Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Education
  • Published:

An innovative approach to teaching cross-cultural communication among dental students

British Dental Journal volume 233, pages 879–884 (2022)Cite this article

Abstract

Introduction There is a lack of concordance in demographics between dental professionals and their patients. Professional organisations have recognised the necessity of cultural competency training in dental education. This study sought to employ and evaluate a novel intervention in cultural competency training on cross-cultural communication for undergraduate dental students.

Material and methods The session employed dyad training, roleplaying, Kleinman's Explanatory Model and introduced the new 'Model for Negotiating Across Cultures', applied to patients' cultures. Learners included 24 first-year and 27 third-year dental students. Evaluation compared pre- and post-intervention responses to the modified Health Belief Attitudes Survey (HBAS). Paired t-tests were conducted to determine difference in pre- and post-intervention scores.

Results For first-year students, the mean difference improvement between the pre- and post-intervention surveys for each HBAS domain was statistically significant (p <0.05). For the third-year students, improvement was significant in all domains except for quality (p = 0.083).

Discussion Dental students were found to have improved cultural competency scores by the HBAS. Implementation of this educational intervention demonstrates a paradigm that could be implemented for cross-cultural communication.

Conclusion The intervention can be utilised as a resource for cross-cultural communication education for dental students and could be expanded for all health professional students.

Key points

  • There is a need for cross-cultural communication training in dental education.

  • The Model for Negotiating Across Cultures, first described here, improves cultural competency scores for dental students as measured by the Health Belief Attitude Survey.

  • This innovation may improve cross-cultural communication skills for dental students and could be considered for expansion for all health profession students.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Office for National Statistics. Ethnicity and National Identity in England and Wales: 2011. 2012. Available at https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/ethnicity/articles/ethnicityandnationalidentity inenglandandwales/2012-12-11 (accessed March 2022).

  2. Office for National Statistics. Public Sector Employment, UK: June 2017. 2017. Available at https://www.ons.gov.uk/releases/publicsectoremploymentukjune2017 (accessed March 2022).

  3. United States Census Bureau. United States Summary: 2000. Available at https://www.census.gov/library/publications/2003/dec/phc-2.html (accessed January 2022).

  4. United States Census Bureau. QuickFacts: United States. Available at https://www.census.gov/quickfacts/fact/table/US/PST045219 (accessed January 2022).

  5. Neville P. Exploring the ethnic diversity of UK dentistry. MedEdPublish 2018; 7: 1.

  6. American Dental Association. The dentist workforce - key workforce facts. 2020. Available at https://www.ada.org/resources/research/health-policy-institute/dentist-workforce (accessed March 2022).

  7. Gallagher J E, Calvert A, Niven V, Cabot L. Do high tuition fees make a difference? Characteristics of applicants to UK medical and dental schools before and after the introduction of high tuition fees in 2012. Br Dent J2017; 222: 181-190.

  8. Slapar F, Cook B J, Stewart D, Valachovic R W. U.S. Dental School Applicants and Enrollees, 2017 Entering Class. J Dent Educ 2018; 82:1228-1238.

  9. Garcia R I, Cadoret C A, Henshaw M. Multicultural issues in oral health. Dent Clin North Am 2008; 52: 319-33.

  10. Janakiram C, Chalmers N I, Fontelo P et al. Sex and race or ethnicity disparities in opioid prescriptions for dental diagnoses among patients receiving Medicaid. J Am Dent Assoc 2018; DOI: 10.1016/j.adaj.2019.06.016.

  11. Zhang W, Wu Y Y, Wu B. Racial/Ethnic Disparities in Dental Service Utilization for Foreign-Born and U.S.-Born Middle-Aged and Older Adults. Res Aging 2019; 41: 845-867.

  12. Patel N, Patel S, Cotti E, Bardini G, Mannocci F. Unconscious Racial Bias May Affect Dentists' Clinical Decisions On Tooth Restorability: A Randomized Clinical Trial. JDR Clin Trans Res 2019; 4: 19-28.

