Practices that work within a particular framework of goals and priorities can become engrained in the work of institutions. But what happens when the framework shifts?  Regular review of practices and the assumptions that support them offers one of the best opportunities to enhance diversity and inclusion, which can in turn improve the effective results of Scholar and Fellow programs. 

The Robert Wood Johnson Foundation (RWJF) Diversity Matters Podcast Series features host Jacinta Gauda in conversation with leaders and subject matter experts on practical ways to support diversity and inclusion.  In the podcast, available now, W. David Brunson, DDS, Senior Director of the Policy Center for Access, Diversity, and Inclusion of the American Dental Education Association (ADEA), and Marc Nivet, EdD, Chief Diversity Officer, Association of American Medical Colleges (AAMC), discuss the practice of holistic review. 

Increasingly adopted by medical and dental schools, holistic review is sometimes misunderstood as affirmative action or as an initiative designed solely to increase diversity.  Nivet and Brunson will clear up these misconceptions, and explain what it is and what it is not.  Listeners will learn how the practice evolved, how it is applied equitably across the entire applicant pool, and how it aligns admissions policies, processes, and criteria with institution-specific goals.  Nivet and Brunson will also describe ADEA- and AAMC-sponsored workshops in which admissions deans, staff, and committee members learn how to integrate holistic review into their admission processes.  

Holistic review can help institutions to achieve the true culture of diversity and inclusion that they will need if they are to effectively address the nation’s challenges in health and health care.

Visit the Diversity Matters Community to download podcasts and summaries for practices that are working to increase representation in health and health care.

The U.S. Department of Health and Human Services (HHS) this week announced more than $100 million in new grants to expand and strengthen the nation’s health care workforce. The goal of the funding is to educate and strengthen training for health care workers, and provide fellowships and traineeships.

The grants include:

- Nursing ($30.2 million): Partial loan forgiveness for students who serve as full-time nursing faculty for a designated period of time after graduating from a master’s or doctoral program; grants for schools of nursing to provide financial aid and mentoring to students from disadvantaged backgrounds underrepresented in nursing; and funding for nurse anesthetist traineeship programs for licensed registered nurses enrolled in master’s or doctoral nurse anesthesia programs.

- Dental ($3.0 million): Grants to increase oral health care education capacity for programs that train future faculty in general, pediatric, or public health dentistry, or in dental hygiene.

- Public Health ($48.0 million): Funds for 37 Public Health Training Centers to train current and future public health workers in basic health skills and key public health issues; and grants to expand public health training programs and support medical residency-type fellowships at state and local health departments.

- Interdisciplinary and Geriatric Education ($6.6 million): Grants for projects to train and educate workers to provide geriatric care for the elderly; and support for the collaboration and integration of public health curricula in medical and clinical education.

- Centers of Excellence ($18.8 million): A five-year program to support the recruitment and performance of underrepresented minority students entering health careers, and to support research and the development of curricula, training and resources related to minority health issues.

“These grants and the programs they support are vital to achieving a comprehensive and culturally competent health professions workforce capable of meeting future health care challenges,” HHS Secretary Kathleen Sebelius said in a statement announcing the funds.

Learn more about the new federal grants here and here.

This is the first in a series of blog posts introducing programs that are part of the Robert Wood Johnson Foundation (RWJF) Human Capital Portfolio. Funded by RWJF, the Summer Medical and Dental Education Program (SMDEP) offers intensive and personalized medical and dental school preparation to freshman and sophomore college students from underrepresented groups and disadvantaged backgrounds. The goal is to help them overcome barriers to medical or dental school.

Meet 26-year-old Carmen Young, a May 2012 graduate of the University of Louisville, School of Medicine who begins her obstetrics and gynecology residency at St. Mary’s Hospital in St. Louis this summer. Her 8th grade commitment—from dream to destination—has been realized with a boost from the Summer Medical and Dental Education Program (SMDEP). Carmen pledges to build a practice that improves outcomes for Black mothers and their babies.

Meet Adrienne Perry, 23, whose eyes were opened to the vast oral health problems faced by adults and children during a trip to Guatemala. That trip, coupled with six weeks of intensive classes through SMDEP, awakened the third-year Howard University School of Dentistry student to similar oral health gaps faced by people in urban communities surrounding her campus in Washington, D.C. When she gets her degree, this Conyers, Georgia native plans to address the oral health crisis among underserved communities both here and abroad. Today, just 12 percent of the nation’s dentists are from minority populations.

And meet Drew Gehring, 24, from rural Garrison, North Dakota. He also participated in SMDEP and was inspired to dive into research probing the causes of colon cancer, hoping to contribute to curing the disease.

SMDEP gave these and other students from economically disadvantaged or medically underserved communities a jumpstart to open educational opportunities and clear career paths to medicine or dentistry. They are among the more than 20,000 alumni of the program.

