Volume 3, Issue 1 September 2012

Getting to Know YOUFrom District 11

Name: Danielle Marquis School/Year: Pacific 2013 Position: District 11 Trustee One tip for first years: Get involved, and learn about the issues early. An opportunity to speak up for your profession may come up sooner than you think! If a mascot had to represent you - what would it be? Definitely a liger. If you could wear any scrub color, what would it be? After two years of business casual, I would be thrilled with scrubs in any color. If you could invent anything for dentistry, what would you invent? Ear buds (for dentist and patient) that selectively turn the sound of the handpiece into the sound of [insert happiest sound memory here].

Name: Kulginder Sran School/Year: UCSF 3rd year Position: District 11 Legislative Chair One tip for first years: Ask upperclassmen for help on anything and everything If a mascot had to represent you - what would it be? An eagle, because we in ASDA fly high If you could wear any scrub color, what would it be? Why? Plain blue. Can't go wrong with tried and true. If you could invent anything for dentistry, what would you invent? Tongue tranquilizer

Inside this Issue: Getting to Know YOU Page 1 SB694: Passionate Support, Opposition, and a Fiscal Kill Page 2 Service is Our Calling Page 3 Dental Anesthesiology – A Recognized Specialty? Page 5 Ethics Scenario: Your First Job! Page 6 DE Part I Pass/Fail Grading and its Affect on Student Preparation and Motivation

Page 6

Editors: Tracy Mackoy

USC School of Dentistry Class of 2014

Jennifer Yau

UCLA School of Dentistry Class of 2013

The Bonding Agent- page 1

Name: Kris Mendoza School/Year: UCLA 2015 Position: District 11 Secretary One tip for first years: Don't sweat the small things and try to have some fun! If a mascot had to represent you – what would it be? The Argonauts If you could wear any scrub color, what would it be? Navy blue with a red and white logo because I'm currently watching the Olympics and feeling patriotic! If you could invent anything for dentistry, what would you invent? I would invent having a personal assistant for dental school... not so much an invention but a dream of mine.

Upcoming Events: ASDA National Leadership

Conference

ASDA Annual Session

Nov 2-4 Chicago, Illinois

Mar 6-9 Atlanta, Georgia

SB694: Passionate Support,

Opposition, and a Fiscal Kill By Ben Hellickson University of the Pacific, Class of 2014 ASDA Chapter President It was late June when I received a call from District Trustee Danielle Marquis to travel to Sacramento and oppose SB694, and since then I have had a fast and furious education on the complexities of state and dental politics. Although SB694 has essentially been killed once money became part of the discussion, it is an issue that will continue throughout our careers and hopefully the experiences I’ve had can shed some light on the recent developments. Over a two week period in late June and early July we met with assembly members, their aids and attended two assembly meetings. The first meeting was the Assembly Health Committee. Senator Padilla focused on the study as a means of "helping the children" of California without access to dental care. The second meeting was the Assembly for Business and Professions. Danielle Marquis, ASDA district 11 Trustee, delivered a succinct and informative testimony in opposition. However, the results of both assemblies resulted in passage of the bill.

Since these two assembly meetings the result of the

assembly appropriations was in essence a fiscal kill of SB694. I would extend the opinion at this point that the work is just starting. There have been many questions raised in this process that have no simple answer; here are some I’ve encountered:

–Should established dentists have more incentive to serve those without access to care rather than our generation of dentists potentially having a PGY1 requirement?

–Do you think it is important to have an office of Oral Health headed by a Dental Director, who is a dentist?

–If more effort and money was put into prevention, would it be more impactful?

–Is a new level of dental provider financially viable for the patient and provider?

–Are we as dentist over trained for some “basic” procedures? Are there “basic” procedures?

–Follow the money. Who benefits fiscally from a study/mid-level providers?

–Is a mid-level provider the next step into solving access issues and making dentists more profitable, much like when hygienists were introduced? These are questions to ask yourself, faculty, and association representatives. The unifying goal for all involved is to improve dental and overall health for those who cannot access it. We all agree with this sentiment. I see evidence that our generation of dentists is willing to unselfishly give time, effort and money to solve this problem, as evidenced in the recent CDA Cares in Sacramento. Why not 10 of these a year? Our generation of dentists must continue efforts to solve the issue of access, otherwise legislators will do it for us – and you can be sure they will do it without our best interests in mind.

