Issues Associated with Developing a Dental Hygiene Baccalaureate Completion Program in Florida

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Title:
Issues Associated with Developing a Dental Hygiene Baccalaureate Completion Program in Florida
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1 online resource (80 p.)
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english
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Smith,Rebecca
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University of Florida
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Gainesville, Fla.
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Degree:
Doctorate ( Ed.D.)
Degree Grantor:
University of Florida
Degree Disciplines:
Higher Education Administration, Human Development and Organizational Studies in Education
Committee Chair:
Honeyman, David S
Committee Members:
Campbell, Dale F
Eldridge, Linda
Repetto, Jeanne

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Subjects / Keywords:
baccalaureate -- dental -- dentistry -- education -- educator -- entry -- florida -- hygiene
Human Development and Organizational Studies in Education -- Dissertations, Academic -- UF
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Higher Education Administration thesis, Ed.D.
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theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
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Electronic Thesis or Dissertation

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Abstract:
The American Dental Hygienists' Association (ADHA) and the American Dental Education Association (ADEA) supported the notion that the baccalaureate degree should be the entry-level degree for the dental hygiene profession. There was also clear evidence that there was a national shortage of baccalaureate-earned-minimum dental hygiene educators. Fourteen Florida dental hygiene program directors (seven state college, seven community college) completed a survey to obtain data on the status of dental hygiene faculty shortages in Florida and perceptions on possible future educational needs for faculty. This study examined whether there were any differences in responses according to institutional setting. All three null hypotheses were rejected due to there being no statistically significant differences in all fourteen Florida dental hygiene program directors? responses to the survey.
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In the series University of Florida Digital Collections.
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Includes vita.
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Description based on online resource; title from PDF title page.
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This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility:
by Rebecca Smith.
Thesis:
Thesis (Ed.D.)--University of Florida, 2011.
Local:
Adviser: Honeyman, David S.

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UFE0043246:00001


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1 ISSUES ASSOCIATED WITH DEVELO PING A DENT AL HYGIENE BACCALAUREATE COMPLETION PROGRAM IN FLORIDA By REBECCA M. SMITH A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUIREMENT S FOR THE DEGREE OF DOCTOR OF EDUCATION UNIVERSITY OF FLORIDA 2011

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2 2011 Rebecca M. Smith

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3 To my daughter, Arielle Maria Thomas: May you see that everything worth having is worth working hard for, May you learn that everything I have sacrif iced I have sacrificed to make a better life for you, May you know that, in spite of everything, I love you with all my heart, mi coraz n de mel n AriMari: my legacy to the world.

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4 ACKNOWLEDGMENTS The earning of this doctoral degree would not have bee n possible without the help and support of many people. Dr. David Honeyman, my Committee Chair, has been encouraging with my chosen topic since Day One. He has been invaluable in his assistance with editing, and making me look at the dissertation from a di fferent perspective. My Committee Dr. Dale Campbell, Dr. Pilar Mendoza, and Dr. Jeanne Repetto were extremely helpful in initially guiding me and staying the course. Thank you so much for your direction and leadership. The statistical portion of this disse rtation would not have been accomplished without the aid of Dr. Kris Arheart from the University of Miami. His guidance in directing me through the pitfalls and confusion of statistical analysis was priceless. Words cannot express my gratitude for his self less dedication to helping a former student A million heartfelt thanks go out to him. my daughter, Arielle Maria Thomas, are proud of all that I have accomplished the se past four years. I thank them, and my nieces and nephew, for being a support system for me throughout it all. I truly appreciate it! For Richard Prentiss, Dr. Susan Kass, Dr. Susan Hudson and all the rest of my coworkers at Miami Dade College I am trul y thankful The encouragement and support I received from each of them is boundless, and I sincerely appreciate it all. Thank you so much! Lastly I would like to thank my parents, Arthur James and Maria Julia Smith. They instilled in me the drive to alway s do better, and the determination to succeed at everything I do. ; I love y ou and miss you both very much. I know you will be with me in spirit on graduation day, proud

