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					Topic: Transcultural education in Dental schools


Abstract


       Transcultural means the independence and acceptance of the people all over the globe

(Dictionary: Transcultural, n.d).


       In this study, we will discuss the literature of cultural education capability in the

profession of health, most specifically, the dentistry, medicine, nursing and dental hygiene. We

will also converse with the methods of educational proficiency concepts, practices in clinical

performance by evaluating students and occupant knowledge. The barriers to emergent valuation

instruments are the foundation ability information regarding the modest agreement, the cultural

group stereotype performance and pursuit invalid philosophy.


       Educational institutes play important roles in developing the nature, attitudes and

behaviors of the students. The aims and objectives of these institutions are to provide a platform,

which can enhance the abilities of the students as well as can generate in them the

responsibilities to become dignified and moral citizens. In these days, the schools and colleges

represent multicultural nations under one roof. As they came from diverse nations, countries or

religions, their languages, classes and backgrounds are also different. However, it is the duty of

the educators to implement such educational programs that can face the challenges of the

emerging society and the developing world. Moreover, it is important to develop such strategies

that are deprived of any difference.


Also in the health sector, cultural differences demands that the organizers and educators should

develop such programs that are based on the beliefs and values that are different from their own.
Further, the need of the trans-cultural education and cultural competency are in practice in the

respective fields of healthcare, dentistry, nursing, etc Invalid source specified..


The purpose and aim of this report is to bring out the consequences of the transcultural education

in schools, more specifically, in the health care centre; dentistry. Stomatology one division is

dentistry, its studies the medicine branch which involved the oral cavity surgical and non

surgical treatment, maxillofacial area, anticipation, costing, conclusion along with their

structures and impact on human body. Teeth are the main beauty of human while smiling and

dentistry is considered for overall health. Dental surgery is the most common treatment in dental

diseases. Rotten or damaged teeth are filled with amalgam, composite or porcelain and

sometimes precious and non precious metals are also used.


The literature section of the report is consists of two parts. In the first part of the literature

review, it has been argued about the general concept or transcultural education and its

consequences. This section brings before us, several theories and models, which are important

for the development of the transcultural environment in the schools. Moreover, it also asserts that

the transcultural education and environment in schools and institutions aimed at helping students

to conduct their activities more effectively; without any discrimination.


We also explore that these institutions and schools prepare themselves to implement diversified

education system in order to explore an open minded approach. These institutions help to

generate, according to the Santrock, “education that values diversity and includes the

perspectives of variety of cultural groups on a regular basis” Invalid source specified..


The later part of the literature review, exhibits the transcultural education in dental schools, more

specifically, schools. We tried to find out the culture and behavior of the dental schools around
the globe. Further, the report also asserts the research finding of the research that was taken by

the Dolhun et al. The aim of this paper is to explore the role and motives of the dental schools.


The essentials poles of this paper are as under:


   What does the transcultural education mean?


   How does cultural competency work?


   What are the aims and objectives of the transcultural education and cultural competency?


   How cultural competency is established in developing dental programs?


After analyzing the transcultural values and cultural competency in the dental schools, the report

brings before us the research finding, which will be done through several polls and questionnaire.


Introduction


The word Transcultural can be defined as the combining element that can join two or more

things together at the same time whereas, the Transcultural education can be defined as the term

that can refer to the education of different cultures, without any partiality. The purpose of

Transcultural education is to establish an environment among students and educators to learn

new ways in terms of social, political, economic and cultural challenges around the world. The

main aim and motive of Transcultural education is to prepare students and educators according to

the different values and cultures.


The Transcultural education provides an opportunity to strengthen connections between people

of the world; to bring people closer. Through Transcultural education, people of different

cultures and nations will not only come on the same platform but will also discover new things
about religion, cultural values, race and class. It is an approach that brings different cultures

together. Teachers and students, except for learning about the different cultures from the

distance, can seek knowledge with people of different societies. Although, it is a new term, but

now it is commonly used and practiced in the field of nursing or education Invalid source

specified.


