increased from 29.6 percent to 48.0 percent. Students reportedthe largest positive change for endodontics and the least positive fororthodontics. Journal entries for both classes revealed similar positivethemes and general appreciation for the experience.

While students perceive a limited benefit from the projectquantitatively, the qualitative remarks and improved board scoressuggest it is a good educational experience. Employer surveys indicatethat students were well prepared with no mention of needing moreexposure to various branches of dentistry.

55. Teaching Cariology in the Preclinical Laboratory:Using the Polymer Bur and Carious Typodont Teeth

Glotzer, David, New York University College of Dentistry, Allen,Kenneth, New York University College of Dentistry

Purpose: The evolving emphasis on contemporary restorativeprocedures in dental education involves minimally invasivepreparations with selective evaluation for complete caries removal.New York University has instituted a program that combines the useof “carious” typodont (Columbia Dentoform) teeth along with thepolymer bur (SSWhite SmartPrep™) to teach these concepts in alaboratory environment.

Prior to their entry into the clinic, D2 students take a courseentitled Restorative Dentistry Practicum. This didactic and laboratorycourse includes a review of the atypical and complex restorativeprocedures that the student will be doing for their patients. Theprevious preclinical education focused on “ideal” preparations on“perfect” teeth. This course incorporates the updated knowledge ofcariology and treatment of deep lesions, with the process of removalof decay. The use of typodont teeth with soft simulated caries enhancesthe realism and clinical application of this laboratory exercise.Students understand that carious dentin is comprised of an outerbacteria-laden irreversibly denatured layer and an inner caries-affectedlayer and that caries-detecting dyes and other diagnostic aids canassist in removing only the outer caries-infected layer. Theintroduction of the polymer bur allows the student to practiceminimally invasive procedures and remove just that outer layer. Thisnewly introduced combination of carious teeth and polymer bur ispart of a pilot program to ease the transition from the preclinical toclinical setting. Students will remove the simulated decay using thepolymer bur. This creates an irregular internal and external shape to



the cavity preparation, greatly simulating actual clinical cases. Thestudent next selects the appropriate liner, base, and restorativematerial, after reviewing the “clinical” criteria for indirect pulpcapping and determining the remaining dentin thickness, even in apreclinical environment.

The students and faculty are excited about adding this newdimension to the simulation lab. If this is successful, it is anticipatedthat it will be expanded to include fixed prosthodontics.

56. Dental Hygiene Student Attitudes Towards PeerEvaluation

Gonzalez, Barbara, Wichita State University, Anderson, Kelly, WichitaState University, Huntley, Diane, Wichita State University

Purpose: To evaluate a peer evaluation process.Evaluation is an important professional competence. A peer

evaluation process was introduced to first-year dental hygiene studentsat the beginning of their first clinical semester to help developevaluative abilities. All students were scheduled as peer evaluator atleast once during their clinical rotations and were required to havepeer evaluations on polishing, fluoride administration, unitdisinfection, oral hygiene education, seating and positioning, probing,ultrasonic scaling, dietary or tobacco cessation counseling, handscaling, and local anesthesia. A survey was administered to assessattitudes about giving and receiving feedback from a peer at the endof each clinical year. At the end of their first year, 82 percent felt theexperience as a peer evaluator was “enriching,” 90 percent madechanges in their own clinical skill based on their observations of otherstudents, and 26 percent did not always mark an item as“unsatisfactory” when they should have. At the end of their secondyear, 85 percent felt the experience as a peer evaluator was“enriching,” 78 percent made changes in their skills based on theirobservations, and 35 percent did not always mark an item as“unsatisfactory” when they should have. Only 3 percent of students(one student) did not like being observed by a peer evaluator whensurveyed at the end of both clinical years. At the end of the first year,76 percent made changes based on peer feedback, and no studentsfelt peer evaluators showed favoritism. At the end of the second year,79 percent made changes in their skills based on peer feedback.Eighteen percent felt there was some favoritism. This may be a resultof closer relationships established during the two years.

In conclusion, the peer evaluation process was consideredvaluable by students as peer evaluators and when being evaluated.

57. The Use of Simulation Laboratory for a LocalAnesthesia Certificate Course for Dental Hygienists

Cirincione, Ulana, Kennedy-King College Dental Hygiene, Beaver,Shirley, Kennedy-King College Dental Hygiene, Salzmann, Larry,University of Illinois at Chicago College of Dentistry, Fannon,Maureen, Kennedy-King College Dental Hygiene

Purpose: To describe the use of simulation in a continuingeducation course on local anesthesia for dental hygienists.

In October 2000, the Illinois Practice Act was changed to allowdental hygienists to administer local anesthesia to their patients. Anumber of continuing education courses have been offered at ourinstitution to provide required certification for interested dentalhygiene practitioners. Feedback from participants indicated the needfor hands-on practice before attempting delivery of local anesthesiaon human subjects. The purpose of this presentation is to describe anewly added simulation component to this continuing educationcourse. The simulation laboratory session included viewing avideotape, armamentarium set-up, injections into fruit, aspiration ofjuices, and the use of a manikin head model. This test head modelemitted a beeping prompt when participants correctly targeted the

injection site with the needle. An informal survey of forty dentalhygienists participating in the simulation session found that themajority felt each component of the laboratory was effective. Thelaboratory offered a relaxed atmosphere for small group learning,problem-solving, discussion, and opportunity for questions andanswers. There were a number of limitations with the manikin head,such as difficulty with oral landmark detection, location of nerveposition, tissue condition, head manipulation, and the beeping prompt.This was the first attempt with this type of laboratory; therefore,additional evaluation and feedback are necessary if future coursescontinue to incorporate simulation rather than human subjects in theirprograms.

Simulation activities can be a useful preparation for dentalhygienists participating in a continuing education course on localanesthesia administration.

58. Root Canal Therapy Using Nickel-Titanium RotaryInstruments: A Program for Entry-Level Students

Bauer, Patricia, University of Michigan School of Dentistry

Purpose: Ni-Ti Rotary Instruments were introduced into theundergraduate preclinical curriculum in spring of 2002. The challengewas to develop a program that provided a standardized techniquethat was easily understood and successfully executed by theinexperienced clinician. It was also necessary that the program wasflexible enough to be effective in a wide range of clinical situationsand adaptable to different skill levels as student rate of achievementof competency is variable.

While nickel titanium (Ni-Ti) rotary instruments are usedroutinely in endodontic specialty practices, many more generalpractice dentists are now using them due to demonstratedimprovements in the quality and efficiency of preparations. Dentalsuppliers who sell the instruments are currently providing dentistswith technical information on their use, so it is important that the useof these instruments be taught in the comprehensive clinic curriculum.Therefore, a plan was developed for the instruction of nickel titaniumrotary instrumentation for undergraduate dental students, who hadno experience whatsoever in the cleaning and shaping of a root canal.In spring 2002, the plan was implemented in the third-year preclinicon extracted teeth using only Ni-Ti files except for the establishmentof trial length where stiffer stainless steel hand files are recommended.Positive results were reported in an ADEA poster presented last year.Beginning in fall 2002, the program was implemented on patients inthe third-year clinic, and it has been enthusiastically embraced.Student response was extremely positive, necessitating instructionfor the fourth-year dental students who had been taught the traditionalhand-filing technique with stainless steel instrumentation. Preliminaryresults in patients on 187 completed anterior and premolar teethdemonstrate that use of Ni-Ti rotary files produced higher qualityroot canals in less time with fewer errors as compared to the teethcompleted using only stainless steel instruments. Summarized resultson quality of completed root canals, judged using specific, measurablecriteria such as shape and density of filled canals, will be presented,along with frequency and type of errors and written student feedback.

Higher-quality root canals can be safely and more efficientlycompleted by undergraduate level dental students using Ni-Ti rotaryinstruments as compared to stainless steel instruments.

59. Improving Access to Preventive Dental Care atMarty Indian School

Nelson, Robert, University of South Dakota

Purpose: To improve access to preventive dental care at MartyIndian School and to give students at the University of South Dakotamore cultural diversity.



In an effort to address the oral health disparities on the YanktonSioux Reservation of South Dakota, the University of South DakotaDepartment of Dental Hygiene and Wagner Indian Health ServicesFacility have jointly created a preventive dentistry clinic in MartyIndian School (MIS). Marty Indian School is a Native Americanboarding school. The entire student body is made up of Dakota orSioux Native Americans. Examinations were performed on 199students, kindergarten through ninth grade. An active decay rate of62 percent was found in the students. The clinic has three operatoriesand a reception area. Dental hygiene students, under the supervisionof faculty and staff, have provided care. In the past year, 199 studentsat MIS have received oral prophylaxis, 1,161 teeth have been sealed,and 322 students had fluoride varnishes applied twice annually.Individual oral health education was offered to a majority of thestudents. All of the MIS students are eligible to receive restorativeand other dental services at Wagner Indian Health Services Facilityin Wagner, which is fifteen miles away. Dental hygiene students wereable to observe and interact with the MIS students.

Marty Indian School students were able to receive preventivedental services that may not have been available if it were not for thepreventive dentistry clinic. Dental hygiene students had theopportunity to observe and interact with the students from MIS.

60. An Analysis of First-Year Dental Students by Stateof Residence and State of School

Wall, Thomas, American Dental Association, Brown, Jack, AmericanDental Association

Purpose: To investigate differences in the per capita number offirst-year dental students each state sends to dental school and, amongstates with dental schools, the difference between the number of first-year students enrolled (both in-state and out-of-state) and the numberof students originally from the state who went to dental school.

Students from all fifty states were represented in the first-yearclasses of U.S. dental schools in 1998. However, the number per onemillion population varied widely by state. New Hampshire was lowestwith 5.1 students. This state and the other five states in the NewEngland region were among the bottom nine, each falling below theU.S. average of 14.4. Utah was highest with sixty-five students. Threeother states in the West (Idaho, Oregon, and Nevada) also were amongthe top five. Although Oregon, California, and Washington had dentalschools, these states were net exporters of dental students. That is,each of these states had fewer first-year dental students enrolled (bothin-state and out-of-state) than it sent to dental school. Dental schoolsin these three states accounted for 16.2 percent of all first-year dentalstudents. However, students originally from these states were 20.4percent of total first-year enrollment. In contrast, New York,Pennsylvania, Massachusetts, and Connecticut were net importersof dental students. Dental schools in these states accounted for 23.8percent of all first-year enrollments, but students originally from thesestates were only 11.5 percent of total first-year enrollment. Thesestates had significant percentages of out-of-state students (NY 50.4percent, PA 62.4 percent, MA 85.5 percent, and CT 70.3 percent).These findings are based on the Survey of Predoctoral DentalEducation conducted by the American Dental Association’s SurveyCenter. State of residence for first-year dental students was usedbecause it most likely reflects each student’s state of residence priorto entering dental school. Enrollments by state of residence and stateof school for three academic years (i.e., 1998/99, 2001/02, and 2002/03) were averaged to reduce year-to-year fluctuations.

States were found to vary in terms of the per capita number ofstudents going to dental school. States with dental schools varied interms of the number of students going to dental school compared tothe number of first-year dental students admitted. However,geographically contiguous states sometimes displayed similarities,

suggesting an interstate, or regional, approach may be helpful inaddressing issues related to enrollment disparities.

61. Do Repeated Clinical Competency RatingsStereotype Students?

Chambers, David, University of the Pacific School of Dentistry

Purpose: A dataset of student clinical ratings over eightsuccessive quarters was analyzed to determine whether differencesexist between scores given by faculty members who rate studentsrepeatedly compared to those who rate students for the first time.

The rating system has been reported in the literature and has aCronbach alpha reliability of .792 for “clinical judgment,” .857 for“patient management,” and between .500 and .700 for technical skillin various clinical disciplines. The predictive validity for ratings earlyin students’ clinical careers with graduation competency is .443. All(ninety-four) faculty making ratings for the first time, except firstquarter, were selected. Correlations between first–time ratings andaverage ratings across all faculty members from the previous quarterand averages and standard deviations comparing first-time ratingswith previous quarter average ratings were calculated. These valueswere compared to the same metrics for peer faculty members whoparticipated in both the subject quarter and previous quarters’ ratings.Evidence of stereotyping would include larger correlations andstandard deviations of across-quarter ratings for faculty members whoprovided ratings both quarters and larger average gain scores for first-time raters. Means, standard deviations, and correlations for ratingsof “patient management” for previous/first-time raters were .30/.30,.68/.32, and .14/.57. The same values for “clinical judgment” were.31/.30, .67/.34, and .18/.28. The ratings for technical skill in clinicaldisciplines were .28/.34, 1.12/.75, and .14/.06. None of thesedifferences support the existence of stereotyping at a statisticallysignificant level. Analysis of extremely high and low scoring studentsand analysis of the small subset of faculty who were new to the facultydid not alter the pattern of these findings.

It is concluded that the competency-based rating system forclinical performance studied in this research shows no evidence thatfaculty members stereotype students.

62. Faculty Perceptions of Work Environment

Froeschle, Mary Lynn, University of Nebraska Medical CenterCollege of Dentistry

Purpose: To assess several characteristics of departmental workpatterns that contribute to positive and negative aspects of the workenvironment.

Work environment has been cited as an important factor in bothaccepting and maintaining a full-time academic position. An onlinesurvey about departmental structure and individual faculty workpatterns and behavior was sent to the deans of fifty-four U.S. dentalschools to disseminate. Additional follow-up surveys were also sentelectronically. Thirty-eight schools (70 percent) responded as did 476individual faculty. Regular and nonparametric statistical analysis weredone, and both supported the results. Faculty in education five yearsor less felt work loads were more equitably distributed and evaluatedthan those who had been in education longer. From two to twentyyears, the more time faculty had been in a specific position, the lessequitably they felt work load was distributed and evaluated; aftertwenty years faculty perceived the greatest equity in work loaddistribution and evaluation. Full professors perceived more equitabledistribution of work loads and were more likely to remain in academiafor the next one to three years; assistant professors perceived theleast equitable distribution of work load. Overall, organizationalbehavior was positive for the tested traits of resiliency, self-efficacy,social efficacy, optimism, and hope. Resiliency, self-efficacy, and



hope correlated significantly to the number of years in education:faculty in education from five to ten years scored lowest. Hopecorresponded significantly to years in position with widely varyingresults. Social efficacy was significantly higher for female facultythan for male faculty. In conclusion, time in education and positionand rank were significant for the perception of equitable work loaddistribution. Perceptions of work load distribution appear to be asignificant factor for faculty in their work environment.

Time in education and position and rank were significant forthe perception of equitable work load distribution.

63. Board Certification Requirement for Directors ofAdvanced Specialty Education Programs

Horan, Catherine, Commission on Dental Accreditation/AmericanDental Association, Neumann, Laura, American Dental Association,Hart, Karen, Commission on Dental Accreditation/American DentalAssociation

Purpose: To study the impact of the board certificationrequirement for advanced specialty education programs in the ninedental specialty areas on the programs’ compliance with accreditationstandards and resulting accreditation status.

Standard 2 of the Accreditation Standards for AdvancedSpecialty Education Programs states: “The program must beadministered by a director who is board certified in the respectivespecialty of the program.” The standard was approved in 1998 andbecame effective January 1, 2000. At the time it was implemented,the communities of interest expressed concern whether programswould lose their accreditation due to their inability to recruit/retainprogram directors qualified in accord with Standard 2. As of August2003, there are 430 advanced specialty education programs in ninespecialty areas accredited by the Commission on Dental Accreditationand subject to compliance with Standard 2. The data provided wascompiled and analyzed from program review data of the last fouryears (2000-03). Analysis includes those specialty programs that havebeen cited for noncompliance with the standard, the length of timetaken for the programs to achieve compliance, and the settings of thecited programs. Results indicate that twenty-three programs in fiveof the nine specialties have been cited for noncompliance withStandard 2. Results further indicate that 30 percent seven of thetwenty-three programs) achieved compliance in six months. Whilethe period of noncompliance varies, the majority of cited programseventually comply. Twice as many of the cited programs reside indental schools than in nondental school settings.

Data based upon accreditation program review since Standard2 was implemented show that approximately 5 percent of accreditedspecialty programs have been cited for noncompliance. It appearstherefore that most programs have been able to comply with the boardcertification requirement. These findings may be of interest to thedental education community as it continues to address recruitment/retention challenges.

64. Restructuring a Clinic Rotation in an Acute CareClinic

Adu-Sarkodie, Heather, University of Iowa College of Dentistry,Stefanac, Stephen, University of Iowa College of Dentistry

Purpose: To improve student evaluation and educationaloutcomes in an acute care rotation.

Instruction in emergency patient management procedures oftenvaries among dental institutions. At the University of Iowa, fourth-year dental students participate in a two-week clinic rotation duringwhich they manage patients with acute care needs. Historically, severalproblems were associated with the rotation. One, students presentedwith a gradation of levels of knowledge and patient care experience

as the senior year progressed. Two, there was no measurement ofcompetency for the diagnosis, treatment planning, and referral ofpatients needing acute care. Three, evaluation of student performancewithin the two-week period was challenging due to the diversity andcomplexity of patient presenting complaints. Our goal was to improvethe emergency clinic rotation by applying the same pedagogicalprinciples required of other clinic courses at the college. We developedspecific learning objectives for the clinic, a new student performanceevaluation system related to these course objectives, a studentassignment to follow-up on care provided in the clinic, and a case-based examination at the end of the rotation to assess competency.Students were also surveyed at the end of the rotation to evaluate thecourse and provide feedback on instructor performance. From courseevaluations, 93 percent of the students slightly to strongly agreedthat they developed increased confidence in diagnostic techniquesand in managing emergency patients. Interaction with faculty wasalso quite positive with greater than 90 percent of the students agreeingthat the instructor provided constructive feedback or encouragedindependent thinking. The patient follow-up assignment confirmed,for the most part, accurate acute-care diagnoses and treatment plansand found a high rate of patient satisfaction following emergencytreatment. As anticipated, results from the first few competencyexaminations show variation in diagnostic competency among thestudent groups. We are addressing this variance with more didacticinstruction before each rotation begins. We also plan to use facultystandardization exercises to improve the reliability of daily studentperformance evaluations.

Overall, the preliminary results of this new program showimprovement in the learning assessments of our acute care clinicalrotation.

BLOCK III – WORKS IN PROGRESS

Monday, March 8

4:00 pm to 5:00 pm

Additional poster added during this Block: 27.Recruitment and Retention of UnderrepresentedPopulation Groups in Dental Hygiene (see page 214).

65. The Clinician Educator: Bringing the Real Worldinto the Faculty

Walton, Joanne, University of British Columbia Faculty of Dentistry,Best, Leandra, University of British Columbia Faculty of Dentistry

Purpose: In the face of ongoing recruiting challenges for full-time dental faculty and the need for real world, “hands-on” education,the Clinician Educator program was instituted at UBC in the fall of2002. The purpose of the program was to improve communication,continuity, consistency, and quality assurance within the D.M.D.program by engaging part-time faculty to teach at least four half daysdays per week across the curriculum, as tutors, clinical teachers, andmentors.

The Clinician Educator program began with a need for increasedcohesiveness in our teaching program and three dedicated part-timefaculty who had demonstrated strong teaching skills, a willingnessto take various teaching roles for a minimum of two days per week,and a commitment to continue developing their teaching skills. Ratherthan requesting applications, these faculty were approached as a groupfor feedback on the Clinician Educator concept and then individuallyto discuss their interest in the program. The benefits of the modelwere in the following areas: 1) Communication among students,patients, and colleagues: core group of teachers who can communicate



amongst themselves and act as a bridge between full-time faculty(mostly specialists) and half day per week part-time faculty (mostlygeneral dentists; communicating a passion for dentistry and forteaching; and modeling professional behavior to students, patients,and colleagues; 2) Continuity of patient care and student interactions:increased student contact via teaching in multiple sessions; clinicianeducators discover what students learn across the program, and this,in turn, provides ongoing, in-house continuing education for theseteachers in terms of currency and comprehensiveness of knowledgethat can be applied across multiple teaching sessions and disciplines;and improved access/availability for students; 3) Consistency ofteaching and assessment: more sessions with same top qualityinstructors leads to increased consistency of teaching and a morecoherent message to students; and clinician educators help interpretvarying clinical opinions to students; 4) Quality Assurance withinprogram and to licensing body: a product of improved communication,continuity and consistency.

To date, the program has been a resounding success as reflectedin improved teaching evaluations by students and increased interestin the program by part-time faculty. It has resulted in improvedcontinuity, communication, consistency, and quality assurance in theD.M.D. program, while relieving full-time faculty of some teachingresponsibilities. The greatest challenge to the continuation of theprogram is financial, with the required increased salaries so far offsetby unfilled full-time faculty slots.

66. A Computer-Aided Enrichment Program toIncrease Student Dentist Comprehension of PulpTherapy for the Pediatric Patient

Johnson, Jeffrey, University of Kentucky College of Dentistry

Purpose: To improve the comprehension of student dentists ofcore concepts in pulp therapy for the pediatric patient and to providea method for improving subject matter instruction.

The “Pediatric Dentistry Pulp Quiz Bowl” program wasdesigned to facilitate student dentists’ comprehension of core conceptsin pulp therapy for the pediatric patient. Computer-based instructionand technology were used to motivate third-year student dentists todemonstrate their comprehension of treatment concepts based onsimulated case scenarios. According to Bonwell and Eison, studentstaught making use of computer-based instruction (CBI) generally learnmore. Based on 199 studies, students’ average achievement rose fromthe 50th to the 61st percentile. Compared to those taught by traditionalmethods, students in CBI classrooms also learned their lessons intwo-thirds of the time (Bonwell and Eison, 1991). After two one-hour sessions of combined PowerPoint discussion and review, eachstudent dentist was provided an individual audience responder. Fifteenquestions representing the core concepts in pulp therapy for thepediatric patient were displayed. Five multiple-choice responses, oneof which was correct, were displayed on a screen. Each question wasread aloud. Students were given one minute to formulate a response,which was registered through the computer-based audience respondersystem. At the end of the “quiz bowl,” students’ scores were tabulatedby the responder system. Self-assessment allowed students to gaugetheir level of understanding and preparation. Rewards were given tothe top three performers in the class. The session was anonymouslyevaluated by student dentists following the “quiz bowl.” Evaluationswill be used for future modifications of the original concept as wellas the lecture/presentation component of the topic. Useful feedbackon what and how well students are learning can be used to help refocusteaching efforts to improve the efficiency and effectiveness of studentlearning (Paulsen and Feldman, 1995). Evaluations will also be usedto gauge student motivation for learning core concepts of pulp therapyfor the pediatric patient.

The intent of the pilot project was to show that there is increasedmotivation by student dentists to learn core concepts in pulp therapywhen encouraged through the use of effective instructionaltechnology. Initial feedback and data will demonstrate areas forneeded improvements and modifications. The project, which iscontinuing, is thought to provide a novel method for student learningin preparation for the clinical experience.

