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Critical Issues in Dental Education |
Key words: predental, pipeline program, dental education, dental careers
Submitted for publication 04/04/07; accepted 02/19/08
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Abstract |
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After reaching a peak in 1996, applications to dental schools nationally declined by approximately 25 percent between 1997 and 2001, with the greatest decline of roughly 14 percent in 2000. This decline also affected the University of Medicine and Dentistry of New Jersey (UMDNJ)-New Jersey Dental School (NJDS), which had an approximately 30 percent decline in applications for the same time period and a nearly 15 percent decline in 2001. Also alarming were approximately 23 and 19 percent decreases in applications from New Jersey residents in 2000 and 2001 respectively (see Table 1
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To increase overall applications, in June 2000, NJDS began what would become a unique and considerable undertaking to recruit college students into the dental profession. Later, after 2002, when NJDS experienced a sharp decline in URM applicants, the program added an objective of attracting diverse students.
The underlying reasoning of these efforts was that prospective dental school applicants would be introduced to the dental profession in their formative career-planning years. An ADEA survey found that approximately 50 percent of the seniors (graduating from dental school) reported that they made the decision to attend dental school during college, and 22 percent made this decision during high school.4 Following this principle, the Gateway to Dentistry (GTD) program recently served as a springboard to develop a second program, Decision for Dentistry (DFD), which aims to spark an interest in dentistry among students at the high school level.
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Program Description |
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TopAuthor informationAbstractProgram descriptionResultsDiscussionConclusionsReferences |
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In 2003, an additional objective was added:
The GTD program was first piloted in June 2000 with five students, all New Jersey residents, attending. Subsequent programs in January 2001, May 2001, and January 2002 had an overwhelming response, filling all twenty available seats with students from throughout the country. Since May 2002, the program has enrolled thirty qualified applicants twice yearly. There were, on average, approximately 150 applications for each GTD program, and more recently this number has increased to 300. In 2003, the application was modified to identify the ethnicity of applicants. Since that time, it has been noted that an average of 22 percent of GTD applicants (and 23 percent of participants) are from URM groups.
Application Process/Selection
The GTD program is described on the NJDS website. Brochures for the program are distributed via a mailing to college prehealth advisors every two years, as well as at all NJDS admissions/recruitment events.
Criteria for acceptance to the program is that the applicants
Both in-state and out-of-state residents are eligible to apply. Applications can be filed electronically through the GTD website. Recently, to offset some program costs, a twenty dollar application fee has been charged to each applicant, with waivers available.
Once complete application packages are received, the GTD selection committee reviews and categorizes as accept, hold, or reject, ranking the accepted students in order of overall strength. Generally, students whose academic performance to date indicates potential to meet the same criteria used by the NJDS Office of Admissions in determining eligibility for interviews are selected for the GTD program. This includes not only their college GPA, exposure to the sciences, and positive recommendation letters, but also consideration of students’ cultural background. Specific efforts are made to open participation to URM students by including URM faculty on the GTD selection committee, with personalized follow-up to encourage GTD application completion.
The highest-ranking (according to the criteria listed above) thirty students categorized as accept are offered admission to the GTD, and the remaining accepted students form a ranked wait-list. Students are then notified via email of the status of their applications.
Housing/Logistics and Scheduling
Participants must carry their own health insurance and are responsible for all personal expenses including room, board, and transportation. While most students either commute from home or stay with family and friends, short-term housing is available on campus.
Students receive an acceptance packet with all necessary information as to when and where to arrive at the school. They must sign agreements to participate in the program and to uphold the university’s Health Insurance Portability and Accountability Act (HIPAA) policy.
Each GTD program is comprised of nine days with eight hours of activities per day. The program is offered biannually during college breaks, for the first two weeks after January 1, and again for two weeks immediately following Memorial Day. This schedule allows the greatest number of students to take part in the program by avoiding conflicts with participants’ college/university class schedules, and it minimizes interference with summer job opportunities.
