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Inclusion, decolonising and dentistry

Bristol Dental School students

27 March 2024

A new study from the University of Bristol seeks to understand the barriers and facilitators of inclusion for dental students, ensuring that every new student, regardless of gender, ethnicity, religion or background, has access to the same opportunities and facilities.

Dr Nilu Ahmed, Senior Lecturer in Social Sciences at the University of Bristol’s Dental School, built on existing research she and her coresearchers have conducted on decolonising the Dental Curriculum, she explains: 

“My studies at the Dental School involve working closely with students to understand what decolonising and inclusion means for us. These are fundamental, but poorly understood challenges for academia, and at present there is little guidance available for health professionals. This study, building on my previous work, aimed to address this by building evidence-based recommendations.” 

Students and staff 

Using funds from the Elizabeth Blackwell Institute, Dr Ahmed was able to extend her research on decolonising to bring a wider focus on intersectionality. Student co-researchers first recruited twelve students from across all the year groups to a focus group, and seven key staff members were interviewed. In total, across the research Dr Ahmed and her colleagues thus interviewed 103 students and 43 members of staff regarding decolonisation and inclusion. 

“The students we spoke to highlighted a number of areas they felt were important areas of inclusion,” said Dr Ahmed. “They spoke about racism, Islamophobia and lack of a sense of safety. Students from lower socio-economic backgrounds discussed the disadvantages faced by students; the lack of representation among staff;  a lack of support for mental health and well-being issues within the School of Dentistry, and they spoke of a disconnect between students of different year groups – a lack of sense of belonging and connection.” 

Consultations 

How to address these issues was the next concern. While Dr Ahmed shared the findings with the School of Dentistry’s Dental Education Committee, the students were also consulted. 

“The students suggested a number of measures,” said Dr Ahmed. “Students felt that issues around racism needed to be handled better. They felt current systems were unsupportive. Some of this was down to the lack of representation of diversity among staff, meaning students felt even when they raised issues around racism and her exclusions they were dismissed. Staff should be instructed not to insist that new students need not buy expensive and unnecessary equipment, such as loupes - which can cost thousands of pounds - as has happened in the past. A guide should be created for new students which incorporates tips from existing students, and there should be a celebration that brings together the staff and all years of the dental school together,” said Dr Ahmed. 

Analysis 

A full data analysis of the data from the project (and its ‘decolonising the curriculum’ siblings) is still ongoing; a number of papers are in progress on inclusion and microaggressions as a result of these investigations. There are also plans for ‘building an inclusive curriculum’ publication, and a peer-reviewed paper with the co-researching students. Students in an all years focus group recalled that a Year One lecture by Dr Ahmed on cross-cultural communication where students shared cultural connections was one their favourite lectures for feeling connected with others. They asked for something similar to involve all year groups.  In October 2023,  an all school event was held to celebrate the Dental School community.  Over 120 people attended with food from different cultures, crafts, games and lots of connections across year groups being made. 

“Elizabeth Blackwell Institute funding was extremely useful. The study was vital in teasing out wider intersectional identities, and it played an important role in the wider work.

Students discussed how the school sometimes felt like it was a place that was designed for those who were wealthier, and from white privileged backgrounds – it was less encouraging for anyone from a poor background or with mental or physical health issues, who could become excluded. The outcomes of the study can hopefully improve the experience of studying at the Dental School, and will make for a more inclusive space for all”. 

Related work 

In addition to these aims of more inclusive educational spaces and practices, Dr Ahmed has undertaken research using decolonial research methods such as storytelling with communities to devise new representative vignettes and scenarios for training health care professionals. She has also worked with students and local community organisations to build partnerships for community engaged pedagogy. She says “with the drive for civic engagement and greater emphasis on community engaged pedagogy, there is the risk of undertaking this work in a way that can cause harm to students and communities. This research explored how we can do this safely. Community engagement must be done in a way that ensures safety. It is skilled work, and like decolonising, we should think carefully about who does the work and whether the right people are involved. Student and community engagment is key”.

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