The Bonding Agent- page 2

Info and facts on bill SB694:

•The author, Senator Alex Padilla, is attempting to address the issue of access to dental care by creating a dental director position in the office of oral health.

•The bill proposes a scientifically rigorous study, at a California dental school, to assess irreversible dental procedures performed by hygienists and assistants for the purpose of informing future decisions about scope of practice changes in the dental workforce that include irreversible or surgical procedures.

•The California Dental Association (CDA) is in support of the bill.

•The American Student Dental Association (ASDA), is in support of CDA in creating dental leadership in California and improving access to care. ASDA’s opposition of SB694 is due to C-1 policy, which opposes non-dentists performing surgical irreversible procedures.

•California has more dentists per capita than any other state.

•Fifty-three of California's 58 counties have at least one area with too few dentists.

Check out http://www.cdafoundation.org/Give/Volunteer/CDACaresFreeDentalClinics.aspx

–Is NO care better than “some” care?

–In a thriving economy, would there be as much opposition to developing a new dental position?

–Would you allow a non-dentist provider to treat YOUR loved one or child?

–Could access be solved with loan forgiveness programs?

Service is Our Calling

By Rachel Tambunan Loma Linda University, Class of 2013 The Loma Linda University School of Dentistry’s outreach program is known as Service Learning. The school’s motto, “Service is our Calling,” is evident as I glance over the outreach project roster. The program that bonds the entire dental school in service is Clinic with a Heart. For 22 years our school has provided free dental care during this event. This past March, 477 volunteers comprised of faculty, residents, students and other volunteers worked together to make this event possible. During my second year, my patient was the first to line up—at 8:00pm the night before. He informed me, “I slept in my car. I didn’t want to miss this opportunity.” This year 250 adults and 29 children were served. Each patient received a cleaning, filling or an extraction, plus an assessment of other dental needs. It is an event that both students and patients look forward to. Another event is Compassion Clinic, a monthly event where free dentistry is provided for one evening to the under-resourced neighboring city of San Bernardino. Two-thirds of the patients seen are uninsured, and fifteen medically underserved areas surround the clinic. Similarly, Homeless Clinic takes place one Sunday each quarter. Our school’s mobile clinic parks at Riverside Presbyterian Church and free dental care is provided to

homeless people. In addition, the patients are fed a warm meal provided by the church. This past spring, our school participated in the LLU’s annual Children’s Day. During this outreach event, children learned proper brushing techniques and practiced brushing skills on the mouths of stuffed animals. The event provided heath education to 1,248 children. Other outreach activities incorporated into our education include rotations at the Assistance League of Redlands, Baldy View Occupational Program, Lugonia Elementary School, Mary’s Mercy Center, Mead Valley Community Complex, MEND, Share Ourselves Clinic (SOS), VA Hospital, Victoria Elementary School, Victorville Federal Correction Complex and selected health fairs in neighboring cities. (Continue on page 4)

The Bonding Agent- page 3

Service is Our Calling

(Continued from page 3) Serving Learning knows no borders. There are international mission trips taken during all breaks, where faculty and students set up clinic and work hard for a week or longer. This year teams have gone to Ethiopia, Honduras, Romania, Haiti, Bangladesh, Nicaragua, Jamaica, Swaziland, Thailand and Peru. This hands-on learning gives students an excellent opportunity to expand their knowledge of dentistry and serve a global community. International mission trips expose students to economic diversity and are reminders of the great need for dentists in third world countries. On these trips, the soul softens, priorities shift and love for humanity cultivates. Closest to my heart, however, is the Honduras Project. During our first year, my class adopted a clinic in Valle de Angeles, Honduras. This fall break marks our fourth trip there. While in Honduras we provide quality dental care and educate our patients on how to maintain a healthy

Christian lifestyle. We aim to provide the necessary tools to inspire patients to take responsibility for their oral and general health. Our class has committed to long-term service after graduation and plans to continue trips to Honduras. Dr. Kasischke, Associate Dean of Admissions, summarizes our outreach program this way: “Service Learning is the essence of the Loma Linda School of Dentistry. We provide opportunities that enable students to have a personal and spiritual experience. We have the chance to go into our local community and also have an opportunity to go abroad. We believe the service of ministry is the cornerstone of the Christian environment that the entire school family tries to nurture and foster.” Service Learning not only allows us to gain experience in dentistry, but it also strengthens a commitment to compassion. It ignites a philanthropic spirit, which will enrich our future in dentistry.