  13. Schwartz S B, Sanders A E, Lee J Y, Divaris K. Sexual orientation-related oral health disparities in the United States. J Public Health Dent 2019; 79: 18-24.

  14. The Commonwealth Fund. Disparities in Patient Experiences, Health Care Processes, and Outcomes: The Role of Patient-Provider Racial, Ethnic, and Language Concordance. 2004. Available at https://www.commonwealthfund.org/publications/fund-reports/2004/jul/disparities-patient-experiences-health-care-processes-and (accessed November 2022).

  15. Commission on Dental Accreditation. Accreditation Standards for Advanced Dental Education Programs in Advanced Education in General Dentistry. 2021. Available athttps://coda.ada.org/-/media/project/ada-organization/ada/coda/files/predoc_standards.pdf? rev=a6bbe0f4fc074a9e920a0720a651d8f1&hash= 6916F010849A542AF6854A34EFB7605D (accessed November 2022).

  16. Holyfield L J, Miller B H. A tool for assessing cultural competence training in dental education. J Dent Educ 2013; 77: 990-997.

  17. Behar-Horenstein L S, Feng X. Enhancing Cultural Competence Among Dental Students Through Active Teaching and Experiential Learning. Qual Rep 2017; 22: 1169-1185.

  18. Forsyth C J, Irving M J, Tennant M, Short S D, Gilroy J A. Teaching Cultural Competence in Dental Education: A Systematic Review and Exploration of Implications for Indigenous Populations in Australia. J Dent Educ 2017; 81: 956-968.

  19. Crosson J C, Deng W, Brazeau C, Boyd L, Soto-Greene M. Evaluating the effect of cultural competency training on medical student attitudes. Fam Med 2004; 36: 199-203.

  20. Kurtz S M, Silverman J D. The Calgary-Cambridge Referenced Observation Guides: an aid to defining the curriculum and organising the teaching in communication training programmes. Med Educ 1996; 30: 83-89.

  21. Kurtz S, Silverman J, Benson J, Draper J. Marrying content and process in clinical method teaching: enhancing the Calgary-Cambridge Guides. Acad Med 2003; 78: 802-809.

  22. Denniston C, Molloy E, Nestel D, Woodward-Kron R, Keating J L. Learning outcomes for communication skills across the health professions: a systematic literature review and qualitative synthesis. BMJ Open 2017; DOI: 10.1136/bmjopen-2016-014570.

  23. Bjerrum A S, Morcke A M. Dyad training: effective, efficient and transferable. What are we waiting for? Med Educ 2015; 49: 242-244.

  24. Bates D, Plog F. Human Adaptive Strategies. 1st ed. New York: McGraw Hill, 1990.

  25. Britton C V. Ensuring culturally effective paediatric care: implications for education and health policy. Paediatrics 2004; 114: 1677-1685.

  26. Eisenberg L. Disease and illness distinctions between professional and popular ideas of sickness. Cult Med Psychiatry 1977; 1: 9-23.

  27. Kleinman A, Benson P. Anthropology in the clinic: the problem of cultural competency and how to fix it. PLoS Med 2006; DOI: 10.1371/journal.pmed.0030294.

  28. Carpenter R, Oestrada C A, Medrano M, Smith A, Massie F S Jr. A web-based cultural competency training for medical students: a randomized trial. Am J Med Sci 2015; 349: 442-446.

  29. De Maesschalck S, Willems S, De Maeseneer J, Deveugele M. Development and validation of EMP-3: an instrument to measure physicians' attitudes towards ethnic minority patients. Fam Med 2010; 42: 262-267.

  30. Albino J E N, Inglehart M R, Tedesco L A. Dental education and changing oral health care needs: disparities and demands. J Dent Educ 2012; 76: 75-88.