67. Community Dentistry Programs in Western NewYork: An Update

Chin Kit-Wells, Meelin, University at Buffalo School of DentalMedicine, Perinpanayagam, Meghan, University at Buffalo Schoolof Dental Medicine, Bernat, Joseph, University at Buffalo School ofDental Medicine, Creighton, Paul R., University at Buffalo School ofDental Medicine

Purpose: To develop a series of community outreach programsto provide dental awareness and access to dental care for underservedand underinsured populations in Western New York.

The Surgeon General’s Report on Oral Health states thatunderserved and underinsured children are more susceptible to dentalcaries. Over 80 percent of the dental problems are found within 20percent of the population in Western New York. The Department ofPediatric and Community Dentistry initiated a series of programs in1996 to provide dental access and care for underserved andunderinsured populations. These include children from lowersocioeconomic populations, low birth weight infants, and childrenand adolescents with special health care needs. The objectives of thecommunity outreach programs are: 1) to train pre/postdoctoralstudents to assess systemic (oral health) needs and become dentaladvocates for the underserved and underinsured; 2) to increase dentaleducation so that the underrepresented may be more self-sufficient;3)to stress the importance of dental health and how it affects systemic(overall health); and 4) to provide access to dental care for uninsuredand underserved populations. Specifically, the programs are: 1) thedelivery of dental care and oral health guidelines to new mothers; 2)an infant dental plate program, which protects a low birth weightinfant’s palate from deformation due to a breathing or feeding tube;3) a mobile dental van that travels throughout Chautauqua County, arural community; and 4) a comprehensive oral health for disabledyouth program. In addition, we participate in National Children’sDental Health Month with two programs. The first, sponsored by theADA, Give Kids A Smile Day, addresses the needs of dental care forBuffalo’s children. The second, Smile Education Day, is observedthrough visits to local elementary schools and dental health booths atlocal malls. Pediatric residents rotate through all these programs andto Roswell Cancer Institute and a hospital-based HIV/AIDS clinic.Overall, the postdoctoral pediatric residency program has expandedfrom five to ten residents, which has helped to treat the increasedneed for dental service requests. Also, these outreach programs haveestablished strong collaborative partnerships with communityhospitals, community health agencies, health professionals, and schoolsystems, which remain a key component to program development,delivery, and successes.

Over a seven-year period, these programs were deemed to besuccessful in increasing dental awareness and access to care forunderserved and uninsured populations.

68. Multiple Resources for Instructing Dental Studentsin Case Presentations

Baechle, Mary, The Ohio State University College of Dentistry,Claman, Lewis, The Ohio State University College of Dentistry,Fischbach, Henry, The Ohio State University College of Dentistry,Halket, Christine, The Ohio State University College of Dentistry,van Putten, Meade, The Ohio State University College of Dentistry



Purpose: To help third-year dental students learn how to giveeffective case presentations to fellow students and faculty, improvetheir diagnostic abilities, and gain experience in treatment planning.

Formal clinical case presentations are an integral part of mostdental residency programs and are essential for clinical dentists whopursue scholarly activity. At the Ohio State University College ofDentistry, third- and fourth-year dental students develop their skillsby giving presentations of patients with complex dental needs to theirpeers and faculty. Third-year students present a pre-treatment casewhich is then presented in the fourth year as the completed treatmentcase. This abstract and poster will focus on the presentations givenby dental students in their third year: the “Dent 3 ComprehensiveCare Patient Presentation.” Within the past three years, several formatchanges have been incorporated in the presentation experience,initiated in 1995. The goals of these changes have includedimprovement in patient documentation (diagnostic casts, clinicalphotographs), the written case narrative, diagnostic skills, andtreatment-planning skills. Changes include development of a casepresentation website on the college Intranet that includes several linkswithin the website and sample patient cases. Current sample casesinclude the case write-up, intraoral and portrait photographs,photographs of casts and diagnostic wax-ups, clinical chart forms,and radiographs. Additionally, previous student case presentationsare available for study in each of the four Comprehensive Care Clinics.Most recently, a lecture and clinical rotation in dental photographyhave been implemented for all third-year dental students. To identifystrengths and weaknesses and make changes in the presentationprocess, faculty and presenting students were given surveys after eachpresentation for the past year. At the time the survey was administered,the website (minus the sample patient cases) was available to allstudents, but previous case presentations were available in only oneof the Comprehensive Care Clinics (approximately 25 percent of thethird-year dental students). Both faculty and student questionnairesrequested responses to positively worded statements based on a scaleof 1 to 5. Results of the survey for the past year will be comparedwith next year’s survey to determine if the recent changes haveenhanced faculty and student perceptions of the presentations.

Students have been provided with multiple resources to enhancethe quality and educational experience of the “Dent 3 ComprehensiveCare Patient Presentation.” Areas of future modification will includea more objective grading form, greater discipline balance in theattending faculty, and further incorporation of digital photographyinto case documentation.

69. A Collaborative Education Program in DentalAssisting, Dental Hygiene, and Postgraduate GeneralDentistry

Porter, Thomas, University of Florida College of Dentistry, Gore,Constance, Hillsborough Community College, Solovan-Gleason,Donna, Hillsborough Community College, Schobert, Krista,University of Florida College of Dentistry, Johnson, Shannon,University of Florida College of Dentistry

Purpose: To more effectively educate dental assisting students,dental hygiene students, and general dentistry residents in the teamconcept of providing dental health care.

Traditionally, the education of dental assistants, dentalhygienists, and general dentistry residents is done in separate clinicareas and in separate curriculums. There is limited or no interactionbetween the disciplines. In contrast, dental assistants, dentalhygienists, and dentists are expected to work in a cohesive andefficient manner on graduation. Recognizing this problem, the dentalassisting and dental hygiene programs, in collaboration with thegeneral dentistry residency, built a facility designed to place the threeprograms in intimate physical contact for didactic and clinical

education. The students are educated in the team concept of providingpatient care. The clinic facility is modeled on a private practice officewith a common reception area; the hygiene treatment area isimmediately adjacent to the resident operatories. Assisting studentsare utilized in the hygiene and resident operatories. Each hygienestudent, assisting student, and resident are grouped into a treatmentteam. Patient treatment is planned and coordinated by the team withfaculty supervision. Responsiblities of the hygiene student includethe patient’s initial periodontal therapy, oral hygiene instruction,postsurgical management, and post-care maintenance. The dentalassisting student provides chairside assisting for the hygiene studentand resident, expanded duties, schedules appointments, and monitorsthe patient’s progress through treatment. The resident is team leaderand responsible for providing patient treatment and monitoring thehygiene and assisting students. Meetings provide the members andthe supervising faculty with the opportunity to review a patient’sprogress. All team members participate in case presentation seminarswhere all are required to present.

As a work in progress, this collaborative program among dentalassisting, dental hygiene, and general dentistry residency enables thestudents to be better prepared for the team concept of providing care.

70. Resources for Attaining Clinical Competency inCast Gold Inlay/Onlay Restoration

Alperstein-Sitzamer, Klara, Temple University School of Dentistry,Boston, Daniel, Temple University School of Dentistry, Sisson, June,Temple University School of Dentistry, Hollingsworth, Jack, TempleUniversity School of Dentistry

Purpose: To identify barriers to attaining clinical competencyin Class II cast inlay/onlay restorations and provide resources forimprovement in a D.M.D. program.

Faculty (n=21), senior students (n=65), and junior students(n=55) of Tufts University School of Dental Medicine were surveyedregarding their attitudes towards cast gold inlay/onlay restorationsand the ability to fulfill competency in cast gold inlay/onlay. Fromthe faculty survey, we found that even though a majority (95 percent)believe that teaching of the cast gold restoration should be part of thecurriculum, many (42 percent) expressed reluctance to supervise orperform cast inlay/onlay restorations, and many more (85 percent)were unlikely to treatment plan a Class II (two- or three-surface)inlay cast restoration while others (38 percent) would unlikelytreatment plan an onlay cast restoration. In addition, many faculty(71 percent) considered degree of difficulty compared to otheralternative procedures, i.e., full crown or amalgam /composite,precluding them from treatment planning. Students identified thefollowing factors contributing to their difficulty in fulfilling thiscompetency: availability of inlay/onlay in the schoolwide patientpopulation (85 percent) and students’ “patient pool” (83 percent);reluctance of faculty to recommend cast gold in treatment planning(89 percent); financial concerns by the patient (94 percent); andesthetics acceptance by the patient (46 percent). At the time ofgraduation, 93/229 or 40 percent (both classes) had completed atleast one cast gold inlay/onlay restoration. In response to the facultyattitudes and students’ requirement in achieving competency in ClassII inlay/onlay restoration, the following has been implemented: anin-service program for the faculty regarding indications and principlesintracoronal cast restorations; reinforcement in treatment planningof cast gold as an alternative to a full crown or amalgam/composite;significant increase in credit for this procedure; and an emphasis ofthis modality in the junior lecture series.

Barriers to gaining competency in cast gold inlay/onlay wereidentified, and changes were implemented. Effectiveness will beevaluated after one year.



71. Block Scheduling: Perceptions of a New Approachfor Clinical Faculty Assignment

Lanning, Sharon, University of Michigan School of Dentistry, Green,Thomas, University of Michigan School of Dentistry, Piontek, Mary,University of Michigan Center for Research on Learning andTeaching, Johnson, Charles, University of Michigan School ofDentistry, Kowlaski, Charles, University of Michigan School ofDentistry, McCauley, Laurie, University of Michigan School ofDentistry, Taichman, Russell, University of Michigan School ofDentistry

Purpose: To compare student and faculty perceptions of blockversus traditional faculty scheduling in Comprehensive Care Clinics.

Periodontal faculty teaching assignments have traditionally beenevenly distributed over an entire academic year. Block scheduling isa new approach whereby faculty are assigned in concentrated blocksof time. Theoretically, block scheduling enhances continuity ofinstruction and provides extended release time for faculty. Threemonths after implementation of block scheduling in one of threeclinics, surveys were distributed to all dental students (n=206) andfaculty (n=37) assessing their perceptions of block versus traditionalscheduling regarding continuity of instruction and assessment, studentlearning, productivity, and satisfaction using a 4-point Likert scale.The overall response rate was 54 percent (students 52 percent; faculty62 percent). There were no statistical differences between studentand faculty perceptions for 25/27 and 30/30 survey items, respectively.Statistical differences included: 1) Students in the block clinic feltless able to review patients’ clinical findings, diagnosis, and treatmentplan with faculty in an efficient manner than students in traditionalclinics (2.6 vs. 3.3; P<0.05); and 2) Students in the block clinic feltfaculty were less able to allocate time fairly and spend the right amountof time with each student compared to students in traditional clinics(2.4 vs. 2.9; P<0.05).

From this initial investigation, students and faculty did not favorblock over traditional scheduling. This may be due to survey designor limited experience with block scheduling since follow-updiscussions with students were favorable. In addition, the sameamount of faculty coverage was provided in all clinics; thus,differences in student perceptions may be related to variations in clinicefficiency and productivity, student numbers, or inherent differencesin students or faculty. Further investigation of these areas is currentlyunder way.

72. Four Canadian Institutions Partner in aBaccalureate Degree in Dental Hygiene

Craig, Bonnie, University of British Columbia Faculty of Dentistry

Purpose: To develop an innovative, cost-effective model for afour-year dental hygiene degree program.

In May 2001 agreement was reached and approval obtained fora unique program to be offered through an inter-institutionalpartnership between three community college dental hygieneprograms and UBC. Primary goals were to develop a creative modelfor a four-year degree program and provide a foundational educationfor graduate studies and research. Additional goals included increasingpublic access to highly qualified clinical dental hygienists, bettermeeting the increasing health care demands of changingdemographics, enabling high school graduates to directly access adental hygiene degree, increasing retention of dental hygieniststhrough enhanced professional expertise and career satisfaction, andresponding to the call from the Canadian Dental HygienistsAssociation and the British Columbia dental hygiene regulatoryauthority for baccalaureate-level education for entry to practice. Thisprogram makes cost-effective use of public education dollars andexisting resources. Eleven students selected on GPA only began their

studies in first year at UBC in September 2002. Second- and thirdyear-studies will be completed at the community colleges and fourth-year at UBC. Only four of eleven students successfully completedthe first year. Refinements and modifications under way includeincreased program promotion, higher GPA, development ofsupplemental admission procedures, and clarification of transfer issuesbetween institutions.

It is anticipated that this partnership model may be of interestto other North American programs.

73. National Dental Certification in Canada

Boyd, Marcia, University of British Columbia Faculty of Dentistry,Gerrow, Jack, Dalhousie University Faculty of Dentistry, Duquette,Pierre, University of Montreal Faculty of Dental Medicine, Haas,Robert, University of Toronto Faculty of Dentistry, Loney, Robert,Dalhousie University Faculty of Dentistry

Purpose: Using a new OSCE format for national licensure andcertification in Canada.

Assessment of dental graduates for practice using a nationallyaccepted and recognized process is desirable. In Canada, thecertification system involves 1) assessment of students’ competenceduring the predoctoral program, 2) the process of accreditation, and3) a national certification examination which consists of a WrittenExamination and an Objective Structured Clinical Examination(OSCE). An OSCE has been in place since 1996. Testing to a nationalstandard against stated and nationally accepted competencies is themandate of the National Dental Examining Board of Canada (NDEB).Test development and implementation constitute an ongoing processthat demands the development and evaluation of new testingmethodologies. The NDEB has developed a new, more challengingOSCE that will be used for graduates of accredited North Americandental programs and non-North American graduates who havesuccessfully completed a two-year qualifying program. Theexamination is case-based with one or more correct answers (up tofifteen options). The template, question stem, and options will remainconstant, but the case material will change annually. Differentialscoring is used. The template will be posted on the NDEB websitefor student and faculty information and study. The OSCE will bepilot-tested in 2004 with implementation in 2005. Previous KR20statistics of the Written and OSCE examinations have been 0.88 and0.73 respectively. Examples of the template, questions, and optionswill be available on site.

74. A Browser-Based Electronic Dissector for Assistingin the Dental Gross Anatomy Laboratory

MacPherson, Brian, University of Kentucky College of Dentistry,Brueckner, Jennifer, University of Kentucky College of Dentistry,Tieman, James, University of Kentucky College of Dentistry

Purpose: To develop and provide a CD-based electronicdissector to assist students in the dissection process, highlight sessionobjectives, integrate the histology/clinical relevance whereverpossible, and provide a value-added curricular enhancement in theirgross anatomy laboratory experience.

Lack of trained faculty has resulted in many departments movingto alternate dissection formats, reducing the number of students inthe gross anatomy lab at any one time. We have found while thishelps, students are often stalled, waiting for faculty to come by theirtable to show them how the area/dissection should be approached.We are developing a CD-based electronic dissector that not only showsthem dissection images, outlining the session’s objectives, but alsothe exact dissectional approach to the area/structure. The dissector isassembled in an HTML editor (Dreamweaver MX). The user interfacehas scrolling text on the left panel with hyperlinked text to dissection



images from Grant’s Atlas Life Art Image collection. Navigationbuttons below the primary image in the right panel include:“Dissection,” a digital image of a typical dissection of the same regionas depicted in the Grant’s Atlas image; “Show Me How,” whichpresents a fifteen to twenty second digital videoclip; and an “IntegrateMy Histology” button, that shows them histological images of thestructure and/or region, as well as a “Clinical Integration” button,where appropriate. All digital images, either still or in movie form,were collated from a complete dissection of the body performed inour department. The histological images incorporated are designedto reinforce integration between histology and gross anatomy. Clinicalintegration is designed to reinforce clinical applications of basicscience material in either gross or microscopic anatomy. The pilotmodule (Head and Neck) will be beta-tested during the 2003-04academic year in all four gross anatomy courses taught in thedepartment. Supported by the James and Barbara Holsinger EndowedProfessorship and the Kentucky Research Challenge Trust Fund.

This value-added dissection aid, used at home prior to thedissection, as well as available in the lab on several computers, shouldsignificantly assist the student with the session’s dissection objectives.

75. Critical Thinking Skills of Pediatric DentistryResidents

Ocanto, Romer, Nova Southeastern University College of DentalMedicine, McGuire, Jason, Nova Southeastern University College ofDental Medicine

Purpose: The purpose of this pilot study was to compare theacceptability of two assessment tools designed to measure students’ability to think critically.

Assessment of learning is a process to improve the knowledge,skills, and attitudes acquired through study and practice. The abilityto distinguish observable, verifiable facts from opinions or untestedtheories is critical to the scientific method and to measures of inquiryused in dental education. The purpose of all courses in the pediatricdentistry graduate program at Nova Southeastern University is todevelop and refine this ability. However, it is necessary first to assessthe pediatric dentistry residents in regard to their cognitive dispositionthrough the use of the appropriate assessment tools.

Twelve residents (four females and eight males, aged twenty-five to thirty-six) were asked to participate in four test sessions. Allparticipants completed two traditional critical thinking (CT) tests:the California Critical Thinking Skills Test (CCTST) and the Watson-Glaser Critical Thinking Appraisal (WGCTA), both context-independent tests. Residents are now in the process of completing anadaptation of the context-dependent Multiple Rating Item (MRI)recommended by Fisher and Scriven (1997) as an alternative toconstructed response questions used in most traditional tests.Furthermore, resident feedback is also being obtained for eachmeasure. CT scores for both context-independent test (CCTST andWGCTA) were reviewed as function of age, gender, and dental schoolGPA scores. Both tests correlated positively with each other (r=.63)indicating a moderate association, and both tests correlated (r=32and r=35 respectively) with GPA scores. These results are consistentwith previous findings (Soh et al., 2002). Comparisons with resultsfrom the MRI will allow us to determine which test or combinationof tests will be suitable to evaluate dental educational interventionsinvolving CT skills.

This pilot study suggests that both context-independent testsare acceptable for this population group; however, comparison withresults from the context-related instrument will provide moreinformation on what test(s) to use while assessing CT skills at thedental graduate level.

76. Accuracy of Automated Blood Pressure Monitors

Nelson, Debralee, University of South Dakota Department of DentalHygiene, Kennedy, Beverly, University of South Dakota Departmentof Dental Hygiene, Regnerus, Carissa, University of South DakotaDepartment of Dental Hygiene

Purpose: To compare blood pressure and pulse readings obtainedby automated and aneroid gauge monitors with the accurate andpreferred traditional mercury column manometer.

Obtaining vital signs for dental patients is considered standardof care, yet many offices do not routinely perform this health servicedue to training and time constraints. The use of automatic bloodpressure monitors addresses both time and expertise concerns. Themercury column manometer, the control in this study, has long beenconsidered the most accurate and preferred instrument for obtainingblood pressure. During this study, 100 participants (eighteen yearsof age and older) consented to having their blood pressure taken withfour different monitors: mercury column manometer and stethoscope,aneroid manometer and stethoscope, automatic arm blood pressuremonitor, and automatic wrist blood pressure monitor. Allmeasurements are taken from the left arm with five minutes allowedbetween measurements. Identical stethoscopes are used with themanual monitors. Each of the four clinicians was assigned to andcalibrated for a specific monitoring device with testing limited to tento twelve individuals per session to avoid operator error. Strictadherence to manufacturer directions and patient preparation isfollowed for all monitors. Measurements recorded onto a master sheetidentify subjects by identification numbers only. Investigators arenot aware of readings obtained by other investigators during testing.Comparisons of readings are made using these master sheets.Individuals with abnormal readings are notified and advised to seekmedical attention.

Preliminary results indicate blood pressure readings obtainedwith automated monitors are significantly different from thoseobtained with the mercury column monitor. Less difference has beennoted between the aneroid and mercury column units.

77. Student/Provider Evaluation of Revisions Made toa Dental Hygiene Field Experience Course

Scheidel, Donal, University of South Dakota

Purpose: To survey students and dentists participating in a fieldexperience summer course regarding their response to a coursereorganization.

The University of South Dakota Department of Dental Hygienehas required students to develop an understanding of the privatepractice setting through participation in a three-week internship classduring the summer between their junior and senior years. The goalsof the course are to enable the student to develop an understandingof the importance of all dental staff members, to expose the studentsto the pace of private practice, to observe the interactions betweenthe various staff members, and to gain an understanding of the variousprocedures performed by the dentist. Their clinical requirements areminimal (three prophylaxis). In past years, the students were requiredto seek out a dental office in which to spend their three-week internshipand would then spend approximately a week each with the dentist,hygienist, and front office staff. The course was changed for thesummer 2003 term to require students to spend one week in a single-dentist practice, a week in a multiple-dentist practice, and a week inan Indian Health Service dental clinic. The change was implementedto expose students to three different practice settings and to exposestudents to different cultures. Each student was scheduled into anoffice convenient to the student’s available free lodging after officesin the four-state area (South Dakota, Iowa, Nebraska, and Minnesota)



agreed to participate in the program. Thirty-eight private practicesettings and seven IHS dental clinics hosted students throughout thesummer. Students were still participating in their internships at thesubmission deadline, but preliminary evaluations from both thestudents and the providers supported the course change. After allevaluations are received, the final evaluation data will be compiled.

Both students and dentists felt the changes in the internshipwere positive, allowing students to gain a broader perspective onavailable practice settings in the workplace and to experience adifferent culture firsthand.

78. Implementation of the Faculty ResearchEnrichment Program for Clinical Dental Educators:First-Year Results

Bilan, Janice, University of Texas Dental Branch at Houston, O’Neill,Paula, University of Texas Dental Branch at Houston, Powers, John,University of Texas Dental Branch at Houston

Purpose: The purpose of the University of Texas Dental Branchat Houston Faculty Research Enrichment Program (FREP) is toprovide clinical faculty a comprehensive package of educational andmentoring offerings aimed at helping them attain their research goals.

In 2003 UT-Dental Branch at Houston developed acomprehensive program to improve research skills of clinical faculty:the Faculty Research Enrichment Program (FREP). Phase I is aseminar series immersing faculty in research methodology; Phase IIincludes four pathways from which faculty can choose, based uponindividualized research goals. This program needs commitment, soPhase I was designed as a pilot project to determine whether seminarsresulted in clinical faculty pursuing Phase II or initiating individualresearch projects. Clinicians (twenty-two) were chosen so that thepilot group varied in age, research experience, and tenure status. Thefour-month seminar series included ten sessions. Phase II includesfour tracks and is arranged to accommodate schedules of clinicalfaculty: 1. degree track; 2. long-term research mentoring track; 3.short-term research mentoring track; and 4. master teacher(educational research component) track. On the degree track, facultyare given three years to complete a M.S. degree. On the long-termtrack, trainees are mentored by senior faculty and administrators forfive years, with the goal of becoming independent researchers. Short-term trainees are mentored by senior faculty and administrators forone year, with the goal of becoming part of a research team. On themaster teacher track, faculty earn a M.Ed. or Fellowship. Phase Iwas assessed using three measures: Likert scale evaluations; numberof participants registering for Phase II; and number of participantsengaged in new research. Evaluations of Phase I were uniformlypositive; ten participants are now involved in research; one trainee isin a short-term mentoring program. Next steps: improve and repeatPhase I and develop assessment measures for Phase II.