Now the study structure of dentistry is clearer, a good number of dentists will treat the patient of

different nations and society, whose native language is not English and their beliefs are different

in case of oral health. A dentist’s need to be cultural proficient for this transcultural education is

necessary. The demographic changes are recognizing from most medical schools. Some schools

implemented four years programs and many selected culturally oriented courses. They do

seminars and elective courses. (Study 4)


If we compare dentistry transcultural education and their professionalism, they are challenge

where diverse population services are concerned. It is important for the better result and

treatment for the patient viewpoint that it’s really helpful if dentist know the cultural differences

and their sensitivity towards their illness. To increase cultural proficiency of dentists various

programs were organized as a tool to improve the line of attack to decrease the failure attempts

towards patients and also reduce their cultural and rational health care relief in health disparities.

A dentist should treat the whole patient to overcome his illness for that purpose transcultural

education help. (Study 5)


If we compare the background of this health care provider cultural education then the

transcultural idea of education is not new. But we must say its popularity has increased in dental

disease and hygiene. Transcultural education helps to raise dentist appearance on health
disparities for the need of dental hygienists. During education many ethnic groups’ activities or

research is kept documented. After the research and transcultural education, studies describe the

average of tribal and cultural oriented patients have higher disease rates as compare to

nonminorities. (Study 2)


According to AYN Rand that the motive of the education is to enhance the mind and thinking

power of a student. It is necessary to teach him the ways of life by providing him the opportunity

to develop his mind in such a way that he can manage to live life and also to deal with the reality.

On the other hand, Bishop Creighton defines education as the purpose of the education is to

establish a thinking process in a man. Education enables a man to think and to ask questions to

seek knowledge about different things that are far away from him Invalid source specified.


Since the early 60s the need of cultural competency has been noticed among the researchers of

educations. The idea has become stronger in the past few years. More specifically, in the sermon

of the minority education it is getting more prominence due to the new ideas of multicultural

education and cultural diversity. Moreover, it has also been suggested that the Transcultural

education; apart from any cultural differences, plays an important role in removing the cultural

biases and differences


As the time passes, the world is emerging so does the problems and necessities. Internet,

telephones, televisions and media provide the opportunities to learn new things with one click. It

can be done from anywhere. In this new world, there is no boundary for education or for seeking

knowledge. People can examine and learn about different countries and can make them up to

date about the issues of any place. According to Pratt and Beaty, “the citizenship is extending

beyond the traditional boundaries of individual countries.”
The aims and duty of a teacher is to provide knowledge to students without any discrimination.

The Transcultural education also aims giving education with no difference. Its goal is to cater

students in the best possible way about the cultures, events and issues that underlie in the outer

world; away from them, and also to develop a sense of understanding about that world. It is a

fact that nature and attitudes cannot be changed, but it is also a fact that thinking can be changed

through education. Transcultural education appends a pathway of understanding multicultural

views and issues. Thorough Transcultural educational programs in schools enable children to

understand the values with an open mind, and adopted societies biases and differences


As a result of globalization, many countries are adjusting themselves in providing equal

opportunities as well as to the services of delivering better health care services to all. It is

important for them to mitigate themselves with the increasing number of immigrants. The

process of migration has promoted the intra and inter cosmopolitan communities. Due to this

reason, countries are compelled to avoid and remove the gap of poor or rich, black or white. It is

a fact that these differences and changes in the perspective of the countries create many problems

and challenges within the health sector The promotion of Transcultural education enables to

understand the differences as well as the similarities among people. Moreover, in the health care

sector, it will provide an opportunity to look beyond what is in front of the nurses, dentists,

researchers or practitioners.


Several approaches are adopted in promoting the cultural awareness and diversified approaches,

but still there are some failures in the field of “cultural proficiency”. The main reason for this is

that the health care services are now transferred from hospitals to communities. It is because of

the cultural differences. For example, in the United States of America and Canada, many dentists

are white and they prefer to work accruing to their group or communities. In order to remove
these differences, it is important to promote cultural proficiency among the individuals so that

they can create an environment which will be good for all


Although, travelling from one country to another is the basic right of human. It provides them an

opportunity to learn new things and new ways and to adopt the means that are suitable for them

as well as for their society. But if the immigrants are Dentists, they face several problems and

issues, in which race and religion issues are of the most importance. It is also worth mentioning

that with the growing population of the world, the dentists are not up to the mark or according to

the requirement of the developed countries. To cope up with this shortage it is necessary to allow

the students from all over the world. These promotions and activities would open gates of an

environment that can remove the cultural issues and undermine the delivery of quality health

care. With the proper infrastructure that can handle issues and problems more effectively, the

proper health care would be provided to those who are needy.


