By Nicole Fauteux
Something at the Ostrow School of Dentistry of the University of Southern California (OSD USC) is producing a high level of engagement around ethics and professionalism. What precisely is the source of this enthusiasm? Consider these theories.
Some folks argue that OSD USC’s humanistic environment and commitment to learner-centered education encourages students to take responsibility for their behavior as well as their learning. Others suggest that students already engaged in small group problem-based learning are primed to take part in challenging discussions. Still others attribute the school’s leading role in promoting a nationwide conversation on ethics and professionalism in dentistry to the passion of a particular faculty member and the OSD USC student who made professionalism his cause.
According to Mahvash Navazesh, D.M.D., Professor of Diagnostic Sciences and Associate Dean of Academic Affairs & Student Life, there is evidence to support all three hypotheses. Dr. Navazesh became Associate Dean in 2006, the year before the results of a nationwide survey unleashed widespread concern about cheating among dental students. She was already at work gathering information from faculty, staff and students for a 360-degree evaluation of the dental school’s facilities, curriculum and human resources when the unwelcome news broke in 2007.
Dr. Navazesh, who likes to take what she calls a “diagnostic approach” to problem solving, decided to extend her evaluation to the school’s ethical environment. She asked then-Chair of OSD USC’s Student Professional Performance Evaluation Committee, Prof. Alvin Rosenblum, D.D.S., now retired, to facilitate conversations with the students about what they thought was motivating unethical behavior among their peers. That dialog resulted in changes that continue to shape OSD USC today.
One of the students in those meetings was Michael Meru, D.D.S., who is now an OSD USC graduate and practicing orthodontist. Today’s students are quick to credit Dr. Meru with the novel idea of forming a student organization to improve the ethical environment on campus. They also credit Dr. Rosenblum with providing the unstinting support and guidance that helped the idea flourish. The outcome of their efforts was the Student Professionalism and Ethics Club (SPEC), which provided an open and respectful forum where students could gather to discuss ethically challenging situations they might encounter.
“Our objective is not to be whistleblowers or hall monitors,” says Craig Lambourne, a third-year OSD USC dental student who participates in those discussions today. “We want to open up the conversation and get people thinking. By the time we get to the clinic floor, the hope is—and I’ve seen it with my own experience—that I was a little more prepared, and hopefully I’m making better decisions because of that.”
Environmental factors may also play a role in shaping the professional climate at OSD USC. Fourth-year dental student Deborah Loh considers OSD USC’s location within the city of Los Angeles a decided asset, and she praises the school’s tradition of community service. Ms. Loh, who received the 2013 Clifton Dummett Endowed Scholarship, has made it a priority to help out in the community, recruiting dental students to serve on humanitarian trips abroad and taking part in several student-run dental outreach efforts closer to home.
“In any profession, it is easy to take shortcuts,” she points out, “but as dental professionals, we are trusted by society to help improve oral health and make a difference in our patients’ lives. The school reminds us to treat every patient with care and compassion.”
According to Dr. Navazesh, these lofty ideals can be difficult to live up to. She confirms that the OSD USC preaches the Golden Rule, but the school also provides more specific guidance.
“Although all human beings try to have good intentions, they may be used to different levels of tolerance,” she says, “so we make sure our students appreciate the fact that we have zero tolerance for unethical behavior.”
That process begins as soon as students enter dental school. Ethics and professionalism constitute a major portion of the orientation-week curriculum. The chair of the Student Professional Performance Evaluation Committee greets the freshmen and presents ethical dilemmas for them to consider. The class receives further information in this regard from the expert faculty in behavioral sciences. The class then breaks into small discussion groups, facilitated by students who are active in the student-run organization, and the class gets its first taste of why these conversations matter. As at many schools, the week ends with a white coat ceremony to symbolize the students’ entry into the profession. After that, teaching ethics and professionalism is a lot less about contact hours and a lot more about giving students responsibility and reinforcing expectations.
“In every situation, they have to be fair, they have to communicate effectively without making assumptions, they have to cooperate and collaborate, they have to show compassion, they have to be prepared, do their best and they have to strive for excellence,” Dr. Navazesh stresses. How does OSD USC know if its students are getting that message? “When you work with students in small groups of eight most of the time, it’s much easier to observe and monitor these behaviors,” she says.
Whatever the reason for OSD USC’s leadership when it comes to ethics and professionalism, it is clear that students and faculty at other schools are also eager to grapple with ethical questions and looking to cultivate robust programs of their own. Three years ago, SPEC became a national organization, the Student Professionalism and Ethics Association in Dentistry (SPEA), with chapters on about three dozen campuses and more chapters in formation. According to Mr. Lambourne, a SPEA Regent responsible for helping schools in several western states establish and grow their chapters, SPEA is “catching fire.” He attributes the organization’s spread to the fact that it is student-run.
“You don’t have the dean or the faculty saying, this is what you should do to be ethical,” he observes. “Now you have students who are promoting ethics and professionalism with each other, and it has a whole different impact on the school.”
It may soon have an impact on the practice community as well.
“I think SPEA provides an awesome framework for how to build your practice, and also how to build your life and your success in any endeavor in the future,” says Jeff Papworth, a third-year student at OSD USC and Co-president of the OSD USC chapter of SPEA. “In private practice, it could be easy to look at something and come to a rash judgment or decision. SPEA has taught me those fundamentals of ethics, but really kind of decision-making—to look at the decision from multiple angles, and understand there’s not necessarily always a clear-cut answer to what’s right and what’s wrong.”
Craig Lambourne agrees that his participation in SPEA will affect his future, and he hopes the same will be true for others as well. “It’s important as a profession that all of us get on board with this and try to live a standard that the community appreciates and respects,” he says.