A Model to Enhance Dental Undergraduate Productivity in Teaching Hospitals

Objectives: A model developed by the Louisiana State University School of Dentistry (hereafter abbreviated as the Louisiana model) has shown that teaching private practice principles to senior dental students can dramatically raise their clinical productivity within one year. These principles include goal setting, teamwork enhancement, personnel evaluation and performance incentives. While the model has its problems, development of a similar model for use in Australia would be of immense public interest. This study aims to explore the feasibility of the Louisiana model and to develop a proposal for an Australian model that addresses specific needs in student professional education and delivery of services in student clinics. Methods: Stakeholders in the public and private dental health sectors were invited to participate in focus groups or individual interviews to discuss the Louisiana model. All interviews were audio-recorded for subsequent transcription and content analysis using N-VIVO, a program for qualitative data analysis. Results: 39 respondents were interviewed. Differences in opinion across sectors and individuals were noted. In general, public sector stakeholders were less accepting of the Louisiana model than their private sector counterparts. Controversial aspects included goal setting, performance incentives, and using nominal dollar values to assess productivity. The consensus was that four factors were essential in the assessment of productivity: Patient satisfaction, ethics, efficiency and quality. Conclusions: Patient satisfaction, ethics, efficiency and quality should be evaluated in combination to measure productivity. A new model is proposed: the PEEQ model, where PEEQ stands for “Patient-oriented, Ethical, Efficient, Quality” delivery of dental services. It aims to circumvent the shortcomings of the Louisiana model while preserving the desired outcome of enhancing student productivity. This study informs a proposal for an education program developed around the PEEQ model and an impact assessment protocol for evaluation of its effectiveness in its initial implementation in the teaching hospitals.