February is National Children’s Dental Health Month, so the Human Capital Blog reached out to John Gusha, DMD, PC, a 2003 Robert Wood Johnson Foundation (RWJF) Community Health Leader, to learn more about children’s oral health. As project director of the Central Massachusetts Oral Health Initiative, Gusha mobilized dozens of dental societies and non-profit groups to provide dental care for low-income residents of Worcester County. Although funding for the Oral Health Initiative has ended, many of the programs Gusha helped create are still in place.

Human Capital Blog: What spurred the Central Massachusetts Oral Health Initiative? What made you aware of this need for oral health care in your community?

John Gusha: There was a special legislative report in 2000 that described disparities in access to oral health care for low-income populations. It raised a lot of questions about what we could be doing in the community and in the dental society to address these gaps. We got funding from the Health Foundation of Central Massachusetts, which also saw this as a critical need for our area, to launch the initiative.

HCB: Tell us about the school-based programs you put in place.

Gusha: The decay rate in Worcester County schools was very high—more than one-third of the students had active decay in their mouths. It was especially prominent in schools with high numbers of free and reduced price lunches, where students came from low-income families that are more likely to be using Medicaid. These students didn’t have access to care and weren’t getting the preventive services they needed.

We started a school-based program that is now in place in more than 30 Worcester County schools. Dental hygiene students from a local community college provide fluoride varnishes, cleanings and other preventive services to students, and the University of Massachusetts’ Ronald McDonald “Care Mobile” visits schools to offer the same services. Community health centers also participate in these programs by adding dental to their school-based health centers. In the past you could go to schools and provide services, but Medicaid rules didn’t allow you to get reimbursed. We were able to help get those rules changed so the program could become sustainable.

HCB: You also had a role in creating a dental residency program and training primary care providers to screen for oral health needs.

Gusha: We wanted to better integrate dentistry into medicine. The University of Massachusetts was the administrator of our program, and the team there developed a dental residency program at the medical school. The University had no classes in oral health before this. The local hospitals were in desperate need of professionals with this kind of training, particularly in emergency rooms. The Medicaid population was presenting there frequently for treatment because they had nowhere else to go, and people with other issues like cardiac problems or cancer needed clearance on their oral health in order to proceed with treatment.

The residency program is still in place at our two local community health centers, and it’s grown now to include education for other disciplines.

Although the number of students applying to dental schools has risen in the last decade, the number of minority students has not risen proportionately. Simply increasing the applicant pool does not guarantee that diversity in the student body will increase, because underrepresented students often struggle to compete as the number of applicants increases and other students may have higher grade point averages and Dental Admission Test scores.

In 2005, the American Dental Education Association (ADEA), with support from the Robert Wood Johnson Foundation (RWJF) Pipeline, Professions, and Practice: Community-Based Dental Education program, created a workshop program to help dental schools foster admissions practices that increase diversity. To date, nearly half of all U.S. dental schools have hosted the ADEA Admissions Committee Workshop.

Now, to further the reach of these promising practices, with support from RWJF, ADEA has developed a web-based resource to generate discussion among admission committee members and to encourage a more diverse student body. Transforming Admissions: A Practical Guide to Fostering Student Diversity in Dental Students includes information on the importance of diversity in higher education and dentistry, tips and discussion topics for admission committees, and data and resources including PowerPoint slides from the ADEA Admissions Committee Workshop.

“We’ve seen from researchers, educators, policy-makers, and even courts that diversity provides a better educational experience for all students and leads to improved access to care,” ADEA President Leo E. Rouse, D.D.S., said in a statement. “This new tool for ADEA members will aid in admissions and accreditation, processes that are absolutely critical to academic dental institutions.”

Read more about the ADEA Transforming Admissions guide.

Denise Davis, Dr.P.H., is an RWJF program officer, and the guiding force behind RWJF’s Pipeline, Profession & Practice: Community Based Dental Education program (the Dental Pipeline program). The program ran from 2001 to 2010, working to increase diversity in the dental profession and to increase access to oral health care among underserved populations. Davis gave the following interview to the Human Capital Blog on May 16, 2011, as part of our RWJF Leaders series of blog posts.

Human Capital Blog: Now that RWJF’s Dental Pipeline program has been completed, how would you assess its impact?

Denise Davis: One focus of the program was to expand the pipeline of diverse applicants to dental schools. Among the most important things we did was to look carefully at admissions committee processes. We hoped to discover how we could retool and retrain admissions committees. And, in fact, we’re still funding the work of the American Dental Education Association in that area, even after the Dental Pipeline program has ended. In any event, we succeeded in this first goal of extending access to a more diverse group of applicants. Quite simply, the number of minority students went up.

The other thing we focused on was expanding the clinical rotations of dental students. Dental schools have their own clinics, and they typically require students in their junior and senior years to practice what they’ve learned there. But they rarely extend those rotations to community clinics. So we required schools participating in the program to create contractual relationships with community clinics, and extend the time that students were engaged in these rotations.