Assessing Dental Students' Knowledge, Attitudes, and Beliefs About Medicaid and Health Care Reform: A Mixed-Methods Study

The aim of this study was to conduct a needs assessment of Medicaid and health care reform education in the current dental curriculum of one U.S. dental school. A mixed-methods approach was employed using focus groups and surveys. Three focus groups with dental students (nine first-and second-year students, eight third-year students, and seven fourth-year students) and one focus group with six external oral health stakeholders were conducted in 2018 to explore participants' attitudes and beliefs about Medicaid and health care reform. The focus groups used a semi-structured guide, and transcripts were analyzed using thematic content analysis. Following the focus groups, all first-and fourth-year dental students were invited to participate in a survey assessing their general and dental-specific Medicaid knowledge and attitudes about Medicaid. In both methods, participants made suggestions for future curricular experiences involving Medicaid. Surveys were returned from 81 first-year students (96% response rate) and 72 fourth-year students (86% response rate), for an overall response rate of 93%. Participating students and stakeholders agreed that Medicaid is confusing and challenging to incorporate into private practice. All participants viewed programs sponsored by organized dentistry as venues to learn about oral health policy. Nearly all participants agreed that private practice mentorship, improved practice management, and more experiential opportunities in the predoctoral curriculum would be effective strategies to increase knowledge about Medicaid and health reform. According to the survey responses, Medicaid and health reform knowledge is poor and scarcely covered in the current curriculum, and only 39% of participating students planned to participate in Medicaid after graduation. These findings suggest that curricular improvements are needed to incorporate more engaging and experiential learning using external resources.