According to the World Health Report, published in 2006, “The growing international nature of

the health workforce related to the flows of migrants, relief workers and volunteers calls for

cooperative agreements to protect the rights and safety of workers and to enhance the adoption of

ethical recruitment practices” (Papadopoulos, n.d). The immigrant professionals, especially

Dentists, are the mean of exchanging culture and skills.


The importance of cultural competence has been felt during the past few years. It enables to

project the long-lasting health without inequality or differences among people in terms of

different races or norms. The cultural competence can be defined as the engagement of different

people on the same platform. The cultural competence is a set of values, which allows one to be:


   Aware of different cultures
   Seeking knowledge of different attitudes and behaviors around the world


   Developing skills that are cross-cultured


   Developing such attitudes that are appropriate for the cultural differences


   Adopting people as they are; without any discrimination or bias.


   Allowing people to work with more opportunities to grow and to work in diversified

    environment


Several means and methods are adopted to create an environment in the health care sector that

provides positive results. These models allow delivering an extraordinary service to the health

care sector. Moreover, these models and means are important to deal with the ever growing

challenges of the multicultural society.


The President, who is also the originator of Transcultural C.A.R.E. Associates, Cincinnati, Ohio,

Josepha Campinha-Bacote, presented her model of cultural competence, which is known as the

Process of Cultural Competence in the Delivery of Healthcare Services. According to her, the

Process of Cultural Competence in the Delivery of Healthcare Services, is a model that enables

the professionals to accomplished their work and goals with efficiency and with considerable

results. It is basically a proper process of becoming, culturally, competent, not being culturally

competent. Moreover, she asserts that this process model will allow the dental practitioners to

become more aware of the cultural norms, knowledge, skills and values


The cultural competent model is important for the healthcare sector in order to develop and

improve:
   The quality of services and results; research findings


   It will satisfy the cultural desires and knowledge


   Provide lifelong commitment


   Provide opportunities to develop equal and mutual benefits


   Motivate healthcare services for the care and commitment that is not biased (Campinha-

    Bacote, 2002).




                     Culturally Competent Model of Care (Campinha-Bacote, 2002)


Methods


PI which means the effects of a cross-cultural patient-instructor, did the program on transcultural

dental student’s attitudes, checks their abilities and to gives them challenge to check their ability

from the help of community trained patients. The students interviewed the patients PIs in two

rotations respectively one in junior and one in senior year. For each rotation dental students used

a demonstration pretest posttest design. After every rotation, the PIs possibilities of engaging,
diversity of thoughts and actions and versus were reported by students. The result of that rotation

was first cross cultural rotation was completed by seventy three students and second by eighty

two. Junior year rotation effect was greater as compare to second rotation. Positive evaluations

were reported from the students after the course. PIs are very creative and helpful for students

who are related to health professions. (Study 1)


During that PIs sessions dentist are aware that this session is for their transcultural education and

the patients are well trained to judge them and after every session to pass comments on every

students performance. Clinical interviews being conducted by students after the appointments.

They also know that during whole session they are being evaluated. This helps to increase the

student’s ability to correct and react according to aspect of patient’s case. After every session, a

detailed feedback from patient’s instructor given to student about their interview skills. This

detailed feedback contains the immediate and individualized performance of their interview

skills. It also gives detail about ascertainment information and interpersonal style related to that

case. They also discuss and point out the student’s weakness and they also give them the offer of

role play towards weakness. Students are also observed by audiovisual equipment of their

behavior science. After each revolving session, feed also provided to student during a briefing

meeting with PIs. (Study 1)


In order to get the clear picture of the research findings, this research is based upon the

qualitative and quantitative methodological approaches. These methods are used to enhance the

reasons and importance of Transcultural education. Furthermore, these methods are used to

identify the issues that are present in the healthcare sector.
The report is based on the examination of Transcultural education programs and processes as

well as the cultural competency in the dental schools.


