Changes in Dental Students' Attitudes About Treating Underserved Populations: A Longitudinal Study

The aim of this study was to assess changes in a group of dental students' feelings about, willingness to treat, and perceived responsibility in treating underserved populations as they progressed through their predoctoral education. A questionnaire was developed to assess the first- through fourth-year (D1-D4) students' attitudes about treating 13 underserved populations after graduation. Surveys were distributed from 2008 to 2014, resulting in longitudinal data from three graduating classes (D1 year: N=240; eligible D4 participants: N=221). A total of 132 students from the three classes (Class of 2012 N=41; 2013 N=46; 2014 N=45; adjusted response rate 60%) completed all surveys (D1-D4). The results showed that changes in students' feelings about treating and willingness to treat underserved populations were population-specific rather than universal. Compared to the D1 year, the students in later years anticipated feeling more negatively towards treating low-income, frail elderly, homebound, homeless, other ethnic groups, and non-English-speaking patients, while their feelings were more positive towards treating known drug users and HIV/AIDS populations. Across the four years, students' willingness to treat low-income, frail elderly, homebound, and non-English-speaking populations after graduation became more negative, while their willingness to treat medically complex populations, known drug users, and HIV/AIDS populations became more positive. The students also became less likely to strongly agree that it is their responsibility as dentists to treat underserved populations as they progressed through school. These respondents reported that clinical and faculty interactions had impacted their likelihood to treat underserved populations. These findings may point to specific types of interventions and faculty mentoring to bring about change.