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Representation in dental education – is it important?

by adminjay

Hassan Shariff discusses the importance of representation in dental education and how small changes can lead to a big difference.

To consider this, we need to be aware of the following definitions:

What is diversity? Go beyond the literal definition of diversity suggesting there are inherent differences within people, and we see that diversity is a concept we should aim for. It encompasses tolerance and respect by increasing awareness and recognition of each individual’s uniqueness.

What is implicit bias? The subconscious association of stereotypes with a group of people without having an active interaction with them.

What is equity? The ability to recognise that some individuals are disadvantaged in society, whether this be from systemic prejudices or oppression. Equality-based interventions which assist everyone in the same way will not benefit these individuals. They will require tailored/specific interventions to reach the same position in society as their non-disadvantaged counterparts.

What is representation? Here, we need to again go beyond the literal definition of representation meaning one is acting on behalf of another but consider representation as an equality-based concept.

Importance of representation

‘Equal representation’ considers those who are in a position to make change or influence a larger population. It advocates that these people share some of the attributes/characteristics of that population.

So, why is equal representation necessary? The UK population for decades has not consisted of one race, religion, or culture. Mid-2020 ONS data estimated the population to consist of 67.1 million people.

Census 2021 data is still being analysed prior to publication. But if we consider the 2011 data readily available for England and Wales, we can see at this point in time 7.5% of the population were from Asian ethnic groups and 3.3% were from black ethnic groups.

This is more than 6.1 million people. A large number, but still a minority when considering the majority identify as white British.

Without representation from black, Asian and minority ethnic (BAME) groups in senior positions, the majority of the population may base their thoughts on minorities using stereotypes from sources such as media outlets, resulting in racial bias.

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Helping minority groups

Therefore, in the educational setting, implementing diversity can increase tolerance/understanding in students for those different to them. This is essential in dentistry, where we are creating a workforce who engage with the wider and also general population.

If we can create a tolerant and welcoming environment, we improve both clinical and non-clinical patient outcomes, by allowing patients to be comfortable in their interactions/dialogues with us.

Let’s consider the impact that equal representation can bring to education.

Elevating others

By giving students from minority groups (such as the BAME or LGBTQIA+ population) access to educators who share a similar background to them we can:

  • Allow them to identify with their educators, preventing a feeling of exclusion and encouraging a sense of recognition. This can create a deeper engagement within educational settings, increasing the likelihood of academic success. For example, a sense of similarity may provide students with someone who is easier to access for emotional support
  • Increase the sympathy and empathy available to those from backgrounds of systemic prejudices and oppression. Evidence suggests those from BAME populations are more likely to be from a low-income background. This correlates with poor educational outcomes. A 2019 analysis of existing data suggested LGBTQIA+ students were also likely to present with poor educational outcomes in comparison to cis-gendered heterosexual pupils. Staff who are able to understand and identify those who are at a detriment, will be able implement additional interventions to increase academic success. Here, it is important to understand that an educator can become an ally simply by understanding where a student has come from. Importantly, the onus here is not to give more to those who are disadvantaged, but to aid them in reaching the same success of their counterparts; equity
  • Increase academic confidence by giving students the ability to see the results of academic success in those similar to them; whilst also demonstrating cultural preservation. Highlighting to students they do not need to erase their heritage to succeed, increasing the likelihood of minority students pursuing educator roles. In turn, this will allow diversity maintenance for the future. Remember, it is difficult to become what you cannot see
  • Allow staff members who come from backgrounds where systemic prejudice or oppression is prevalent to implement change at the policy level to benefit those who come after them. Here it is important to consider the difference between diversity and inclusion. Having a diverse workforce will not allow those from minority groups to flourish if staff members themselves are not made to feel equally as valued as their counterparts.

Simply hiring not enough

Senior individuals need to encourage diversity. We need to consider that simply hiring people from minority groups does not promote diversity entirely (this is not a checklist item that should be ticked off). An emphasis should be placed on hiring staff from these backgrounds who are adequately suited for the role.

The General Dental Council ‘registration statistical report’ noted in 2020 that 31% of registered dentists were from BAME groups. For dental care professionals (DCPs), the percentage dropped to eight.

If we loosely extrapolate this data to dental schools, we can consider a large majority of the teaching population are likely to be white British. This, from experience, is more so prevalent in DCP training schools in comparison to BDS providers.

Analysing data from the following dental institutions: Plymouth, Portsmouth, Bristol, King’s College London and Queen Mary University of London, there was no publicly available information on minority population percentages for staff.

In contrast, many universities across the country actively advertise how diverse their student population is. But as discussed beforehand, without diversity being apparent at senior levels/throughout an organisation, some students will inevitably feel excluded from their environment.

Small changes make a difference

Both diversity and inclusivity cannot be achieved overnight. But overtime educational establishments can utilise small changes to be impactful, these can include:

  • Continuing professional development courses for staff to ensure correct terminology is utilised and to prevent the use of stereotypes/unconscious racial bias
  • Ensuring advertisements for future staff welcome and encourage applications from minority populations; universities should be transparent if their current staff population is minimally diverse
  • The celebration of holidays and events significant to non-UK born nationals to prevent feelings of exclusion
  • Making sure teaching resources reflect the students within the classroom; we control the imagery we use
  • Where the staffing population is not diverse, staff should be aware of charities and support groups they can refer their students too
  • Institutions should also aim for a lifelong commitment to diversity. This will involve reviewing the effects of changes over time and considering both staff and student opinions.

Here is to a future where organisations have equality at their base, but also strive to build on these foundations in order to create an environment that is welcoming to all.

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