The methods that are used for the qualitative methodology are the case study, observations and

interviews. Research also includes a method of quantitative approach i.e. survey. The methods,

that have been adopted, aim to find out whether the development in Transcultural education

enhances the behaviors, thinking process, and awareness aspects in students or if it makes no

differences.


For this purpose, 50 participants are chosen to take part in the proposed questionnaire. Moreover,

several people are approached to take part. These people belong to the different classes,

societies, religions and cultures. The survey will be conducted through different means and

methods in order to get proper and appropriate results. Internet, telephones, focus group

approach, observations and in-person methods will help a lot in concluding the findings.


The key targets of this research are as under:


   Schools


   Educators


   Courses or curriculum


   Student reactions


Result


The findings of this report are based upon the facts are research that we would discuss in the

literature review. As the literature review is the backbone of any report, the results can be
determined through the reviews of different studies and details that are being presented in the

review of the literature. In order to understand the results and findings let us summarize the key

essentials of the report. The main points that are illustrated from the research are as follows:


   The opinions of the students are mixed; some have positive attitude, some are negative and

    some of them responds equally


   It has been observed that many schools are not equipped with the cultural competency.


   The research brings before us the fact that the need of the Transcultural education in the

    dental schools is now being felt by the educators and practitioners.


   It has been noticed that several schools are adopting the cultural competency and

    Transcultural education as a tool to provide an open minded and diversified education system

    among the students.


   Many students are expected to respond positively about the need of the cultural competency

    and Transcultural education. However, it is to be tested.


   Many schools respond to the fact that the cultural competency is necessary for the more

    profound dental education.


   The Transcultural education provides an opportunity to strengthen connection between the

    different people of the world.


   The research proves that the Transcultural educational programs accelerate and encourage

    divergence in the dental schools.


   It enhances the level cultural competency significance.
Evaluation


As the world is changing, the approaches are also changing; the challenges of employing

educational programs that can facilitate the needs of the emerging world are also increasing. It is

necessary for the medical schools, to establish such programs that can appreciate the norms and

values of different students. Moreover, it is also important to provide platform to the student,

who belong to the different cultures, races, societies and religions which will be beneficial for

the students as well as for the institutions (White, 2003)


Cross-cultural has played an important position in the dental healthcare. It is due to the absence

of some important knowledge about the cultural differences and the lack of communication

between the patients and the dentists. The poor communication give way to the contradictory

affects to dental care services. It also affects the treatment and the satisfaction of patients. In

recent years, the need for the cultural competency is felt badly in the healthcare sector as well as

in other fields also. In order to overcome the discriminative attitude in healthcare sector,

implementation of new plans and strategies are practiced, to cater the broadening society. It has

also been observed that with the passage of time, the cultural competency in literature of the

healthcare is being established, in order to exclude cultural and social difference.


It has been noted that in recent times, the dental schools are adopting the means of cultural

competency and the Transcultural education for the betterment of knowledge and behaviors

among the students of the dental schools. Moreover, it is also interesting to point out that in the

survey of Hewlett, many students assured that they are ready to treat patients from diversified

cultures. The number of students that has been illustrated from the report is approx. 86%

(Gregorczyk & Bailit, 2008).
The study reports that many schools respond to the fact that the cultural competency is necessary

for more profound dental education. While some of them have projected the same culture to

produce the more profitable environment. The research asserts that there are the high percentages

of schools that are being associated with the Transcultural education system in the dental

education.


The opinions of students are mixed; some have positive attitude, some are negative and some

of them responds equal. But it is worth mentioning that the students with the positive attitudes

are more than the students that have mixed or negative responds. Further, the program is also

associated with the faculty members who are not biased in their opinions or style of teaching. It

is being noted that teachers teaches what they really are. It means that they are the

representatives of their own cultures. But with this program, the faculty members and

educators will provide a broader perspective of the cultural competency and Transcultural

values. Further, they will also be responsible to transfer in their students the significance of

cultural differences and norms. It is also worth mentioning that through this study clearly

illustrates the requirement of proper teacher training and students programs in terms of

diversity and cultural competency.