Based upon initial observations, the first year of the FREPinitiative was positive. The plan is to continue FREP at the DentalBranch.

79. Assessment of OSCE-Based Examination forPediatric Dentistry Competency Evaluation

Correa Luna, Adolfo, University of Puerto Rico School of Dentistry,Garri, Viviana, University of Puerto Rico School Of Dentistry,Melendez, Jorge, University of Puerto Rico School of Dentistry,Hernandez, Jose, University of Puerto Rico School of Dentistry,Torres, Jose, University of Puerto Rico School of Dentistry, Crespo,Kathleen, University of Puerto Rico School of Dentistry

Purpose: This study was designed to internally validate theOSCE-based examination and demonstrate usefulness in measuringthe students’ competency attainment.

The pediatric dentistry predoctoral clinic at the University ofPuerto Rico School of Dentistry has used OSCE (ObjectivelyStructured Competency Examination)-based examinations for someyears to measure the students’ progress after the preclinical and third-year clinical rotation, where, in a closed setting, the student completestwo comprehensive school-aged patients. The senior students arerequired to complete two more patients in a Comprehensive CareClinic, in addition to an external clinical rotation at a hospital-baseddental clinic. In order to assess curriculum adequacy of all thecomponents within the pediatric dentistry section, a prospectiveassessment of our evaluation strategies is being developed, applyingpurposeful assessment techniques. The overall project consists of theadministration of an OSCE-based examination in two consecutiveyears, measuring skills and knowledge in basic examination,diagnosis, and treatment planning of the child patient. Comparisonof student performance will be assessed using linear scales, ensuring“person-free” and “item-free” measurements. Our hypothesis is thatthe OSCE-based examination will adequately measure students’ entry-level clinical knowledge and skill as well as basic competency inpediatric dentistry. The first phase of the study was conducted at theend of the last academic year. The OSCE-based examination wasadministered to the junior and senior classes (n=90). Mean raw scorefor juniors was 46.53 (Std 3.68) and for seniors was of 50.19 (Std2.84). This difference was statistically significant at P<0.01.

The preliminary results indicate our OSCE-based examinationdiscriminates between levels of competency. This instrument will beassessed and improved after an item evaluation, to be readministeredin May 2004 to the current classes, in the second phase of the study.

80. Development of a Comprehensive IntegratedGeriatric Dental Curriculum

Hjertstedt, Jadwiga, Marquette University School of Dentistry,Schrubbe, Katherine, Marquette University School of Dentistry,Iacopino, Anthony, Marquette University School of Dentistry

Purpose: To produce dental students competent in gerontologyand geriatric dentistry.

The rapidly growing older population with complex dental,medical, and psychosocial needs requires competent dental clinicianswith a unique set of attitudes, knowledge, and skills. Future generaldentists must be able to work as interdisciplinary team members toprovide optimal care to the aging population. As part of a schoolwidecurricular revision and renewal, the proposed four-year integratedgeriatric dentistry curriculum was developed and approved forimplementation. Geriatric concepts were woven into existing didacticmaterial, rather than creating separate discipline-based courses. Thekey features of the curriculum employ a general dentistry approach,provide clinical experiences with older adults during all four yearsof instruction, facilitate progressive reinforcement of basic/behavioralsciences, and emphasize principles of preventive dentistry, publichealth, and ethics. The curriculum uses different teaching methodsincluding dental rounds, computer-assisted independent learning,small group discussions, and case-based instruction to emphasizeproblem-solving skills, critical thinking, and lifelong learning. Thecurriculum emphasizes early clinical and community-based trainingexposing students to the role of the dentist as a member of aninterdisciplinary team caring for older adults. A comprehensiveevaluation strategy has been developed to support ongoingrefinements and modifications of the educational program. Pilotprograms conducted for the freshmen class during the 2002-03academic year provided an initial baseline for comparison. The D1students completed a “Palmore’s Facts on Aging” quiz to assessknowledge and attitudes about aging. The results revealed a generallack of knowledge and many misconceptions about the elderly. The



next step in the development of the curriculum is implementation ofeducational components for each dental class in the 2003-04 academicyear.

A comprehensive geriatric dental curriculum was developedfor D1 through D4 students at Marquette University School ofDentistry.

81. Establishing a Clinical Tobacco Cessation/Prevention Intervention as One Part of a University-Wide Tobacco Control Initiative

Davis, Joan, Southern Illinois University School of Dental Medicine

Purpose: To offer participants interested in establishing orenhancing a tobacco control program at their institution strategiesand insight as to how to use an institution-wide, comprehensive,multidisciplinary approach.

Healthy People 2010 has set a goal for the number of Americanssmoking to be reduced from a current estimate of 25 percent to 12percent. An integral part of the reduction strategy includes healthcare providers’ offering tobacco cessation interventions to everytobacco user. Dental professionals have a professional and ethicalresponsibility to offer these services, but often do not due to a feelingof being inadequately prepared. Providing a tobacco cessationprogram in the clinical arm of a dental or an allied health curriculummay better prepare clinicians to intervene in private practice. AMidwest university, with an enrollment of 22,000, receivedgovernment funding to develop and implement a campus-wide,multidisciplinary tobacco control initiative over a two-year period.This initiative included policy components, advocacy, positive mediamessages, a public health component, evaluation, and cessationservices. The cessation component included a baccaloriate dentalhygiene program, with 100 students and fifteen faculty. The dentalhygiene staff and tobacco coodinator researched, designed, andimplemented a comprehensive tobacco cessation program thatincludes: identifying tobacco users, their readiness to quit, briefmotivational interviewing, oral cancer exam, free nicotinereplacements, follow-up, and evaluation. Over 350 university studentsused the dental hygiene clinic fall 2002 and spring 2003. Each studentfilled out a tobacco use survey as a part of the intake. A total of 41percent of the student tobacco users indicated they were interested inquitting. A great many insights have been gained, materials developed,and resources compiled that could save other faculty interested startingtheir program a great deal of time and effort. The exchange of ideascould benefit all.

Through the process of developing and continuing to refine amultidisciplinary clinical tobacco intervention program, bothpresenter and participants could gain from sharing ideas and strategies.

82. Development of a Web-Based Discovery Tool forEnhancement of Dental Service Learning and CivicEngagement Programs

Garetto, Lawrence, Indiana University School of Dentistry, Yoder,Karen, Indiana University School of Dentistry, Gosney, John, IndianaUniversity School of Dentistry

Purpose: Many problems in service learning (SL) and civicengagement (CE) programs require a combination of traditionalscientific knowledge and an understanding of various socioeconomicfactors. We are developing a web-based assessment tool that can 1)help facilitate a new level of communication between the patient andhealth care provider; 2) enhance the level of interaction among faculty,staff and students within the Indiana University School of Dentistry(IUSD); and 3) increase communication between dental schoolpersonnel and alumni, as well as local and state communities.

SL and CE are key components of IUSD’s predoctoralcurriculum. As our students actively engage in various SL and CEprograms (many of which are in remote locations away from thedental school), they will need to have quick access to an intuitive,powerful information delivery system that can help them best addresssituations and problems requiring specific dental knowledge as wellas access to socioeconomic information. Additionally, faculty andstaff, as they assist the primary focus group participants, will alsoneed direct access to the web-based system in order to best facilitatethe learning opportunities offered by the programs. The web-basedtool under development utilizes a “stream of thought” designmethodology that will allow users to have a learning experience basedon their own pre-existing knowledge base. In short, the tool will allowfor exploration based on specific interests, but in the sense theexploration is self-guided (with the ability to record the “learningpath” for presentation and evaluation to the users as they leave thesite). Critically, this “stream of thought” design methodology willcomplement the pedagogical focus of IUSD’s problem-based learning(PBL) initiative in the predoctoral curriculum. Since PBL requiresparticipants to draw on their existing knowledge base to understandand ultimately deal with a given problem, this tool, and how it isused outside the traditional classroom, will further the students’ abilityto develop “real world” solutions via this conceptual discoveryprocess. The web-based tool is specifically facilitating ourcommunity/SL “Seal Indiana” program (a state-of-the-art mobiledental unit that provides community-based sealant care tounderprivileged children throughout the state of Indiana). Supportedby an SBC Technology Fellowship.

Given their participation in this program is a required part ofour fourth-year D.D.S. students’ schedule of rotations, a primary goalof the tool is to record both their pre- and post-experience reflectionsconcerning this rotation. Problems in service learning and civicengagement programs require a combination of traditional scientificknowledge and an understanding of various socioeconomic factors.By asking students to respond in narrative format (via the web-basedtool) to these varied issues, we are already witnessing a betterunderstanding of what the term “service learning” means and how itcan be applied to our students’ professional careers. In short, the web-based tool is facilitating a more complete “service learningexperience” by not only requiring this pre- and post-experiencereflection but also allowing (because the narrative information iscaptured) the later review of these narratives by students just enteringthe rotation, thus giving them more insight into the goals of theprogram. The narratives also provide rich material for the developmentof cases in our predoctoral PBL curriculum. As such, the web-basedtool is also facilitating a more holistic integration of our entirecurriculum given that first- and second-year students working throughPBL cases will benefit from the experiences of their fourth-year peers.

83. Toward Better Integration of Biomedical Scienceand Clinical Dentistry

Humphrey, Sue, University of Kentucky College of Dentistry, Skelton,Judith, University of Kentucky College of Dentistry, West, Karen,University of Kentucky College of Dentistry, MacPherson, Brian,University of Kentucky College of Dentistry

Purpose: To improve the integration of biomedical scienceinstruction with clinical dentistry.

The integration of biomedical and clinical sciences has longchallenged dental educators. Inherent to the problem is the lack ofexpertise outside of faculty’s respective biomedical or dental field.As a result, there is constant tension between the instruction studentsreceive and value in biomedical and clinical sciences. In an attemptto address this issue, a survey was administered to dental faculty,



biomedical faculty, and dental students. Dental students were askedto evaluate the integration of dental sciences in each of ten biomedicalscience courses in their curriculum and to report the use of dentalexamples/applications, small group discussions, participation bydental faculty, and the general degree of clinical integration withineach biomedical science course. Dental and biomedical sciencefaculties were asked to evaluate integration and participation incourses from their own perspective. All groups were asked torecommend specific methods to better integrate biomedical sciencewith clinical dentistry. With an average of 78.5 percent of studentsand 54.5 percent of faculty responding, the survey gave us significantdata to aid in curricular improvement. Results to be reported includespecific areas for improvement, some of which have already beeninitiated: for example, identification of topical areas that need to belinked early in specific biomedical science classes and reinforced inclinical courses. In addition, 92.8 percent of biomedical and dentalfaculty responded positively to participating in the development andimplementation of curricular modifications. This process could beadapted to other schools with similar concerns.

The results of the survey give evidence of specific areas ofevaluation and recommendations in an effort to improve theintegration of biomedical science with clinical dentistry. Mostencouraging was the volume of student responses, along with thepositive response by faculty for participation.

84. Vertical Integration of Cariology in a Four-YearCurriculum

Collins, Claire, University of Colorado School of Dentistry, Passon,Craig, University of Colorado School of Dentistry

Purpose: To describe the development and implementation of aprogram integrating the study of dental caries into the four-yearcurriculum.

The process of dental caries, one of the two main diseases wetreat, is complex. Its detection has long been the subject of conjecture.Early detection is essential to conserve tooth structure. Students needsound core information to detect, manage, and assess outcomes.Previously, information about dental caries had been taughtdisjointedly, resulting in students having fragmented knowledge aboutthe topic. Program: A four-year curriculum is in progress. CariologyI (January of Year 1): Introduction to Caries as a Disease Processwas first presented in January 2003. It correlates the microbiology ofcaries and plaque, immunology, microanatomy, nutrition, fluoride,prevention/plaque removal techniques, and progression patternsrelated to dental anatomy with other courses. A clinic exercise withstudents acting as both clinician and patient to evaluate plaqueaccumulation and conduct saliva tests was performed. Cariology II(January of Year 2): Methods of Detection and Caries Risk Assessmentwill be presented in January 2004. It will correlate with clinicaldiagnosis and treatment planning. The various detection methods,practice of these methods on extracted teeth and standardized patients,and use of patient interviews to determine risk factors is planned.Cariology III (fall semester of year 3) and IV (fall semester of year4) integrate cariology with clinic care. The development of portfoliosdocumenting risks, planning caries management programs, andproviding follow-up evaluation and treatment are part of the plannedcourse activities. The portfolios will provide outcomes assessment.A clinic competency in the process and nonsurgical management ofnoncavitated lesions is already a requirement.

After the first course, students better understand the need forsurgical intervention and the impact of caries progression onpreparation design. Student reactions to the clinic exercise inCariology I are being submitted in a separate abstract.

85. Comfort and Effectiveness of the AMSA NerveBlock Injection

Pollard, Marti, University of South Dakota, Bly, JoNell, Universityof South Dakota, Nelson, Robert, University of South Dakota

Purpose: This study was designed to determine the comfort andsuccess of the AMSA nerve block injection utilizing a computer-controlled anesthetic delivery system.

Many dental patients have preconceived thoughts concerningpain upon the injection of local anesthetic. Dental clinicians have thetask of achieving successful anesthesia with a minimum of patientdiscomfort. The Anterior Middle Superior Alveolar (AMSA) nerveblock achieves pulpal and lingual soft tissue anesthesia for themaxillary central incisor through the maxillary second premolar,without collateral anesthesia of the face or lips. This injection isaccomplished using a computer-controlled anesthetic delivery system.A pilot study was conducted to determine ease of administration,degree of anesthesia achieved, and perceived comfort level of thepatient when the AMSA technique is utilized. A small conveniencesample of nine senior dental hygiene students enrolled in university-based dental hygiene program was selected to participate in this study.Study participants administered the AMSA injection to a studentpartner using the Dentsply Comfort Control Syringe™. Operatorsadministered 0.9 ml of lidocaine with epinephrine 1:100,000. Theoperator and student partner completed separate surveys to evaluatethe injection technique. The preliminary conclusions indicate thatthis injection is easy to administer, relatively comfortable to receive,and achieves effective anesthesia. The next step is to expand thisresearch project by increasing the number of subjects and byevaluating the comfort level of the subjects during a scaling procedure.Prior to scaling maxillary premolar and incisor areas, contra-lateralareas will be anesthetized following the AMSA technique andtraditional palatal, ASA, and MSA techniques respectively. Followingthe scaling procedure, subjects will rate the comfort of each injectionand scaling procedure.

The investigators of this study anticipate this ongoing researchwill confirm the findings of the pilot study and provide further insightinto the use of the AMSA nerve block injection.

86. The Case-Based Group Interview as a Pre-Admission Selection Tool

Bolivar, Sandra, University of Southern California School of Dentistry

Purpose: To evaluate dental applicants’ abilities to work andlearn in a PBL environment.

In 2001, the USC School of Dentistry fully adopted PBL as itscurriculum pedagogy following a six-year pilot program. With PBLas the pedagogy, all USC dental students must be able to learn andwork cooperatively in small groups where their contributions andbehavior affect their own and their peers’ learning. Consequently,the School of Dentistry modified its pre-admission process to identifya class of 144 entering students who will be best suited to a the school’sunique learning environment and who will find the PBL environmentsuitable to their personal learning preference. This admission processwas originally developed for the twelve students admitted to the PBLpilot program, but required additional planning to implement in theprocess to admit a class of 144. The interview day begins with agroup of up to thirty students who participate in a detailed orientationto PBL and the USC curriculum. This is followed by observation ofan actual PBL learning session with currently enrolled students inthe first- or second-year classes followed by the opportunity to interactwith these students and learn about their experiences in PBL. Toobserve the students in a group learning environment, applicants aredivided into smaller groups of between six and ten who then engage



in an hour and a half long problem-based learning exercise based ona nonbiomedical case. The applicants participating in the PBL sessionare observed by two members of the selection committee and areevaluated and ranked in the areas of interpersonal behavior, language,reasoning, and feedback skills. This group learning evaluationcriterion becomes a central element incorporated into the admissionsdecision.

This method of screening applicants has yielded classes ofstudents who are more team-oriented and collaborative as measuredby student and faculty feedback. Efforts to maximize our ability toselect students with the most positive behavioral skills continue.

87. Innovative Teaching of Operative Dentistry UsingBi-Layered Caries Teeth and Simulated Radiographs

Strassler, Howard, University of Maryland Dental School, Kaim,James, New York University College of Dentistry, Porter, Judith,University of Maryland Dental School

Purpose: This program is designed to teach cavity preparationsin operative dentistry with a case-based approach using a simulatedpatient using bi-layered plastic teeth that have caries pathology andradiographs demonstrating the presence of caries.

The challenge when teaching operative dentistry preparationson plastic teeth is how to teach diagnosis, decision-making, and toothpreparation design when the tooth has no pathology. The developmentof a bi-layered (dentin-enamel) plastic tooth with site-specific cariesplacement has been developed and is under evaluation. The cariesallows students to be challenged with simulated clinical situations.To further enhance diagnosis of pathology, the “simulated patient”with the caries teeth placed into the typodont comes withaccompanying radiographs that mimic the radiographic appearanceof caries that coincides with the location of the caries in the bi-layeredteeth. Using this methodology the student in the preclinical laboratorymay be exposed to case studies that are problem-based. This case-based approach is innovative in that a first-year dental student is givena patient history with a typodont that has simulated caries andaccompanying radiographs. The caries teeth can be customized tomimic incipient caries, more extensive caries that may need baseand/or liners, or more extensive caries for a cusp replacementrestoration. Traditionally, cavity preparations in the simulationlaboratory have been limited to “ideal or classical” designs. Withthese innovative bi-layered caries teeth, the student can now bechallenged to make decisions for diagnosis and preparation design.Initial experiences with this approach have been well received byboth students and faculty. Students are able to chart their simulatedpatient using the visual appearance of the caries teeth and radiographsand then design and prepare teeth based upon the extent of the caries.This program will present examples of case-based simulated patientsusing bi-layered caries teeth and radiographs and how it may beincorporated into a restorative program.

Using a case-based problem-based methodology along with bi-layered caries teeth and simulated radiographs, students learndiagnosis, charting, treatment planning, and appropriate surgicaltreatment.

88. Problem-Based Learning Tutor Triad FormativeFeedback Process

Fitzgerald, Brenda, Indiana University School of Dentistry, Garetto,Lawrence, Indiana University School of Dentistry

Purpose: This study discusses the “Tutor Triad” process wherebyPBL tutors observe each other, generate formative self and peerfeedback, and discuss tutoring techniques. Goals include providingessential feedback and support to tutors, actively engaging them in

methodological dialogue, modeling the PBL process, and providingpractical yet effective faculty development.

In 1997, Indiana University School of Dentistry (IUSD)introduced student-centered problem-based learning (PBL) into itscurriculum. In small-group sessions, students explore health carescenarios that involve specifically designed yet ill-structured patientproblems. They identify gaps in their knowledge in a hypothesis-driven manner by drawing on prior knowledge and identifying areasfor research. An essential element of PBL groups is the tutor. In novicegroups, tutors model desirable PBL process skills and, as studentsgain experience and progress through stages of group development,help them build group dynamics, insist they support their statements,and encourage them to control and direct their own learning. In anintensive two-day workshop, new tutors gain a foundationalunderstanding of the PBL process and receive detailed instructionand mandatory practice giving constructive, in-depth self and studentfeedback. Yet though expected to give in-group feedback, tutorsreceived no formal formative peer review nor training following theirinitial workshop, and their skills varied widely with no plan forsystematic review or improvement. Thus, the Tutor Triad was createdwherein an experienced tutor called the “Float” observes a less-experienced tutor (A) facilitate a PBL session. Immediatelyafterwards, they discuss that session’s process. For the next casesession, the Float substitute tutors for A, enabling A to observe anothertutor (B). Following this session, A and B reflect on that day’sfacilitation process. At a third session, the Float substitutes for B,thus allowing B to observe A and to discuss it afterwards. Finally,and most importantly, the Float and tutors A and B meet to discussand reflect on their observations during all sessions.

Initial survey data indicates 60 percent of triad participantsagreed the system was a good use of their time; 80 percent agreed orstrongly agreed that it was useful to observe another PBL tutor. Despitethese positive results, only 40 percent agreed and 40 percent wereundecided that the system helped them develop more effective tutoringskills. Our current focus is on what else should be done to translatethis positively viewed process into one that generates improvedtutoring skills.

BLOCK IV, Tuesday, March 9

10:00 am to 11:30 am

89. Clinical Application of Emerging Technologies inPredoctoral Periodontics Programs at U.S. DentalSchools

Pryor, Mary, Temple University School of Dentistry

Purpose: The extent and reasons for clinical use or nonuse of avariety of traditional and emerging periodontal diagnostic andtherapeutic modalities in predoctoral educational programs at dentalschools in the United States were evaluted by a survey questionnaire.

A standardized written survey questionnaire was mailed topredoctoral periodontology program directors at all U.S. dentalschools (n=53), which assessed the depth and scope of clinical trainingin nonsurgical periodontal therapy at a predoctoral level relative toanti-infective treatment approaches that have emerged in recent years.Survey items inquired about predoctoral clinic use of PeriodontalScreening and Recording (PSR) scores, IL-1 beta geneticpolymorphism testing, microbiological analysis (culture, nucleic acidprobes, phase-contrast microscopy, serum antibody assessment),gingival crevicular fluid evaluation, povidone-iodine pocket irrigation,local subgingival application of sustained-release tetracycline(Actisite), doxycycline (Atridox), minocycline (Arrestin), and



chlorhexidine (PerioChip), low-dose systemic doxycycline (Periostat)therapy, and systemic amoxicillin-metronidazole antibioticadministration. The survey also assessed predoctoral clinical use ofmore traditional periodontal diagnostic procedures, such asevaluations of probing depth/clinical attachment level, bleeding onprobing, tooth mobility, furcation involvement, and mucogingivaldefects, as well as treatment with nonsurgical periodontal scalingand root planing. Respondents provided information as to how oftenthe procedures were carried out in their predoctoral clinics and thestudent skill level sought. Reasons for not utilizing any of the emergingperiodontal diagnostic/therapeutic procedures were also obtained.Ninety-two percent of U.S. predoctoral periodontology programsresponded to the survey. Survey findings revealed that traditionaldiagnostic/treatment procedures are clinically used in nearly allpredoctoral periodontology programs. Interestingly, measurementsof clinical periodontal attachment level are not employed routinely/frequently in approximately one-third of all U.S. predoctoralperiodontology clinics. The PSR screening system is clinically taughtin only half of these programs despite past national campaigns topromote its clinical use. Other emerging diagnostic techniques arealmost entirely not used in U.S. predoctoral periodontology clinics,with concerns expressed by nonusers most often about the lack ofclinic time (25 percent), high costs (30 percent), and a perceived lackof scientific validity (30 percent) for these procedures.