  31. Mariño R, Ghanim A, Morgan M, Barrow S. Cultural competency and communication skills of dental students: clinical supervisors' perceptions. Eur J Dent Educ 2017; DOI: 10.1111/eje.12227.

  32. Räder S B E W, Henriksen A-H, Butrymovich V et al. A study of the effect of dyad practice versus that of individual practice on simulation-based complex skills learning and of students' perceptions of how and why dyad practice contributes to learning. Acad Med 2014; 89: 1287-1294.

  33. Chua J W, See K. Dyad Training: An Effective and Efficient Method of Basic Echocardiography Training for ICU Residents. CHEST 2017; DOI: 10.1016/j.chest.2017.08.645.

  34. Elwyn G, Frosch D, Thomson R et al. M. Shared decision making: a model for clinical practice. J Gen Intern Med 2012; 27: 1361-1367.

  35. Alrqiq H M, Scott T E, Mascarenhas A K. Evaluating A Cultural Competency Curriculum: Changes In Dental Students' Perceived Awareness, Knowledge, and Skills. J Dent Educ 2015; 79:1009-1015.

  36. Ali K, McColl E, Tredwin C, Hanks S, Coelho C, Witton R. Addressing racial inequalities in dental education: decolonising the dental curricula. Br Dent J 2021; 230:165-169.

  37. Forsyth C, Irving M, Short S, Tennant M, Gilroy J. Students don't know what they don't know: dental and oral health students' perspectives on developing cultural competence regarding indigenous peoples. J Dent Educ 2019; 83: 679-686.

  38. Gregorczyk S M, Bailit H L. Assessing the cultural competency of dental students and residents. J Dent Educ 2008; 72: 1122-1127.

  39. Lie D, Boker J, Cleveland E. Using the tool for assessing cultural competence training (TACCT) to measure faculty and medical student perceptions of cultural competence instruction in the first three years of the curriculum. Acad Med 2006; 81: 557-564.

Download references

Author information

Authors and Affiliations

  1. McGaw Medical Centre of Northwestern University, 420 East Superior Street, Suite 9-900, Chicago, Illinois, 60611, USA

    Joseph R. Fuchs

  2. Department of Surgery, University of Colorado School of Medicine, 13001 East 17th Avenue 61171, Aurora, Colorado, 80045, USA

    Andrew M. Tannous

  3. Office of Evaluation, University of Colorado School of Medicine, 13001 East 17th Place Building 500, Box F523 Aurora, Colorado, 80045, USA

    Gretchen Guiton

  4. Section of Adolescent Medicine, Medical College of Wisconsin, 999 North 92nd Street, Suite 460, Milwaukee, Wisconsin, 53226, USA

    Paritosh Kaul

Authors
  1. Joseph R. Fuchs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew M. Tannous
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gretchen Guiton
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paritosh Kaul
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Joseph R. Fuchs: formal analysis, data curation, writing - original draft, writing - review and editing, visualisation, project administration. Andrew M. Tannous: formal analysis, data curation, writing - original draft, writing - review and editing, visualisation. Gretchen Guiton: methodology, software, formal analysis, investigation, writing - review and editing. Paritosh Kaul: conceptualisation, methodology, investigation, resources, writing - review and editing, supervision, project administration.

Corresponding author

Correspondence to Joseph R. Fuchs.

Ethics declarations

The authors declare no conflicts of interest.

The survey and methodology were approved by the Colorado Multiple Institutional Review Board (COMIRB 20-2674). Participants consented in accordance with the Institutional Review Board's guidelines before taking the pre-intervention survey.

Supplementary Information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fuchs, J., Tannous, A., Guiton, G. et al. An innovative approach to teaching cross-cultural communication among dental students. Br Dent J 233, 879–884 (2022). https://doi.org/10.1038/s41415-022-5211-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41415-022-5211-9

This article is cited by

Search

Advanced search

Quick links