Special Feature
July, 2008 edition

Vision for the Dental Hygiene Doctoral Curriculum

   
By Harold A. Henson, RDH, PhD(c), JoAnn R. Gurenlian, RDH, PhD, and Linda D. Boyd, RDH, RD, EdD

Introduction

Doctoral education is an essential factor in leadership, scholarship, research, policy and education in the dental hygiene profession.[1,2] This has become increasingly evident in the current health care environment, with so many health professions moving towards a doctorate as their entry level. Advanced education tends to lend credibility to professions, and while other health care providers are advancing their educational level, associate-level programs constitute the majority of accredited dental hygiene programs (83 percent).[3,4] Dental hygiene has a history of being leaders in prevention and health; however, this has largely been within the confines of private dental practice, limiting the appreciation for the expertise and value of the discipline by the public and other health care providers.

Challenges

Funding in the current educational environment is a constant challenge given dwindling state support for higher education. Dental hygiene education will be forced to look for innovative approaches for funding, as well as an increase in externally funded research grants as a means to supplement faculty compensation.

Interest from the dental hygiene community in doctoral education may prove to be another challenge. Based on an informal survey of master’s-level graduate dental hygiene (MSDH) programs conducted by Idaho State University in the fall of 2006, there were approximately 115 students enrolled nationwide. In addition to MSDH degrees, a significant number of dental hygiene educators and practitioners have degrees in other disciplines such as education, public health and business. These master’s-level dental hygienists provide a market for future doctoral education, and efforts should be under way to mentor these individuals towards furthering their education.

The number of MSDH and related programs continues to grow annually, with two new programs in 2007 and several more slated to begin in 2008-09 (see sidebar). Building an infrastructure of dental hygienists with doctoral degrees is necessary to ensure adequate faculty for the growing number of MSDH programs. It is a first step in preparing to initiate doctoral education.

Model of Doctoral Education

The doctorate in dental hygiene must build on the master’s in dental hygiene curricula. Ideally, a task force for graduate education would come together to develop a core curriculum with input from key stakeholders, much like the American Dental Hygienists’ Association did for the Advanced Dental Hygiene Practitioner (ADHP) curriculum. (Figure 1 provides a sample curriculum model with emphasis areas). Creation and implementation of a doctoral dental hygiene degree is not dependent upon individual state practice laws and regulations and could therefore come to fruition more easily than the realization of the ADHP.

Systematic Approach to Curriculum Development

One of the recommendations from the Focus on Advancing the Profession is to develop and publish curricular models for clinical and academic.[5] Components of a systematic approach to curriculum development include the following:[6]

• Needs Assessment
       -   Design and perform needs assessments to determine local, institutional, societal and other needs in the curriculum design process.
• Philosophy and Mission Statement
       -    Develop a carefully thought-out philosophy for the program that will then be connected with the individual institutional and/or departmental mission statement(s).
• Goals and Program Outcomes (Competencies)
       -    Organize a plan to identify curricular areas that need to be developed (i.e., educational leadership, policy, clinical research).
       -    Define goals and measurable intended outcomes/competencies to match needs assessment results.
• Curriculum Planning
       -    Design a logical course sequence for a curriculum plan based on the intended outcomes. A curriculum map is useful in systematically planning for course sequencing and the links between courses.[7]
       -    Select and design courses with educational strategies that incorporate adult learning principles.
• Program Evaluation
       -    Design a long-range curriculum-management plan to determine effectiveness of the curriculum.
       -    Develop evaluation tools for intended outcomes.
• Collaborative Strategies
       -    Collaboration will be essential to bring a doctorate in dental hygiene to fruition. The majority of MSDH programs are directed by people with a masters’ degrees; therefore, it appears there is not a critical mass of doctorally prepared dental hygienists at any one institution. No recent survey has been conducted to determine exact numbers of doctorally prepared faculty at dental hygiene education settings. In addition to the lack of adequate faculty in any one institution, there is also the issue of lack of funding for new programs that would benefit from collaboration.

