Objective: Analyze reflection essays written by one graduating class of students after an initial experience in a clinic for adults with special health care needs (SHCN) and intellectual and developmental disabilities, to draw insights from the patterns of observations expressed.
Methods: Essays were written by students from the University of Colorado School of Dental Medicine during the 2016-2017 academic year after completing a 1-day clinical experience treating this patient population. Readers identified 18 primary themes (PTs) previously identified in essays written during 2012-2013.
Results: The PT Complex communicating through third party was identified in 79.4% of essays. Least common were Frustrated patient could not understand (1.9%) and Frustrated patient could not talk (1.9%). Nine PTs were grouped to represent 3 component themes (CTs): CT1 Communication challenges, CT2 Behavioral challenge, and CT3 Altruistic responses. This grouping showed moderate internal reliability. A fourth, CT4 Emotional challenges, was rejected due to low internal reliability. CT1 was most frequently identified, followed by CT3 then CT2. Three PTs were chosen as indicative of desirable outcomes and were labeled outcome themes (OTs): OT1 Willing to see patients with SHCNs after graduation, OT2 Would like more Special Care Clinic (SCC) experiences in the future, and OT3 Looking forward to next SCC experience. Associations between CTs and OTs were not statistically significant, but provided useful insights.
Conclusion: Reflection essays indicate discussion of strategies to manage behavioral challenges and encouragement of altruistic feelings are both vital in orientation sessions. These topics may be critical to positive student perceptions of the experience.
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