Program Features
Although each time the program is offered, there are minor variations to the schedule, some programmatic features are relatively constant. During the first-day orientation, participants are welcomed by faculty and student mentors and given final program schedules, surgical scrub attire, locker assignments, a tour of the school, and an overview/introduction by program faculty. Students are instructed on using the software to evaluate the individual presentations or activities. It is emphasized that their input has a meaningful role in program improvement, and all constructive comments are taken into consideration for future revisions to the program. Each discipline is represented in the program through lectures, preclinical laboratory exercises, and clinical observations. Table 2 presents a list of the various activities.
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The final day includes an exit interview, a group exercise in which the participants provide suggestions and feedback about the overall program to supplement the computer-based surveys on the individual sessions. As in the orientation, faculty, staff, and student mentors join with the Gateway students for a closing ceremony and luncheon at which each student is awarded a certificate of completion.
Program Evaluation
All information from the exit interviews is retained in a database. This information not only assists the staff in reviewing the program and continually making revisions in a positive direction, but also provides an assessment of how this program influenced the participants’ career choices with regard to dentistry.
In addition, after each activity during the two weeks in the program, the students are asked to give feedback and critique the lecture or activity they just experienced. Students complete these evaluations online using the same software that NJDS students use to complete their course evaluations. This information is reviewed by the program director and associate dean and forwarded on to participating faculty. If indicated, subsequent meetings with pertinent faculty members are held to review comments and revise their segment of the program. In addition, when students identify areas of interest not addressed in the current program, new segments are considered and added if appropriate. For example, the original program did not include gross anatomy; based on student feedback, this subject was developed and implemented in later programs. Through this process of continuous feedback and refinement, the program’s evolution is dynamic. Therefore, no two GTD programs are exactly alike.
Most importantly, all 325 students who have participated in the GTD program have been tracked since June 2000. Notation is made when GTD students apply, are interviewed, accepted, or enrolled at NJDS (see Table 3). About 8.5 percent of the participants who were offered acceptance at NJDS declined, with at least half of those reporting that they were attending other dental schools, which is also noted in the GTD database.
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Mentors and Program Administration
A critical component of the program is the participants’ interaction with their student mentors. At least fifteen third-year students are invited to serve as mentors based on overall performance and attitude. They serve as informal role models who recently went through the same decision-making and application process for dental school. An orientation describes their role and specific responsibilities, which include pouring up models for the participants’ hands-on activities, attending the orientation breakfast, having lunch with their assigned students on the first day of the program and during the second week of the program, allowing the students to observe them in their clinical activities, and attending the graduation luncheon. Mentors usually serve for two successive sessions: in May at the close of their third year and in January of their fourth year. For these activities, mentors are awarded two selective credits per session (toward their sixty selective/elective credit requirement).
Two faculty members were key in conceiving and founding the GTD program: Dr. Kim Fenesy (then director of student advisement) and Dr. Blaise Curcio (then division director of the General and Operative Dentistry Department). They recruited faculty volunteers and coordinated with the Office of Clinical Affairs and each department in obtaining supplies for the various activities. Additional administrative support was provided by the staff in the Office of Student Affairs. While both of the cofounders have moved on to other positions, Dr. Fenesy retains overall oversight of the program through her role as associate dean for student affairs, and the current director of student advisement, Ms. Jeanette DeCastro, serves as program director.
In addition to planning and day-to-day administration of the program while it is in session, about forty NJDS faculty volunteer substantial amounts of time to the program. Quite a few faculty volunteers are members of the admissions committee, along with a high proportion of the school’s URM faculty members. There are times in the schedule when students are split into smaller groups to allow for more supervision of hands-on activities, so faculty may present the same activity two to four times.
The impression-taking, pour-up, and model trimming activities are labor-intensive, with at least four faculty overseeing each group of fifteen students for eight hours total. One faculty member presents the comparative anatomy lecture, supervises the indirect vision exercise, and is usually involved in one of the impression-taking exercises as well. In addition, all of these hands-on activities keep our clinic staff engaged in ensuring that GTD participants have all the equipment and supplies that are needed.