The aim of this study is to provide a platform to enhance and explore the role of culture and

ethnicity in the dental curriculum. High percentage of schools are agreed to establish much

programs that can improve the communication between the patients and the Dentists and also

help is maintaining the relationship between them (Rowland, Bean, & Casamassimo, 2006)


Discussion
The Census Bureau of United States compiled a report in which, it is mentioned that more than

8.6 million residents who are not English speaking and in these residents, there are several

graduates who are dentists and who worked with the challenges including growing population

and different cultures, etc. The Pew Health Professions Commission asserts that more than half

of the dentists’ practices are poor or not competent. Therefore, the University of California has

been striving to equip itself in order to deliver such strategies that are appropriate for the

cultural competency (Milto, 1998).


Sherling asserts truly the worst education that teaches self-denial is better than the best that

teaches everything else and not that. The concept of human civilization is too much complex and

does not lend itself to a precise definition. It will be readily conceded that one of its essential

elements is man’s constant endeavor for broadening his outlook and interest. Biologically, man

is a self-centered creature, anxious for the fulfillment of his physical; needs like rest, hunger,

mating and procreation, etc. But since man is a rational animal, his reasons teach him not to give

a free play to his animal instincts. Consequently, man has been endeavoring, through ages, to

sublimate his primitive instincts and learn to live in organized society and appreciate his rights

and duties therein.


In the U.S. dental schools, the literature of the dental education deliver information about the

“status, strategies, or guiding principles of cultural competency education”. With the diversified

cultures, U.S. healthcare centers are now determined to create an environment that is suitable for

all; without any differences in culture, and values. According to the reports of the Institute of

Medicine, the U.S. health care services are dealing, in a positive way, to cater the differences of

race, culture, and color.
The ever growing world, with many cultures and behaviors, expects that within the health care

services Dentists or practitioners should provide and develop knowledge and skills that are

useful for all without discrimination. It has been observed that in understanding the values and

cultures, cultural awareness plays an important role. By developing a sense of exploration, the

practitioners can move beyond the “ethnocentrism” which would be possible through

appreciation and acceptance of cultural differences. It is only possible when the practitioners

choose and follow the rules of Transcultural approach not only in their practices but also in

attitudes (Carpio & Majumdar, 1993)


The aim of cultural care is to provide equal opportunities to people without taking into account

their religion, race or color. Dentists are eager to provide attention and care to the families or

individuals of diverse cultures or with similarities. Although, we are living in different

communities, groups and countries; with no borders, we tackle diversified opinions and notions.

With the increasing number of notions and changing realities of human rights, health care

policies as well as the researches are affected. It is of great importance to develop such strategies

that will provide results appropriate for the diversified challenges and approaches. This can be

done in two ways; whether the practitioners or researchers adopt the methods of health care that

can be defined as the “one -size-fits-all”, which is a universal approach or they will try to create

and innovate some special approaches. However, it is important to notice that the approach

should address the needs and requirements of the pluralistic society. Moreover, it is the duty of

the researchers and practitioners to adopt the approaches that are Transcultural (Papadopoulos,

n.d)


Recommendation
http://journals.lww.com/lww-

medicalcare/Abstract/2005/04000/Cultural_Competence__A_Systematic_Review_of_Health.7.a

spx


To civilize the information policy, educational proficiency guidance shows secure, attitudes, and

skills in health professionals. The improvement in patient evidence the observation to treatment,

health outcomes is wanting in equality of services and cultural groups. This is very important for

future teaching and study the subject should be focused and what will be the effective outcomes.


The cultural competence training impacts patient satisfaction is good evidence, 3 of 3 studies of

beneficial effect demonstrated. The patient adherence is poor evidence in cultural competence

training; the beneficial effect study was demonstrated to evidence this study. But for the patient

health status outcomes no studies have been evaluated. The cost of cultural competence training

is poor evidence to determine, like 5 studies were included but estimates cost was zero.

				
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