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Campus Spotlight: Loma Linda University School of Dentistry

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By Nicole Fauteux

If teaching cultural competency is challenging on any campus, then teaching it at a Christian school founded to serve its faith adherents should be especially challenging, right? Well, maybe, and maybe not.

Loma Linda University (LLU), located 60 miles east of Los Angeles, is part of the Seventh-day Adventist Church system of higher education. Dr. Graham Stacey, Associate Dean for Student Affairs at Loma Linda University School of Dentistry (LLUSD), readily admits that the school is probably thought of as a place for students who are white, Adventist and rich.
Loma Linda Logo

“That’s not the school any longer,” he explains. “It hasn’t been that for a decade. While we maintain the culture of our faith tradition, and people know that it is a faith-based school, we intentionally want many cultures, ethnicities and religions to be part of it.”

Indeed, LLUSD has evolved and has done so thanks in part to traditions associated with its core mission. Founded in 1953 with a strong commitment to what is now called service learning, the dental school is well known both for the mission trips it sponsors abroad and for the opportunities if offers students to provide care for the underserved locally. In a video on the LLUSD website, LLU President Richard Hart, M.D., Dr.P.H., shares his view that these opportunities create teachable moments. “Once you step across a cultural boundary and an economic boundary,” he says, “you suddenly have to look at life in a different way, and when you do that, you learn.”

This longstanding concern with crossing culture boundaries remains a central component of the LLUSD experience, but its expression has morphed in recent years. Loma Linda’s health professions students continue to travel abroad, and the university still calls these experiences “mission trips,” but the focus is on service, not religious conversion. Additionally, the cultural exposure that accompanies service learning is now an adjunct, rather than the centerpiece, of LLUSD’s cultural competency initiatives.

These have evolved over the years, thanks initially to William Hooker, Ph.D., who currently teaches part-time and served until 2008 as LLUSD’s Associate Dean for Student Affairs. Prior to that, he held the same position at the LLU School of Medicine, where he first began wrestling with the issues of cultural competency and diversity.

In the 1980s, Dr. Hooker decided to expand the medical school’s diversity programs and hired a professor—known for his efforts to increase underrepresented minority (URM) student numbers in medical schools—to write a grant proposal. The professor had been an outspoken critic of Loma Linda because its medical school lacked a diversity program at that time. To everyone’s surprise, his research for the grant revealed that from the 1920s through the 1940s, Loma Linda had admitted more underrepresented minority students than any other medical school except Meharry Medical College and Howard University.

When asked about this history, Dr. Hooker replies, “It was congruent with our commitment to help Adventist kids get a medical education independent of what their ethnicity was.” Still, Dr. Hooker and his fellow administrators were stunned to learn that the medical school had been a leader in the area of diversity. Following this revelation, they were no longer content to simply settle for having four or five underrepresented minority students in each class.

In 1993, Dr. Hooker moved to LLUSD, and two years later, he started teaching the Personal Development course that still anchors the dental school’s cultural competency curriculum.

“It was a small, two-hour course in the junior year,” he recalls, “and it had enough topics in it for 10 courses, so I started doing things with it that I thought needed to be done.”

Those things included moving the course to the sophomore year, increasing the number of hours and introducing the topic of cultural diversity. This content received further attention when LLUSD began participating in the Pipeline, Profession & Practice: Community-Based Dental Education program in 2002. At a Pipeline meeting in Chicago, Dr. Hooker became acquainted with a number of resources that he says enhanced his teaching of cultural competency. He was especially impressed by the Frontline documentary A Class Divided, which chronicles a classroom experiment in discrimination. He began using this and other documentary films to spur discussions with his students on a range of topics, and he brought in guest speakers as well.

The Personal Development course was further enriched when Loma Linda’s international student program decided to enroll its students. According to Assistant Professor Margie Arnett, M.S., who was involved in implementing the Pipeline program and who continues to support cultural competency education at LLUSD, this decision led to some “eye-opening conversations. We found it was very beneficial to have the predoctoral and the international students together.”

Prof. Arnett stated that American-born students were sometimes shocked to learn how differently people experience dentistry in other countries, and that foreign students found the information on communicating and relationship building especially enlightening.

The Pipeline program also transformed the cultural competency curriculum in other ways. By 2011, the number of curriculum hours devoted to cultural competency had risen from 27 to 136, and the aspects of diversity addressed extended well beyond race and ethnicity to include age, gender, sexual orientation, disabilities, religious pluralism, class status and social standing. (For details, see Prof. Arnett’s article with Ronald Forde, D.D.S., M.S.D., in the Journal of Dental Education.)

The slow but steady evolution of cultural competency instruction at LLUSD has mirrored, to some extent, changes within society at large. Although the Adventist mission “to make man whole” had long been understood at LLUSD as a philosophy of caring for the whole person, the earlier curriculum at the dental school reflected some cultural blind spots. Dr. Hooker recalls attending a meeting of the Association of American Medical Colleges (AAMC) on sexual orientation in 1981.

“We had never thought of addressing something like that,” he recalls, “but it became easy to talk about all those things as the decades went by.”

Similarly, Dr. Hooker remembers that addiction was a taboo subject when he first joined Loma Linda’s faculty.

“Up until the 1980s, nobody thought there was a problem. Everybody thought good Adventist students and Christians don’t use alcohol and drugs. It was bizarre, and so I’m quite pleased that now it’s a different world. We’ve just had to grow as a church and as an institution.”

Dr. Stacey has also witnessed an evolution in LLUSD’s comfort with and appreciation for cultural differences.

“Up until about five years ago,” he says, “if you talked about cultural issues on campus, it was almost entirely centered on race, and if we had an African-American or Hispanic person heading up the diversity program, we felt we’d sort of covered it. That’s no longer the attitude. We realize how much bigger the issue is.”

LLUSD is committed to continuing to advance cultural competency, especially when it comes to ensuring that students from religious, ethnic and other diverse backgrounds feel comfortable on campus.

“That’s probably our university’s growth spot,” says Dr. Stacey. “When it comes to intentional awareness building, I don’t know that there is enough being done.”

In 2012, the Loma Linda University Health Sciences Center appointed a new Senior Vice President for Human Resources, Cari M. Dominguez, Ph.D., M.A., who formerly chaired the U.S. Equal Employment Opportunity Commission. She is actively engaging the university community around the many dimensions of diversity, and it seems that everyone has high hopes that her efforts will continue to expand the community’s cultural competency. 

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