Community-Based Dental Education Research Articles

Community-based dental education in Iranian dental schools

BackgroundCommunity-based dental education (CBDE) has been an essential advancement in dental education in recent decades, enhancing it in many aspects. This study aimed to determine the characteristics and improvements of CBDE in dental schools in Iran.MethodsIn the present descriptive study, an electronic questionnaire, including 18 “yes/no”, “multiple choice”, and “short answer” questions about the nature and extent of CBDE and students’ experience in CBDE, was used. In early 2021, the questionnaires were mailed to the deans of all 43 dental schools in Iran under the supervision of the Council for Dental Education of the Iranian Ministry of Health and Medical Education. Reminder calls were made after 6 and 12 weeks. Dental schools that did not follow the CBDE program were excluded. The responses were analyzed descriptively.ResultsThirty-six dental schools completed the questionnaire (response rate: 84%). Seventeen schools (47%) reported having CBDE in their dental program. Sites lacking a well-equipped dental setting were the most used out of all extramural sites. The number of weeks dedicated to CBDE ranged between 1 and 20 (median: 4). The most common dental procedures practiced in extramural sites were pediatric dentistry (100%), restorative dentistry (71%), and dental examination (59%). The student-to-supervisor ratio in CBDE ranged between 3 and 15 (median: 5). In most schools (65%), the staff involved in directing CBDE were Community Oral Health PhDs.ConclusionsAn increasing number of Iranian dental schools have integrated CBDE into their undergraduate dental curriculum. The characteristics and extent of this educational strategy vary widely among dental schools. CBDE can be more effective by making positive changes in dental programs.

Student and clinical supervisor perceptions of community-based dental educational experiences: A scoping review.

This scoping review was conducted to map the breadth of experiences in community-based dental education (CBDE), as reported by students and clinical supervisors. This scoping review was conducted following the structured framework proposed by Arksey and O'Malley and adhering to PRISMA-SCR guidelines for scoping reviews. Applying specified eligibility criteria, a systematic search of four electronic databases (PubMed, Scopus, Embase, and Web of Science) was followed by data extraction and data synthesis of full-text articles. Research was conducted between June 2022 and September 2022. Sixteen articles were identified for the final full-text review. Utilizing a narrative thematic review, the following five domains emerged: preparation for autonomous practice, understanding of primary care dentistry, understanding of health disparities and patient needs, clinical confidence, clinical diversity, and skill development, and perspectives on quality of teaching and assessment. Community/outreach dental education effectively supplements traditional dental school-based education from the perspectives of students and community-based clinical supervisors.

'The dental nurse played a vital role in helping to manage the patient': a thematic analysis of undergraduate dental students' reflective journals from outreach placements.

Introduction Community-based dental education, or 'outreach', forms a key part of dental courses in some high-income countries. Its educational benefits are well-established and once graduated, participants feel better prepared for their early career. Yet, it is less clear what students actually learn while on placements.Materials and method Qualitative document and thematic analysis of a convenience sample of anonymised dental student reflective journals (n = 51).Results The reflective journals described varied and broadly positive learning experiences. Analysis identified a number of themes of learning. Most related to the process and outcomes of care, but two key themes - dental anxiety and teamworking - were interrelated with both. Within teamworking, dental nurses appeared important in students' learning. Three process interrelated themes of learning were identified in the data. These were: tailoring your approach; communication and time; and evidence-based dentistry and minimising risk. Two broad interrelated themes relating to outcomes for patients and students were also identified: trust and confidence; and professionalism and personal development.Conclusion This research identified important and potentially transformative learning from outreach placements. This included how dental anxiety impacts patients and the dental team, the importance of teamworking, and the role of dental nurses in students' experiential learning.

Foreign-trained dentists' reflections on access to care after participating in a community-based dental education curriculum.

Many people suffer poor oral health due to dentists not providing care to them. The number of foreign-trained dentists in the US is increasing, yet little is known about their involvement in providing care to underserved populations. Dental education programs use community-based dental education (CBDE) to expose dental students to access to care issues, and encourage them to provide care to underserved populations upon graduation. The aim of this study was to assess foreign-trained dentists' attitudes about access to care issues after completing a CBDE course at a dental school in the Midwest. Fifty-two dentists participated in the CBDE program from 2018 to 2019, as part of an advanced standing curriculum, and completed guided, reflective essays. Forty-seven dentists agreed to have their essays anonymously coded for research. Four researchers reviewed the essays independently, developed a coding scheme, and recoded to agreement. The main themes dentists mentioned were the affect of the CBDE program on enhancing their clinical skills, fostering an awareness of healthcare system inadequacies, as well as an awareness of how specific social determinants limit access to care, and helping to encourage a sense of personal and professional responsibility to address access to care issues. This study highlights the value of CBDE on helping future dental providers learn about and reflect on access to care issues. It also provides insight into foreign-trained dentists' attitudes about access to care issues, and supports their participation in CBDE programs to foster their contributions in addressing access to care issues in the US.