In summary, GTD is a labor-intensive activity, for which faculty continue to volunteer their efforts. Many cite the rewards of working with enthusiastic novices, along with viewing their participation as a way to contribute to the growth of their profession. Regardless of motivation, it is clear the program is faculty-dependent: in the latest GTD program (January 2006 as of this writing), there were forty-six faculty involved in thirty-four presentations, totaling sixty-five faculty hours.
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Results |
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The 2007 exit interview results approximate the responses on all previous exit interviews: 86.67 percent mentioned hands-on exercises as the major strength of the program; 83.33 percent felt the program solidified their decision to pursue dentistry; and 6.67 percent indicated they were still wrestling with the decision to enter dentistry or medicine.
Table 1
presents data on application trends both nationally and in New Jersey and demonstrates that, for the last several years, the relative increase in applications to NJDS has been greater than the increase at the national level. Since the program’s inception, the number of applications from New Jersey residents has doubled from 145 to 296. Table 3 shows the proportion of GTD students enrolled in each class at NJDS. Between 16 and 30 percent of incoming classes consist of former GTD participants. Table 4 shows the percentage of GTD students by session who later enrolled in NJDS. Since the program’s full implementation, between one-third and one-half of all students in a particular Gateway session have been accepted to NJDS, excluding those sessions from which students have yet to apply. Table 5 shows the number of URM students enrolled at NJDS by class and the percentage of those who were GTD participants. Since the pilot, between 22 and 67 percent of enrolled URM students were former GTD participants.
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Discussion |
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TopAuthor informationAbstractProgram descriptionResultsDiscussionConclusionsReferences |
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It should be noted that some of the GTD program participants were in their first or second year of college at the time of their participation in the program and may not have applied to NJDS yet. For example in Table 4, the January 2006 session shows only about 17 percent enrollment. Over time, that percent can be expected to peak by 2011. The length of time between students’ participation in the program and their application date varies depending on their years of college completed. Thus, at least for the last six sessions of the program, information on the number of participants who eventually enrolled is incomplete. Put another way, multiple GTD sessions serve as feeders for each class with a mixture of students from different sessions combining to make up nearly a quarter of most incoming classes.
Second, Tables 2 and 3 focus on enrolled students, rather than students who applied but were not accepted to NJDS or students who were accepted but did not enroll, although this information is kept in the database. Among the participants who did not later enroll at NJDS, there is a subset of students who pursued their dental education elsewhere. Thus, the program recruits applicants both to NJDS and to the profession in general. Current Associated American Dental Schools Application Service (AADSAS) practices do not allow us to track applicants to other schools, but recent changes will permit that in the future.
The GTD brochure expressly states that participation in the program does not imply or guarantee acceptance to NJDS. Yet the program permits NJDS admissions faculty to observe future admissions candidates and allows students to evaluate NJDS to a greater degree than a normal admissions day visit allows. While it is rare, it is possible that program faculty will observe students exhibiting undesirable behavioral patterns (uncooperativeness, disinterest, habitual tardiness, or negative attitudes). More often, both the student and school tend to put their best foot forward during the program, in order to present themselves in the best possible light.
It is not possible to discern unequivocally how many of the GTD participants who later enrolled at NJDS would not have enrolled at NJDS had they not participated in the program. Based on their feedback, the majority of participants have indicated that this program allowed them to solidify their plans to apply to dental school.
One area of future research interest would be to explore long-term program effects, such as whether there is a difference in educational achievements while in dental school between GTD program participants and nonparticipants. Another avenue of research would be to identify exactly what components of the program contribute most to its overall effectiveness (program length or combination of lecture, hands-on activities, and clinical observation). This information would be useful to other schools seeking to develop programs of this nature. However, given that the hand-on activities were consistently rated as the strengths of the program, it’s likely that this would be among its most effective components. In addition, the reasons behind the higher proportion of URM enrollees who were GTD participants should be researched. It is possible that the connections built with current students and faculty of the same ethnicity/cultural background provided a higher comfort level, which may have impacted student decisions to attend NJDS more so than other students.
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Conclusions |
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Acknowledgments |
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REFERENCES |
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