Regional Initiatives in Dental Education (RIDE)

Description

Rural and underserved populations experience higher rates of dental caries and permanent tooth loss, often due to economic conditions and distances from dental providers. Although dental educators acknowledge that the reported benefits of community-based dental education (CBDE) — enhancing increase access to care, increasing clinical expertise, improving cultural competence, and fostering community engagement — can impact these disparities, only around 45% of dental schools have offered this curriculum.

To both leverage CBDE benefits and to increase the numbers of dentists serving the state's rural and underserved populations, in 2007, the University of Washington School of Dentistry (UWSOD) received state funding to begin their RIDE program, or Regional Initiatives in Dental Education.

Of the nearly 100 RIDE program graduates to date, about 81% are practicing in rural and underserved areas, with 71% specifically practicing in rural and underserved areas in Washington.

RIDE's primary location is in Spokane. There the program links to the health education structures of another state academic institution, Eastern Washington University (EWU) with its College of Health Sciences and Public Health. The RIDE program is equivalent to the general Seattle-based DDS program, with the same length and curriculum, employing a mix of distance learning modalities and on-site instruction by EWU and UW Spokane faculty. In this academic setting, RIDE students benefit from an ideal student-to-teacher ratio, interprofessional opportunities with UW School of Medicine and EWU Dental Hygiene students, and proximity to rural/underserved communities.

RIDE curriculum includes a four-week rotation in a community clinic in Eastern or Central Washington after the students' first year. In their final year — and usually in the same community health clinic as their four-week rotation — the students spend an extended five-month rotation where clinical and professional skills are refined under the mentorship of UW affiliate faculty, some of whom are RIDE alum.

In 2023, a decision was made to add rural health leadership training to the first year RIDE curriculum.

Since its official start in 2009, RIDE has proved a popular program as noted by its increasing number of applicants. To accommodate this interest and the state's persistent need for dentists, in 2024, the state legislature provided $2.5 million to help the program double its participants from 32 to 64, add a second year of training at the Spokane campus, and enable the building of a regional dental simulation center, all of which unifies the curriculum's preclinical simulation and classroom spaces into one new, state of-the-art facility. The Spokane regional training center will also support the future growth of the RIDE program and serve as a hub for oral health training in the region.

In addition to state support, the RIDE program has received other funding. A 2020 United States Department of Agriculture (USDA) award provided a $1 million grant for interactive video conferencing equipment for tele-dentistry expansion in six Washington counties' rural clinical sites, along with five Montana counties.

Other past financial assistance has come from multiple sources: a Health Resources and Services Administration's (HRSA) American Recovery and Reinvestment grant, the Washington State Department of Health, and in-kind resources from the other institutions.

RIDE partners and stakeholders also include area dental associations, Community Health Centers (CHCs), Indian Health Service (IHS) Hospitals, Federally Qualified Health Centers (FQHCs), rural private practices, and the Washington Area Health Education Center (AHEC).

In 2017, UWSOD RIDE program received the ADEAGies Foundation award for an academic dental institution's Outstanding Vision.

This video provides a visual overview of UWSOD's innovative RIDE program:

Services offered

In addition to the standard UWSOD curriculum, RIDE students receive two specially focused training rotations in the rural and underserved sites of Washington state. The first is the four-week Rural/Underserved Opportunities Program (RUOP) that follows the completion of the first-year studies. The second occurs in the two quarters following the students' final year studies. These experiences are supervised by UW faculty practicing at those sites, including previous RIDE alumni.

Results

During the RIDE community clinic rotations, students impact access to dental care. They assist with capacity demands, often seeing more patients than the standard dental curriculum requires. In these non-urban locations, they also help provide emergency dental care that decreases response time for patients with critical needs.

As of 2024:

• With about 80% of nearly 100 graduates in rural and underserved communities, 70% practice in the state's own rural and underserved areas
• RIDE students have provided over 55,000 hours of patient care in rural Washington

RIDE success now allows its academic leadership to consider further expansion. For example, RIDE leadership is currently working with Montana dental experts to explore program expansion with first year classes to be located at Montana State University in Bozeman.

Loan Repayment:

Some RIDE students might be eligible for loan repayment opportunities:

• National Health Service Corps
• Washington's State Loan Repayment Program
• Other loan repayment opportunities

These videos provide more information about the RIDE program:

• How a program at UW School of Dentistry is changing rural oral health access
• RIDE: Making a difference in dental education

See also this online magazine story:

• Washington Program Trains Dental Super-Generalists to Serve Rural Communities.The Rural Monitor. March, 2018.

Challenges

After a decade-plus of offering the RIDE program, most of the initial challenges have been resolved. However, some students might consider the following RIDE curriculum elements as challenges:

• Geographic separation from the larger dental school class during the first year and for part of the fourth year of dental school
• An accelerated timeline for completion of graduation requirements in order to spend the second half of of their final year of dental school in RIDE's focused rural clinical rotation.

Replication

Since RIDE was first envisioned in 2003, the UWSOD experts now consider the program to be a “cost-effective, scalable model for increasing the number of dentists trained to meet the needs of rural and underserved populations.”

For others interested in replication, first determine feasibility by assessing the following:

• Any specific or new alignment within a school's mission/vision to the train professionals to deliver care to rural and underserved populations
• Intended rural and underserved communities' unmet needs using workforce studies, population-based oral health surveys, and reports
• Administrative support of key personnel within the university and the dental school
• Potential opposition of other professional groups such as state and component dental associations, or within local communities, regional schools, community health centers, dental insurers, commissioner(s) of higher education, dental/dental hygiene, and other health professional schools
• Number of faculty – preferably from a variety of departments – who would be committed to the mission of training dentists to deliver care to rural and underserved populations
• Resource availability:
  • Faculty support, administrative staff, distance learning, and other local similar considerations
  • Regional educational and clinical infrastructure
  • Funding avenues
• Additionally, program planning might benefit the creation of an ideal student persona with:
  • An interest in providing care to underserved populations
  • Ability to manage an increased academic workload
  • Possess strong independent learning skills
  • Able to navigate logistical challenges associated with location changes

Once feasibility is determined, before ultimately presenting a program to a state legislative body or other major funder, the following elements are suggested:

• Clear project plan
• Clear budget requirements
• Achievement of needed internal academic approval

For, RIDE, these steps required two-plus years.

Contact Information

Sarah Kosnoff, RIDE Program Operations Manager, Office of Regional Affairs & RIDE
University of Washington School of Dentistry
206.543.0903
sarahv4@uw.edu