Financial assessment of the community-based dental education program at the Indiana University School of Dentistry.

There is a gap in access to oral health services for millions of Americans residing in health professional shortage areas. The community-based dental education program at the Indiana University School of Dentistry is an innovative model that aims to improve access to oral health services in rural underserved Indiana. With this study, our goal was to assess the financial implications of the program over a period of 3 years (2018-2021). Proxy estimates for the revenue generated by students at the community clinic sites were calculated and compared against the implementation costs of the program as well as revenue lost by the school during the rotation period. Descriptive statistics were used to assess the quantitative impact of the program over the 3 years. The total of 7460 patients who were offered care as part of this program were mostly from the uninsured group or were covered under Medicaid. According to our cost-benefit analysis which was conducted during the peak of the coronavirus disease 2019 (COVID-19) pandemic, the total revenue of $1,777,097 was generated by students at the community sites through the 3-year period. The revenue generated was still more than the dollar amount invested in running the program, given the timeline of the study was when elective services were mostly suspended. We conclude community programs like these have an impact beyond the dollar value; they can be modeled to be cost-effective, improve access to oral health services for millions of Americans in underserved settings and at the same time provide a great learning experience for dental students.

Community dental health coordinators' role in community-based pediatric dental education.

The University of Alabama at Birmingham (UAB) School of Dentistry utilized a Community Dental Health Coordinator (CDHC) to transform a community-based dental education rotation into a positive learning experience for senior dental students. Based in a county health department's Women, Infant, and Children's (WIC) clinic and dental clinic, the initial rotation before implementation of the CDHC was received poorly by students and community partners. This paper reports how CDHC involvement improved student experiences with pediatric patients. In 2018, the CDHC embedded in the WIC clinic where student rotations occur and developed relationships with the community partners to identify key issues. The CDHC then implemented qualitative improvements, including a restructured workflow, preparatory educational modules, and assessment systems to address the issues. Student performance reports, focus group discussions, and a postgraduation questionnaire provided data for evaluation of performance. By year 3, dental appointments for patients under age 6 increased, resulting in 95% of UAB students seeing this age patient; 74% completed four or more. Three-quarters of students reported performing restorative procedures on children. Student and community partner acceptance of the rotation also improved. Postgraduation questionnaires (32% response rate) indicate 35% of graduates continue to treat Medicaid patients after graduation. The CDHC's unique skills in community relationship-building, community-based dental screenings, and pediatric dental care coordination produced measurable improvements in community participation and student clinical experiences. The CDHC can be a vital part of dental education, especially in community education settings. Community-based dental education generated measurable improvements in students' clinical experiences.

Students’ viewpoints on a community-based dental education course in an Iranian faculty of dentistry: A conventional content analysis study

Background : Community-based dental education helps nurture a generation of dentists who pay more attention to community needs. The purpose of this qualitative study was to explore the viewpoints of dental students about a community-based dentistry course conducted at the Dental School of the Kurdistan University of Medical Sciences in Sanandaj. Methods: In all, 36 senior dentistry students provided children aged 6 to 14 from an underprivileged background with care and preventive services under the indirect supervision of a dental instructor. At the end of the course in May 2018, individual and group interviews were conducted to obtain students’ viewpoints on the course. The collected data was categorized and analyzed using MAXQDA 10. Testing of acceptability, dependability, stability, verifiability, fittingness and transferability criteria were applied to evaluate the accuracy and reliability of the qualitative data. Results: The results were categorized into two main themes: weaknesses and strengths of the clinical experience. Four main categories of the course’s strengths were identified: personal development, deeper understanding of oral health in the community, becoming familiar with executive and managerial systems, and payment and financial issues. Three main categories of the course’s weaknesses were identified: executive problems, issues around coordination and planning, and limiting coverage of the dental services provided to Levels I and II. Conclusion: The most important aspects of these courses from the students’ viewpoints were providing the opportunity to individual and professional development and gaining a broader perspective on preventive dentistry.