Despite considerable research activity, virtually no clinicalapplication of recently developed periodontal diagnostic techniquesis occurring in U.S. predoctoral periodontal educational programs.In comparison, 50 percent of these programs employ a variety ofemerging local and systemic antimicrobial agents. These surveyfindings underscore potential barriers in attaining transfer of newtechnologies from a research environment to clinical practice settings.

90. The University of Maryland’s Dental HygieneFellowship Program

Bress, Lisa, University of Maryland Dental School Department ofDental Hygiene

Purpose: The Department of Dental Hygiene in the Universityof Maryland Dental School offers a Dental Hygiene (DHYG)Fellowship Program (FP) to newly graduated students prior tolicensure. The DHYG-FP provides these new DHYG graduates withthe opportunity to enhance their clinic and patient management skillswhile they wait to receive their licenses.

Interested DHYG graduates submit applications, and a groupis subsequently selected to provide initial therapy services in theAdvanced Education General Dentistry (AEGD) clinic andmaintenance services in AEGD and the general practice clinics. Overtheir four-week commitment, fellows also attend seminars on currentdental topics. The dental school’s patient pool is growing annually.In the summer, fewer dental and DHYG students are available toprovide services to recare patients. Based on this year’s reports, thefellows not only helped maintain the growing recall pool but alsogenerated operative work for dental students. The fellowship programhelps DHYG graduates establish their own practice philosophies,select future employment settings wisely, and ease their transitionfrom school to practice. Initial evaluations have been favorable. Thefellows report that their confidence, independence, and clinical skillsimproved during their four weeks in the program. The combined reportfrom the business managers in the undergraduate and AEGD clinicsis that the fellows treated a total of 164 patients and generatedsubstantial revenues.

A Dental Hygiene Fellowship Program may be established inany dental hygiene program with a viable patient pool. Such a programhas the potential to increase graduates’ clinical proficiency and

generate revenue while providing a valuable service to the patientpopulation.

91. Dental Students’ Reactions to First Dental ClinicExperience

LeClaire, JoAnn, University of Colorado School of Dentistry, Collins,Claire, University of Colorado School of Dentistry

Purpose: To examine dental student reactions to their firstclinical experience as a function of their own/family dentalbackground and their opinions of value and curricular timeliness oftheir initial clinical experience.

Dental student (DS) backgrounds vary, many having no priordental work experience (DWE) or family members in the profession(FMP). This first clinical experience occurred as part of Cariology I,second semester, during the basic science/preclinical (BSP)curriculum. Methods: Forty first-year DS were enrolled in CariologyI. The clinic component included simulation clinic training and aclinical exercise (CX) in plaque removal, with each DS acting asclinician and patient, after which they provided reflective responses.Later, thirty-one DS (78 percent) completed a thirty-three questionsurvey based on these reflections. Demographic data, DWE, FMP,and 5-point opinion scales were obtained. Descriptive summarystatistics and ridit analysis for ordinal scales (at p<0.05) are presented.Results: Respondents were similar in distribution to the schoolpopulation. More than 87 percent agreed (A) or strongly agreed (SA)that CX was educational, rewarding, and encouraging and curricularplacement was relevant and appropriate. At least 63 percent SA saidthat CX was practical and improved empathy for patients. DS withno DWE were more likely to SA that the exercise was educational(p=0.02) or fun/interesting (p=0.05). DS with FMP were more likelyto consider the exercise difficult (p=0.03). One hundred percent A/SA that CX was valuable at this stage, and 94 percent A/SA that CXhelped make BSP curriculum more relevant. One hundred percentwould like to have more CX, and 93 percent would consider CX inthe first semester helpful. Ninety-seven percent felt that CX helpedput themselves in the role of dental professional. Discussion: MostDS enjoyed the CX and found it valuable to identify with theprofession. DS with more experience in dentistry have a basis forcomparison about the difficulty of tasks. Those with no PWE/FMPmay be more enthused by the newness of the experiences.

Although some differences were shown, the data suggest that1) DWE/FMP makes little difference in positive opinions of firstclinical experience; 2) having early CX enhances the value andrelevance of the BSP curriculum; 3) early CX assists DS to identifytheir roles as dental professionals; and 4) consideration might be givento increase clinic exercises in the first year.

92. Survey of Undergraduate Dental StudentsRegarding Their Perceptions of the Value of ThirdMolars

Eisen, Steven, Tufts University School of Dental Medicine, Eisen,Debbie, Tufts University School of Dental Medicine, Silvestri,Anthony, Tufts University School of Dental Medicine

Purpose: To assess how dental students perceive the value ofthird molars in terms of their long-term value for the dentition asopposed to their lifelong potential for causing disease and damage tothe rest of the dentition. We were interested in assessing theirperceptions in order to better aid us in teaching them how to do rationaltreatment planning, which requires their weighing these two aspectsof third molars in situations where there is a lack of reliableprognosticative information.



To help better prepare students for dealing with these complexissues, we conducted a survey of first- and second-year undergraduatedental students at Tufts University School of Dental Medicineconcerning their perceptions of third molars including the value thirdmolars add to the dentition, the wisdom of therapeutic interventionssuch as prophylactic surgical extractions of third molars, andalternative treatments including the extraction of second molars atan early age to allow third molars to erupt in their place as well asinterventions that would prevent the development of third molarsaltogether. The vast majority of both first-year student respondents(90.1 percent) and second-year respondents (87.8 percent) believethat third molars are the most difficult teeth to keep clean and free ofdisease. They also feel these teeth have the least functional value,with 90.1 percent of first-years and 87.8 percent of second-yearsexpressing assent. They believe third molars to be the most difficultmolars to restore, with 75.6 percent of the first-years and 80.2 percentof the second-years agreeing. As to the statement that third molarsare the least effective molar bridge abutments, there was lessagreement here, with just 50.8 percent of the first-year students and45.8 percent of the second-year students agreeing. We also foundthat 17.8 percent of the first-years and 14.8 percent of the second-years held that extracting second molars at a young age to let thirdmolars erupt in their place is not a desirable orthodontic therapeuticapproach. The students were split on their opinion as to whether ornot people who never develop third molars experience less pain andsuffering as a result, with 57.9 percent of the first-years and 51.9percent of the second-years believing a patient would experience lesspain and one-third believing they would experience more.

There appears to be general agreement among the first- andsecond-year students of Tufts University School of Dental Medicinethat third molars are teeth that have little functional value, are moredifficult to keep clean, and are more prone to disease than any otherteeth. Compared to other molars, these teeth appear to pose difficultiesfor dentists trying to restore them. Whereas most students would preferthat their children never develop these teeth, they do not appear tofavor a therapeutic interventional approach at an early age to stoptheir development.

Third molars continue to present dentists with a problem. Thevalue of these teeth in the dentition is perceived to be extremely low,the difficulty in keeping them clean and free of disease high, and theability of the dentist to restore them limited. Their remains no effectivemanagement strategy to deal with their presence in the dentition. Allthis presents dental educators with a problem, in that it is ourresponsibility, given these facts, to teach our students how to makerational treatment decisions that will best benefit their patients.

93. New Program of Flexible Requirements for ClinicalRestorative Dentistry

Boston, Daniel, Temple University School of Dentistry, Alperstein,Klara, Temple University School of Dentistry, Appleby, David, TempleUniversity School of Dentistry, Arocho, Sheldon, Temple UniversitySchool of Dentistry, Winkler, Sheldon, Temple University School ofDentistry, Gray, Sarah, Temple University School of Dentistry

Purpose: To increase flexibility in meeting minimum clinicalexperience requirements in the disciplines of treatment planning,operative dentistry, fixed prosthodontics, and removableprosthodontics while supporting comprehensive care, attainment ofcompetencies, and strong clinical experience.

A new combined minimum requirements system wasimplemented in Restorative Dentistry to replace previous discipline-based systems that specified all experiences by discipline. The newstructure maintains previous overall minimum clinical activity, butprovides flexibility for 27 percent of the minimum requirement (163

of 600 pts) and total flexibility above 600 pts, while defining a smaller,more focused set of mandated experiences. A full range of requiredcompetency/skill exams was also implemented. Points are earnedfor clinical experiences, e.g., 3-surf amalgam=4 pts, single crown=12pts, complete denture arch=12 pts, caries-risk assessment=5pts.Minimum experiences are defined, e.g., Cl II amalgam 50pts, CD orRPD arches 132 pts, Crn or FxBr 180 pts including 1 FxBr. Outcomesof the Class of 2002 were analyzed. Results: Average activity 690pts, range 600-1180. Sixty-one percent of flexible pts were earned inoperative dentistry, 29 percent in fixed prosthodontics, and 10 percentin removable prosthodontics. For the top 10 percent of the class, anaverage of 905 pts was earned. Forty-four percent of flexible ptswere earned in operative dentistry, 46 percent in fixed prosthodontics,and 10 percent in removable prosthodontics. For the bottom 10 percentof the class, an average of 601 pts was earned. Sixty-five percent offlexible pts were in operative dentistry, 26 percent in fixedprosthodontics, and 9 percent in removable prosthodontics. Additionalanalyses show similar variations. All students passed all competency/skill exams prior to graduation.

The new system resulted in flexible clinical experiences whilecontinuing to support comprehensive care, attainment ofcompetencies, and strong clinical experience for the Class of 2002.The system is applicable to schools with the ability to combinemultiple disciplines.

94. Preparing Residents to Work with HIV/AIDSPatients: Knowledge and Attitudes About HIV/AIDS

Calero-Breckheimer, Ayxa, Columbia University School of Dentaland Oral Surgery, Murrman, Marita, Columbia University School ofDental and Oral Surgery, Ahluwalia, Kavita, Columbia UniversitySchool of Dental and Oral Surgery, Weglein, Sandra, Harlem UnitedCAC, Burkett, Sandra, Columbia University School of Dental andOral Surgery, Darlington, Tanya, Columbia University School ofDental and Oral Surgery, Diaz, Yessica, Columbia University Schoolof Dental and Oral Surgery, Edelstein, Burton, Columbia UniversitySchool of Dental and Oral Surgery

Purpose: To help implement and inform a course on HIV/AIDSfor postdoctoral dental residents, residents’ attitudes, knowledge, andperceived competence in treating HIV/AIDS patients were assessed.A questionnaire was administered prior to the start of a nine-weekcourse entitled “Integrated Management of HIV/AIDS Patients.” Datafrom this questionnaire were used to modify the course and to developa post-implementation evaluation tool.

Methods: All registrants (twenty-four) completed the pre-testconsisting of forty items divided into five sections: 1) experienceand perceived competence in treating HIV/AIDS patients; 2) generalattitudes towards HIV/AIDS patients; 3) perceived risks and fears;4) general HIV/AIDS knowledge; and 5) residents’ socio-demographics. Items assessing dentists’ willingness to treat peoplewith HIV/AIDS used in an earlier study by division faculty werealso included. Summary: Results indicated 46 percent of residentshad mixed feelings about being adequately prepared to treat andmanage HIV/AIDS patients, even though 83 percent had receiveddidactic training about HIV/AIDS in dental school and 92 percentreported treating HIV/AIDS patients in the past. Seventy-nine percentof residents reported a commitment to treating all patients the sameregardless of medical condition, with 55 percent believing thatmanaging AIDS patients is within the scope of general dentistry andis a rewarding experience. Results for correctly answering HIV/AIDSknowledge items ranged from 55 percent to 88 percent indicatingroom for improvement.

Even with a strong commitment to treat HIV/AIDS patients atbaseline, residents may not have had the requisite knowledge and



clinical skills needed to act upon these attitudes in practice. Identifyingthis attitude-knowledge gap and specifying the areas for improvementwere crucial for tailoring the development and implementation ofthe course, as well as the post-implementation evaluation of this newcourse for postdoctoral dental residents.

95. Centralizing Faculty Credentialing Documentation

Suffet, Eileen, University of Southern California School of Dentistry,Eisenberg, Larry, University of Southern California School ofDentistry, Shuler, Charles, University of Southern California Schoolof Dentistry

Purpose: To computerize and improve faculty credentialingdocumentation procedures, thus ensuring that faculty are incompliance with necessary standards.

Continual documentation of faculty credentials is an essentialactivity. In the past, individual school departments were responsiblefor collecting faculty credentials and monitoring the process. Thisresulted in numerous collection and recording approaches. Followinga school-wide reorganization, this responsibility became centralizedin the Outcomes Assessment Office. It was clear that tracking andmonitoring CPR and licensure credentials for more than 450 faculty(including some 300 part-time and volunteers) was an unwieldy andcomplicated task not easily achieved in the previously decentralizedapproach. A Microsoft Access database for faculty credentials wasdeveloped that connects to the school’s personnel records and therosters of our five divisions. This database enables us to record, track,maintain, and “prompt” faculty members of their need to update theircredentials. Monthly “pop-ups” alert the outcomes office of thosefaculty members whose credentials are expiring in the next thirtydays, and an automated email goes out advising the faculty memberthat recertification needs to be documented. Each month a status reportis generated for division administrators who are responsible forcontacting specific individuals for the needed information. In May2002, before the creation of the database system, accumulation ofthe information maintained by individual departments indicated that33.9 percent of the faculty involved with patient care had evidenceof their credentials on file. In less than one year, this figure increasedto 82.7 percent. While 100 percent compliance is a goal, it is nearlyimpossible since about 10 percent of all credentials are scheduled toexpire each month. Thus our outcomes assessment target has beenadjusted to 90 percent, and in one year we have nearly achieved thisobjective.

In the past year, the institution of a faculty credentials databasehas resulted in a dramatic increase in our percentage of faculty with“evidence of required credentials.” Other significant outcomes havealso emerged through the use of this database including better trackingof faculty assignments and increased ease in scheduling faculty forclinical teaching responsibilities.

96. Dental Hygiene Students’ Perceptions of PeerTeacher Assistance During Initial Patient CareExperiences

Klausner, Christine, University of Michigan School of Dentistry

Purpose: To assess first-year dental hygiene students’perceptions regarding the use of peer teachers to assist with initialpatient care experiences.

Providing dental hygiene care in a clinic setting involves theperformance of a set of complex tasks while managing and caringfor a patient. For beginning dental hygiene students, it can be anoverwhelming and anxiety-producing experience. To encourage andassist first-year students with initial patient care, senior dental hygiene

students were selected to act as peer teachers. Students wereintroduced to their peer teachers during a clinic seminar. The rolesand responsibilities of the peer teachers were explained, and thestudents were informed that peer teachers would not be involved inthe direct grading but were there to answer questions and providesupport. After twenty-five clinic sessions, students were asked toevaluate the peer teaching experience using an 11-item Likert-stylesurvey. Response options ranged from strongly agree to stronglydisagree. Two additional open-ended questions were included to allowstudents to make comments regarding positive and negative aspectsof their experience and to suggest ways in which it could be improved.Twenty-eight of the thirty-one students completed the survey (90percent). Favorable responses ranged from 96 to 100 percent for tenof the eleven items. The statement “The peer teacher divided his/hertime equitably among the students” was responded to negatively bythree students (14 percent). Students’ responses to open-endedquestions indicated that they felt more comfortable asking questionsof the peer teachers and that peer teachers were more available thanthe regular instructional faculty. The most frequent response to howthe program could be improved was to have more peer teachersavailable in all clinic sessions.

The results of this study indicate that the use of student peerteachers in a clinical situation was well received and overwhelminglysupported by first-year dental hygiene students. Students felt theybenefited from peer teacher instruction. Students indicated theaddition of more peer teachers at all clinic sessions would enhancetheir clinical experience.

97. The Use of a Dental Anatomy CD-ROM in a DentalHygiene Dental Morphology Course: A Pilot Test

Mitchell, Tanya Villalpando, University of Missouri-Kansas CitySchool of Dentistry, Keselyak, Nancy, University of Missouri-KansasCity School of Dentistry, Branson, Bonnie, University of Missouri-Kansas City School of Dentistry

Purpose: To determine if a dental anatomy CD-ROM wasbeneficial in students’ learning in a dental morphology course.

The study of dental anatomy in the first semester of a dentalhygiene program serves as an important piece of foundationalknowledge of the relationship of the teeth and the application of dentalmorphology to the practice of dentistry. In the fall of 2002, the coursecoordinator of a dental hygiene dental morphology course wanted toexamine the possibility of incorporating a dental anatomy CD-ROMinto the DH3000 course at the University of Missouri–Kansas City.Mean entering grade point averages determined which group ofstudents were chosen to participate in the pilot study. Students wereaware of their participation in the study and had the option of notparticipating. No specific instructions on how to operate the CD weregiven to students. However, students were asked to keep a journalthroughout the semester-long course. The CD was used as an adjunctto lecture and lab notes as well as to the required course book. At theconclusion of the course, students were asked to complete aquestionnaire relating to their experience with the CD. Survey resultsindicated overall satisfaction with the CD. Students strongly agreedthat the CD was easy to open and operate. They also felt that the CDhelped them to better understand and visualize the teeth. They eitheragreed or strongly agreed that they would recommend the CD toothers enrolled in the same course. Journal entries indicated the CD“to be a wonderful addition to the information provided in class.”

Based on these results, the CD-ROM will be incorporated intothe dental hygiene dental morphology course in the fall of 2003, andall students enrolled will use it.



98. Institutional Resources Needed to Conduct a MockBoard Exam

Sabaitis, Eva, University of Illinois at Chicago College of Dentistry,Gehrke, Ken, University of Illinois at Chicago College of Dentistry

Purpose: To quantify and evaluate the amount of financialsupport, personnel, facilities, time, and materials that are committedby a school when providing a simulated regional board examinationfor graduating dental students.

To assist their graduates with preparation for a licensureexamination, most dental schools conduct a simulated boardexamination. The resources needed to administer such an examination,comparable to the actual exam in format and design, are substantial.This past year, an effort was made to assess all of the resourcescommitted by our school when conducting a mock board examination.The exam was given over a three-day period, with a day committedto patient procedures, a day to manikin procedures, and a day to aprosthodontic station-to-station exam. General clinics were closedfor two days to accommodate operation of the exam. Three clinicrooms and one laboratory were utilized. Fifty-five seniors, sixty-five juniors, thirty faculty, nineteen support staff, and fourmaintenance engineers participated. Items assessed includedmanpower hours and related costs for: 1) development of theprosthodontic station exam; 2) organization and set-up for the exam;3) sterilization of instruments; and 4) administration of the mockexam. Additional items evaluated were: 1) loss of clinic revenuesdue to clinic closure, free patient screenings, and procedures done atN/C during the exam; 2) cost of materials and supplies; and 3) facultytime for calibration, grading and preparation of exam results, andremediation. Approximate manpower hours needed and costsassociated with the simulated board exam were as follows: 1)development of station exam, 72 hrs/$3,300; 2) set-up of supplies,instruments, and facilities for exam, 461 hrs/$9,200; and 3)administration of exam, 909 hrs/$25,900. In addition, $4,800 ofmaterials and supplies were used, and $32,000 of lost revenues wereincurred. In summary, over 1,400 manpower hours and $75,000 ofcosts were attributable to the mock examination. An itemized cost/time analysis will be presented.

Providing a simulated board examination to prepare studentsfor challenging regional dental board licensing examinations is acostly and labor-intensive endeavor. However, the “trial run”experience with the board exam format that this provides studentsand the potential for an increase in the pass rate provide strongrationales for continuing this program.

99. Mastery Learning in an Esthetic DentistryCurriculum: A Two-Year Comparison

Osborne, Paul, University of Kentucky College of Dentistry

Purpose: A mastery learning approach was incorporated in a2002, first-year operative dentistry esthetics course. After a second,consecutive year utilizing this approach, the purpose of this endeavoris to compare the survey results between two first-year undergraduatedental classes’ perceptions of mastery learning.

Mastery learning as a teaching discipline has been firmlyestablished in educational literature as an effective educationalepistemology. An initial trial with this teaching approach wasundertaken with the University of Kentucky first-year estheticdentistry course in the spring semester 2002 (previously reported in2003 ADEA Abstract #62). The identical survey was repeated to gainstudent perceptions of the mastery approach with the 2003 class offirst-year students (n=50). Also, the final, summative examination of100 questions was altered in sequence and format to attempt toascertain if the learning achieved was “rote” or understanding was

truly accomplished. The same ten formative examinations of tenquestions each were administered prior to each appropriate lectureas the preceding year reported. Summative exam results reflectedsimilarly high achievement between the two-year groups. Acomparison of the survey results of the two classes (forty-eight vs.fifty students) reveals an overall positive perception of theirexperience with mastery learning with some noteworthy differences.Overall, students’ perceptions of their experience with masterylearning continued to be overwhelmingly positive. However, as theformative and summative exams were identical for the two-yeargroups, an increasing number of students felt the approach was “tooeasy” and lent itself to cheating and plagarism (10.42 percent vs. 28percent). There was also a slight increase in the perception that thislearning technique did not allow the gifted student to excel (8.33percent vs. 18 percent). As in the previous year, however, nearly allstudents reported they enjoyed the mastery learning experience andwould readily enroll in another course using that approach.

Even though summative evaluation results reflected favorablelearning achievement, the survey trends reflected growing concernsthat some students were simply copying formative exam answers.As this two-year survey comparison demonstrates, if a masterylearning approach utilizes identical formative exams, there was anincreasing perception that students merely copied those results fromother students rather than ascertaining the appropriate answer fromthe assigned readings.

100. Assessment of Enrichment and RecruitmentPrograms on Dental School Enrollment ofUnderrepresented Minority Students

Gravely, Tamara, University of Tennessee Health Science CenterCollege of Dentistry, McCann, Ann, Baylor College of Dentistry,Brooks, Ernestine, Baylor College of Dentistry, Harman, William,Baylor College of Dentistry

Purpose: A survey of U.S. dental school enrichment andrecruitment programs (n=23) was conducted in 2002 to identifyprogram characteristics and outcomes that were related to participantsgetting into dental school. Recruitment programs encourage studentsto consider dentistry as a career choice, while enrichment programsstrengthen academic skills so students can successfully compete foracceptance into dental school.

The survey assessed program background, participantdemographics, program components, and program outcomes todetermine factors relating to successful admission into dental school.Success factors were further explored in telephone interviews withselected program directors. The survey response rate was 73.9 percent(n=17). The majority of programs had been in place for ten or moreyears (n=10). The majority of program participants wereunderrepresented minorities (URM) students (program median=100percent). The leading program goals were to increase minorityenrollment (47 percent) and URM competitiveness (35 percent). Themedian program length was seven weeks and forty hours per week.Programs offered the following components: basic sciences (thirty-two median hours), DAT review/preparation (thirty median hours),introduction to dentistry (sixteen median hours), preclinical laboratoryactivities (sixteen median hours), and learning strategies (nine medianhours). The overall median percentage for dental school enrollmentof program participants in the study was 52.3 percent. Regressionanalysis revealed that the length of program time in existence was asignificant predictor of participant enrollment into dental school (Rsquared=.320; p=.035). Interviews of program directors withparticipant enrollment in dental school greater than 60 percent (n=4/6) provided further insight into their strategies. Five of the sixsuccessful programs were very well established (two in existence for



ten to fourteen years; three for fifteen or more years). They reportedthat mentorship, institutional support, program structure, andadmission policies were key factors contributing to success.

