ADEA CCI Liaison Ledger

HPV Calls for an Interprofessional Approach

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By Jacquelyn L. Fried, Associate Professor and Director of Interprofessional Initiatives, University of Maryland School of Dentistry

By 2020, the prevalence of HPV-related head and neck cancers associated with the human papilloma virus (HPV) is anticipated to reach epidemic proportions. This pressing public health issue provides an opportunity for interprofessional education (IPE) where oral health is a key focal point. Students across the health professions must understand how prevention, detection, referral and treatment are essential to the eradication of HPV and associated oropharyngeal cancers (OPC). Dental hygiene and dental school faculty are in ideal positions to develop curricula related to HPV and OPC, share curricula interprofessionally and increase the visibility of these contemporary health threats.

The HPV-knowledge base is relevant to all helping professions, and HPV’s alarming growth makes a strong case for including cross-disciplinary perspectives in an expanded curriculum that examines HPV, its transmission and its association with OPC. Traditional curriculum content on oral cancer often does not apply to OPC as it currently manifests itself, so the reassessment and amplification of current curriculum are warranted.

What might a new interprofessional HPV/OPC curriculum look like? Essential content areas would include epidemiologic data, associated risk factors, the virus’s pathophysiology and mechanism of action, evolution of the infection, strains of the virus, transmission routes, vaccinations, prevention, patient education, treatment and prognosis. Students of dentistry, dental hygiene, psychology, health education, medicine, social work and nursing could share didactic experiences, but faculty must ensure that the delivery of didactic content promotes student interaction and makes use of diverse learning activities and environments. The Interprofessional Education Collaborative (IPEC) Core Competencies for Interprofessional Collaborative Practice outlines four competency domains (teamwork, values/ethics, roles and responsibilities and communication) to guide faculty through the process of creating interprofessionally competent graduates.

A new interprofessional curriculum must also emphasize communication; in particular, how to address sensitive issues with patients and other health care providers. In general, the scientific literature describes health professionals as having ineffective communication skills and a penchant toward ignoring sensitive issues. Role-playing with diverse groups of students and faculty could help learners assess what they would say, how they would say it and how they feel about addressing HPV with a patient. Practicing communication skills together through peer teaching will help these future providers learn how to discuss sensitive topics with their patients and each other. Since baseline communication skills and exposure to teamwork may vary among different groups of professional students, self-paced activities might be especially engaging. Case studies with small group discussions could provide additional learning opportunities.

On a population-based level, oral health professionals could work with nurses, physicians, social workers, gynecologists, community groups and professional organizations to support efforts to prevent HPV-associated OPC. Oral health professionals could devise and lead a public health campaign to prevent HPV transmission and HPV-associated head and neck cancers. Dentists’ and dental hygienists’ involvement in supporting the use of preventive vaccines and providing education on safe sexual practices could catapult the oral health professions into prominence and demonstrate their commitment to breaking down professional education silos.

Forces shaping the health care delivery system are dynamic. So are lifestyles and behaviors that trigger changes in society’s health. Likewise, health professions educators must adjust their curricula to respond to new health care challenges. Currently, bona fide curriculum content related to HPV must be developed and shared across health professions schools and programs. The increase in HPV-associated OPC provides an opportunity for oral health professionals to increase their visibility and take the lead in promoting IPE while addressing a serious public health threat. 

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