Educating Dental Hygienists to Meet Future Health Care Needs and Roles of the Profession.

1031 Across the United States, the role of the dental hygienist is evolving. As a result, the dental hygiene curriculum must expand from a traditional private practice focus to include other career pathways, such as providing direct access oral health care in alternative settings, practicing in interprofessional health care environments, being an educator, engaging in research, participating in public health efforts, working in corporate settings, being an entrepreneur, and serving in administrative positions.1 Direct access for dental hygienists to provide preventive dental care to vulnerable populations is now part of the practice act in 38 states.2 Settings specified in many of these state practice acts include hospitals, schools, Head Start programs, senior centers, group homes, migrant work facilities, correctional institutions, long-term care facilities, and many more. Dental hygiene graduates of the future must be prepared to work with medically complex populations and individuals with special needs and to demonstrate effective collaboration skills in interprofessional teams. However, it is not clear that dental hygiene education is preparing students for these roles. Over the past decade, the American Dental Education Association (ADEA) has issued numerous recommendations for change in allied dental education in documents such as the proceedings of the 2006 ADEA Summit on Allied Dental Education; the ADEA Guiding Principles for the Education of Oral Health Professionals in Emerging Workforce Models, approved by the 2011 ADEA House of Delegates; and the Competency Domains for Oral Health Professionals in Emerging Workforce Models recommended by the ADEA Council of Allied Dental Program Directors Task Force on Collaboration, Innovation, and Differentiation.3-5 Despite these recommendations, the 2016 Commission on Dental Accreditation (CODA) Accreditation Standards for Dental Hygiene Programs show few significant changes to support the needed evolution in dental hygiene education to prepare graduates for emerging workforce models and new roles in oral health care of the public.6 These CODA standards remain focused on the private practice role of the dental hygienist with prescriptive minimal clinical hours that typically occur in the controlled on-campus clinic for tracking of student patient care and program outcomes assessment. Competence in care of special needs patients remains limited to treatment planning in these standards, and utilization of extramural clinical sites has become increasingly challenging due to implementation of expectations for prior approval by CODA. CODA Standard 2 addresses the educational program; however, only one clause (2-16) relates to community health promotion and disease prevention. These omissions create a barrier for dental hygiene curricula to expand into less traditional practice settings and effectively educate students for emerging roles within the profession. In a continuing attempt to address these emerging dental hygiene roles, in 2013 the American Dental Hygienists’ Association (ADHA), in collaboration with the U.S. Department of Health and Human Services, brought together stakeholders to develop learning domains and curricula for a new approach to dental hygiene education to better prepare future graduates.7 Some of the additions to the more traditional domains of dental hygiene education include communication and collaboration with intraand interprofessional teams and preparation to integrate oral health into the broader health care system. These proposed new domains mirror those in the previous Competency Domains for Oral Health Professionals in Emerging Workforce Models.5 This issue of the Journal of Dental Education addresses some of the domains necessary to prepare graduates for the future of health care, with Guest Editorial