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5 TABLE OF CONTENTS page ACKNOWLEDGMENTS ................................ ................................ ................................ ............... 4 LIST OF TABLES ................................ ................................ ................................ ........................... 7 ABSTRACT ................................ ................................ ................................ ................................ ..... 9 CHAPTER 1 INTRODUCTION AND STATEMENT OF THE PROBLEM ................................ ............. 10 Introduction ................................ ................................ ................................ ............................. 10 Statement of the Problem ................................ ................................ ................................ ........ 12 Purpose of the Stud y ................................ ................................ ................................ ............... 13 Significance of the Study ................................ ................................ ................................ ........ 13 Delimitations ................................ ................................ ................................ ........................... 14 Limitations ................................ ................................ ................................ .............................. 14 Assumptions ................................ ................................ ................................ ........................... 15 Hypotheses ................................ ................................ ................................ .............................. 15 Definition of Terms ................................ ................................ ................................ ................ 16 2 REVIEW OF THE LITERATURE ................................ ................................ ........................ 17 Background of the Problem ................................ ................................ ................................ .... 17 Dental Hygiene ................................ ................................ ................................ ....................... 21 Occupational Therapy ................................ ................................ ................................ ............. 27 Physical Therapy ................................ ................................ ................................ .................... 29 Physician Assista nt ................................ ................................ ................................ ................. 31 Nursing ................................ ................................ ................................ ................................ ... 32 Audiology ................................ ................................ ................................ ............................... 34 Summary ................................ ................................ ................................ ................................ 37 3 METHODOLOGY ................................ ................................ ................................ ................. 38 Research Design ................................ ................................ ................................ ..................... 38 Study Participants and Rationale for Selection ................................ ................................ ...... 40 Description of the Sites ................................ ................................ ................................ ........... 41 ............... 41 Instrument Design ................................ ................................ ................................ ................... 42 Data Collection ................................ ................................ ................................ ....................... 42 4 RESULTS ................................ ................................ ................................ ............................... 44 Institutional Demographics ................................ ................................ ................................ ..... 44 Number of Full Time Faculty ................................ ................................ ................................ 45

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6 Number of Part Time Faculty ................................ ................................ ................................ 46 Full Time Faculty Required Credentials ................................ ................................ ................ 47 Part Time Faculty Required Credentials ................................ ................................ ................ 47 Other Institu tional Dental Hygiene Program Demographics ................................ .................. 49 Perceptions on Dental Hygiene Baccalaureate Degree Completion Programs ...................... 52 Analysis of Research Questions ................................ ................................ ............................. 58 5 CONCLUSIONS ................................ ................................ ................................ .................... 61 Introduction ................................ ................................ ................................ ............................. 61 Discu ssion of Findings ................................ ................................ ................................ ........... 61 Conclusions ................................ ................................ ................................ ............................. 64 Implications for Dental Hygiene Education ................................ ................................ ........... 65 Implications for Higher Education Leaders ................................ ................................ ............ 66 Recommendations for Future Studies ................................ ................................ ..................... 67 APPENDIX: FLORIDA DENTAL HYG QUESTIONS ................................ ................................ ................................ .......................... 69 REFERENCES ................................ ................................ ................................ .............................. 75 BIOGRAPHICAL SKETCH ................................ ................................ ................................ ......... 80

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7 LIST OF TABLES Table page 4 1 Institutional setting of responding Florida dental hygiene program directors. .................. 44 4 2 Minimum number of years of education requi red for student admis sion to dental hygiene programs. ................................ ................................ ................................ .............. 44 4 3 Total number of full time dental hygiene faculty, full time dental hygiene faculty with baccalaureate degrees in dental hygiene, and full time dental hygiene faculty with baccalaureate degrees in a discip line other than dental hygiene .............................. 45 4 4 Total number of part time dental hygiene faculty, part time dental hygiene f aculty with baccalaureate degrees in dental hygiene, and part time dental hygiene faculty with baccalaureate degrees in a disci pline other than dental hygiene. ............................. 46 4 5 Credentials required f or full time dental hygiene faculty appointment . .......................... 48 4 6 Credentials required for part time dental hygiene faculty appointment by ...................... 49 4 7 Institutional need to hire dental hygiene faculty with credentials lower than minimum requirement in order to fill critical den tal hygiene faculty positions ................................ 50 4 8 Institutio nal redistribution of workload to existing dental hygiene faculty in order to compensate for unfilled full time d ental hygiene faculty positions ................................ .. 50 4 9 Institutional redistribution of workl oad to existing dental hygiene faculty in order to compensate for unfilled part time dental hygiene faculty positions. ................................ 50 4 10 Anticipated need for replacement of full time dental hygiene fa c ulty within the next five years ................................ ................................ ................................ ........................... 51 4 11 Reasons for anticipated replacement of full time dental hygiene faculty within the next five years. ................................ ................................ ................................ ................... 51 4 12 Currently available unfilled full time and part time dental hygiene faculty positions. ..... 51 4 13 d result from a d ental hygiene education program. ................................ ................................ ............... 52 4 14 institution to advance the entry level educational requireme nts for dental hyg ienists to a ................................ ................................ ................................ ............. 53 4 15 community to advance the entry level educational requirements for dental hy gienists to a ................................ ................................ ................................ ............ 54

