Dental school curriculum is built around technical, procedure-focused training, but research suggests that focus can wear down students’ empathy.
The University of Iowa College of Dentistry in Iowa City is trying to change that by teaching empathy and patient-centered communication alongside clinical skills. Brendan Young, PhD, director of behavioral science and an associate professor in preventive and community dentistry at the dental school, teaches behavioral science courses throughout all four years of the program. Students learn through case analyses, standardized and peer patient encounters and simulations.
Dr. Young and Leonardo Marchini, DDS, professor and chair of the preventive and community dentistry department, recently joined the Becker’s Dental and DSO Review podcast to talk about the program. They explained how the college tracks whether graduates are becoming more empathetic, person-centered dentists as well as technically proficient ones.
Note: Responses have been lightly edited for clarity and length.
Question: How do you define success for this model, and what evidence would convince you that graduates are becoming more empathetic, person-centered clinicians?
Dr. Brendan Young: We always want to be evidence-based. One of the challenges is that you ultimately want your patients to give you feedback on how well you’re doing. But as patients, we often don’t want to give negative feedback to our dentists, because they hold so much power to help or harm us. We do get patient evaluations of our students in our dental clinics, and they’re shared with faculty and with the students. By and large, they’re really positive, and often they’re about how the student communicates.
We also have standardized patient evaluations. In a 2023 study I co-authored, we found that 81.7% of our third-year student evaluations were classified as excellent, with treatment planning a particular strength. We also found we needed to work on health history recording, so we’ve focused on that since. We also developed a typology of empathic communication strategies based on examples from our standardized patients.
Students also get daily or weekly faculty evaluations in our clinics, starting in their first year. More recently, I developed an AI chatbot that lets students practice their verbal communication skills and gives them feedback on how they did. And then there are the student self-reflections. I haven’t published on those yet, but I’ve graded them over the years, and students are surprisingly honest. They rarely give themselves perfect scores and always leave room for improvement, which is something we emphasize here.
Dr. Leonardo Marchini: In the geriatric and special needs clinic in our department, our fourth-year students see patients who need a lot of accommodations so they can be treated in an outpatient setting. These are patients with significant special healthcare needs and disabilities, including mental health conditions, dementia and intellectual disability. They can have challenging behaviors and attitudes. Our students handle them with a lot of compassion, empathy and care, in the most extreme circumstances you would see in a dental office.
For me, as a clinician teaching the next generation of the dental workforce, that’s the proof in the pudding. Everything Dr. Young has been doing over these years is having the final benefit we want to see, even when students’ empathy and compassion are tested in the most extreme situations.
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