Preparedness of dental under-graduate students towards practicing endodontics in rural and remote areas of India.

Background:Undergraduate students can provide valuable opinions and suggestions for modifying the educational program for the enhancement of learning. Therefore, the aim of this study was to explore the preparedness of undergraduate dental students with regard to practice endodontics in the rural and remote areas of India.Materials and Methods:The present cross-sectional questionnaire-based study was conducted among dental undergraduates (interns). The survey was conducted among the students of 3 private dental colleges. For the data collection, a close-ended questionnaire was designed to test the knowledge for performing endodontic therapy, root canal therapy (RCT), attitude, and behavior of performing these procedures in the rural set-ups. Unpaired t test and one way analysis of variance (ANOVA) was used to compare the significant difference based on demographics and Pearson's correlation was applied to find the associations among knowledge, attitude, and behavior of study participants. The level of significance was set at below 0.05.Results:A total of 79 students participated, out of which 22 respondents were males (27.8%), and 57 were females (72.15%). Overall mean knowledge scores for endodontics was 9.72 ± 2.19, and the scores of female students were slightly higher than males, whereas the attitude and behavior were better in males but there was no statistical significant difference between both the genders (P > 0.05). A statistically significant positive correlation was observed between attitude and behavior on practicing endodontics in rural settings among study subjects (P < 0.05).Conclusion:These findings highlights the necessity for taking initiatives to enhance the community-based dental education programs by various dental colleges for improving oral health care access for rural and isolated populations.

Dental Students' Non-Clinical Learning During Community-Based Experiences: A Survey of U.S. Dental Schools.

Dental schools use community-based dental education (CBDE) to ensure students gain experience in treating diverse and underserved patient populations. However, it is unclear to what extent schools utilize CBDE experiences to increase students' knowledge of structural factors impacting access to care. The aim of this study was to determine the level and types of non- clinical learning included in CBDE experiences and how that learning is being assessed across U.S. dental schools. This cross- sectional analysis used an 18-item questionnaire distributed to associate deans and CBDE directors at all 66 U.S. dental schools. The questions focused on rotation structure, CBDE objectives, and didactic content for CBDE programs. Representatives from 31 schools-public (71%) and private (29%)-responded, for a 44% response rate. The primary objectives for the community-based rotations were reported to be demonstrating cultural competence in diverse clinical settings (93.1%), addressing access to care (86.2%), and diagnosing and treating oral diseases (75.9%). Of the respondents, 73% reported that their schools supported clinical experiences with non-clinical didactic course work, which addressed access to care (95%), professional responsibility (91%), social determinants of health (86%), the U.S. health care system (77%), health policy (73%), practice management (73%), motivational interviewing (50%), and public presentation training (32%). The results suggest that U.S. dental schools are using CBDE rotations to provide didactic content and assessing students on their knowledge of access to care, social determinants of health, interprofessional practice, and oral health policy. These important aspects of students' education provide additional evidence of the value of CBDE in dental education.

Dental Students' Intent to Practice in Rural Communities Before and After Community-Based Rotations in a Rural Area.

Community-based dental education (CBDE) has the potential to positively impact the educational process in a manner that both contributes to educational outcomes and shapes the learner's behavior. The aim of this study was to determine the correlation between dental students' intended practice location and the size of their hometown and to assess any impact their CBDE rotation in a rural location had on practice location intention. From March 7, 2016, to August 12, 2018, fourth-year students at one U.S. dental school were invited to complete a ten-item questionnaire prior to and after their four-week clinical rotations at a rural clinic. Of the 123 dental students on rotation at the clinic during this time, 106 completed the pre-rotation survey and 112 the post-rotation survey, for response rates of 86% and 91%, respectively. Prior to the rotation, 58.6% selected one of the rural locations as an ideal practice location, and that percentage increased slightly to 61.4% after the rotation; the difference was not statistically significant (p=0.984). The results did show a significant increase from pre to post rotation for women intending to practice in rural communities (p=0.0413). This study found that students' intent to practice in a rural location was not significantly affected by a clinical rotation in a rural clinic; however, there was strong evidence that students from rural communities intended to practice in rural communities after graduation.

Influence of Community-Based Dental Education on Practice Choice: Preliminary Data from East Carolina University.