It is concluded that enrichment and recruitment programs aresuccessful in getting their participants into dental school. Dentalschools should consider these programs as a viable option forincreasing URM enrollment.

101. Active Mentoring Strategies for Future DentalEducators

Lefever, Karen, University of California, Los Angeles School ofDentistry, Bibb, Carol, University of California, Los Angeles Schoolof Dentistry

Purpose: To describe an experiential program to mentor futuredental educators.

The UCLA School of Dentistry mentors future dental educatorsthrough apprenticeships that reflect the professional activities ofacademic dentists. Under the supervision of faculty mentors, fourth-year students have the option to teach fine motor skill developmentin the introductory waxing lab course, teach in the Restorative Clinic,design and deliver a didactic course in dental anatomy for first-yearstudents, and/or conduct educational research. In the waxing lab,student teachers adopt a group of twelve students and provide themini lectures, demonstrations, and feedback critical to fine motorskill development. In the new clinical teaching option, fourth-yearstudents who have met competency requirements in restorativedentistry will provide clinical instruction to second and third yearsunder the supervision of a clinical faculty mentor. Twenty-sevenstudents have completed the didactic teaching apprenticeship, nowin its fourth year. Eight are currently enrolled in the 2003-04 cycle.Women constitute 60 percent of the participants; men, 40 percent.Longitudinal follow-up of the twenty-seven graduates was conductedin summer 2003 to assess their continuing commitment to teaching.Seventy percent were or are enrolled in residency programs; thus,the most consistent finding was an emphasis on the benefits ofPowerPoint and public speaking experience in delivering the seminarpresentations and predoctoral teaching assignments required ofresidents. Financial concerns were the primary reason that graduateswho went directly into general practice have not pursued teachingopportunities. Additionally, one graduate declined a part-time positionteaching radiology in a dental hygiene program due to child careissues. Student experience in educational research is fostered by theADEA-sponsored UCLA Student Teaching Group (STG). Each year,the STG identifies a research question, develops a research planincluding submission to appropriate campus oversight groups,conducts the study, analyses the findings, and submits an abstract forthe annual ADEA meeting. Past participants in the didacticapprenticeship have presented their research on course outcomes ina poster at the 2002 ADEA meeting. The current STG leaders havesubmitted an abstract for the 2004 ADEA meeting describing theresults of a survey on teaching skills. The overall impact of theteaching apprenticeships and formation of an active STG has been topromote student interest in teaching and educational research andfaculty commitment to mentoring future dental educators.

The program has promoted student interest in dental educationand faculty commitment to mentoring.

102. Age Distribution of Pediatric Dentists in Indiana:The Challenge for Education

De Ball, Suzanne, Indiana University School of Dentistry,Baumgartner, Michael, Indiana University School of Dentistry

Purpose: First, to determine the demographic age distributionof practicing pediatric dentists in the state of Indiana, and second, to

try to forecast the number of pediatric dentists who will be availableto treat the state’s children by 2012.

Dental caries is the most common chronic disease of childhood.In the last twenty-five years, the number of filled and decayed teethin children aged two to four has remained unchanged. Theramifications of untreated dental caries in children can be severe andcan include systemic sequelae. Nationwide, the dentist-to-populationratio is declining. In Indiana, the total number of dentists has declinedfrom 2,951 in 1998 to 2,650 in 2002. General dentists provide themajority of dental care for children. However, a percentage of thechild population needs specialized pediatric dental care, and there isa need for a sufficient number of pediatric dentistry specialists toprovide this care. In 1998, the national age information for pediatricdentists showed 26.9 percent over age fifty-five and an additional24.2 percent aged fifty to fifty-four. Figures for the 2000-01 academicyear show 216 first-year pediatric dentistry residency positionsavailable. These statistics appear to point to a dangerous “graying”of pediatric dentists nationwide, without adequate graduates to taketheir places when they retire. Does the same hold true for the state ofIndiana? The ages and practice locations were determined for allprivate practice pediatric dentists in Indiana as of July 1, 2002. Therewere ninety-one pediatric dentists in the state. Thirty-five percentpractice in the northern third of the state, 47 percent in the centralthird, and 18 percent in the southern third. In the entire state, 37percent of pediatric dentists are over age fifty-five, but only 10 percentare under age thirty-five. Sixty-seven percent of pediatric dentists inIndiana are over the age of forty-five. In the past ten years, 24 percentof pediatric dentists graduating from the state’s pediatric dentistryresidency have remained in the state.

Using the data reviewed, we project that there will be aconsiderable shortfall of pediatric dentists, with the possibility of atleast thirty-four pediatric dentists retiring and only thirteen newpediatric dentists beginning practice.

103. Less Restrictive Operative Dentistry “Test Case”Criteria Have No Adverse Effect on State Dental BoardPerformance

Pitigoi-Aron, Gabriela, University of the Pacific School of Dentistry,Hagge, Mark, University of the Pacific School of Dentistry, Loos,Larry, University of the Pacific School of Dentistry, Simon, James F.,University of Tennessee School of Dentistry

Purpose: To see if less stringent requirements for operativeclinical test case criteria would detrimentally affect overall pass ratesor pass rates/mean scores for two operative dentistry proceduresperformed during a state dental board examination.

We reported last year (J Dent Educ 2003;67:191-2 [Abstr No.45]) that state dental board performance in 2001 was not adverselyaffected by a 37.5 percent reduction (from eight to five cases) inrequired senior student operative test cases (OTC) because ofconcomitant quality improvements made to the OTC program. Infact, the pass rate for the amalgam procedure improved significantlyin 2001 as compared to 2000. Even so, not all 2001 graduatescompleted the five-case requirement (56 percent completed five; 86percent completed four or five), which resulted in lower final coursegrades. Students insisted that a lack of eligible lesions (previouslyunrestored interproximal caries) was responsible. Therefore, for the2002 senior class, two replacement restorations were permitted, butrequired moderate recurrent caries, base placement, and could onlybe performed during the first two academic quarters. Overall boardpass rates and pass rates/scores for the amalgam and compositeprocedures from 2000, 2001, and 2002 were tabulated and compared(Chi-square test for pass rates; Kruskal-Wallace ANOVA for meanscores). Results: The students’ OTC completion rate improved in 2002(71 percent completed five; 97 percent completed four or five). The



2002 graduates also demonstrated very slight improvements in overallboard pass rates (2002: 94.35 percent; 2001: 93.89 percent) andcomposite pass rate/mean score when compared to 2001 graduates(2002: 89.52 percent/80.40; 2001: 86.26 percent/80.37), but exhibiteda slight decrease in amalgam pass rate/mean score (2002: 79.84percent/77.85; 2001: 84.73 percent/78.21). However, none of thesedifferences were significant (p > .05), nor were any significantdifferences detected between overall board pass rates or operativeprocedure pass rates/mean scores from 2002 and those reported in2001 or 2000 (2000: overall 90.90 percent; composite 85.61 percent/80.30; amalgam 76.52 percent/78.40).

Permitting replacement restorations for 40 percent (2/5) ofsenior operative test cases did not adversely affect overall state boardpass rates or pass rates and scores for composite and amalgamprocedures.

104. Factors Affecting Underrepresented MinorityStudents’ Dental Career Decisions

Morgan, Yewande, National Institute of Dental and CraniofacialResearch, National Institutes of Health

Purpose: To better understand the factors that affectunderrepresented minority (URM) students’ decisions to studydentistry and the factors affecting their postgraduation career choice.Using data collected by the American Dental Education Association(ADEA), the study explored whether there are any differences in thefactors deemed important by URM and non-Hispanic white students.The study emphasized students’ motivations for pursuing dentistry,factors influencing career choice, the roles of finances (parents’income, educational debt upon entry, and dental education expenses)and prior exposure to the dental profession. In addition, associationsbetween time of career decision and the influence of external factorson career decisions were examined.

Underrepresented minorities (URM) from American Indian/Alaska Native, Hispanic, and non-Hispanic black backgroundsgenerally have the poorest oral health in the U.S. population. Whilethe growth of minority populations is increasing substantially in theUnited States, the number of URM students enrolling in dental schoolshas dropped significantly over the last decade and is far below itsproportion in the U.S. population. Yet studies show that URM dentalhealth professionals are more likely than their non-Hispanic white(NHW) counterparts to provide oral health care to minoritypopulations. Data were obtained from the American Dental EducationAssociation Survey of Graduating Seniors and analyzed with SASV8 to determine the importance of certain factors to students’ careerdecisions. While some statistically significant differences were found,the results showed that overall pattern of importance attached to thevarious factors was similar for URM and NHW students. Blackstudents had disproportionately greater amounts of debt upon entryto dental school than did Hispanic and NHW students. Educationaldebt affected career choice in over 75 percent of the students. Manymore URM students expressed a willingness to practice in locationswhere the majority of their patients would be from inner-city orunderserved populations.

In general, factors related to students’ personal motivations wererated as being highly influential in their career decisions, while factorsrelated to the influence of external forces were not rated as beinghighly important. Both URM and NHW students appeared to beinfluenced more by internal factors than by external factors.Opportunity for self-employment and high income potential stoodout as motivating factors cited by all the students. Neither URM norNHW students rated the influence of outreach and recruitmentactivities as highly important. The influence of family-related mentors

was much lower in URM than in NHW students. This may be areflection of the proportionally fewer number of suitable mentorsfrom underrepresented and minority backgrounds. However, familyfriends appear to be a fairly high influencing factor among URMstudents who make a late decision to pursue dentistry as a career.Educational debt affects students’ career choice, but many more URMstudents expressed a “debt-unrelated” willingness to practice amonginner-city and underserved populations. White students may need tobe exposed to practice settings where the majority of the patients arefrom underserved backgrounds through community-based or outreachprograms during their dental school education.

105. Tobacco Use Among Patients ReceivingEmergency and Comprehensive Care in an UrbanDental School Clinic

Shaner, John, Creighton University School of Dentistry, Romito,Laura, Creighton University School of Dentistry, Calixte, Karine,University of South Florida

Purpose: To characterize tobacco use in patients receivingepisodic dental care via the Emergency Clinic compared to thosereceiving comprehensive care through the adult clinic at the CreightonUniversity School of Dentistry.

Tobacco use is associated with increased morbidities of generaland oral health, including periodontitis and oral cancer. Oral cancerscreening and tobacco cessation interventions in high-risk populationsmay decrease the potential for such morbidities. It was hypothesizedthat patients receiving episodic care are more likely to have unhealthylifestyle behaviors, such as tobacco use, compared to patientsreceiving regular, comprehensive care. As such, the Emergency Clinicwould be a focal point for oral cancer screenings and tobacco cessationinterventions. Methods: A representative sample of 600 dental recordsof patients presenting for care at Creighton University School ofDentistry (300 each from emergency and adult clinic) between Januaryand June 2003 were reviewed for the following information: patientage, sex, tobacco use, and tobacco type. Results: The emergency clinicsample contained 163 males and 137 females; the comprehensivecare sample had 140 males and 160 females. Of emergency patients,54 percent used tobacco compared to 34 percent of comprehensivecare patients. Z-test revealed a statistically significant difference(p<.05) in tobacco use between the emergency and comprehensivecare patient populations. Smoke tobacco accounted for more than 95percent of the tobacco used by tobacco users in both groups. Oftobacco-using emergency patients, 58 percent were male and 42percent were female, compared to 52 percent and 48 percent,respectively, in comprehensive care. Of emergency patients, 60percent were <40 yrs of age; they represented 64 percent of the tobaccousers in this group. In contrast, 74 percent of comprehensive carepatients were >40 yrs of age; they represented 70 percent of tobaccousers in that group.

Patients receiving emergency dental care tend to be younger,male, and more likely to use tobacco than patients receivingcomprehensive care. However, incidence of tobacco use in bothclinics’ patient populations was higher than national and statewideaverages of 25 percent and 17 percent, respectively, indicating thisurban dental school population is at greater risk for tobacco–associatedmorbidity and mortality. Thus, it is an appropriate target populationfor oral cancer screenings and tobacco cessation education/interventions. Because the incidence of tobacco use is greatest in theemergency dental clinic, it should be the focal point for initiatingsuch programs within the school.



106. Students’ Understanding of the HIPAACompliance Act

Herren, Michael, University of Kentucky College of Dentistry, Short,Roger, University of Kentucky HIPPA Compliance Officer,McConnell, Thomas, University of Kentucky College of Dentistry

Purpose: To assess the student dentists’ understanding andapplication of HIPAA protocols in our undergraduate clinic.

The Health Insurance Portability and Accountability Act(HIPAA) became effective on April 14, 2003. As part of ourcurriculum we instituted mandatory HIPAA training for all student,faculty, and staff. The purpose of the following study was to determinethe students’ knowledge of HIPAA. A lecture was given to all faculty,students, and staff about HIPAA prior to April 14. It was mandatoryfor all participants to attend the course and take an examination. Thecourse was given in early December in anticipation of the April 14deadline. A score of 100 percent was required for successfulcompletion of the course. The undergraduate student dentists weregiven a follow-up questionnaire at the end of April to determine theirretention of this important information. The questionnaire coveredbasic information required for HIPAA compliance. The questionnairewas given to rising third- and fourth-year student dentists. No studentwas able to correctly answer all questions. Examples of scores onsome questions: 42 percent could not correctly identify what HIPAAstands for; 68 percent correctly answered a question concerning whena patient should be informed about HIPAA; many believed the patientmust be informed at every appointment; 100 percent knew a patientmust sign receipt of a Notice of Privacy Practices from the school;36 percent could not correctly answer a question about leavingmessages on a patient’s machine concerning his or her appointment;and 52 percent did not know whether a patient could further restrictrelease of his or her health records. In conclusion, this survey hasrevealed the need for further instruction and monitoring of our studentdentists to ensure compliance with HIPAA protocol. This will beimportant for them not only while in school but throughout theirprofessional careers.

Further work is needed to ensure proper education andcompliance. Students may not be cognizant of the serious nature ofHIPAA violations. Students may have a false sense of security due totheir status as a student.

107. Format Preferences for Electronic LecturePresentations

Drahos, Gary, University of Illinois at Chicago College of Dentistry,Licari, Frank, University of Illinois at Chicago College of Dentistry,Drahos, Lee, University of Illinois at Chicago College of Dentistry

Purpose: To determine viewer preferences for electronicallyproduced lecture material.

An increasing amount of lecture material is being presented inthe electronic format (such as Microsoft PowerPoint). Slides, lecturematerial, photographs, graphs, and other material can be incorporatedinto these electronic presentations. A group of 294 students from theD1, D2, D3, D4, and postgraduate classes at the UIC College ofDentistry, as well as faculty members, comprised the test group. AMicrosoft PowerPoint presentation consisting of 132 slides of varyingbackgrounds, font sizes, case letter, animations, and slide templatedesigns was made in an approximately one-hour time slot usingdimmed overhead lighting. Part of the presentation was alsopersonalized for the subject audience. The tempo of the slidepresentation was also varied. A questionnaire was developed askingthe viewer to grade each slide for various aspects of readability andteaching effectiveness. Viewer preferences were as follows:

1. A darker background (black or navy blue) with a lighter font (whiteor pastel yellow or violet) was the most preferred combinationfor readability and ease on the eyes;

2. Larger font sizes and fewer bullets per slide were preferred tosmaller font size and more content per slide;

3. Sentence case style was preferred to all capitals;4. Bold type font selection was preferred;5. Varying the background colors and template design of the

presentation was preferred over a continuous selected background;6. An occasional shocking slide (bright color, odd color, visually

stimulating photo, or animation) was enjoyed;7. Humorous slides were enjoyed more than regular educational

slides;8. Personalized slides specific for the instant audience were enjoyed

more than regular informational slides; and9. More slides with less content at a faster tempo were preferred

over fewer slides with more information at a slower pace.Viewers have definite preferences for viewing electronic media

presentations. Electronic media presentations can be formatted toconform to viewer preferences and enhance viewer enjoyability andreadability.

108. Integrating and Facilitating the Diagnosis andTreatment of Urgent Care Patients into theUndergraduate Clinic

Licari, Frank, University of Illinois at Chicago College of Dentistry,Drahos, Gary, University of Illinois at Chicago College of Dentistry,Burger-Zellinger, Rudolph, University of Illinois at Chicago Collegeof Dentistry

Purpose: To introduce the dental student to the process involvedin diagnosing and treating the episodic urgent care patient andimproving the timeliness and patient satisfaction with the process.

In recent years, the University of Illinois at Chicago College ofDentistry has treated urgent care (emergency) patients by admittinga defined number of patients to be seen during the day (usually twelveto sixteen). Exams and x-rays were ordered, and staff dentists providedthe diagnoses. The patients were then routed to a department withinthe college that could best facilitate their urgent care needs (endo,oral surgery, postgraduate clinics, undergraduate clinics, GeneralPractice Residency, etc.). This diagnosis process took, on the average,ninety-three minutes to complete and, depending on student and clinicavailability, often did not result in same-day dental treatment. InSeptember 2002, the College of Dentistry undertook a majorreconfiguration of the undergraduate clinic experience. Six identicalclinics were developed that took the form of large group dentalpractices. The urgent care patient treatment was integrated into thisclinic model to introduce the students to the actual diagnosis andtreatment planning phases for the emergency patient. The patientsare registered as before and are immediately escorted to one of thegroup practice clinics where they are seen by assigned dental students.The students work independently according to a developed flow chartand obtain the necessary diagnostic information (radiographs, pulptest, medical information, consultations, etc.) to establish a diagnosis.The patient is advised of all treatment options, and the agreed-upontreatment is performed immediately by the assigned student or therequired clinic. Treatment under this process has reduced averagepatient waiting time, from registration to treatment, to sixty minutes.Patient satisfaction (by survey) with treatment is 89 percent. Studentacceptance of the program (by survey) as a useful learning experienceis 94 percent.

Integration of the urgent care diagnosis, treatment planning,and treatment process into the undergraduate clinic decreases the



waiting time for the patients and effects treatment for them in a moretimely manner. Patient satisfaction with this process is high. Ninety-four percent of the students feel that participation in urgent carediagnosis and treatment is a useful learning experience.

109. Oral Care for Autistic Patients: The Role of DentalEducation

Inglehart, Marita, University of Michigan School of Dentistry,Ramaswami, Neerrajah, University of Michigan School of Dentistry,Feigal, Robert, University of Minnesota School of Dentistry

Purpose: To explore the role of undergraduate and graduateeducation for pediatric dentists’ decisions to treat autistic dentalpatients and attitudes towards treating autistic patients.

In the year 2000, the first U.S. Surgeon General’s Report onOral Health stressed the importance of providing oral health care tospecial needs patients. The objective of this research project was toexplore whether dental education about special needs patients, andin particular about autistic patients, will affect whether pediatricdentists will actually treat autistic patients and their attitude towardstreating autistic dental patients. Data were collected with a surveymailed to a random sample of 500 members of the American Academyof Pediatric Dentistry (AAPD) in the USA (response rate: 42.4percent; N=212). Overall, 69.5 percent of the respondents indicatedthat their undergraduate dental education had not prepared them wellto treat special needs patients, 70.9 percent that they had not beeneducated well to manage patients with mental retardation, and 79.6percent that they were not educated well to treat patients with autism.Pediatric dentists who did not treat autistic children (N=21) differedfrom those who treated autistic children (N=182) in several ways.They were more likely to be male (p=.064), white (p=.032), and agreedless strongly with statements such as “I like to treat autistic children”(means on 5 point scale: 2.76 vs. 3.41; p=.005) and “Graduateeducation prepared me well to treat autistic children” (3.30 vs. 3.98;p=.015) than pediatric dentists who treated autistic children. Theattitude towards treating autistic patients was significantly correlatedwith how many patients with special needs (r=.17*), with mentalretardation (r=.18*), and with autism (r=.20**) they treated in anaverage week, as well as with how well the respondents felt that theirdental undergraduate education and their dental graduate educationhad prepared them to treat autistic children (r=.19**; r=.25***).

This research showed that pediatric dentists differ in the degreeto which they treat patients with special needs and in particular withautism and that dental undergraduate and graduate education aboutthis special patient population not only affects the attitudes towardstreating these patients, but even more so the degree to which dentistsdecide to treat these patients. The results point to the significance ofcurriculum development efforts in this area.

110. Assessment of Postgraduate Periodontics andDental Hygiene Programs Collaboration

Lupovici, Eva, New York University College of Dentistry, Schoor,Robert, New York University College of Dentistry, Westphal, Cheryl,New York University College of Dentistry, Kreismann, Judy, NewYork University College of Dentistry

Purpose: To assess the collaboration between a Postgraduate(PG) Periodontic program and a Dental Hygiene (DH) program.

A collaboration was established between a PG Periodonticspogram and a DH program to provide interchange between second-year dental hygiene students and PG Periodontics residents in themanagement of periodontal patients. DH students rotated throughthe PG clinic to provide periodontal maintenance (PM) care to patientsof the program. Residents scheduled the initial appointment of theirpatients, while subsequent recall appointments were scheduled by

the DH students. A resident was assigned to each of the clinic sessionswhere DH students provided care and evaluated the examination,diagnosis, and therapy of each patient, whether their own patient orthe patient of other residents. Questionnaires were developed andadministered to the twenty-eight participating students to assess thecollaboration. Results indicated that 36 percent of the residents hadno previous knowledge of the utilization of DH in PM, while DHstudens were very and somewhat knowledgeable (29 percent and 71percent, respectively) and 43 percent of residents had no previousexperience working with a DH. All residents found DH students veryor mostly valuable in PM provided to their patients (86 percent and14 percent respectively), and 93 percent stated that the collaborationallowed them to maximize their time in clinic to provide othertreatment to their patients. All the residents responded that thecollaboration should continue and, based on these experiences, wouldhire a DH for their periodontal private practice in the future. All theDH students responded that the collaboration should continue sinceit allowed a forum for the application of didactic information andopportunity to continue developing competence in care of periodontalpatients. Based on these experiences, 92 percent of DH students wouldseek a private practice DH position in a periodontal specialty office.

The assessment of the collaboration indicated that it wasbeneficial both to the PG Periodontics residents and DH students.The interaction provided the residents the opportunity to learn aboututilization of the DH in a simulated private practice setting, whileDH students continued to develop competence in monitoringperiodontal patients. It also provided an opportunity for both to nurtureinterpersonal skills as periodontal cotherapists.

