Assessing dental education and practices regarding patients with special needs: a pilot study proposal

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The timeline for completing this proposal is dependent on two things: how many recent graduates participate and how fast the recent graduates return the surveys. Schools will first need to be contacted in order to fill out the curriculum survey and to get in touch with the alumni association for the dental classes of 2014 and 2015. As the pilot program aims to have 250 respondents (approximately 50 recent graduates from each of the 5 chosen schools), if not enough dentists participate in the first mailing, a second mailing as well as a possible expansion of the classes involved (for instance, adding the class of 2013) will be necessary. Deadlines will be placed on the surveys as two weeks after the mailing date to encourage recent graduates to fill out the survey immediately and return it.

The initial contact with the school, survey distribution, and data collection will aim to be done at the same time across all five schools. However, depending on alumni mailing cycles, a wait period of 1-6 months may be necessary for different schools. Because of this and the anticipation that an expansion of classes or a second mailing may be necessary, the pilot program will allot 18 months for complete data collection.

2.4Survey and Analysis

Identified class members from each of the pilot schools will receive the survey presented in Appendix C. After receiving the survey in a group mailing through the dental school’s Alumni associations, new graduates will fill the survey out and return it in a pre-stamped envelope to the research team. This data will be collected in IBM SPSS Statistics 22.0 and analyzed starting with the first returned survey.

2.4.1Effects of Dental Education Quality in Treating Patients with Special Needs

To assess the effect of dentists’ who recently graduated perceptions of their dental education on their professional behavior, practice characteristics, and confidence levels/attitudes toward special needs patients, univariate analyses of variance will be conducted with the independent variable “Quality of education.” Respondents who strongly disagree or disagree with the item “Dental school prepared me well for treating patients with special needs” will be grouped into a category of “negative educational experience”; those respondents who strongly agree or agree with this statement will be grouped into a category “positive educational experience”; and respondents who choose the neutral answer (“3” on five-point scale) will be grouped into a category of “neutral experience.” The same groupings will also be used to assess how graduates treat children with special needs by asking the question “Dental school prepared me well for treating children with special needs”. Dependent variables will include the number of patients with special needs seen by the office, the number of children with special needs seen by the office, and the number of referrals to other dental providers.

2.4.2Effects of Dental Education Quantity and Type in Treating Patients with Special Needs

To assess the effect of the quantity of dental education on recent graduates practices, the data collected from dental schools in Appendix B will be used. The number of hours of didactic, clinical, and community outreach will be looked at individually as well as combined into total hours. For each category, “0-5 hours” will be considered “low educational experience”, “6-10 hours” will be considered “moderate educational experience”, and “>10 hours” will be considered “high educational experience”. When all four years of dental school are combined into total hours, “0-20 hours” will be considered “low total educational experience”, “20-40 hours” will be considered “moderate total educational experience”, and “>60 hours” will be considered “high total educational experience”. Univariate analyses of variance will be conducted with the independent variable “Quantity of education”.

2.4.3Dental Education and Confidence/Attitudes toward Patients with Special Needs

The respondents will also indicate how much they agree with statements regarding how much they like to treat patients with special needs, children with special needs and how confident they were in treating these patients. Correlation analysis will be done with the expectation that dentists’ who are better prepared and feel more confidence will treat more patients with special needs with a positive correlation. It is also expected that there will be a correlation that dentists who like treating special needs patients and are confident in their abilities will treat more patients with special needs. Using the Cronbach alpha reliability index, there is likely to be high inter-item consistency in responses to these questions.

2.4.4Analysis of Dental Office Preparedness in Treating Patients with Special Needs

The dental office, specialized dental equipment, and staff will also affect the behavior of dentists in treating patients with special needs. Multiple univariate analyses of variance will be conducted with many different independent variables including “Office is set up for patients with special needs” and “Office staff is well prepared”. Type of dental practice, including private practice, private group practice, and public funded practice, will also be a variable of interest.

2.5Pilot Study Evaluation

The use of a pilot study before expanding to a full-scale evaluation of special needs education has many purposes. This study will allow the researchers to evaluate the feasibility of the study design and adjust any areas that did not work efficiently. Testing the research surveys for adequacy, understandability, and relevancy is a necessary step before increasing the number of participants. Preliminary data can also be collected in order to establish a preliminary result. The pilot study is also a way to convince funding bodies that the research team is competent and reliable, that the main study is feasible and worth funding, and to convince other dental schools and alumni that the main study is worth supporting with their participation.

One area of particular interest will be in survey distribution to dental students. Although mailing with the alumni newsletter is an inexpensive and convenient way to distribute the surveys, the recent graduate population may respond better to electronic mail. In the past, studies have shown that surveying by mail is an effective method when the desired sample (in this case, recent graduates from dental school) have high education and literacy levels and are interested in the subject being surveyed (Truel et al., 2002). However, email based or web based surveys have an extremely fast response rate, low costs, and respondents are more likely to provide more detail to open-ended questions when compared to mail surveys (Truel et al., 2002). Depending on feedback from alumni groups, dental schools, and new graduates themselves, it may be to the advantage of the research team to use email at one of the schools selected for the pilot program.

School compliance will also be necessary to evaluate. Getting the alumni list from the dental schools or at least being able to provide surveys in the alumni mailings is a key aspect of the methodology of the pilot program. Without the dental schools support for this study, contact with recent graduates will be difficult and may not be feasible. In that case, another school will be identified for the pilot program. After the pilot program is completed, feedback from dental schools will be solicited in order to evaluate the feasibility of expanding the pilot program into a comprehensive review of all dental schools.

Dentist compliance will be evaluated as well. Without the dentists be willing to fill out the surveys and mail them back, this study will not have enough participants to further explore the relationship between special needs education and dental practices. It may be necessary to provide incentives to recent graduates to complete the survey including participation in a raffle, a gift certificate, or some other reward. After the pilot program is completed, dentists will be asked for their input on making the survey easier for them to get and return as well as if incentives are necessary for their participation.

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