Maldistribution of the dental workforce contributes to poor access to oral health care. Community-based dental education (CBDE) may help to address this problem by using experiential learning to encourage new dentists to practice in underserved areas. The East Carolina University School of Dental Medicine (East Carolina University SoDM) employs a multifaceted strategy, including CBDE, to increase the number of dentists practicing in underserved areas of North Carolina. The aim of this study was to assess the influence of CBDE and other factors on practice choice among East Carolina University SoDM graduates. This cross-sectional study assessed practice intentions before and after a senior-year CBDE experience. Data were obtained for students in three graduating years from written student reflections and self-reported practice plans solicited at graduation. Of the total 156 students between 2015 and 2017 (52 each year), all students participated in at least one component of this evaluation: all students (100%) completed required student reflections, and 148 (95%) provided pre-graduation practice plans. Data were also obtained on alumni practice characteristics via a survey of recent graduates; 72 alumni (46% response rate) participated in the alumni survey. The assessments found positive attitudes towards the CBDE program before and after participation, although areas for improvement relating to business management and financial viability were reported. The majority of alumni respondents (67%) remained in the state to practice after graduation, with half reporting practicing in rural areas. For most alumni respondents (>75%), debt, salary, benefits, type of patient population, and desire to own/run a business were important factors other than the CBDE program influencing their practice choice. Nearly half of them (45.8%) rated desire to work in a public health setting as an important factor. This study provides preliminary evidence of the effectiveness of this educational model in retaining new dentists within the state to address the critical shortage of dentists in North Carolina.

Benefits and Challenges of Partner Site Engagement with Community-Based Dental Education Programs: The Partner Sites' Perspectives.

The aim of this qualitative study was to examine the perspectives of key personnel at partner sites providing community learning experiences to dental students to gain more understanding of the effects that community-based programs have on the sites themselves. Fourteen semi-structured interviews were conducted in 2015 with individuals from nine extramural sites. Interviewees had a range of roles from clinicians to CEOs, with six also reporting they were faculty preceptors. Three of the researchers developed a coding scheme focused on the benefits and challenges that community sites experience from participating in a community-based dental education (CBDE) program. Each coder then reviewed the interview transcripts independently before final group discussions and recoding to agreement. The main themes related to benefits were recruiting future dentists, staying current with clinical developments, sites' indirectly improving their missions by exposing students to broader roles of oral health providers, raising awareness regarding the need for dentistry in community settings, and nurturing a positive workplace environment. The main themes related to challenges were balancing education and training for students with clinical demands, communication with the university, and managing distinctive clinical and professional characteristics of students. This study's participants reported that the main benefit of CBDE for partner sites was dentist recruitment. The study also provided insights for both partner sites and dental schools to consider when developing and maintaining these partnerships.

Assessing Dental Students' Readiness to Treat Populations That Are Underserved: A Scoping Review.

In North America, all dental schools have adopted some form of community-based dental education (CBDE) or service-learning, but little is known about the areas being researched and reported in published studies. The aim of this study was to conduct a scoping review to determine what areas of research had been conducted to determine the effects of CBDE on dental students' readiness to treat populations that are underserved. A systematic search of articles published in English or French since 2000 was performed on July 29, 2015, and combined quantitative and qualitative synthesis of data was conducted. Of the 32 studies evaluated, 23 (72%) were quantitative, seven (22%) were qualitative, and two were multi-method. The majority (66%) used self-report methods, most frequently surveys. Participants in 50% of the studies were fourth-year dental students; the others assessed third- and fourth-year (13%), first- and second-year (6%), and first-year (13%) students. Dentists were the participants in three studies (9%), with dentists and students in one study (3%). Either the types of populations receiving care were unspecified or four or more groups were pooled together in 25 studies (78%), while two focused on children, one on rural populations, one on elderly populations, two on persons with special health care needs, and one on low-income populations. The study areas were wide-ranging, but generally fell into three categories: student performance (37.5%), teaching approaches and evaluation methods (37.5%), and perceptions of CBDE (25%). This review identified many research gaps for determining whether students are prepared to treat populations that are underserved. The disparate nature of CBDE research demonstrates a compelling argument for determining elements that define student readiness to care for patients who are underserved and for research that includes the voices of patients, curriculum development, and more comprehensive and rigorous evaluation methodologies.

Care Provided by Students in Community-Based Dental Education: Helping Meet Oral Health Needs in Underserved Communities.

