Bulletin of Dental Education

Symposium on Global Outreach in U.S. Dental Schools: Synopsis

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On Oct. 24, 2019, U.S. universities gathered in Denver, CO, for a symposium addressing best global service-learning practices. The symposium was organized with the intent of facilitating better communication and networking between faculty doing similar work at separate schools, discussing methods and goals to attempt agreement on best practices, raising the ethical bar in global oral health service learning that may influence those doing similar work in non-academic settings and sharing passions that drive the leaders of this field. 

The attendees heard keynote presentations delivered by two significant and influential players in global oral health academics and global health policy. The symposium started with an insightful talk by Brittany Seymour, D.D.S., M.P.H., from Harvard School of Dental Medicine on “Amending the Headless Heart: Toward Evidence-based Global Service-learning Programs in Dental Education.” Using the story of her successes and failures that formed her path, as well as referencing the “headless heart” analogy taken from The Bottom Billion (written by Paul Collier), Dr. Seymour’s address motivated the audience to be cognizant of power dynamics and longitudinal effects on communities when serving abroad. Her address equally pushed the audience to be aware of demographics that must influence team goals, to strive for change over time and to expand the student learning experience beyond just specific treatment experiences. Her talk ended with an impactful quote by Maya Angelou: “Do the best you can until you know better. Then when you know better, do better.”

In the afternoon, the second keynote was delivered by Habib Benzian, D.D.S., M.S.C.D.P.H., Ph.D., who lives in Berlin, Germany; works for NYU College of Dentistry (NYU Dentistry); and consults globally on oral health government policy. In his talk, “Ethics of Short-term Experiences in Global Health,” Dr. Benzian used both public health data from around the world and humorous videos to help attendees understand the importance of having appropriate effects on communities, which led to a discussion of upriver effects in contrast with the endless line of individuals needing treatment. He also emphasized the importance of all service learning programs, academic or non-governmental organizations (NGO), prioritizing collaboration with host community health officers to determine community need. A concluding explanation of the World Health Organization’s 2030 Sustainable Development Goals enabled symposium participants to understand the collective long-term vision of all working in this field. 

Aside from the keynote presentations, the two days were filled with breakout sessions on multiple subjects, followed by productive group discussions allowing all to voice broad subjects of interest or concern. The organizing members did not assume attendees would gain answers to all of their questions; rather, the symposium facilitated further questioning and discussion, thereby equipping attendees with more knowledge and a greater network of friends and colleagues to address these questions. 

The first day included a panel discussion on “What is Your Why? Defining Your Purpose and Goals.” Sunny Fereshteh, D.D.S., from University of Southern California moderated the panel, which included Rachel Hill, M.P.H., from NYU Dentistry; Luiz Pimenta, D.D.S., M.S., Ph.D., from University of North Carolina; and Carlos Gonzalez-Cabezas, D.D.S., M.S.D., Ph.D., from University of Michigan. They each used a description of their schools’ global programs to tell about the journeys they had from “just doing” (the What) to setting goals (the Why). Each panelist shared learning lessons that ultimately led to change. All three schools have grown to include service, education and research in their program goals, and each school has a unique approach to incorporating travel and service in their educational programming. Attendees were not led to repeat any of these schools’ academic outlines, but instead were encouraged to be original in their search for adding “Why” to their “What.”

One group discussion included an examination of terms used to address this entire subject matter. Included in descriptive words were global service learning, international service learning, global initiatives, mission trips, community outreach, community impact programs, international volunteer programs, enrichment programs and domestic and international initiatives. Connotations and biases included in different terms were shared, but no final consensus on a “best” descriptive term was reached. Hopefully, a broader understanding of others’ perspectives was met. 

“Financing and Sustainability in Your Program,” a breakout session led by Stuart Hirsch, D.D.S., from NYU, was well attended. Dr. Hirsch discussed financial needs to run school GSL programs as well as methods to look for non-university money sources, such as corporate and alumni approaches or scholarship, gifting and unique socially responsible partnerships. He also shared how and where he “tells the story” to keep people involved and allow others to understand the challenges.

Another well-attended session addressed “Legal, Insurance, Security & Risk Management.” Together, Mike Leibowitz and Will Huser from NYU discussed how they support the GSL program from a university perspective. In a pre-meeting survey, this group of concerns were indicated as a significant interest. In a 2016 report from the American Dental Association Foundation addressing this, multiple people responded that their university did not have GSL programs due to concern over security, insurance or other risk management. While many attendees did have support from their universities similar to that discussed by Leibowitz and Huser, other attendees gained insight on how this process may be presented to their respective university support systems. 

“Impact, Evaluation & Research” facilitated by Jenny Park, M.P.H., from NYU had participants discussing output data, monitoring versus evaluating, pre- and post-trip surveys and continuity of patient data. In addition, consent forms for minors were discussed along with photo image policies. Program impact definitions varied by school while some admitted that project and exit strategies are not always well defined. 

Eve Cuny, M.S., from University of the Pacific led a session on “Field Operations for Clinical Programs: Site Logistics, Protocols, Infection Control, Equipment & Supplies.” She shared her experiences at organizing and overseeing programs at UoP, but also from her leadership with the Organization for Safety, Asepsis and Prevention (OSAP). “Program Design and Logistics” was addressed by Rachel Hill, M.P.H., from NYU. 

On Friday morning, other sessions offered included “Participant Roles and Oversight for an Effective Team” by Carmen Dielman, D.H.Sc., LDH, from Indiana University, South Bend, and “Developing Partnerships to ensure success” by Elizabeth Shick, D.D.S., M.P.H., from University of Colorado. Each facilitator brought their personal experiences to their group, yet they allowed the group discussion to move the conversations within their intended subjects. With intention, the sessions allowed each participant to hear perspectives in areas of their interest, discover alternate ways to address similar challenges, meet people who shared common passions and make friends that will allow future networking. 

The final day closed with a full group wrap-up and closing remarks by Dr. Seymour. During the wrap-up, it was proposed that, if interest exists, another meeting like this should be organized soon. As this meeting addressed university faculty perspectives and suggested finding common best practices that might be first set by academia, a subsequent meeting might invite faculty from outside of the United States, NGO representatives and/or other interested parties. In the meantime, email threads between participants can discuss ethical standards, collaborations between sharing hosts or locations, mentoring between experienced and first-time programs, experience using equipment or supplies, financing ideas or insurance research. Dr. Seymour closed by coming full circle with her story of trying to do good but learning that doing good was a difficult target to aim for. She included the popularly quoted Steve Jobs piece, “The Crazy Ones,” which finishes with, “Because the ones who are crazy enough to think they can change the world are the ones who do.” A toast to the crazy ones!

Courtesy of Dr. Jeffrey Steele, D.D.S., Indiana University School of Dentistry


Published on Feb. 12, 2020

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