The Bonding Agent- page 4

Dental Anesthesiology – A Recognized Specialty?

By Tracy Mackoy Ostrow School of Dentistry of USC, Class of 2014 In May of this year, ASDA broke huge ground in its campaign for becoming a recognized specialty. Not “our” ASDA, rather, the American Society of Dentist Anesthesiologists, got the news that their area of dentistry will be voted upon the ADA House floor this coming October in San Francisco. The ADA’s House of Delegates will vote on whether or not dental anesthesiology, which is currently a 2-year post-doctoral certificate or 3-year Master’s program, should be recognized as an ADA official dental specialty. What exactly is a dentist anesthesiologist (DA)? A DA is a dentist who is trained in the administration and management of minimal to deep sedation and general anesthesia in a dental setting. They are utilized for dental patients in which local anesthesia and minimal sedation is inadequate to provide proper dental care or require advanced monitoring. This includes, but is not limited to, working with other dentists on pre-cooperative children, individuals with developmental disabilities or special needs, and fearful patients. Should dental anesthesia be a recognized specialty? After a year-long study of their application, the ADA’s Council on Dental Education and Licensure (CDEL) believes so. The pending specialty has demonstrated the six requirements for consideration: 1. Sponsored by an organization: ASDA (American Society

of Dentist Anesthesiologists) 2. Unique knowledge and skill: Exclusive anesthesia

training for all facets of dentistry 3. Able to provide a service not currently provided by

other dentists: DA’s provide anesthesia services for all dental disciplines and procedures (GP, pedo, endo, perio, OMFS, etc)

4. Contributing new knowledge to the field of dentistry: Continuing research and texts for sedation, pharmacology, emergency management and anesthesia

5. Directly benefitting clinical patient care: Major impacts with pediatrics and patients with special needs, establishing ambulatory office-based anesthesia an accepted practice in areas lacking such services

6. At least 2 years of post-doctoral education: The only two year post-doctoral residency program devoted to a single discipline to not be an ADA recognized specialty; and it will be a required 3 year program pending Commission on Dental Accreditation action in 2013

So why should “our” ASDA support the “other” ASDA and vice versa? Bottom line: access to care, patient safety and education. Over 60 million Americans fall into the categories of people possibly serviced by dentist anesthesiologists. Many of these patients who are untreatable in a normal dental setting go without dental care. People with Down syndrome, Alzheimer’s, autism, Parkinson’s and severe anxiety are among the patients with potential increased access to dental care with the acceptance of this specialty. The field of dentistry is an ever-evolving hybrid of art and science. Just as the field of dentistry has progressed by leaps and bounds in materials and technology, so too must we push the advancement of humane patient care and safe dental treatment. Seizing the opportunity of establishing a new specialty will enhance and support, not restrict, the profession. We must embrace the positive changes and continue to stand together as a profession by putting the patients first. This means improving access to care; improving access to safe and quality care.

The Bonding Agent- page 5

Over 60 million Americans fall into the categories of people possibly serviced by dentist anesthesiologists.

Ethics Scenario : Your First Job!

By Jennifer Yau University of California Los Angeles, Class of 2013 As a new graduate, you are excited to find your new job and to finally start to pay back your enormous student loan. Unfortunately, the job market in the area you want to be in is extremely competitive. You searched online job listings, sent out your resume and even personally visited individual practices. After six months of searching, you at last found a job as an associate in a local practice. You enter your first day of work eager to get started. Your first patient needs a prophy. Done! Your second patient needs two crowns. Nice! Wait… With the 14 year-old patient in the chair, you take a look at the radiographs. #14 and #15 show limited radiolucencies in the proximal areas. Even from your minimal experience, you conclude that #14 will only need a DO restoration and #15 an MO restoration. Upon clinical examination, there are neither obvious decay nor fracture lines present on the teeth in question. As you decide to alter the treatment plan, the assistant comes up to you and says to just follow the proposed treatment of the two crowns. The practicing dentist always places crowns with such findings and expects you to do the same without question. If you are the treating dentist, how will you proceed in solving the situation? If you have any suggestions, please write to newsletterdistrict11@gmail.com . Your response may show up in the next edition.

