Abstract
BackgroundInverted classroom approaches and the use of vignettes have been suggested in health care education. The objective of this study was to use an educational vignette to discuss issues of stigma around substance use and mental disorders within undergraduate Doctor of Medicine in Dentistry (DMD) and Bachelor of Dental Science in Dental Hygiene (BDSc-DH) students at the University of British Columbia, Canada. Our research question was “how can an educational vignette, depicting a fictitious patient with a history of substance use and mental health disorders accessing dental care, promote an open dialogue about stigma?”MethodsAn educational vignette was developed based on individuals’ lived-experiences with a variety of substance use and/or mental health disorders. This vignette was used to generate in-class discussion involving all the DMD and BDSc-DH undergraduate students enrolled between 2015/16 and 2018/19 who attended a mandatory 2.5 h didactic session using an inverted classroom approach. Students were also encouraged to provide a post-class voluntary written reflection, between 200 and 300 words, around stigma. The authors took written field notes on students’ response to the vignette and used excerpts from students’ de-identified reflections to illustrate the impact of such an educational tool.ResultsA total of 323 DMD and BDSc-DH students attended the didactic sessions between 2015/16 and 2018/19, and 148 reflections were submitted over the same time period. The inverted classroom approached showed to be engaging and collaborative. The vignette promoted open dialogue and was determined to be a conducive tool to generate in-class discussion and reflection. Major themes from the textual data included ‘exploring power relations’ and ‘patient-centered care approach to counteract stigma’. The vignette also enabled the discussion of positive experiences characterized by empathy, reassurance and communication, although it might not have prompted all students to participate in class or in writing the reflections.ConclusionThe inverted classroom approach and the vignette seemed to be an effective way to facilitate dialogue and reflection for most students. This study highlighted the need to explore innovative ways in which to continuously prepare current and future oral health care providers to professionally address the needs of patients with a history of substance use and/or mental health disorders.
Highlights
Inverted classroom approaches and the use of vignettes have been suggested in health care education
Access to oral health care hinges upon the ability to afford the services [1, 2]. For those individuals with history of substance use and/or who suffer from mental health disorders, access to this care is further impacted by stigma they likely face by the providers and their staff [3, 4]
The class size of undergraduate dental students varies from 47 to 60 students, and the undergraduate dental hygiene varies from 23 to 26 students, depending on the academic year [19, 25, 32]. This 2.5-h didactic session employs an inverted classroom approach where students had a required prereading pertaining to the session’s content to be discussed in class, a brief introduction about the pathophysiology of addiction in general, a testimony from community members experiencing substance use and/or mental health disorders, small group discussion about the vignette followed by a wrap up conversation, and a post-session volunteer reflection (Table 1)
Summary
Inverted classroom approaches and the use of vignettes have been suggested in health care education. Individuals with substance use and/or mental health disorders are more likely to be stigmatized and discriminated against by the public at large [11] and by health providers in particular compared to their counterparts [3, 12, 13] Such stigma is manifested in a wide range of behaviours, from refusal of care [14], to unethical treatments and expressions of discomfort around patients [15] as experienced by those with HIV/AIDS [16], who are homeless [17], or who are of certain ethnicities [18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
