What can students gain from
community-based education (CBE)? If you ask Evelyn Joyce
Bettencourt, RDH, M.A., she'll say a challenging work environment,
exposure to a variety of patients, the chance to work with other
health professionals, and opportunities for personal growth.
As the off-campus rotations coordinator
for the dental hygiene program at Foothill
College in Los Altos Hills, California, Prof. Bettencourt began
placing students in public health clinics in Santa Clara County in
2002. A startup grant from The Health
Trust got the program rolling, and today the Foothill
Commission, a nonprofit that supports initiatives on the Foothill
campus, sponsors Foothill's community dental health outreach
The Director of Foothill's dental hygiene
program, Phyllis A. Spragge, agrees with Prof. Bettencourt about
the benefits of CBE and adds, "The students feel it prepares them
well for private practice." Second-year students spend Monday
through Thursday in the college clinic, where they may spend three
hours or more treating each patient. Most Fridays, they work in
community settings at double or triple that pace, treating many
Although we tend to associate Silicon
Valley with wealthy young entrepreneurs, the valley also has its
share of low-income residents and the valley's population has areas
of rampant tooth decay. Portions of San Jose, for instance, lack
fluoridation services, and state budget cuts to county clinics have
reduced the availability of oral health services for the area's
poorest residents. This reduction in clinic hours translates into
fewer chairs available for use by dental hygiene students. To fill
the gap, the college has created partnerships with additional
clinics in San Mateo County, further diversifying students' patient
care experiences. One new partner clinic serves patients with HIV,
and another provides charitable services to the most needy.
Students also spend some Fridays at area
schools providing oral health education to underserved students.
These include developmentally delayed teenagers, who welcome the
attention of the dental hygiene students. At the elementary school
level, they conduct science experiments that demonstrate the effect
of acids on tooth enamel to teach children about tooth decay.
Patti Walter Chan, RDH, M.S., who teaches
Foothill's CBE course, came up with the idea for this off-campus
experience after she became aware of a need for oral health
education in her own children's school. Both Chan and Bettencourt
are clinical instructors of long standing in the dental hygiene
program, and having outreach coordinators who know the needs of the
educational program appears to be one key to the success of CBE at
"When our students go to school sites,"
Prof. Bettencourt says, "Patti is with them. And every Friday, I am
on call if a student feels uncomfortable or has an issue. Once a
quarter, we sit down with students to reflect on their experiences.
We talk about whether or not the clinic is meeting its goals, and
discuss any ethical dilemmas they may have faced. The students gain
a deep appreciation for access issues in the process."
Foothill and its partner clinics take
part in the Silicon Valley Oral Health Collaborative, which the
Health Trust initiated a few years back to address the area's unmet
needs for care. Prof. Spragge describes the newly forged ties
between education and public health as a win for both.
"CBE is shaping our students feelings
about serving the community," Prof. Spragge says. "We see our
former graduates volunteering in our partner clinics. That is the
strongest legacy of the program."