The Bonding Agent- page 6

On January 1st, 2012 a highly anticipated change occurred to the National Board of Dental Examiners Part- I test. From then on, student performance on the exam would be reported as Pass/Fail, as opposed to percentile grading. Historically, Pass/Fail grading systems were implemented in medical and dental programs to reduce student stress and promote group learning. A variety of studies throughout the past 50 years have demonstrated that Pass/Fail pedagogies do in fact enhance student well being, while decreasing anxiety and depression (Spring, 2006). However, there is conflicting data on the affects of Pass/Fail grading in regards to academic achievement and student motivation. Thus, a study was conducted at the Ostrow School of Dentistry of USC to analyze the influence of Pass/Fail grading on NDBE Part-I examinees in regards to student preparation and effort.

Data was gathered by administering a multiple-choice web-based survey to students of the Junior (2013) and Senior (2012) classes at the Ostrow School of Dentistry. Respondents were initially asked about their actual exam preparation tactics and efforts. Next, the same variables were tested had the participants’ exam been: reported as Pass/Fail, taken on the exact same date of their actual test, and of equal difficulty. The following topics were addressed in the survey to measure and compare student motivation, preparation and study tactics: a) start date of studying, b) hours of average daily study, c) amount of monetary investment, and d) the number times the Dental Decks were reviewed. (Continue on page 7)

Circumstances of NBDE Part I Pass/Fail Grading By Hamid Barkhordar and Pooyan Nasibi Ostrow School of Dentistry of USC, Class of 2013 Faculty Advisor: Dr. Dennis J. Tartakow (USC School of Dentistry)

The Bonding Agent- page 7

(Continued from page 6) The survey was completed by 207 of the 279 Junior and Senior students at the Ostrow School of Dentistry. The survey results demonstrated a decline in the start date of studying, the average hours of daily study and the number of times decks reviewed. The data suggests that students are willing to work harder and aim for greater achievement when examinations are graded competitively on a percentile basis. The variable that showed independence of grading format was monetary investment for study resources (Figure 4). This suggests that although students are willing to spend less time and effort studying for an exam that is reported as Pass/Fail, they are still willing to make monetary sacrifices to purchase the required study materials. Even though there is an apparent decline in student motivation in regards to an NBDE Part-I exam graded on a Pass/Fail system, not all students were equally affected by this change. Many respondents reported minimal or no change at all in preparation and motivation with Pass/Fail grading. Many argue that if students aren’t driven by their own intrinsic motivation to learn, they shouldn’t be in that particular field. Professor Tim Wilkinson, associate dean of Medical Education at the University of Otago, states, “Do we want to graduate doctors who will only learn if someone pats them on the back and rewards them?” It is clear that the goal of health professional educators is to train individuals who possess enough desire and interest in that particular field so that grades will not influence one’s study

tactics and motivation. Although students shouldn’t be driven by competition and percentile scores, psychological educational studies have determined this to be the case. A study by Harackiewicz, et al., “found learning goals to predict greater intrinsic motivation, but only performance-approach goals predicted better (letter grade) achievement.” This demonstrates that although students are interested in learning, their driving force for academic achievement is a “pat in the back”. Consequently, the benefits of Pass ⁄ Fail grading may include “reduced stress, enhanced well-being, a less competitive learning environment and a greater focus on learning rather than on studying minutia purely for higher-grade achievement” (Spring, 2011). Although past studies have reported conflicting results in regard to the influence of Pass/Fail grading on academic performance, our study found that student preparation may slightly decline. Scoring creates a competitive nature that Pass/Fail grading systems were designed to reduce. Are we eliminating this driving force for academic performance and effort by implementing Pass/Fail grading? Spring, L., Robillard, D., Gehlbach, L., & Simas, T. (2011). Impact of pass/fail grading on medical students’ well-being and academic outcomes. Medical Education, 45, 867–87.

For full article and references, please email: newsletterdistrict11@gmail.com.

0

20

40

60

80

100

< $200 $200-300 $300-500 $500-1000 > $1000

5

76 84

42

0 6

79 81

41

0

#

o

f

R

e

s

p

o

n

d

e

n

t

s

Appoximate Monetary Investment

Monetary Investment for NBDE-I Resources

Scored

Pass/Fail

Figure 4

Circumstances of NBDE Part I Pass/Fail Grading