Community Service Learning in the School of Dental Medicine
By Nicholas Covaleski, Assistant Director at CELT
This interview is with Dr. Cynthia Yered, Associate Professor and Director of the Community Service Learning Externship Program in Tufts School of Dental Medicine’s Department of Public Health and Community Service. Nick chatted with Dr. Yered to learn more about how she is using experiential pedagogies in her teaching, her motivations for doing so, and what insights she may have for other Tufts faculty who are interested in experiential education.
Can you start by telling us a little bit about yourself and the Externship Program at the School of Dental Medicine?
Dr. Yered: I am a general dentist and alum of Tufts Dental School. The Community Service Learning externship (CSLE) is a very exciting part of the dental school curriculum, as it’s the first opportunity students have to practice dentistry outside of the school’s dental clinic. It’s rewarding for me to be an integral part of training our students to be practice-ready.
The program is a five-week rotation, involving thirty community partners located in urban and rural areas across twelve states. The community partners (CSLE sites) include community health centers, non-profit dental clinics, state correctional facilities, and Native American Health Center and Dental Support Organizations. It’s an opportunity for students to increase their competency with both hands-on and diagnostic skills as well as to care for diverse, vulnerable patient populations. The program really increases students’ understanding of the many barriers that patients can encounter when accessing quality oral health care.
In what ways have you integrated experiential learning approaches into this program, and what were your motivations for doing so?
Dr. Yered: The CSLE program has always been an experiential program that allows students to improve their clinical and time-management skills. However, in addition to gaining hands-on experience with technical skills, I knew I wanted to do something different so that students would appreciate all of the learning opportunities this experiential rotation offered. During debriefing sessions, I would listen to students comment on the number of procedures they completed during the program or complain if certain procedures hadn’t been available to them. When I asked students if they had a good experience, many answers were based solely on whether or not they had completed a root canal procedure. But students should also be aware of the social determinants of health to better understand why patients may not choose the optimal treatment, or why patients seek emergency care rather than preventive and comprehensive treatment. This motivated me to add several pedagogical strategies to boost the learning experiences and outcomes.
What sorts of strategies did you add?
Dr. Yered: I added a structured reflection assignment at the end of the experience to develop critical thinking and connect what they learned in the classroom to practice. The reflections were very positive and thoughtful, recognizing important factors such as limited oral health education and financial security.
I took it a step further by adding weekly journal entries to encourage students to reflect on their learning and challenges more often. I augmented the preparation phase with asynchronous online learning modules, along with an assignment that asks students to learn more about the site and the community that they will be attending to. The pre-externship seminar was modified to include discussions around barriers patients confront obtaining dental care.
What do you see as the main pedagogical benefits of these approaches? In other words, what do you hope your students, as soon-to-be dentists, will most gain from them?
Dr. Yered: My hope is that students will become more aware of where patients are coming from and become more empathetic dentists. I believe the additional approaches do accomplish this, as evidenced in the weekly journals, reflections, and debriefing sessions. Students write and speak positively about all they learned and the learning is no longer exclusively about the number of procedures. It includes learning to deal with the challenges of language barriers, oral health promotion, health literacy, transportation, and childcare, meeting the patients where they are, and understanding why the patient may opt for a large restoration or an extraction rather than a crown.
Many students express desire to work in a community health center, a correctional facility, or a non-profit dental clinic, and to advocate for disadvantaged communities and find time to give back on a regular basis. They continue to increase their speed and their skills but also have a deeper understanding of, and empathy for, patients.
What advice do you have or what insights might you share for other Tufts faculty who are interested in incorporating experiential learning into their teaching – even if it’s not community service learning?
Dr. Yered: Experiential learning is powerful approach to learning. Whether it’s community service learning or a different form of experiential learning, most students learn best through active participation. Hands-on experiences are far more engaging, and tend to leave a lasting impression, making them more meaningful than lectures or seminars alone.
CSLE is a complex program with many moving parts. However, effective experiential learning does not need to be this complex. I recommend starting small, with a simple idea, aligning the activity with a specific skill or competency.
It is important to include:
- A strategic planning phase
- Student preparation
- Structured reflection
- Debriefing sessions
Debriefing sessions are extremely helpful. I highly recommend obtaining feedback from students and any partners involved, early on, to improve on the experience.
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