111. Designing Innovative Dental EducationExperiences That Reinforce a New Curriculum

Lobb, William, Marquette University School of Dentistry, Schnuck,Lawrence, Kahler Slater Architects

Purpose: To educate university and dental school administrators,faculty, and students on how a holistic approach to their new building/renovation project can successfully integrate a new curriculum intothe design of innovative experiences for all users at their institution,which will improve faculty recruitment and retention; increasecollaboration, teamwork, and mentorship among students, faculty,and alumni; provide a technologically advanced yet comfortable andsafe environment for research, study, and team building; and ensurea more flexible and stress-free environment for patients.

Visionary leaders of dental/allied dental education institutionsunderstand that to adequately support the latest education practices,they must successfully integrate school and university visions with asolid curriculum and innovative experience for all dental school usergroups. Presenting Marquette University Dental School and theCollege of Dental Medicine at the Medical University of SouthCarolina as case studies, our poster will illustrate how eachinstitution’s unique, holistic design process—contrary to “traditionalarchitecture”—has helped to transform the way modern-day dentaleducation is delivered and practiced in a real world clinical setting.Poster illustrations depicting this design process will include thefollowing: visioning workshops where faculty, students,administrators, facilities staff, architects, and contractors focus ondeveloping project goals that are consistent with the university’s visionand could be measured against this vision at every phase of theplanning process; case-based curriculum in action where studentsprepare for future dental practice through hands-on interdisciplinarylearning; and new building design that supports the university anddental school vision and enhances the ideal student, faculty, and patientexperience. Case studies also will represent each institution’s vision-driven results through the following images: small group rooms wherefaculty and students come together to develop solutions for actual



clinical cases and problems; “rounds rooms” where students can viewand discuss hands-on learning activities with their peers in real time;and operatories where patients receive technologically advanceddental care in a friendly, warm environment.

This poster presentation will provide participants who are eithercontemplating or already in the early planning stages of a renovationand/or new building project with ideas on how to successfully designinnovative faculty, student, and patient experiences that reinforce anew curriculum at dental/allied dental education institutions.

112. The Effects of Mentoring on Dental Educators’Workplace Perceptions and Experiences

Nesbitt, Paula, Meharry Medical College, Inglehart, Marita,University of Michigan School of Dentistry, Sinkford, Jeanne,American Dental Education Association

Purpose: To investigate how mentoring experiences affectedmale and female dental educators’ workplace perceptions andexperiences.

In May 2001, survey data were collected from 870 facultymembers in U.S. dental schools. While 498 (60.1 percent) respondentsindicated that they had a mentor either in the past or currently, 331(39.9 percent) reported never to have had a mentor. Of the 299 femalerespondents, 192 (65.5 percent) had mentoring experiences, while306 (57.1 percent) of the 568 male respondents reported having beenmentored (p=.011). The results showed that dental educators withmentoring experiences agreed more strongly with statements thatindicated that they felt more welcomed as members of their dentalschool community (5-point scale: 3.82 vs. 3.48; p=.000), that theyfelt like a full and equal participant in problem-solving anddecisionmaking (3.72 vs. 3.28; p=.000), and that they were moresatisfied with their work setting (3.53 vs. 3.19; p=.000), their potentialto achieve professional goals (3.68 vs. 3.18; p=.000), their overallprofessional practice/research (3.65 vs. 3.28; p=.000), and the extentto which this practice had met their expectations (3.63 vs. 3.22;p=.000) when compared to respondents without mentoringexperiences. Mentoring experiences were especially important forfemale respondents. While female respondents describe theirworkplace experiences as more negative than male respondents,female educators with mentoring experiences were less negative aboutthe work climate (2.33 vs. 2.98; p=.000) and their professionalsituation (3.41 vs. 3.00; p=.000) than female respondents withoutmentoring experiences.

These findings showed that while mentoring can make animportant difference for all dental educators’ workplace perceptionsand their satisfaction with their work situation, it was of even greaterimportance for the female respondents. Efforts to offer mentoring toall incoming faculty members may lead to an increase in jobsatisfaction and faculty retention.

113. Recruiting Disadvantaged Students into Dentistry:A Systematic Approach

Woolfolk, Marilyn, University of Michigan School of Dentistry,Inglehart, Marita, University of Michigan School of Dentistry, Ester,Todd, University of Michigan School of Dentistry, Markels, Geraldine,University of Michigan School of Dentistry, Daniels, Charlita,University of Michigan School of Dentistry, Katcher, Patricia,University of Michigan School of Dentistry, Green, Thomas,University of Michigan School of Dentistry

Purpose: This educational research project investigated howthe Pipeline Program for first- and second-year undergraduates andthe Profile for Success (PFS) Program for junior and seniorundergraduates interested in dentistry affected the participants’

academic achievement, their confidence in their academic skills, andtheir motivation to become dental care providers.

The objectives of this study are to explore whether two programsfor potential dental students from disadvantaged backgrounds helpedthe participants to increase their academic skills, confidence toperform well academically, and motivation to become dentists. ThePipeline Program is a program for disadvantaged first- second-yearundergraduates who are interested in dentistry. The studentsparticipate in academic skills, biology, chemistry, and physicsworkshops. The Profile for Success (PFS) Program is for junior andsenior undergraduates who plan to attend dental school. Theparticipants prepare themselves for the dental school admissionprocess. All students interact with dental students and faculty andlearn about dentistry in hands-on preclinical exercises and lectures.The participants responded to surveys and academic tests before andat the end of the programs (Pipeline Program: Nelson-Denny ReadingTest; subject-specific tests; PFS Program: DAT). Data from 108students in the Pipeline Program and 117 students in the PFS Programwho participated between 1998 and 2003 were analyzed. The resultsshowed that the students improved academically (Pipeline Program:vocabulary percent ranks before/after: 46.58/61.37***; readingcomprehension: 52.52/64.19***; reading rate: 36.14/80.39***; PFSProgram: beginning/midterm/end: perceptual: 14.31/16.31/17.54;academic: 13.72/13.92/14.80***), increased their desire to becomedentists, and became more confident to do well academically (PipelineProgram-4 point rating scale: before/after: biology: 3.23/3.31;chemistry: 2.96/3.34; physics: 2.59/3.50*; PFS Program: doing wellon DAT: 2.88/3.61; in admission interview: 3.11/3.67; in admissionessay: 3.16/3.63***).

The data suggest that these two programs support students fromdisadvantaged backgrounds in their academic careers and help toincrease their academic skills, their confidence in doing wellacademically, and their interest in dentistry. These outcomes willultimately contribute to creating more diverse dental school classesnationwide.

114. Performance Trends by Ethnicity on the Surveyof the Natural Sciences and the AAVE Scores of theDAT

Yang, June, American Dental Association

Purpose: This study was designed to investigate performancetrends on the Survey of the Natural Sciences (SNS) and the AcademicAverage (AAVE) scores on the Dental Admission Test (DAT) duringa six-year period, 1997-2002, by all examinees and five ethnic groups.The existing standardized DAT test scores for the examinees whovolunteered ethnicity information were a sample of convenience forthe data analyses. Performance trends on the DAT were analyzed forall examinees as a group, for each year, and for each ethnic groupover the six-year period.

The questions to be investigated were: 1) Were there statisticallysignificant performance level changes on the DAT subtest scores byall examinees each year? 2) Were there statistically significantdifferences on the DAT performance levels by five ethnic groupsover the six-year period? and 3) Were there statistically significantperformance fluctuations by particular ethnic groups over particularyears? That is, were the trends similar in all ethnic groups from yearto year, or were there particular ethnic groups that showed markedlydifferent trends in their performance? A two-factor design was usedfor the statistical significance test. Because the numbers of ethnicgroups were unbalanced, the general linear model (GLM) was usedfor the analysis. The results showed that there were statisticallysignificant (p<.0001) performance differences from year to year, byvarious ethnic groups, over the six-year period, and by particular



groups in some years. A statistically significant performancedifference among the ethnic groups and/or a trend in a certain directionmay have some implications for future applicants’ educationalplanning and preparation for their goal of gaining admission to dentalschools. In-depth comparisons among the ethnic groups were not apurpose of this study. However, some differences are noted.

The results showed that there were statistically significant(p<.0001) performance differences from year to year, by variousethnic groups, over the six-year period, and by particular groups insome years.

115. Ceramics Laboratory Quality Assurance Program

McConnell, Thomas, University of Kentucky College of Dentistry,Armentrout, Timothy, University of Kentucky College of Dentistry,Chaney, Alex, University of Kentucky College of Dentistry, Robinson,Fonda, University of Kentucky College of Dentistry, Timmons, James,University of Kentucky College of Dentistry

Purpose: To develop and implement a ceramics laboratoryquality assurance program and have students participate in theassessment.

Student dentists will need to evaluate the quality of lab workprovided for them upon graduation from dental school. This programgives them a framework for assessing ceramic laboratory work whenthey enter private practice. A quality assurance survey was developedwith input from the ceramics laboratory supervisor, faculty, andstudents. After editing, the survey was distributed with random casesto ensure that every technician was evaluated throughout the year.With faculty assistance, student dentists would evaluate the fit,esthetics, and function of the prosthesis to be delivered. After oneyear of use the following results were obtained: 123 units of crownand bridge were evaluated, including 96 PFMs, 13 FGCs, 10 porcelainveneers, 2 resin bonded FPD abutments, 1 inlay, and 1 onlay.Seventeen percent of the units were high in occlusion. Proximalcontacts, margins, shade match, and contours were all 9 percent orless. Only one crown had to be remade (remake rate of 0.8 percent).This compares favorably with the ceramics laboratory overall remakerate of 4.8 percent. Twenty-five positive comments and one negativecomment were listed. Strategies are currently being developed toimprove the problem of high occlusion.

The quality of the ceramics laboratory was found to be verygood to excellent, and student participation was a good learning tool.

116. The Interest of Michigan Dental Hygiene Studentsin Obtaining a Baccalaureate Degree

Luxmore, Judi, University of Detroit Mercy School of Dentistry,Coleman, Margaret, University of Detroit Mercy School of Dentistry,Shepherd, Kathi, University of Detroit Mercy School of Dentistry,Pink, Frank, University of Detroit Mercy School of Dentistry

Purpose: To determine the interest of Michigan dental hygienestudents in obtaining a baccalaureate degree; determine their perceivedvalue in obtaining a Bachelor of Science degree; and determine theservices of a degree completion program and/or college campus thatwould attract or discourage prospective students into a degreecompletion program.

The American Dental Hygienists’ Association (ADHA)advocates an advanced degree for all dental hygienists to expandscientific knowledge beyond the entry level. Data is not available todocument the number of dental hygienists in Michigan withbaccalaureate degrees; however, the assumption is that the majorityof hygienists in the state do not have an advanced degree. Of thetwelve dental hygiene programs in the state, two offer a Bachelor ofScience program (dental hygiene major), nine offer an Associate ofApplied Science program, and one offers an Associate of Science

program. A nine-item survey was used to question a population of269 dental hygiene students in Michiagn (DH ’02 and ’03) on theirinterests in obtaining a baccalaureate degree. Of the surveys returned,67 percent (N=179) had been completed for analysis. Preliminaryresults indicate that 66.9 percent (N=119) of the dental hygienestudents were interested in pursuing a baccalaureate degree, and 2.8percent (N=5) indicated that they did not perceive a value in obtainingan advanced degree. Of 172 responses to “overall value of a Bachelorof Science degree,” 53.5 percent (N=92) indicated “increased generalknowledge leading to diverse skills,” and 52.3 percent (N=90)indicated “expanded dental hygiene skills.” Services that wouldattract a prospective student (out of 546 responses, with multiplechoices allowed) into a degree completion program were flexibletime commitment (23.8 percent, N=130), campus location (19.6percent, N=107), and cost (19 percent, N=104). The following issues(out of 322 responses, with multiple choices allowed) woulddiscourage a prospective student: cost (34.2 percent, N=110), campuslocation (31.4 percent, N=101), and limited time to complete program(23 percent, N=74). If graduated from a degree completion program,62.1 percent (N=77) indicated their primary professional role wouldbe as a clinician, 21 percent (N=26) indicated as a dental hygieneeducator, and 5.6 percent (N=7) indicated working in business/sales.

The data suggests that dental hygiene students in Michigan areinterested in pursuing a baccalaureate degree after completion of adental hygiene program to increase general knowledge. To encourageenrollment into such a program, degree completion programs shouldfocus on specific flexibility of coursework within the program andoffer financial aid opportunities and extension programs as stimuli.

BLOCK V, Tuesday, March 9

12:00 noon to 1:30 pm

117. Correlation of a Carving Test to the First ThreeYears of Dental School Performance

Kwapis-Jaeger, Judy, University of Detroit Mercy School of Dentistry,Abbott, Lawrence, University of Detroit Mercy School of Dentistry,Pink, Frank, University of Detroit Mercy School of Dentistry,Coleman, Margaret, University of Detroit Mercy School of Dentistry,Kashani, Nahid, University of Detroit Mercy School of Dentistry,Linger, Jackson, University of Detroit Mercy School of Dentistry,Mattana, Durinda, University of Detroit Mercy School of Dentistry,Shepherd, Kathi, University of Detroit Mercy School of Dentistry

Purpose: To test whether a carving dexterity test correlates withthe first three years of dental school performance.

The identification and development of hand skills has alwaysbeen an issue in dental education. Today, U.S. dental schools use thePMAT of the DAT to assess potential psychomotor skills, whileCanadian schools and Louisiana State University use a carving testfor this purpose. This study was to assess the relationship between acarving test similar to that used by the CDA and LSU and the firstthree years of dental school performance, measured by operative GPA,clinical performance as represented by operative dentistry competencyexams, and National Board Part I scores. First-year students, withoutprior notice, carved a specific design into standardized sticks of soapon the first and last day of class. Carvings were evaluated by a teamof eight faculty who had been calibrated using the standardized criteriaand format used by the CDA. Criteria were flatness of planes,sharpness of angles, symmetry, and accuracy of reproduction. Onepair of faculty evaluated the same criterion on each carving assigningscore values of 0-4. At the end of the third year, relevant summarydata of the class was obtained, including third-year operative GPA,third-year Science GPA, clinical operative competency scores, and



Part I National Board Scores. Data was then statistically analyzedusing ANOVA, Kruskal-Wallis, regression, and correlation analyses.A weak correlation was observed between carving scores andcompetency scores. The first-year competency score is significantlyrelated to the second carving, as one improved so does the other,ANOVA 0.04. No correlation between carving scores and third-yearoperative GPA or third-year Science GPA was observed. NationalBoard Part I scores had no significant relationship to either carving,p>0.05. National Board Part I scores are correlated to first-yearcumulative GPA, linear regression p=0.00, slope=.80.

A carving dexterity test weakly correlates with third-yearoperative competency scores, but more closely correlates a secondwax carving with first-year competency scores which may not reflectinherent manual dexterity.

118. Time Interval Between Gutta Percha Obturationand the Placement of a Definitive Seal of the Root CanalSystem in Two Dental Schools

Lin, Jarshen, Harvard School of Dental Medicine, Kwon, Kung-Rock,Kyung Hee University, Weber, Hans-Peter, Harvard School of DentalMedicine, Samet, Nachum, Harvard School of Dental Medicine

Purpose: Ideally, dental students treat patients only afteracquiring patient history, initial examination, and treatment planning.However, in many cases, students are required to perform emergencyroot canal treatment, even before finalizing data collection. Sinceonly one procedure can be completed in the time allotted per clinicsession, emergency endodontically treated teeth are often left withouta permanent seal. However, endodontic treatment is not consideredcomplete until a permanent coronal sealing material is placed.Postponing of the definitive seal often worsens the prognosis ofendodontic treatment by allowing leakage and secondary decay, toothfracture, gingival inflammation, migration of neighboring and/oropposing teeth, etc. The purpose of the study was to evaluate thetime interval between the completion of gutta percha obturation andthe placement of a definitive seal of the root canal system in twodental schools: Harvard School of Dental Medicine (HSDM), Boston,MA, USA, and Kyung Hee University dental school (KHU), Seoul,South Korea.

The study groups included 112 teeth treated by senior dentalstudents at the HSDM and and 178 treated teeth at the KHU duringthe year 2003. A definitive seal of the root canal system includedeither the placement of an amalgam or a composite core buildupmaterial, the placement of a prefabricated post and core, or thecementation of a cast post and core. At both schools, a cast post andcore were always covered with a temporary crown after cementation.The average time interval between gutta percha obturation and theplacement of a definitive seal of the root canal system was found tobe seventy days at the HSDM and 77.4 days at the KHU. The longesttime interval at HSDM was 295 days, compared with 428 days at theKHU. The shortest time interval in both schools was zero days, incases where a core build-up material was used directly following thecompletion of gutta percha obturation. No significant statisticaldifferences were found between the two dental schools. In bothschools, three main reasons were found to be the most common forthe prolonged time intervals: students’ skills and ability, availabilityof clinical time, and neglect by the patients.

In overcoming this delay clinically, the use of glass ionomermaterials as temporary restorative materials should be consideredfor both its superior sealing and mechanical properties.Administratively, a better tracking system would allow for betterfollow-up of the teeth after the completion of gutta percha obturation.Furthermore, since endodontic treatment is technically only completewith a definitive sealing, no credits should be given to students until

this point is reached. Encouraging expeditious completion of rootcanal therapy would be in the best interest of the patient, as well asthe educational interest of the student.

119. A Bachelors’ Degree Completion Online ProgramAssessment

Barnes, W. Gail, East Tennessee State University

Purpose: To identify the pros and cons of a Bachelor of ScienceCompletion Online program.

The assessment of a new program is a vital component of itssuccess. In an effort to meet the needs of present and future studentsof the BSDH Degree Completion Online program, the researcherdeveloped a survey to ascertain the positive and negative aspects ofthe program that had been in existence for one year (three semesters).An Internet survey was mailed to the twenty-nine students enrolledin the online program, asking them to identify the positive andnegative aspects of their experiences as online students. The surveyconsisted of twenty items: closed-ended questions and qualitativeopen-ended questions (to help with interpretation of quantitativeresults). The data sample consisted of twenty-two useable responses(76 percent). Data were downloaded from the web and manuallyentered into SPSS 10.0. The results indicated that, of the coursesthey had taken, the students were most positive regarding the“flexibility of classes, i.e., no specific lecture time and day” (N=20,91 percent). “Asynchronous communication” and “developingPowerPoint presentations” both had a 32 percent response rate.Conversely, the students responded most negatively to the “other”category (N=8, 32 percent). The qualitative responses for “other”revealed that the group projects were too difficult to complete online,communication with instructors was limited, some of the courseswere better suited for the traditional classroom setting, and thepersonal computer was very slow. Only one student (5 percent)responded negatively to each of the following categories:asynchronous communication, testing method, developingPowerPoint presentations, and flexibility of classes.

It is concluded that the year-end assessment of the students’experiences provided valuable data for program evaluation, revision,and implementation of online courses.

120. Effect of Different Types of Dental SimulationTraining on Students’ Performance in OperativeDentistry

Urbankova, Alice, Columbia University School of Dental and OralSurgery, Hadavi, Farhad, Columbia University School of Dental andOral Surgery, Lichtenthal, Richard, Columbia University School ofDental and Oral Surgery, LeBlanc, Vickie, University of TorontoCenter of Research in Education

Purpose: This study compares the effect of faculty-assisted andvirtual reality computerized training on students’ proficiency inoperative dentistry. Evaluation of students’ progress was determinedby standard grading procedures utilized in the operative dentistrycourse in SDOS at Columbia University.

Methods and materials: 153 students participating in this studywere randomly divided into four groups; A, B, C, and D. All studentsin this study participated in an eight-hour training program usingdifferent learning procedures. Group A, which consisted of forty-one students, practiced with KaVo noncomputerized simulator (KaVoAmerica Corp) with faculty supervision (F/S ratio 1/3). Group B,which consisted of thirty-two students, received conventionalpreclinical lab training with faculty feedback (F/S ratio 1/12). GroupC, which consisted of forty students, practiced using VR-DS compactKaVo/DentSim Virtual Reality Simulator (DenX America, Inc.). The



feedback and evaluation were provided by computer software (CS)(CS/S ratio 1/1). Group D, which consisted of forty students, receivedconventional training (CL) without any supervision from faculty. Allstudents in this study participated in the formal course of operativedentistry consisting of sixty-five hours of lectures and 110 hours oflaboratory exercises. In conventional settings the feedback is limitedand offered with delay on the first-come, first-served basis. However,the VR-DS system with computerized instruction software offersimmediate and limitless evaluation and feedback on demand.

Results and Discussion: The students’ learning curve is affectedmainly by repetitive practice of specific procedures and by thefeedback component.

The preliminary data of this study confirms the results of ourprevious studies showing significant difference between conventionaland computerized training. If the improvement of the students’performance depends mainly on the amount of time spent practicingoperative procedures, then Groups A, B, and C will perform betteron the standardized practical examinations then those in Group D.However, if the learning mainly depends on the quality and quantityof feedback, then the performance of Group C will be significantlybetter then Groups A, B, and D.

121. The Synergy of Community Service

Hlava, Gwen, University of Nebraska Medical Center College ofDentistry, Froeschle, Mary Lynn, University of Nebraska MedicalCenter College of Dentistry

Purpose: The purpose of the Sealing Smiles Dental SealantProgram was to provide preventive dental care to needy children.

The program has provided dental exams, sealants, fluoridetreatments, and education to an underserved population of second-and third-grade children. Dental hygiene students gained valuableexperience in treating children and being involved in communityservice. The dental hygiene department teamed with local communityservice organizations to coordinate the logistics and identify thosechildren most in need. Six dental hygiene students, one dental hygienefaculty, and two dentists from federal health clinics took portableequipment to each school. All children received an oral exam, fluoridetreatment, indicated sealants, and individual oral health education.This is the first time dental hygiene students were allowed to delivercare in the public school system. Innovative approaches tocoordinating existing community organizations and resources allowedthis program to evolve. The four separate site visits were each oneweek in duration. A total of 515 children participated. Twenty dentalhygiene students provided 1000 sealants, 439 fluoride treatments,and patient education. The on-site dentists referred 220 children tofederal clinics for additional dental care. As financial pressuresincrease, off-site locations and community involvement gain addedimportance to dental schools. No outside costs were incurred by theCollege of Dentistry. The format and implementation are easilyreplicated to fit other educational institutions and experiences. Thevalue of the services rendered were tabulated at each site. The firstyear almost $63,000 worth of preventive care was provided. Fivenew sites have been targeted for the upcoming year.

The program met the strategic mission of the college: studenteducation, patient care, and community outreach. Outcomes exceededexpectations in the areas of community dental health and clinicalpractice.