Since 2000, reports have documented the challenges faced by many Americans in receiving oral health care and the consequences of inadequate care such as high levels of dental caries among many U.S. children. To help address this problem, many dental schools now include community-based dental education (CBDE) in their curricula, placing students in extramural clinics where they provide care in underserved communities. CBDE is intended to both broaden the education of future oral health professionals and expand care for patients in community clinics. The aim of this study was to develop a three-year profile of the patients seen and the care provided by students at extramural clinics associated with one U.S. dental school. Three student cohorts participated in the rotations: final-year students in the Doctor of Dental Surgery, Bachelor of Science in Dental Hygiene, and Master of Dental Therapy programs. The study was a retrospective analysis of data retrieved from the school's database for three consecutive academic years. The data included patients' demographics and special health care needs status (based on information collected by students from their patients) and procedures students performed while on rotations. For the three-year period, the results showed a total of 43,128 patients were treated by 418 student providers. Approximately 25% of all encounters were with pediatric patients. Students completed 5,908 child prophylaxis, 5,386 topical fluoride varnish, and 7,678 sealant procedures on pediatric patients. Annually, 7% of the total patients treated had special health care needs. The results show that these students in CBDE rotations provided a substantial amount of oral health care at extramural sites and gained additional experience in caring for a diverse population of patients and performing a wide range of procedures.

Impact of Community-Based Clinical Training on Dental Students' Confidence in Treating Pediatric Patients.

With a significant need for more general dentists to provide care for pediatric patients, previous studies have found that community-based clinical training experience with children increased dental students' willingness to provide care to pediatric patients after graduation. The aim of our study was to determine the impact of community-based clinical training with pediatric patients on dental students' self-perceived confidence in treating pediatric patients, both overall and related to specific procedures. Of the total 105 fourth-year dental students at one U.S. dental school invited to participate in the study in academic year 2011-12, 76 completed the survey about their community-based dental education (CBDE), for a 72% response rate. Over half of the respondents (55%) reported feeling more confident in treating pediatric patients after their rotations. The increase in confidence was not associated with demographics. The placement of sealants (p=0.0022) and experience in giving local anesthesia (p=0.0008) were the two procedures most strongly associated with the increase in confidence. Also, these students received more experience in pulp therapy, extractions, and treating children up to three years of age during their community-based rotations than in the school-based clinic. In this study, greater exposure to pediatric dental clinical experiences during CBDE increased the students' confidence in treating pediatric patients. These results suggest that community-based experiences are useful in supplementing the school-based pediatric clinical experience, including increasing entry-level dentists' confidence in treating pediatric patients.

A Reflection Curriculum for Longitudinal Community-Based Clinical Experiences: Impact on Student Perceptions of the Safety Net.

Community-based dental education (CBDE) allows dental students to be immersed in community settings and provide care to populations that are underserved. Exposure to those groups during training may impact provider attitudes, which may be strengthened by supporting students' reflection and exploration of their own attitudes. The aim of this study was to describe the implementation and preliminary results of a pilot longitudinal reflection curriculum integrated into a community-based clinical experience (CBCE) for senior dental students at one U.S. dental school and to report the impact of the reflection curriculum and CBCE on student experiences with populations that are underserved. In academic year 2015-16, all 35 senior dental students at one U.S. dental school were invited to complete an 11-item survey before and after completing a 12-week CBCE with integrated, longitudinal online reflections. Students received feedback from a faculty member after each reflection. All 35 students completed the survey, for a 100% response rate. After the CBCE, the students reported improved clinical efficiency and increased confidence in treatment planning and in treating dental emergencies and dentally anxious patients. They also reported improved understanding of the structure and relevance of community health centers, the role of different health care team members, and the impact of health policy. There was no significant difference in future plans to work with groups that are underserved. These results suggest that the CBCE and reflection curriculum had a positive impact on the students' clinical confidence as well as expanding their understanding of the broader oral health care delivery system. To address persistent oral health disparities, dental schools should continue to adopt CBDE programming that will prepare providers to effectively care for populations that are underserved.

The perceptions of dental practitioners of their role as clinical teachers in a UK outreach dental clinic.

Community-based dental education supports the General Dental Council learning outcomes by enabling integrated clinical practice in a primary care setting. There is little available research to identify any additional demands on the outreach clinical teacher. A case study using mixed methods, including interviews, was used to identify the supposed skills and attributes required and the individuals' perception of their preparedness for their teaching role. An online questionnaire survey of student and staff groups (N = 474) was analysed and the results informed a topic guide used in semi-structured interviews of outreach clinical teachers (N = 8). The in-depth interviews were transcribed and analysed thematically. The most desirable skills and attributes of best clinical teachers were perceived to be clinical competence, being current and able to provide clinical demonstration of procedures and to serve as a positive role model. In addition, attributes of being very experienced clinicians and providers of a safe learning environment were expressed as being particularly important to the outreach clinicians, of whom the majority felt somewhat isolated and ill-prepared for their teaching role. Outreach clinicians perceive benefit from integration with the main dental hospital site and of specific induction to their teaching role.