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8 4 16 dental hygiene baccalaureate degree completion programs in Florida ............................. 54 4 17 faculty would be eased if more Florida dental hygiene baccalaureate degree comp letion programs were available. ................................ ................................ ............... 55 4 18 their programs to have the opportunity to pursue a baccala ureat e degree in dental hygiene ................................ ................................ ................................ .............................. 55 4 19 Summary of analysis of research questions ................................ ................................ ....... 60

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9 Abstract of Dissertation Presented to the Graduate School of the Univer sity of Florida in Partial Fulfillment of the Requirements for the Degree of Doctor of Education ISSUES ASSOCIATED WITH DEVELOP ING A DENTAL HYGIENE BACCALAUREATE COMPLETION PROGRAM IN FLORIDA By Rebecca M. Smith August 2011 Chair: David S. Honeyman Major: Higher Education Administration Education Association (ADEA) supported the notion that the baccalaureate degree should be the entry level degree for the dental hygiene profession. There was also clear evidence that there was a national shortage of baccalaureate earned minimum dental hygiene educators. Fourteen Florida dental hygiene program directors (seven state college, seven community college) completed a surv ey to obtain data on the status of dental hygiene faculty shortages in Florida and perceptions on possible future educational needs for faculty. This study examined whether there were any differences in responses according to institutional setting. All thr ee null hypotheses were rejected due to there being no statistically significant differences in all fourteen Florida dental hygiene

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10 CHAPTER 1 INTRODUCTION AND STA TEMENT OF THE PROBLE M Introduction For over a cen health needs. In 1907, dental hygiene was legally recognized in Connecticut as an adjunct to dental practice, and in 1916, Connecticut passed legislation specifically describi ng the practice of dental hygiene. Thirty four states followed Connecticut by 1935. By 1951, practice acts of all states, as well as the District of Columbia and the Commonwealth of Puerto Rico, included provisions for dental hygiene practice (Haden, Morr, & Valachovic, 2001). In 1945, sixteen dental hygiene programs were in existence. In 1947, the American Dental Association (ADA) Council on Dental Education, now the Commission on Dental Education, adopted the first accreditation standards for dental hygie ne programs (Haden et al, 2001). The number of new programs grew dramatically and by 1974 there were 158 dental hygiene programs. In 2001 there were 255 dental hygiene education programs (Haden et al, 2001). In 2009, there were 309 entry level dental hygie ne programs in the United States (American Dental Dental hygiene educators were officially recognized as a constituency in the American Association of Dental Schools (AADS) in 1967 when the AADS House of Delegates revised the et al, 2001). This official recognition of dental hygiene education meant that dental hygiene making a ctivities by virtue of their presence in the AADS House of Delegates. In 2000, the AADS House of Delegates voted to change the name of the Association to the American Dental Education Association. The new name more accurately reflect ed the breadth of its c

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11 Sections include d dental hygi ene education and this section wa s the largest section with over 500 members (Haden et al, 2001). According to the Commission on Dental Accreditation (CODA) (2010), a dental hygiene program must be staffed by a core of well qualified full time faculty who possess ed a baccalaureate or higher degree. In recent years it had become increasingly apparent that the United States was facing a faculty shortage situation in dental hygiene educa tion. From 1990 to 2005 there was a stagnation of instructor and assistant professor ranks which was attributed to either the scarcity of new faculty entering dental hygiene education or the short duration of new faculty careers in dental hygiene education (Collins, Zinskie, Keskula, & Thompson, 2007a; Darby, 2004; Palmer, 2003). It had become progressively more difficult to hire qualified faculty as the majority of dental hygiene programs graduated students with an entry level associate degree (American De Both ADEA and the A merican D ental H A ssociation (ADHA) supported the notion of the baccalaureate degree becoming the entry level degree for the dental hygiene profession. There was also clear evidence that the re was a national shortage of baccalaureate earned minimum dental hygiene educators. In 2010, Florida had eighteen CODA accredited dental hygiene programs. There was one baccalaureate degree completion program located within Florida, and no Master of Scien ce in Dental Hygiene program. This study sought to examine the challenges associated with implementing a four year dental hygiene baccalaureate degree completion program in Florida. Florida dental hygiene program directors completed a survey to obtain data on the status of dental hygiene faculty shortages in Florida and perceptions on possible future educational needs for faculty. The results of this study assisted the dental hygiene program directors of all eighteen programs to determine the need for facul ty

