Guest Perspective(2)

Interprofessional Education: One Way New Schools Can Contribute
to Progress in Dental Education

James J. Koelbl, D.D.S., M.S., M.J., Founding Dean, Western University of Health Sciences College of Dental Medicine

There has been much discussion regarding the opening of several new dental schools throughout the country. Questions have been raised about the need for additional dental schools and concerns about whether these new schools will truly be university/research-based institutions. Since most of the new schools in the last decade have been affiliated with schools of osteopathic medicine, there have also been questions regarding the influence of osteopathic medicine on the profession of dentistry.

I don't profess to have all the answers to these concerns, but I do believe that we may be asking the wrong questions. I suggest the real question is: How can these new dental schools help to move the profession forward?

Many learned individuals have spoken and written over the past 50 years or more about the need for change in dental education. One of the many issues raised by these discussions has been the concept of interprofessional education (IPE). According to a recent article by Wilder et al[1], interest in IPE has been sparked by several factors in the health care system, including the increased awareness of oral-systemic connections, an aging population, the shift of the burden of illness from acute to chronic care, and lack of access to basic oral care. However, the authors argue that little has changed in the way dental students are taught and prepared to participate in IPE.

In another article by Rafter et al[2], the authors reviewed the literature on IPE and reported on a preliminary survey of the current status of interprofessional education in seven academic health centers that have schools of dentistry associated with them. The authors noted that there is wide variability in interpretation of the term "interprofessional," and many barriers to interprofessional education exist. These include already overcrowded curricula in health professions schools, lack of support from faculty and administration, and financial constraints.

If we are to have new dental schools, then why not take advantage of the opportunities provided by being able to start with a clean slate? Why not expect, or even demand, that the new dental schools will move the debate on change forward by trying innovative solutions to better prepare our future professionals for the evolving world of health care? After all, the new schools have no "baggage." There is no one to say "this is the way we've always done it." And they are not bound by years of "tradition" that sometimes seem to weigh against meaningful change.

How can the new schools accomplish this? As the founding dean of a new dental school located in a university that also includes a college of osteopathic medicine, I can only speak to one institution's experience.

Two thousand years ago, Hippocrates, the father of medicine, taught that the focus of treatment must not be on the disease, but on the patient. Dr. Andrew Taylor Still founded the first school of osteopathic medicine more than 100 years ago because, echoing Hippocrates, he realized that health was more than the absence of disease - it involves the whole person and the person's relationship to others and the world. This is an inherent philosophy within osteopathic medicine today, and it is woven into the fabric of the training of all health professionals studying at Western University of Health Sciences. One very positive result of this philosophy is the recognition of the importance of oral health to overall health.

At our university, we are fortunate in that by August 2009 we will have nine professional graduate colleges on one campus. These include allied health, biomedical sciences, dentistry, graduate nursing, medicine, optometry, podiatric medicine, pharmacy, and veterinary medicine. Our tradition of whole health, or "one medicine," clearly supports the concept of interprofessional education.

Western University has made a commitment to include interprofessional education as a core concept in the curricula of each professional program. Each of the deans has supported that commitment, and a common campuswide block of time has been set aside for students and faculty to participate in interprofessional education activities. Currently, a pilot program is being conducted using cases specifically developed to highlight interprofessional issues. Students from every professional program, aided by specially trained faculty mentors, meet in small groups to discuss these cases.

Our new Patient Care Center will include a special interprofessional clinic in which clinical students from each of the professional colleges will gather to provide comprehensive diagnostic services for patients with highly complex health care needs. The IPE Clinic will contain state-of-the-art diagnostic equipment, and the students will take turns discussing their own profession's role in the overall care of the patient. The Patient Care Center will include treatment areas in pharmacy, medicine, dentistry, optometry, and podiatric medicine, where definitive care will be provided.

In addition, efforts have begun to address the specific need to provide more education in oral health to medical students. These efforts have been strongly supported by the dean of the college of medicine, and there has already been one lecture to second-year medical students on the current status of research into the relationships between periodontal disease and cardiovascular disease. While this is just a beginning, it serves as one example of the openness and collaborative spirit that exists at Western University.

Each college at our university is committed to conducting a high-quality, research-based, innovative educational program, and for each of us, our primary goal is to graduate highly competent health care professionals in our own disciplines. However, each of our programs also has a goal of educating individuals who will have a greater appreciation for and understanding of the contributions that each of the health professions can make to the overall health of our patients.

As Dr. Rick Valachovic noted in the May 2007 issue of ADEA's Charting Progress, one thing that remains "unchanged throughout the history of dental education is the critical need for dental schools to mesh their priorities with their parent institutions and make its value to the university and to the community as highly visible as a welcoming front porch."

As oral health care professionals, we have long known the importance of oral health as a key to systemic health. Our profession continues to be founded in science, and we have a long track record of success in prevention. Interprofessional education provides an effective venue for all of our schools to showcase the scientific basis of dentistry, to demonstrate the value of our education as "oral physicians," and to take the lead in ensuring that future generations of health care professionals will truly understand that the mouth is part of the whole person. This is one more way in which dental schools can continue to integrate themselves into the fabric of their universities.

References

1. Rebecca S. Wilder, Jean A. O'Donnell, J. Mark Barry, Dominique M. Galli, Foroud F. Hakim, Lavern J. Holyfield, and Miriam R. Robbins. Is Dentistry at Risk? A Case for Interprofessional Education. J Dent Educ. 2008 72: 1231-1237.

2. Mary E. Rafter, Igor J. Pesun, Michael Herren, Jeffrey C. Linfante, Mina Mina, Christine D. Wu, and Jane P. Casada. A Preliminary Survey of Interprofessional Education. J Dent Educ. 2006 70: 417-427.