122. Only in New York: PGY-1 Law Changes DentalLicensure

McAndrew, Maureen, New York University College of Dentistry, Peltz,Ivy, New York University College of Dentistry

Purpose: To describe New York State’s new “PGY-1” law andto discuss the implications of the law and its impact on dentaleducation

Groundbreaking legislation was recently passed in New YorkState that has changed the way dentists may be licensed. This law,known as PGY-1 (postgraduate year one), mandates that prospectivedentists wishing to practice in New York State now have two routesto achieve licensure. One is the traditional route: four years ofattendance at an accredited dental school, passage of Parts I and II ofthe National Boards, and passage of clinical exam with live patientsadministered by the North East Regional Board of Dental Examiners(NERB). The new alternative allows a year-long residency in dentistryat an approved institution in lieu of the clinical exam. This momentouschange was due in large part to the concerted efforts of the AmericanDental Association (ADA) and dental educators to eliminate the livepatient exam. Many reasons were cited including high failure rates,allegations of unethical and inappropriate patient treatment, lack ofexam validity and examiner reliability, and the nonalignment withthe medical profession’s method of licensure. Requiring a fifth yearof additional training in a hospital setting reflects the changing natureof dentistry. It has evolved from a surgical model limited to the oralstructures to a medical one where comprehensive care is the norm.Dentistry has also become far more complex. Implants, porcelainlaminates, CAD-CAM restorations, to name but a few, have beenadded to the dental curriculum. It has become a real challenge fordental educators to address this expansion of dental services in thesame four-year time frame. The diverse and aging population of theUnited States makes this task even more daunting. For those studentswho intend to practice in New York State, the senior year of dentalschool could provide a much richer experience. Currently, a largeportion of a student’s senior year consists of practicing the requiredprocedures for the NERBS and looking for ideal patients. With theburden of the clinical exam lifted and a residency to look forward to,the curriculum could be tailored to the student’s level of expertiseand interest. More students could participate in research projects anddo longer rotations in the different specialties.

New York’s “PGY-1” has profound implications not only fordental licensure in the remaining forty-nine United States, but alsofor dental education in general.

123. The Dental Aptitude Carving Test: A LearnableSkill?

Abbott, Lawrence, University of Detroit Mercy School of Dentistry,Kwapis-Jaeger, Judy, University of Detroit Mercy School of Dentistry,Pink, Frank, University of Detroit Mercy School of Dentistry,Coleman, Margaret, University of Detroit Mercy School of Dentistry,Kashani, Nahid, University of Detroit Mercy School of Dentistry,Linger, Jackson, University of Detroit Mercy School of Dentistry,Mattana, Durinda, University of Detroit Mercy School of Dentistry,Shepherd, Kathi, University of Detroit Mercy School of Dentistry

Purpose: The purpose of this study is to test whetherperformance on a carving aptitude test can be improved by repetitionand previous experience.

Predicting success in dental school has always been a challenge.While past academic performance is a proven predictor of futureacademic performance, predicting the psychomotor skills necessaryfor dentistry has been more difficult. Until 1972 the ADA used achalk carving exercise to attempt to predict such skills. Since thenthe PMAT has been used as a predictor. However, all Canadian schoolsand LSU still require a carving test for admission. But if a carvingtest is used, to what degree does it predict innate ability and to whatdegree can it be learned? Previous studies suggested a correlationbetween PMAT performance and carving dexterity tests, but no known



studies have been conducted on whether repeated practice on a carvingtest will yield a measurable improvement in that test. The purpose ofthis study was to assess the change in mean carving scores between agroup of students who had no previous experience in such an exerciseand a second group who had performed the exercise previously. First-year students carved a specific design into standardized sticks of soapon the first and last day of class. Carvings were evaluated by a teamof eight faculty calibrated to the standardized criteria of the CDA.Criteria were flatness of planes, sharpness of angles, symmetry, andaccuracy of reproduction. One pair of faculty evaluated the samecriterion on each carving, assigning scores of 0-4. The mean aggregatecarving scores of US students (N=62) who had not carved previouslywere compared to mean aggregate scores of Canadian students (N=13)who had carved as part of their application to Canadian schools.ANOVA analysis compared the two carving scores. For the 1st carvingthe mean U.S. score was 4.645 and mean Canadian score was 6.846,p=0.011. For the second carving, the mean U.S. score was 7.629 andmean Canadian score was 9.769, p=0.212. The data suggests alearning curve associated with this test. The U.S. students who hadnot carved previously scored significantly lower than their Canadianclassmates in the first exercise. But both groups improved in thesecond exercise, with the difference between the two no longerstatistically significant.

For schools using carving as an admission test, the degree towhich an applicant can improve his or her performance maycompromise the validity and reliability of the test.

124. Preparing Students for Private Practice Is anAttribute of Mentoring

Dower, James, University of the Pacific School of Dentistry, Salimi,Sima, University of the Pacific School of Dentistry, Garcia, Richard,University of the Pacific School of Dentistry, White, Marc, Universityof the Pacific School of Dentistry, Geissberger, Marc, University ofthe Pacific School of Dentistry

Purpose: Preparing students for private practice.At the University of the Pacific School of Dentistry, the

Operative Dentistry Department has been preparing the students forprivate practice with a curriculum including an extensive preclinicaloperative course, three half-days of an advanced restorative blockthe quarter before entering the clinic, selectives in placing direct classII composite resins, didactic courses, the availability of five half-days a week for two years in esthetic dentistry clinics, the estheticdentistry done in the regular clinics, and a large esthetic dentistrystudy club. To assess how well this was meeting the students’ needs,a survey was done of 114 graduating students two weeks beforegraduation. The results of the survey showed seventy-eight studentsplaced fifty or more amalgams and twenty-seven students placedtwenty-five to fifty, while seventy-eight students placed zero to tenposterior composites and twenty-seven placed ten to twenty-five.Fifty-five of the students felt adequately trained for placing posteriorcomposites, and fifty-nine did not feel adequately trained. Of course,many students do not feel adequately trained in a variety of subjects,which is one of the reasons for the applications to AEGD and GPRprograms. The students were also asked what percentage of directposterior restorations they expected to place in private practice. Sixexpected 81-100 percent amalgam, eighteen expected 61-80 percentamalgam, twenty-one expected 41-60 percent amalgam, nineteenexpected 21-40 percent amalgam, and fifty-two expected 0-20 percentamalgam while sixteen expected 81-100 percent composite, twenty-seven expected 61-80 percent composite, twenty-one expected 41-60 percent composite, twenty-two expected 21-40 percent composite,and thirty expected to do 0-20 percent composite. From this data itappears that fifty-nine to seventy-eight of the 114 students desire or

need more training on direct posterior composites prior to graduation.The biggest factor in the number of composites and amalgams donein the dental school clinic is the best choice in restorative materialsconsidering all the aspects of the patient’s oral cavity and budget. Weare currently looking at ways to provide the students with moreopportunities to place direct posterior composites on simulatorsthrough selectives and block assignments.

A dental school’s patient population may cause graduatingstudents to be less than well prepared for entering private practice,and the students could get those experiences through simulations.

125. Mentoring Dental Students Considering DentalAssociateships

Fields, W, University of Tennessee College of Dentistry

Purpose: To provide individualized assistance to dental students(and alumni) in analyzing associateship opportunities by identifyingpotential problems in employment contracts and refining strategiesfor negotiating equitable and mutually beneficial relationships.

Twenty years after the American Dental Association fundedthe Private Practice Associateship Program pilot project at theUniversity of Tennessee, associateships still represent the mostcommon avenue for transition into practice for dental studentsplanning to enter general practice immediately following graduation.In spite of improved curricular content related to career choices,students approach this decision with varying degrees of trepidation.The feeling of unease is intensified by the complexity of associateshipcontracts, with their intimidating and seemingly unavoidable legalese.A Contract Assessment Program (CAP) was developed to provideindividualized assistance to students as they review and interpretspecific contracts defining associateship offers. It is emphasized thatsuch assessment is intended as an adjunct to rather than a replacementfor a legal review by an attorney. Over 150 contracts have beenassessed, with 100 percent favorable feedback from students andalumni. A checklist of clauses that are or should be found in anassociateship contract will be displayed, along with commonlyencountered red flags (clauses with potential for causing dissonancebetween the owner-dentist and the associate). Sample assessmentswill be available for review and discussion, along with excerpts fromtheir respective contracts.

A formal program to mentor dental students in assessingassociateship offers can ensure that common problems resulting fromthe wording of contract clauses are identified and addressed, and itcan alleviate some of the anxiety inherent in leaving a twenty-yearcareer as a student to initiate a new career as a health care professionaland businessperson.

126. Case-Based Learning in Endodontic Diagnosis

Rafter, Mary, University of Michigan School of Dentistry

Purpose: To compare outcomes following teaching ofendodontic diagnosis using traditional lecture-based methods aloneor in combination with a case-based learning session.

In the preclinical endodontic program at the University ofMichigan, endodontic diagnosis had always been taught using thetraditional lecture-based format. A one-hour lecture, using slides andan extensive hand-out, covered history taking, clinical examination,and diagnostic tests. During a subsequent lecture, considerable timewas spent explaining how this data should be collected and used toreach the correct diagnosis. In spring 2003, the second lecture wasreplaced by a case-based learning session. The class was divided intosmall groups. Two types of cases were developed by endodonticfaculty. In the first type, the history and the results of the clinicalexamination and diagnostic tests were provided, and the students were



required to reach a pulpal and periradicular diagnosis. The final twocases consisted of clinical pictures and radiographs. The studentswere not provided with the results of the examination, but wererequired to ask the appropriate questions to collect the data necessaryto reach a diagnosis. As part of the test case for completion of thepreclinical program, the students are required to complete anevaluation form and reach a pulpal and periradicular diagnosis basedon information provided. The results achieved by preclinical studentsin 2002 (lecture alone) and 2003 (lecture in combination with case-based learning session) were compared. In 2002, 30.5 percent ofstudents achieved a score of 100 percent, while, in 2003, 63 percentachieved this score. The data was statistically analyzed using the chi-square test. The outcomes following the case-based learning sessionwere statistically significantly superior to those achieved with lecturealone.

It was concluded that a combination of lecture and case-basedlearning was more effective than lecture alone for student acquisitionof endodontic diagnostic skills.

127. Distribution of Course Materials in MultipleFormats to Meet Different Learning Styles

Levine, Alan, University of Texas Health Science Center, Houston

Purpose: To assess the value of providing students in a dentalbiochemistry course with learning materials in alternative formats tomeet different learning styles.

Student learning style is an important contributor to academicand clinical success in dental school. We attempted to meet this needby supplementing traditional lectures in the intermediary metabolismsection of the dental biochemistry course with posted PowerPointslides from all lectures, web-based lessons, and additional Internetresources. Students were encouraged to utilize all materials and thetextbook in their studies. Dental students from five consecutive first-year classes at UT-Houston, Dental Branch completed an onlinequestionnaire that included both scaled and free-text responses toquestions evaluating the use and design of the resources. Results fromthis questionnaire showed that students completed, on average, 65percent of the lessons and spent approximately five hours online.Evaluation of responses related to the web-based lessons indicatedthat a majority (60-90 percent) of students either agreed or stronglyagreed that practice exercises and the ability to control the pace ofthe lessons were important, that the illustrations, animations, andhyperlinks were helpful, and that the lessons were effective as areview. Students particularly liked the practice exams that includedanswers and explanations. The highly positive response to the web-based lessons indicates the usefulness of this approach as a study aidfor dental students. Greater than 85 percent of the students agreed orstrongly agreed that posting of PowerPoint slides and the use ofBlackboard™ as a vehicle for accessing the online material washelpful in studying for the course. Approximately 25 percent of thestudents’ comments contained statements regarding learning styles,and the majority of these responses indicated the importance of havingstudy materials available in alternative formats.

Faculty should be aware of student learning styles and providecourse materials in various formats including web-based lessons toenhance student learning.

128. Outcome of Computerized Telephone Reminderson Clinic Appointment Attendance

Kula, Theodore, University of Missouri-Kansas City School ofDentistry, Roth, John, University of Missouri-Kansas City School ofDentistry, Glaros, Alan, University of Missouri-Kansas City Schoolof Dentistry, Kula, Katherine University of Missouri-Kansas CitySchool of Dentistry

Purpose: This prospective, longitudinal, randomized study wasdesigned to determine whether there was a significant difference inbroken appointments in a group of orthodontic patients receiving acomputer-generated telephone reminder (HouseCalls™, Televox™)as compared with a group not receiving a reminder.

Broken appointments can affect the length of treatment, thequality of resident clinical experience, and the productivity of auniversity orthodontic postgraduate clinic. Patients in active treatmentwere randomly assigned to either of two groups: call or no-call groups.The patients in the call group (n=114) with 495 scheduledappointments received a computer-generated reminder the night priorto their appointment. The no-call group (114 patients) with 541scheduled appointments received no reminder. The call group hadtwenty-two broken appointments (4.4 percent failure rate) and theno-call group had forty-six broken appointments (8.5 percent failurerate). There was a significant difference in total broken appointmentsand in broken appointments at each of the first three visits (Chi-square;p<0.05). Applying this data to an average orthodontic office, theestimated clinic savings was $14,000 a year. The time required forstaff or residents to make calls was minimized; staff could performother duties; the residents’ clinical experiences were maximized; andpatient treatment schedules were better maintained. The savings inmonies and time are important to economically stressed academicinstitutions. Other features of the HouseCalls™ system included itsinterface with patient management software, ease of use, less thanfive minutes daily set-up time, personalized messages, flexibility inplacing calls at optimal times to contact patients, ability to recordpatient messages, and the identification of incorrect and out-of-ordertelephone numbers.

Thus, the use of a computer-generated telephone remindersystem, HouseCalls™, significantly decreased the number of brokenappointments in a university clinic.

129. Learning in the First Year of a SimulationLaboratory

Yanus, Margaret, Baylor College of Dentistry, McCann, Ann, BaylorCollege of Dentistry, Griffin, Stephen, Baylor College of Dentistry,Beninger, Thomas, Baylor College of Dentistry, McKinney, Thomas,Baylor College of Dentistry, Miller, Amp, Baylor College of Dentistry,McCarthy, Sandra, Baylor College of Dentistry, Mash, Kay, BaylorCollege of Dentistry

Purpose: The simulation laboratory at Baylor was built in thesummer of 2002 to improve the environment for teaching and learningof preclinical dentistry. The goal was to enhance the learning ofsecond-year dental (D2) students so that they would feel prepared toenter the clinic.

This simulation laboratory features 100 stations, each with asim unit, operator chair, and monitor linked to a state-of-the-artmultimedia center. The D2 classes in operative, fixed, and removableprosthodontics began in the fall of 2002, with modules from otherpreclinical courses introduced throughout the year. The focus ofinstruction across the disciplines was the teaching of ergonomics,indirect vision, and using the handpiece intraorally on a simulatedpatient. The students (n=86) completed an evaluation of the sim labexperience at the end of the second year where they identified theexperiences that improved their learning, the ease of using the variouspieces of equipment, and their preparation for various procedures.They also compared learning in the lab to other environments. Theyreported that the following sim lab features improved their learning:computer monitors (93 percent “agree” or “strongly agree”), mediasystem (91 percent), sim heads (90 percent), and delivery system forhandpieces and suction (89 percent). Overall, 81 percent of thestudents “agreed” or “strongly agreed” that they felt prepared to begin



patient care in the clinic. Specifically, more than 80 percent “agreed”or “strongly agreed” that they felt prepared to use correct postureand chair positioning, indirect vision, and the handpiece. More than92 percent reported that they preferred learning operative proceduresand taking practical exams on the sim heads. The lowest ratings werefor the assistance arm (55 percent did not “agree” or “strongly agree”that it improved their learning), lectures in the sim lab (47 percent),and cheek material on the sim head (32 percent). When asked toidentify the “one thing they liked the most,” the students mostcommonly cited some variant of the “simulation of the real patientexperience” (n=40).

In conclusion, preclinical courses were introduced successfullyinto the new lab with only minor problems identified. The D2 studentsreported that the sim lab improved their learning, and they feltprepared to begin patient care.

130. Educational CD-ROM on Fabrication ofImmediate Denture

Abadi, Behruz, University of Kentucky College of Dentistry, Herren,Michael, University of Kentucky College of Dentistry, McConnell,Thomas, University of Kentucky College of Dentistry

Purpose: To develop a program for students to review thefabrication of a provisional denture.

The clinical setting is the application of preclinical knowledgeas applied to real situations. The transfer of didactic material intoclinical application is a challenge for students. Students in clinicalsettings are all working under different situations. Instruction takesplace individually with the clinical instructor. The challenge forclinical teachers is how do we provide students with instruction inthis type of curriculum? We are now using Asynchronous LearningNetworks (ALN) to augment our traditional curriculum. CD-ROMmedia have been developed to demonstrate clinical procedures. ACD-ROM demonstrating the fabrication of a provisional denture wasfabricated to assist students. The use of alternate teaching methods isbecoming commonplace in dentistry. Further incorporation of CD-ROM software and computer technology into clinical teaching isexpected.

A survey of the students revealed the following: 93 percenthave access to a computer at home; 100 percent have access to acomputer at school; and 100 percent found the CD-ROM useful totheir clinical experience.

131. Expanding Community Services While IncreasingDental School Clinic Production

Fredekind, Richard, University of the Pacific School of Dentistry,Miller, Christine, University of the Pacific School of Dentistry, Kirk,Jeffrey, University of the Pacific School of Dentistry, Barniv, Zuri,University of the Pacific School of Dentistry

Purpose: To balance the provision of dental services tounderserved populations in northern California with the maintenanceof fiscal responsibility in a dental school clinic.

Access to dental care is a significant problem in California.The existing ratio of dentists to patients is 1:1700 and growing. Overthe past twelve years, the University of the Pacific School of Dentistryhas developed many programs staffed by predoctoral students andvolunteer faculty to help meet this need. Concurrently, the economiccrisis in California has created a $35 billion deficit. The purpose ofour program is to achieve a balance between supporting our clinicmission, expanding service to our communities, and providing a broadspectrum of student experiences, while increasing clinic revenues.The outreach programs target many diverse groups including thedisabled, the working poor, those on state-funded assistance, ESL

populations, the medically compromised, children, the elderly, andpeople in recovery. Services have been provided in many locationsincluding community clinics, dental school clinics, extramural sitesas much as 100 miles away, local schools, private practices, andhospitals. Treatment is provided during weekday rotations as well asweekend and vacation rotations. This approach allows students toincrease access to care without impacting their curricular activitiesor clinic production. In fact, gross clinic production has increased 9percent in each of the last two years by enhanced student efficiencyand targeted fee increases. Approximately 8,000 patients have beentreated under these programs, in 16,000 visits, with over $2,500,000of treatment provided. The number of patients receiving other outreachservices has increased from approximately 1,973 to 2,316 (17 percentgrowth increase). Future growth is dependent on our ability toestablish an effective distance-learning program and identifyalternative funding sources to maintain fiscal responsibility.

Innovative approaches to student community clinic assignmentshave allowed a dental school to increase the provision of care tounderserved populations while maintaining dental school clinicproductivity and patient care.

132. Student Benefits from a Summer PreparatoryCourse in Dental Histology

Moved to Monday, 2:00-3:30 pm

Brueckner, Jennifer, University of Kentucky College of Medicine

Purpose: To evaluate the educational impact of a summer shortcourse on student understanding of basic histological concepts andon student performance in an eighteen-week dental histology course.

The University of Kentucky College of Dentistry offers a twoand a half week summer preparatory (PREP) course annually forincoming first-year students who have limited backgrounds in thebasic sciences. This program seeks to introduce and review core topicsin three scientific disciplines (histology, physiology, andbiochemistry), as well as to acquaint students with the format in whicheach course is taught. The efficacy of the histology component of thePREP program was evaluated in 2002-03 by measuring: 1) studentperformance on pre- and post-PREP course quizzes addressing basichistological concepts, and 2) PREP student performance in theeighteen-week dental histology course taught in the fall semester.Results from pre- and postcourse quizzes administered on the firstand last days of the PREP program indicate a significant increase instudents’ mastery of basic concepts in histology (understanding thechemistry of staining and distinguishing tissue types). Preliminarydata also suggest that participation in the PREP program confers anacademic advantage to students on exams covering PREP content inthe fall dental histology course.

Qualitative and quantitative evaluation of the histologycomponent of the PREP program revealed that this short course notonly familiarized incoming freshmen to the format and expectationsof the eighteen-week fall histology course, but also provided anacademic advantage to these students over their classmates as theyentered the fall course.

133. Measuring Written PBL Assessment Quality:Rubric Design and Testing

Fitzgerald, Brenda, Indiana University School of Dentistry, Meadows,Melinda, Indiana University School of Dentistry, Aguirre-Zero,Odette, Indiana University School of Dentistry, Garetto, LawrenceP., Indiana University School of Dentistry

Purpose: To develop a rubric to evaluate the “quality” ofassessment narratives written by tutors about students in their PBLgroups.



In the first two years of its curriculum, Indiana University Schoolof Dentistry uses problem-based learning (PBL) in addition totraditional lectures to introduce basic/clinical science content, enhancecritical thinking skills, and develop students’ ability to assessthemselves and others. At routine intervals, students and tutors usespecific criteria to evaluate their performance in four categories:Knowledge Base, Reasoning Process, Communication, andAssessment. While tutors are expected to model PBL process skills,including writing effective assessments, in practice, their assessmentshave varied in content, length, tone, and specificity. Thus, tutors mayinappropriately model poor assessment skills or provide little directionfor improvement. Using a sixteen-item tool, we evaluate whethertutors addressed criteria, gave specific examples, suggested areas forimprovement, and gave scores congruent with their narrative. Todetermine whether different raters used the rubric consistently, threeresearchers independently coded a set of sixty tutor-writtenassessments. Intraclass correlation coefficients (ICC) were computedfor each evaluation area. The ICC values for the first wave ofassessments averaged 0.58 overall. ICC values for the category“support of score” were lower (average 0.19) than the other threecategories (average 0.71). Coding rules were subsequently refined,and the same three examiners working independently applied therevised coding system to a new set of fifty assessments. The ICCvalues for the second set were substantially higher overall than thefirst (average 0.75), the coefficients for the “support of score” itemsincreased considerably (average 0.53), and the ICCs for the otherthree categories increased as well (average 0.82).

These results suggest that our instrument allows raters of variousbackgrounds and experience to achieve significant agreement onscores of written narratives that address a wide range of PBL behaviorsand observable outcomes.

134. Project CARES: Two-Year Outcomes

Zittel-Palamara, Kimberley, State University of New York at Buffalo,Davis, Elaine, State University of New York at Buffalo, Fabiano, Jude,State University of New York at Buffalo, Goldberg, Deborah, StateUniversity of New York at Buffalo, Waldrop, Deborah, State Universityof New York at Buffalo

Purpose: The CARES (Counseling, Advocacy, Referrals,Education, and Service) Program goals included enhancing patientretention and recruitment, strengthening community relationships,solidifying interdisciplinary relationships, and integrating all of theabove into dental student education.

