Formative Evaluation of Dental Student Rotations Promoting Careers in Safety-Net and Community Health Center Settings

This evaluation examines the impact of a community-based dental education (CBDE) program in North Dakota on dental students' clinical competence, attitudes toward safety-net practice, and interest in serving underserved populations. It also evaluates the program's role in enhancing dental workforce recruitment and promoting healthcare access equity in the state.

A longitudinal formative evaluation was conducted from 2018 to 2024, analyzing data from 44 dental students completing rotations at three community health centers (CHCs). Evaluation data included clinical service reports, billing records, pre- and post-rotation surveys, and interviews. Quantitative data assessed clinical service delivery and changes in perceptions, while qualitative data explored students' experiences and practice intentions.

The program facilitated over 3000 patient encounters and generated $673,714 in Medicaid billing, addressing patient backlogs, and expanding access to care. Student interest in CHC practice rose from 25% pre-rotation to 71% post-rotation. Participants reported improved familiarity with safety-net operations, loan repayment programs, and interdisciplinary care. Reflective practices deepened understanding of social determinants of health and commitment to health equity. However, financial concerns remained a significant barrier to long-term safety-net practice.

CBDE programs in North Dakota prepare dental students to address oral health disparities and inspire interest in underserved practice in the state. These findings highlight the importance of integrating immersive, reflective CBDE experiences to develop an equity-driven workforce in North Dakota. Addressing financial barriers and standardizing CBDE models will be crucial for enhancing their impact on dental education and public health.