Comparing Oral Health Integration Curricula Across Primary Care Education Programs

In 2000, the Surgeon General’s landmark report on ‘Oral Health in America’ prompted a sense of urgency for primary care education to increase provider understanding, skills, and ownership of oral health (OH) care. Primary care clinicians including physicians, PAs, nurses, pharmacists, and dental professionals are now working to embed oral health and interprofessional practice competencies across their education programs. The ultimate goal is to equip the health care workforce with the knowledge and skills required by new integrated holistic healthcare models to include oral health.

The purpose of this study was to conduct a comparison of curricular design elements of OH education across primary care professions, which can serve as baseline information and be used to track future curricular integration within and across primary care professions. In 2017, using internet-based questionnaires, our team surveyed 13 disciplines (2245 potential primary care programs) and included disciplines with response rates of 40% in the analyses. In order to compare across multiple primary care disciplines, our team created the Oral Health Education Comparative (OHEC) Tool utilizing responses to the survey items. The Input, Process, Output (IPO) systems-based evaluation framework served as the theoretical model for designing the OHEC Tool. The OHEC Tool enabled a quantifiable format for comparing different primary care disciplines across curriculum design domains of inputs, processes, and outputs.

Out of 1686 eligible programs, 767 respondents representing 9 disciplines were chosen for analysis (response rate of 45%). Peds/ meds- peds residency and pediatric nurse practitioner (PNP) programs scored the highest points in the input domain of the OHEC Tool. Physician assistant (PA) and PNP programs were the highest scorers in the process and output domains.

Finally, PA and PNP programs scored the highest overall points on the OHEC Tool (i.e., most integration) whereas family medicine residency and geriatric fellowship programs scored the lowest. The OHEC Tool could serve as a replicable framework for developing and evaluating curriculum integration design domains of inputs, processes, and outputs. Lessons can be learned from PNP and PA programs for OH integration and efforts should be invested in sharing promising practices across primary care disciplines.