The Schools of Dental Medicine and Social Work collaboratedto establish a program to increase the accessibility of dental treatmentfor marginalized populations and to provide dental students with themeans to address these patients needs in future dental practices.Rationale: Patient surveys (N=928; mean age fifty-seven yrs) revealed42 percent with monthly incomes below the poverty level. Patients’main concerns were health (32 percent), finances (25 percent), medicalbills (16 percent), and family problems (14 percent). In-depth follow-up interviews with 157 respondents were used to develop the program.Approach: CARES is staffed by one full-time Ph.D. social worksupervisor who provides field education instruction to six MSWinterns and didactic instruction to dental students. Results: Retentionresults showed a 26 percent decrease in discharge rates and a 9.3percent increase in new patients since CARES started. Further, 71.7percent of patients seen by CARES saw their dental student duringthe past year. Financial results showed patients receiving social workintervention spent on average $400.00 more for dental treatment thanthey did prior to social work intervention. Also, patients seen byCARES have contributed approximately $87,000 to SDM revenue,for which CARES is partially responsible. Educational results showedthat approximately 75 percent of students found CARES useful.

Results indicate that a social work presence is a positive additionto the SDM clinical program. In addition to providing needed servicesto patients, CARES also exposes SDM students, faculty, and staff tosocial work as a key interdisciplinary team member in total patientcare. Revenue, retention, and admissions to the SDM have increasedsince the inception of the CARES Program. For fall 2003, the programplans on increasing dental student and social worker interactions,increasing community outreach projects, and integrating casevignettes and communication skills into three biobehavioral dentalcourses.

135. The Effect of Eliminating Clinical Grading onStudents’ Stress

Ray, Carolyn, Texas Woman’s University Department of DentalHygiene

Purpose: To determine if the elimination of grading prophylacticprocedures had an effect on students’ perceptions of their stress levelin Clinic I experience.

An important goal of dental hygiene education is graduatingclinically competent practitioners. Much of the clinical curriculumincludes process and product evaluations that monitor and assessdental hygiene students’ clinical abilities. The purpose of this studywas to determine if the elimination of grading prophylactic procedureshad an effect on students’ perceptions of their stress level in Clinic Iexperience. A survey was administered with twenty-one junior dentalhygiene students (class of 2003) two months after completion of theirfirst semester of clinic in a 1 + 3 bachelor degree dental hygieneprogram. One hundred percent (N=21) completed the questionnaire.The survey asked the students to rate their stress level using a 1-5Likert scale (1=very low, 2=low, 3=average, 4=high, 5=very high).The mean stress level reported was 3.89 (range 2-5). Students wereasked open-ended questions to determine which factors theyconsidered to contribute to their stress level and to indicate whichfactors were most stressful, stressful, and least stressful. Writtencomments were categorized and weighted (most stressful=3,stressful=2, least stressful=1). The three top categories and theirweights are as follows: requirements=40, grading=24, and instructors/staff=22. A curricular change that eliminated grading of prophylacticprocedures was incorporated into the next Clinic I session. The samesurvey was administered with twenty-three junior dental hygienestudents (class of 2004) two months after completion of their ClinicI experience without having prophylactic procedures graded. Ninety-two percent (N=23) completed the questionnaire. The mean stresslevel reported was 3.37 (range 3-5). Survey results were comparedfor the two groups using a t-test for independent samples (p<0.05). Asignificant difference (p=0.04) was found between the two groups.Changes in the evaluation system, i.e., elimination of gradingprophylactic procedures, resulted in a reduction of stress level. Dentalhygiene educators can deduce that a reduction of student stress isworth considering adjustments in evaluation methods.

Changes in the evaluation system (elimination of gradingprophylactic procedures) resulted in a reduction of stress level.

136. Student Identification of Learning Issues in aCurriculum Utilizing PBL

McDonald, James, Indiana University School of Dentistry, Olson,Byron, Indiana University School of Dentistry, Garetto, Lawrence,Indiana University School of Dentistry

Purpose: To compare biomedical, ethical, behavioral, andpopulation learning issues generated by students in a PBL curriculum.

The Indiana University School of Dentistry curriculum containssome thirty-five PBL cases utilized during the first two years.Typically, groups of five to six students and one facilitator meet for



three three-hour sessions for each case. During that time, studentsare presented with dental health-related cases to explore. They areexpected to collectively probe their prior knowledge related to factspresented in the case, identify knowledge gaps, convert these gapsinto researchable questions (learning issues), research the issues, andthen present their findings at the next group session. Students areencouraged to consider four major domains as they read through thecase: Biomedical, Behavioral, Ethical, and Population. Havingidentified their specific learning issues, each PBL group then entersthem into a web-based learning issues library. In doing so, they mustcategorize the learning issues into one of the four domains. The enteredlearning issues can then be monitored. Historically, students preferto explore learning issues within the biomedical realm, largely becauseour assessment process drives them in this direction. This presentationcompares the number of learning issues in each of the four domainsgenerated by students during the first year of the curriculum. FivePBL cases are compared: the 1st three cases (#1, 2, and 3) as enteringfreshmen vs. the last two cases (#18 and 19) at the end of the firstyear. In case #1, 62 percent of the issues were biomedically related;35 percent were ethically related; 1 percent were behavioral and 1percent were population related. In case #2, 67 percent werebiomedical; 18 percent ethical; 10 percent behavioral; and 5 percentpopulation. In case #3, 80 percent were biomedical; 4 percent ethical;5 percent behavioral; and 10 percent population. Towards the end ofthe first year in case #18, 88 percent were biomedical; 1 percentethical; 7 percent behavioral; and 3 percent population. In the lastPBL case of the first year, 95 percent were biomedical; 2 percentethical; 2 percent were behavioral; and no population issues wereresearched. In conclusion, it is clear that students increasingly focuson biomedical issues to research as the academic year progresses.This presentation will discuss why these results were obtained andwhat is being done to encourage a more balanced approach toexploring the four domains in each case.

Students select learning issues within the four domains basedon their expectations of how they will be assessed on the information.

137. Recovery of Periodontopathogenic Bacteria fromEmbalmed Human Cadavers

Wood, Nelson, University of Mississippi Medical Center, Johnson,Roger, University of Mississippi Medical Center

Purpose: To determine whether periodontal pathogenic bacteriacould be recovered from the coronary arteries and the bronchi ofhuman embalmed cadavers used in a gross anatomy course.

Bacterial samples were collected from the right coronary arteryand the right superior secondary bronchus from eight human cadavers(four edentulous and four dentuluous), using paper points.Specifically, specimens were collected from the right superiorsecondary bronchus at its junction with the right primary bronchusand from the right coronary artery 1 cm distal to its origin.Concentrations of eight periodontopathogenic bacteria weredetermined by DNA analysis (MicroDentX, Ft. Myers, FL). Thelaboratory could detect the presence of the following bacteria: A.actinomycetemcomitans, P. intermedia, P. gingivalis, E. corrodens,C. rectus, B. forsythus, T. denticola, and F. nucleatum. In addition,concentrations of each species was determined using the followingclassification: negative (pathogen concentration <103 cells), low ,moderate, and high (pathogen concentration >105 cells). Frequenciesof each species were calculated and compared using a Kruskall-WallisH test and correlations between the presence of teeth, bacterial species,and sites were determined by Spearman’s rho correlation tests, usingSPSS v10.1. A. actinomycetemcomitans and B. forsythus frequencieswere different between the sites (p<0.05); the frequency of B.forsythus at the bronchial site was different in dentulous andedentulous subjects (p<0.05). Numerous other correlations were

identified between strains of bacteria, site, and presence of teeth(p<0.05). Significant site and strain differences between groups ofsubjects suggest that the presence of periodontopathogenic bacterialDNA at coronary artery and bronchial sites was not an artifact of theembalming procedure and likely represented the sites of the bacterialcolonies during the life of the subject.

Thus, periodontopathogenic bacterial DNA can be recoveredfrom human embalmed cadavers, suggesting that cadavers used foranatomical instruction could also be used for research studies of linksbetween periodontal and systemic diseases. Collection andidentification of these bacteria could be a useful clinical correlationactivity for dental students.

138. A Residential Model for Providing Experience inEmergency Care

Cox, Stephen, University of Sydney, Martin, Elizabeth, University ofSydney, Zoellner, Hans, University of Sydney, Gonsalkorale, Shalinie,University of Sydney, Russell, Delyse, University of Sydney

Purpose: To demonstrate a residential model for the provisionof experience and training of students in emergency care of themedically compromised patient.

Preparation and training for medical emergencies is difficult ina school environment. Medical emergencies can occur both insideand outside the clinics and by definition are unpredictable. The dentalschool at the University of Sydney is linked with a general hospital,which allows for a residency program in emergency care. Studentsparticipate in the program over an allotted period in which they areable to observe emergency procedures and protocols, assist inemergency care where appropriate, and observe the importance ofhaving an experienced team of people who have specific tasks. Areview of this program shows good student preparation for anappropriate response to a medical emergency and very positivefeedback to participation in a residential model.

Participation in a residential program in a hospital emergencydepartment by dental students is an important educational process inpreparing students for medical emergencies.

139. Mentoring: Use of a Local Anesthesia CE Courseto Develop Leaders in the Dental Hygiene Community

Coleman, Margaret, University of Detroit-Mercy School of Dentistry,Cabanilla, Leyvee Lynn, University of Detroit-Mercy School ofDentistry, Linger, Jackson, University of Detroit-Mercy School ofDentistry

Purpose: An online survey assessed the use of local anesthesiaby dental hygienists who completed a continuing education courseat the University of Detroit Mercy (UDM) School of Dentistry. Theobjectives of this study were to evaluate how dental hygienists utilizetheir skill in administering local anesthesia; assess the levels of successas well as incidences of complications; and provide insights on patientand dental professional acceptance of hygienists administering localanesthesia.

Michigan has become the twenty-eighth state to legalize localanesthesia (LA) administration by dental hygienists. Support fromthe dental profession and acceptance in the patient population dependson the success of clinicians in performing their newly acquired skills.UDM Dental School seized the opportunity to utilize dental facultyas mentors to train practicing hygienists to become skilled in LAadministration, thereby preparing them to become leaders in thehygiene community. Since November 2002, UDM has trained 445dental hygienists through a Continuing Education Course usingdidactic, online pre-study, and hands on clinical laboratories. A fifty-five-item online survey was made available to all 445 participants todetermine when they implemented this skill, most common techniques



utilized, frequency of administration, procedures that requiredanesthesia, success rates, incidences of complications, overallacceptance by patients and support from dental practitioners. Earlypreliminary results (N=28) revealed 93 percent of the respondentsstarted administering LA; 96 percent stated they felt well preparedfor the licensing exam upon completion of the course; 53 percentdelivered LA with a frequency of one to three times a week; and 89percent stated that patients were comfortable with hygienistsadministering LA. Hygienists most frequently deliver anesthesia forscaling and root planing procedures (82 percent), and 17 percentadminister anesthesia for restorative patients. Eighty-five percent ofthe respondents stated that employers felt comfortable in their abilityto administer LA and felt this skill was an asset to the practice. Ingeneral, respondents reported high success rates, with the IAN beingthe most difficult to achieve. Seventeen percent experiencedcomplications, the most common of which was hematoma.

The local anesthesia CE Course at UDM adapted the principleof mentoring by using dental faculty to train practicing hygienistswho would become some of the first leaders in the dental hygienecommunity. Preliminary results of this survey indicate that hygienistswho completed this course provided effective and safe LAadministration. This new skill has been well received by patients anddental employers alike.

140. Utilizing the Periodontal Ligament Injection inDental Education

Park, Jun, University of the Pacific School of Dentistry, Dower, James,University of the Pacific School of Dentistry, Nguyen, Nhi, Universityof the Pacific School of Dentistry

Purpose: To clinically instruct students in overcomingdifficulties with incomplete mandibular anesthesia and the use of thePDL injection.

The most important thing to a dental patient is profoundanesthesia. Unfortunately, anesthesia of the mandible may not becomplete even when the lip has symptoms of profound anesthesia.Our students take a course in overcoming difficulties with anesthesiawhere they learn how to diagnose and treat incomplete mandibularanesthesia and proceed with another mandibular block injection and/or injections for accessory innervations and, as a last resort, the PDLinjection due to short duration of anesthesia and postoperativecomplaints. The PDL technique taught is associated with less painduring the injection by giving local anesthetic in the sulcus for tenseconds before penetrating the PDL. Each student gave and received1/4 cartridge (~.45 ml) of 2 percent lidocaine with 1:100,000epinephrine on the distal of #30 with a PDL syringe and drops ofsolution at the mesial with a standard syringe due to the difficulty inexpressing the solution. A 30-gauge extra-short needle was used withboth syringes. Ninety-nine students took the block and recordedsensations from the PDL injections that included pain, pressure andtachycardia, and postoperative effects. The student was given sixcategories to use in recording the level of pain. Thirty-four registeredno pain, thirty-two indicated a sensation similar to a gentle probing,twenty-one registered it was a little uncomfortable, eleven indicatedmoderate discomfort, one registered it was very uncomfortable, andnone said it was excruciating. Thirty students reported nopostoperative complaints, fifty-nine experienced a period of highocclusion, and thirty-nine experienced soreness, pain, pain on biting,dull ache, or throbbing. Twenty-nine of those experiencing pain hadit for fifteen minutes to four hours, eight experienced it for half-dayto a full day, and two experienced it for two days.

This rotation in local anesthesia provides the student with theskills and knowledge necessary for treating incomplete anesthesia

and giving the PDL injection when necessary. This is importanttraining considering the difficulties practitioners have with mandibularanesthesia.

141. International Outreach Programs: Charity,Education, or Both?

Cunningham, Ralph, New York University College of Dentistry, Peltz,Ivy, New York University College of Dentistry, Maloney, William,New York University College of Dentistry, Studley, Eric, New YorkUniversity College of Dentistry

Purpose: To evaluate the educational outcomes of a dentaloutreach program for the underserved from the student perspective.

A medical-dental team consisting of eighteen dental students(fourteen from NYUCD, three from UMDNJ, and one from Meharry)and four dentists (two NYUCD faculty and two practicing dentists)participated in a volunteer outreach to the underserved in Jamaica,WI. HealthCare International, SNDA, NYU College of Dentistry,and Rotary International sponsored the outreach program. May Pen,a city near the center of the island, was the base of operations. Buseswere loaded daily with medical-dental equipment, and clinics wereset up in local or distant schools and community centers. Dentalstudents delivered oral hygiene instructions to the population, whowere then screened at the clinic. Any necessary extractions wereperformed. Restorative procedures were accomplished with a portableelectric compressor unit. All procedures were done in close quarterswith regular chairs under natural light or with a small mag flashlight.Students treated between twenty and thirty patients per day. Prior tothe trip, the students were interviewed and asked to write a briefexplanation of their reasons for participating in the outreach. Themost common responses included a desire to educate patients, a desireto serve others, the challenge to adapt to unusual conditions, and adesire to be part of a team. After completion of the outreach program,the students were asked to submit written responses to the question,“Did your outreach experience affect your dental education?” Theircomments included: “gained confidence,” “invaluable,” “can not helpbut learn,” “single most valuable experience in dental schooleducation,” “unparalleled,” “more competent,” and “changed me.”

The student remarks prior to and subsequent to the trip indicatethat there is a positive educational outcome in a well-organized andfaculty-supervised dental outreach program. The students involvedin this outreach recognized it as a source of information andenlightenment and an experience to be called upon as they progressthrough their professional careers.

142. Dental Explorers Program: A Summer Programfor Pre-College Students

Bolivar, Sandra, University of Southern California School of Dentistry

Purpose: To introduce minority pre-college students to dentistryand dental hygiene as career options.

Efforts to attract and enroll historically underrepresentedminority students must begin early to increase the dental pipelineand ultimately yield measurable results. The Dental Explorersprogram at the USC School of Dentistry was a collaborative effortwith the university’s Education Opportunity Programs Center(EOPC). The EOPC mission is to serve the campus-area communityand the Los Angeles Unified School District and “increase the numberof low income and first generation college-bound residents to pursueand successfully complete a post-secondary educational program.”The USC School of Dentistry enrolled seven students in a summerday camp experience. Four of the seven students were high schoolgraduates beginning college in the fall; the other three participants



will be high school seniors. The students were presurveyed todetermine their current career objective, which ranged from politicalscience to law and medicine. None of the seven students indicateddentistry as a career objective. The week-long experience combinedteam building exercises, clinic shadowing, hands-on clinical exercises,a lecture on oral cancer, and career seminars. The week ended with arecognition lunch where the students, their parents, faculty, anduniversity administrators attended a mock graduation exercise. Eachstudent presented a personal summary of the week’s activitiesincluding what was learned and most enjoyed. Each student receiveda white clinic jacket to commemorate the experience. An evaluationat the end of the program asked students to anonymously evaluatethe program using both a ranking scale (1 low to 5 high) andcomments. The student evaluations were exceptional with a totalnumerical ranking of all areas being 4.8. Each participant nowconsidered dentistry or dental hygiene as a potential future careerchoice. Comments included: “The program overall was great; it wasjust too short”; “Change nothing; everything was great. Just try toextend the program to at least two weeks”; and “Lunch with dentalstudents was a great experience.”

In conclusion, this type of partnership with the university servedthe university, the school of dentistry, the community, and theprofession well by introducing students from minority backgroundsto the dental profession. These students will be tracked during thenext few years to monitor their progress and career choices.

143. Beauty Is a Joy Forever: The Benefits of TeachingAesthetic Dentistry in a State-of-the-Art AestheticCenter

Peltz, Ivy, New York University College of Dentistry, McAndrew,Maureen, New York University College of Dentistry, Cunningham,Ralph, New York University College of Dentistry, Estafan, Denise,New York University College of Dentistry

Purpose: To describe the educational and patient care benefitsof exporting aesthetic cases out of the general clinics and into aseparate, state-of-the-art aesthetic center.

Patients requesting aesthetic dentistry frequently have highexpectations for the outcome of their cases. They are informedconsumers, and their motivation to seek treatment is often to improvetheir appearance. With the inception of the Larry Rosenthal Institutefor Aesthetic Dentistry at New York University College of Dentistry,patients have an opportunity to experience the delivery of aestheticdentistry by predoctoral third- and fourth-year dental students whoare supervised by standardized faculty in a luxurious, state-of-the-art environment. Faculty attended weekly seminars addressing thecore technique of aesthetic dentistry procedures and CAD/CAMtechnology. Once the faculty were considered proficient, they wereinvited to teach in the Rosenthal Institute. The faculty to student ratioin the Rosenthal Institute is double that of the general clinics;consequently, students receive closer supervision while performingdemanding aesthetic procedures. The higher faculty to student ratioalso enables students to work more efficiently, thus providing studentswith more satisfying educational experiences and patients with moreimmediate results. In this setting, students are exposed to CAD/CAMprocedures, chairside and at-home tooth whitening procedures,indirect ceramic and ceromer inlays and onlays, porcelain veneers,single unit ceramic crowns, and all ceramic fixed partial dentures.Students must make maxillary and mandibular full arch preliminaryimpressions of prospective patients and mount the poured casts on asemi-adjustable articulator. Students then perform a diagnosticcomposite wax-up of the case, which they present to the course

director before initiating treatment. The wax-up is then displayed forthe patient’s approval.

A state-of-the-art aesthetic center is conducive to the demandsof patients requiring aesthetic dentistry and can provide students witha more closely supervised and stimulating learning environment.Additionally, the luxurious setting generates excitement amongfaculty, students, and patients alike!

144. Evaluation of the Effectiveness of IntegratedBiosciences: A Review Course for Part I of the NationalBoard Examinations

Otsuka, Allen, Southern Illinois University School of Dental Medicine,Jenkins, David, Southern Illinois University School of DentalMedicine, Boyle, Ann, Southern Illinois University School of DentalMedicine

Purpose: To determine the effectiveness of changes to IntegratedBiosciences: A review course for Part I of the National Boardexaminations.

Since 1997, second-year students have taken a forty-onehourreview course in June, just prior to taking Part I of the National Boardexaminations. This review course, called Integrated Biosciences,consists of classroom review in gross anatomy, neuroanatomy,histology, pathology, biochemistry, physiology and microbiology.Within the course, two examinations utilizing a National Board formataccount for 50 percent of a student’s grade. The remaining 50 percentof the course grade is based on the student’s performance on Part I ofthe National Board examinations. Students are not scheduled for anyclassroom or clinical activities for the week prior to taking Part I ofthe National Board examinations. Faculty changes in the abovebiomedical science courses have been minimal over the past elevenyears. Prior to 1997, students were only required to attend the reviewsessions. No examinations were administered and no course gradeswere issued. The average school ranks (out of all schools taking PartI of the National Boards) and the average school failure rates werecalculated and compared for the periods of 1997-2002 and 1992-96.From 1997 to 2002, students at the school had an average rank of19.5, and the average school failure rate was 3.4 percent. (Nationalfailure rate average was 9.3 percent for this time period.) Incomparison, students from 1992 to 1996 had an average rank of 31.4,and the school failure rate was 8.5 percent. (National failure rateaverage was 13.6 percent for this time period.)

From the above data it is evident that the combination of thetwo factors (examinations and time off to study immediately prior totaking National Boards) were effective in helping the students achievea marked increase in average school rank and a decrease in averagefailure rate.

145. A Written Exercise in Dental Hygiene Admissions

Maseman, Denise, Wichita State University Dental HygieneDepartment, Huntley, Diane, Wichita State University Dental HygieneDepartment

Purpose: A written exercise was developed as a pilot programto enhance the dental hygiene admissions process and replace oralinterviews. The purpose/objective of the written exercise was to assessapplicants’ written communication skills and seriousness towards theprogram.

The exercise counted for 20 percent of the applicant’sevaluation. The rationale was that concerns had been expressed byfaculty and administrators with the personal interview process. Theconcerns related to possible bias with personal interviews, ineffectiveuse of faculty time, large applicant pools, and student expense for



out-of-state applicants. The Dental Hygiene Admissions Committeedeveloped items and an evaluation scale for possible responses. Itemsasked applicants to describe their interest in or suitability for a careerin dental hygiene and how they would handle a specific problem. Allqualified applicants were notified of the date, time, and location ofthe exercise. Applicants were given forty-five minutes to completethe three items. Applicants more than three hours away could makearrangements to take the exercise at another testing site. Applicantswere assigned numbers for the forms utilized during the exercise.Two members of the Admissions Committee evaluated and scoredeach blinded forms. Each item was evaluated 50 percent based onresponse content and 50 percent based spelling, grammar,organization, and clarity of thought. Results of the written exercisewere self-elimination of approximately 20 percent of the applicantpool and providing a structured, objective evaluation of writtencommunication in a test-like situation.

Faculty expressed strong satisfaction with the written exercise,and the pilot program was adopted as a permanent component of theapplication process

Poster Sessions: Poster Abstracts - Journal of Dental Education

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