Community‐Based Dental Education Models: An Analysis of Current Practices at U.S. Dental Schools

Community-based dental education (CBDE) enhances students' clinical expertise, improves their cultural competence, increases access to care, and fosters community engagement. As emphasis on CBDE has increased over the last decades, the aim of this survey study was to determine how CBDE is currently being implemented in U.S. dental schools. The study used a 20-item, author-designed survey emailed in April to August 2015 to 60 of the 65 U.S. dental schools, excluding those that had been recently established. Of the 60 schools, representatives of 33 responded, resulting in a 55% response rate: 70% public and 30% private. These respondents reported that the extramural sites being used the most were community clinics (90.9%), Federally Qualified Health Clinics (66.7%), public health clinics (54.5%), and Indian Health Service clinics (42.4%). The majority of responding schools (63.6%) had ten or more sites available for rotations, and the rotation lengths were 1-2 weeks (29%), 2-4 weeks (25%), 4-6 weeks (29%), 6-8 weeks (3.2%), and 8-10 weeks (12.9%). Most of the respondents (78.8%) reported that their students were unable to be assessed for clinical competencies at external clinical sites, but roughly half allowed students to receive clinical credit. After students completed their rotations, the majority of the respondents (81.8%) reported that students were required to produce a reflection, and 87.9% reported that students completed a post-rotation survey. Considering the benefits of CBDE for students' education and for improving access to oral health care, it is encouraging that over 45% of the responding schools required their students to spend four weeks or longer on external rotations.

Psychometric Evaluation of a 13‐Point Measure of Students’ Overall Competence in Community‐Based Dental Education Programs

Since 2006, the University of Michigan School of Dentistry has used a 13-point measure of overall competence instrument to assess fourth-year dental students' end-rotation performance at community clinics. The aim of this study was to assess the reliability and validity of this instrument used by preceptors to rate students' overall competence during community-based dental education experiences. The measure was analyzed using performance ratings for all fourth-year DDS students in the graduating classes of 2012 and 2013 (combined n=201). The results were that interrater agreement was satisfactory and the measure scored high for internal consistency; also, the measure loaded highly on a single overall competence factor. Ratings on this measure did not correlate with students' final cumulative dental school GPA, but showed a significant positive correlation with their fourth-year fall patient management grades (which signify students' conscientiousness in managing patients and their families in a professional and ethical manner). There were differences in grading systems between the 2012 cohort (which used a pass/fail system) and the 2013 cohort (which used a letter grade system) and the mean ratings they received (higher for the 2013 cohort). Overall, the study found that the 13-point measure demonstrated excellent reliability and validity, suggesting it is useful in determining a student's clinical competence in these settings.

Impact of Community‐Based Dental Education on Attainment of ADEA Competencies: Students’ Self‐Ratings

Fourth-year dental students at the College of Dentistry, University of Nebraska Medical Center participate in a community-based dental education (CBDE) program that includes a four-week rotation in rural dental practices and community health clinics across Nebraska and nearby states. The aim of this study was to assess the impact of participation in the CBDE program on the self-rated competencies of these students. A retrospective survey was administered to students who participated in extramural rotations in two academic years. The survey collected demographic data and asked students to rate themselves on a scale from 1=not competent at all to 5=very competent on attainment of the American Dental Education Association (ADEA) Competencies for the New General Dentist for before and after the rotations. A total of 92 responses were obtained: 43 students for 2011-12 and 49 students for 2012-13 (95% response rate for each cohort). The results showed that the students' mean pre-program self-ratings ranged from 3.28 for the competency domain of Practice Management and Informatics to 3.93 for Professionalism. Their mean post-program self-ratings ranged from 3.76 for Practice Management and Informatics to 4.31 for Professionalism. The students showed a statistically significant increase in self-ratings for all six competency domains. The increase was greatest in the domain of Critical Thinking and least in Communication and Interpersonal Skills. Overall, these results suggest that the CBDE program was effective in improving the students' self-perceptions of competence in all six domains and support the idea that a competency-based evaluation of CBDE programs can provide valuable information to dental educators about program effectiveness.