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Some U.S. states have more difficulty than others in recruiting or retaining dentists. Part of the problem is that often dental students are not aware of opportunities across geographic regions of either their home state or the state where they were educated. With student input, the University of Iowa College of Dentistry and Dental Clinics designed and launched an interactive website that provides basic demographic, economic, and other meaningful information to help dental students locate potential practice locations and identify current employment opportunities in Iowa. Although this website is not a recruitment or retention panacea, it provides an easy method for dental students to explore all or parts of the state as they go about making one of the most important decisions of their careers. The website also provides a showcase for current practitioners and communities to demonstrate what they have to offer as practice opportunities.

The Institute of Medicine and the Commission on Dental Accreditation (CODA) have recommended that dental schools incorporate community-based dental education (CBDE) programs into their curricula. The expectation is that CBDE participation will help dental students gain the skills and motivation to treat vulnerable populations after graduation. The purpose of this study was to determine whether dentists' involvement with charitable dental care is associated with participation in CBDE as dental students. A questionnaire was mailed to private practice Iowa dentists (N=1,312); the response rate was 41.2 percent (n=541). Logistic regression analyses, controlling for age, gender, number of hours worked per week, graduation year, and alma mater, were conducted. A majority of the respondents provided charitable care: 85 percent in their offices, and 70 percent in the community. Seventy-nine percent had participated in CBDE as dental students. Respondents who reported being very satisfied/satisfied with their charitable care experiences were more likely to provide charitable care in their offices and the community than respondents who were not satisfied with their experiences. Respondents who participated in CBDE as dental students were more likely to provide charitable care in the community than respondents who did not participate in CBDE. The type of sites where dentists completed their CBDE experiences was associated with where they provide charitable care. This study suggests that participation in CBDE may be associated with dental students' providing charitable dental care after graduation.

The purpose of this project was to determine new dentists' comfort levels in treating traditionally underserved populations after participating in two consecutive five-week community-based clinical experiences while in dental school. A written survey was mailed to all known University of Iowa alumni (1992-2002; N=745). Respondents were asked to rank their comfort levels in treating twelve underserved populations on a five-point Likert type scale (5=no problem; 1=will not). Bivariate and logistic regression model analyses were performed to examine associations (p<0.05) among comfort and six predictor variables. Alumni (n=372) were most comfortable treating other ethnic, low-income, non-English-speaking, and HIV+/AIDS populations and least comfortable treating incarcerated and homebound populations. The following variables were significantly associated with comfort: 1) perception that the community experiences had great/much value; 2) practice located in larger communities; 3) non-solo practitioners; and 4) dentist's gender. As more dental schools utilize community-based clinical experiences to increase students' exposure to underserved populations, it is important that these experiences provide exposure to a variety of populations. Additionally, dental schools should continuously monitor the short- and long-term value of these programs for their students and recent graduates.

The purpose of this study was to analyze students' perceptions of comfort and anticipated willingness to treat selected special needs and traditionally underserved populations immediately upon completion of community-based clinical assignments. The sample consisted of University of Iowa senior dental students who completed a questionnaire that asked, in part, about student comfort with and future willingness to treat twelve vulnerable population groups. With student comfort and future willingness to treat each group as dependent variables, logistic models were developed to determine whether there were significant associations between dependent variables and gender, graduation year, and students' prior experience with these groups. Regression models indicate students' prior experience is most often associated with comfort in treating the associated population group. Likewise, experience and comfort add different dimensions to perceived future willingness to treat almost all of the twelve groups. Student gender, graduation year from dental school, and community assignments influence only a few of these targeted population groups. This study provides empirical evidence concerning students' perceptions about comfort with various vulnerable populations after completing their extramural rotations. Students were more comfortable treating certain population groups as well as more willing to consider including these groups in their future practices.

The purpose of this study was to assess the status of cross-cultural education in U.S. dental schools and to identify characteristics associated with having a formal cross-cultural curriculum. An eighteen-item survey, which included questions about curricular format, teaching and evaluation methods, time, and course content, was sent to all U.S. dental schools. Comparisons were made using whether or not institutions had formal cross-cultural curricula. Forty-five of fifty-six schools responded. Twenty-nine schools reported having formal cross-cultural curricula in a separate course and/or integrated with other courses with specific goals and objectives. Schools that have formal cross-cultural curricula had higher scores on depth of curricula and spent more time than schools that reported having informal curricula (p=0.03). Competing curricular time and lack of faculty expertise were the most frequently cited impeding factors for inclusion of cross-cultural issues (87.8 percent and 68.3 percent, respectively), while diverse patient population and leadership commitment were the most frequently cited facilitating factors (92.5 percent and 67.5 percent, respectively). There is wide variation among dental schools regarding how they teach these issues and how students are evaluated. Dental schools lack guidance about how to best incorporate this curricular content.

This study analyzed senior dental students' perceptions prior to extramural rotations for comfort and future willingness to treat patients with special needs and other vulnerable groups. The sample included 690 University of Iowa senior dental students who graduated from 1992 through 2004. These students completed a questionnaire concerning twelve vulnerable population groups. Logistic regression models were performed, using student comfort and future willingness to treat each group as the dependent variable. There was a wide percentage of range of comfort with these groups, yet there was no individual group that more than 60 percent of these students were willing to treat in their future practices. Generally, prior experience with the group had a positive impact on comfort level. When gender was included in the regression models, male students were more likely to express comfort. In all instances except one, experience had a positive influence on perceived future willingness to treat the associated group. However, younger graduates had a greater willingness to treat. When controlling for other variables within the future willingness to treat models, comfort was statistically significant only for HIV+/AIDS and non-English speaking groups. This study provides insight about comfort with and perceived future willingness to treat special needs and other vulnerable patient groups.

Ethics education in dentistry is a requirement for accreditation. Despite universal adoption of ethics courses, there is ongoing discussion about the appropriate content of these courses and about methods to engage students. Faculty who teach ethics must select a limited set of topics from the broad fields of professional ethics, bioethics, and the humanities. The purpose of this article is to describe the ethical issues reported by fourth-year dental students during community-based extramural clinical experiences. Senior dental students (n=123) wrote essays describing an ethical issue they encountered during one of two extramural rotations. Ethical issues were categorized and coded by consensus between two faculty authors. Students most often reported perceived dilemmas related to patients' limited resources (25 percent), conflict between professionals (19 percent), clinic policy or procedures (15 percent), and decision making by patients' surrogates (13 percent). One student (<1 percent) reported encountering no ethical issues. Students' perceptions of ethical issues in clinical practice offer faculty a foundation for designing a dental ethics curriculum that is practical and immediately relevant to the experience of a dental student. Students' reports may also yield a method for systematic assessment of students' abilities to apply classroom ethics instruction to clinical practice.

With an increasing number of states requiring continuing dental education (CDE) for license renewal, dentists are opting for different ways of earning these credit hours beyond the traditional didactic presentation. One alternative is a home study correspondence course. Little is known about the type of dentists who participate in these home study courses. This study examines characteristics of 507 general dentists in Ohio who were required to submit information concerning their CDE courses and credit hours during the biennium, 1992-93. Twenty-five percent of the general dentists took at least one home study course, and approximately five percent of those dentists participating in any home study earned all their credit hours this way. A logistic regression model indicated that home study users are less likely to be ADA members and less likely to leave the state for any CDE. This study suggests that the current methods of home study courses may provide continuing education opportunities for dentists who otherwise might not be reached by more traditional ways of CDE.