Introduction We will have one last class that will be a class debate focused on a Dental Mission Trip Case. The class will be divided into 8 groups and each group will be called to debate another group. Each member of the group must participate. Groups will meet prior to class and discuss their viewpoint and how they will present their side. No research is expected, I just want you to use the knowledge you already have to think about the people, issues and consequences surrounding the different scenarios. All students should read the entire case but you only need to argue you one Group Question during class. Participation in class will count as your final “assignment” (10 points). Each student following the debate class. Should upload your biggest ‘take-away” from the case to the discussion board. In answering your question, think about what has commonly been called Voluntourism. Is it more about checking a box on your dental school application, or even prestige, profit, or power rather than about the people in need, often the marginalized. Are we (people who go on these trips) taking advantage of the most vulnerable populations? Many think it should be more about leaving those we visit with sustainable tools and knowledge, showing solidarity and respect and not about stopping in for a day, and not returning again for a year…. or ever…. The Mission Trip Part 1 Stephanie, a second-year dental student is an excellent student earning primarily A’s and B’s in her didactic courses. She is well liked by her peers, is active in ASDA, is part of the executive board of the wellness subcommittee and is also very active in the community with oral health outreach and education. She did OK during her first year of pre-clinical coursework in the SLC but is really struggling this year. She is not developing the psychomotor hands skills she needs and may not pass her courses. This is very unusual for her and she is not handling it well. It is taking a toll on her emotional health and doesn’t know what to do. She is on the wellness committee! Her good friend Sam notices the change in her demeanor and tries to help. She suggests Steph chat with her advisor or another professor who has acted as her mentor and ask for extra help or even speak to an upperclassman for guidance. Steph is uncomfortable with drawing attention to herself and is self-conscious about her inferior hand skills. She is so afraid she won’t pass the course and even more afraid of treating patients in just a few short months as she transitions to the clinic. She doesn’t do anything she just keeps the stress bottled up inside herself. Stephanie overhears another peer sharing about how he has been doing volunteer work at the local mission clinic on the border for some time. Stephanie wonders if this might be a way to get over her fear of treating patients and improve her skills. It might also help lift her spirits and bring back her passion for dentistry which she seems to have lost due to all the stress. She thought more about it and realized these people have no one else to treat them so any help is better than nothing. Group 1: Should Stephanie Volunteer at the Mission? ARGUE YES & WHY Group 2: Should Stephanie Volunteer at the Mission? ARGUE NO & WHY The Mission Trip Part 2 Stephanie does go to the mission. As they arrived, she is excited and snaps off several pictures as the approached the town, and posts them to Instagram. When she arrives, she realizes that there are many more people than their five-member team can take care of in one day. Still – she snaps a few more pictures and posts saying #Arrived. The team unpacks the large van and reality sets in; she begins to realize that their limited supplies won’t last for all these patients. She takes a deep breath and says to herself “you can do this”. This was stress of a very different kind than what she was experiencing at dental school. These were real people who needed care. The two dentists, both faculty from her dental school, and two dental assistants set up stations to see patients and Stephanie begins to speak to each patient to determine their needs trying to prioritize their place in line based on pain level and treatment needs. She feels badly that is all she can do to help due to her lack of clinical skills, but realizes that she is making a difference. Once the scene appeared more under control, she draws the children together to educate them about oral health care. This was a strength – she had done this often back at school in her local community. She provides the children with toothpaste and toothbrushes that they brought along, trying to occupy them while their parents were being treated. Stephanie begins to remember why she chose dentistry as her profession. At one point, the dentist calls her over to assist as one of the dental assistants had to step away to manage an emergency and he was in the middle of a procedure. As time went on, the dental assistant did not return, so Stephanie remained working at chairside. After assisting with several extractions, the dentist allowed her to cut a simple preparation. It was scary but with the dentist’s encouragement it worked out fine. Her self-doubt began to fade away and she realized that this was what she was missing. She needed to be out in the community giving back and using the skills she was developing. She continued to work side-by-side with the dentist for the rest of the afternoon. Her confidence building with each patient she tended to. In answering the question below consider the following: Why do “we” justify a double standard and allow care by under- or un- qualified clinicians in underdeveloped countries that would never be allowed under normal circumstances to treat patients in the US just because we are serving vulnerable populations and say it’s better than nothing. Groups 3: Was it appropriate for Stephanie to provide direct patient care at the mission under the current circumstances? ARGUE YES & WHY …… Does it matter that she was working with a faculty member from the dental school? Group 4: Was it appropriate for Stephanie to provide direct patient care at the mission under the current circumstances? ARGUE NO & WHY…… Does it matter that she was working with a faculty member from the dental school? The Mission Trip Part 3 A week after returning from the Mission trip, Stephanie receives a letter requesting her presence at a meeting before the school's disciplinary board. The letter informs her that she should not be volunteering to do clinical work when she has not passed her second-year preclinical courses. Stephanie is confused. She had never heard of such a rule as she knew other friends who had volunteered. She searches the school’s policies and procedures and does not find any policy prohibiting clinical volunteering. She appears before the board. She argues that there is no school rule prohibiting this and asks for clarification. Stephanie says she has not done anything wrong, reinforcing that students do it all the time. If it's unethical, she argues the school should make a rule. In answering the question below consider this: Is this case about the faculty member responsibly training Stephanie or about Stephanie overstepping her clinical skills? When does a student becomes responsible for their own actions? Groups 5: Does Stephanie Have A Legitimate Argument? ARGUE YES & WHY Would you recommend the Dental School make as a policy change to assure the guidelines are clear in the future? Group 6: Does Stephanie Have A Legitimate Argument? ARGUE NO & WHY ……… Does is matter that she was working with a faculty from the dental school? What would you recommend for punishment? Mission Trip Conclusion Groups 7: Should schools, states, government, any authority …. provide policies to cover all circumstances that may be confronted in healthcare or at some point should students and healthcare providers take responsibility and be able to use their best judgement in making clinical and ethical decisions to protect and “do not harm”? Argue YES & Why? Group 8: Should schools, states, government, any authority …. provide policies to cover all circumstances that may be confronted in healthcare or at some point should students and healthcare providers take responsibility and be able to use their best judgement in making clinical and ethical decisions to protect and “do not harm”? Argue NO & Why?