Inter-Institutional Collaboration

One approach to collaboration for a doctoral degree is between universities. An example of this type of collaboration is facilitated by the regional Western Interstate Commission for Higher Education (WICHE). WICHE-ICE (Internet Course Exchange) assists in policy and procedure development along with support for sharing internet courses.[8] Through WICHE, Oregon Health and Science University, University of Colorado-Denver, University of Northern Colorado and the University of Utah collaborate to facilitate enrollment in courses not available on the student’s home campus.[9] The benefit of having several institutions collaborate is that it brings together doctoral-level dental hygiene educators, allows students access to educators with a wider variety of expertise and reduces the expense for faculty salaries for each of the collaborators. The challenges of collaborating with other institutions are many, including the logistics of admissions, tuition and fees, grading and transcripts issues, etc. In order for collaboration to occur, it may be best to start with investigating the possibilities for regional sharing of courses similar to the program that WICHE offers its 14 member states.

Intra-Institutional Collaboration

Within an institution, it may be possible to partner with nursing and other health professions to offer common core courses to minimize the number of doctoral-level dental hygiene educators needed. The benefit to this is the interdisciplinary opportunities for collaboration, as well as learning to appreciate the various topics through the ‘lens’ of another discipline, yet allow doctoral students to pursue topics that may be specific to dental hygiene leadership, research or education. The challenge to interdisciplinary collaboration is in making the content meaningful to a variety of health professions.

Conclusion

Task force members for the development of doctoral curricula need to be identified, followed by development of curricular models and competencies. The American Association of Colleges of Nursing has delineated competencies, indicators of quality, curricular elements and structure for research-focused and practice-focused doctorate.[1,2] The time is now to gather a task force to begin systematic development of graduate curricula, as well as to investigate opportunities for collaboration to provide models for approaches to implementing doctoral curricula.

References

1.  American Association of Colleges of Nursing. AACN position statement: Indicators of quality in research-focused doctoral programs in nursing. 2001. Available at www.aacn.nche.edu/Publications/positions/qualityindicators. htm. Accessed Mar. 5, 2008.
2. American Association of Colleges of Nursing. The essentials of doctoral education for advanced nursing practice. 2006/ Available at www.aacn.nche.edu/DNP/pdf/Essentials.pdf.Accessed Mar. 5, 2008.
3. American Dental Hygienists’ Association. Entry-level dental hygiene programs. 2007. Available at www.adha.org/downloads/edu/Entry_Level_Schools_for_Web_Site.pdf. Accessed Mar. 5, 2008.
4. American Dental Hygienists’ Association. Entry-level dental hygiene programs – bachelor degree. Available at www.adha.org/downloads/edu/Bachelor_Degree_Schools_for_Web_Site.pdf. 2007. Accessed Mar. 5, 2008.
5. American Dental Hygienists’ Association. Dental hygiene: focus on advancing the profession. 2005Available at www.adha.org/downloads/ADHA_Focus_Report.pdf Accessed Mar. 5, 2008.
6. Diamond RM. Designing and assessing courses and curricula: a practical guide. San Francisco: Jossey-Bass; 1998.
7. Prideaux D. ABC’s of learning and teaching in medicine. Brit Med J 2003; 326; 268-70.
8. WICHE. Internet Course Exchange (ICE). http://wiche.edu/prosvcs/ice/. Accessed Mar. 14, 2008.
9. WICHE. NEXus: Nursing Education Exchange. http://winnexus.org/winnexus/index.asp. Updated Mar. 14, 2008. Accessed Mar. 14, 2008.

Linda D. Boyd, RDH, RD, EdD, is an associate professor and director of the online Master of Science Degree in Dental Hygiene in the Department of Dental Hygiene at Idaho State University. She has practiced for 30 years in general and periodontal practices. She serves as a CODA curriculum consultant. Dr. Boyd presents continuing education and publishes widely in textbooks and journals on the topic of nutrition and oral health as well as the development of critical thinking in students.

Harold A. Henson, RDH, PhD(c) is currently an assistant professor in the Department of Periodontics in School of Dental Hygiene at The University of Texas Dental Branch at Houston. He has held numerous leadership positions at the national, state and local dental hygiene levels. He has served on the American Dental Hygienists’ Association (ADHA) Councils on Education and Member Services. He is currently on ADHA’s Access Editorial Advisory Board.

JoAnn R. Gurenlian, RDH, PhD, is the owner of Gurenlian & Associates, offering consulting and continuing education programs for health care providers. She has experience in general, periodontic, pediatric and orthodontic practices and works part-time in a medical practice. She is an internationally recognized speaker on the topics of oral pathology, oral medicine, diabetes and women’s health. Dr. Gurenlian volunteers with local cancer, health and political organizations and currently serves as vice president of the International Federation of Dental Hygienists.