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12 professional development and/or curriculum changes to facilitate faculty earning of in determining whether their programs were prepared to establish a dent al hygiene baccalaureate degree completion program had the need ar ose Statement of the Problem In 2009 there were 309 entry level dental hygiene programs in the United States. Of these, 267 programs offered associate degrees as the terminal degree, while 44 programs offered the Bachelor of Science in Dental Hygiene as the terminal degree. There were no Bachelor of Science in Dental Hygiene programs located in Florida. Of sixty baccalaureate degree completion (Bachelor of Applied Science in Dental Hygiene) programs in the United States, one was located in Florida (St. Petersburg College). Nationally, fourteen dental hygiene programs offered the Master of Science in Dental Hygiene. There were no Master of Science in Dental Hygiene programs located in Florida American Dental Education Association to make the baccalaureate degree the entry level degree in dental hygiene, Florid a would have been greatly affected if these campaigns had succeeded. Accreditation standards would have changed to accommodate the new higher entry level degree, and those changes would have been reflected in more qualified faculty needed in order for prog rams to remain in compliance with the new standard. In response to the anticipation of a new entry level degree in dental hygiene, the focus of this study was to evaluate the responses of fourteen Florida dental hygiene program directors to a survey on whe ther they believe d that a baccalaureate degree should result from a dental hygiene education program in Florida and perceptions on whether there should have be en an increase in the availability of dental hygiene baccalaureate degree completion programs in Florida and if this would have ease d the difficulty

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13 in finding qualified dental hygiene faculty, as well as dete rmining whether those programs we re prepared to establish a dental hygiene baccalaureate degree completion program had the need aro se. Purpose o f the Study The baccalaureate degree as entry level in dental hygiene was an idea that ha d been promoted since 1986. This study investigated the faculty needs at fourteen Florida dental hygiene programs (seven state colleges and seven community colleges) a nd the perceptions of those program directors on future educational needs for their faculty, and det ermined whether those programs we re prepared to establish a dental hygiene baccalaureate degree completion program had the need aro se. This study answered t he following questions: (1) Was there a difference in perceptions among Florida state college dental hygiene program directors and Florida community college dental hygiene program directors that a baccalaureate degree should result from a dental hygiene ed ucation program? (2) Was there a difference in perceptions among Florida state college dental hygiene program directors and Florida community college dental hygiene program directors about the need for the establishment of additional dental hygiene baccala ureate degree completion programs in Florida? (3) Wa s there a difference in perceptions among Florida state college dental hygiene program directors and Florida community college dental hygiene program directors about their ins t tablish a dental hygiene baccalaureate degree completion program? Significance of the Study This study contributed to the dental hygiene literature and can be used by dental hygiene educators in a number of ways. The study investigated whether there was a difference in perceptions among Florida state college dental hygiene program directors and Florida

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14 community college dental hygiene program directors that a baccalaureate degree should result from a dental hygiene education program. It examined differences in perceptions among Florida state college dental hygiene program directors and Florida community college dental hygiene program directors as to whether there was a need for more baccalaureate degree completions programs in Florida. The study also determi ned whether Florida state college dental hygiene program directors and Florida community college de ntal hygiene program directors we re prepared to establish a dental hygiene baccalaureate degree completion program at their own institutions had the need ar o se. Delimitations Delimitations of the study included: 1. The study was conducted only in Florida. 2. The generalizability of the study was limited to states which currently only offer the associate degree in dental hygiene as the entry level degree. 3. The resear ch sample was a cohort of Florida state (N 1 =7) and community (N 2 =7) college dental hygiene program directors in 2010. 4. A survey was used to obtain the data. The survey was developed and tested by the lead researcher. Limitations Possible limitations of the study included: 1. Dental hygiene program directors may not have answered the survey truthfully. 2. The study captured one moment in time, and therefore the responses would have changed over time. 3. The economic and job situation in Florida during the time of the study would have

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15 4. The research sample (N 1 =7, N 2 =7) was very small. 5. The survey was pilot tested among 3 full time dental hygiene program faculty members and one clinical supervisor from Miami Dade Co llege, the Dean of Health Sciences from St. Petersburg College, and the Director of Baccalaureate Programs at Indian River State College. Assumptions Assumptions of this study included: 1. The dental hygiene program directors answered the questions on the su rvey truthfully. 2. The dental hygiene program directors were capable of objective assessment of their programs. Hypoth es es The following null hypotheses were tested: H 01 : There was no difference in perceptions among Florida state college and community college dental hygiene program directors that a baccalaureate degree should result from a dental hygiene education program. H 02 : There was no difference in perceptions among Florida state college and community college dental hygiene p rogram directors about the need for more dental hygiene baccalaureate degree completion programs in Florida. H 03 : There was no difference in perceptions among Florida state college dental hygiene program directors and Florida community co llege dental hygiene program directors about their ins t degree completion program

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16 Definition of Terms A SSOCIATE S C OLLEGE included institutions where all degrees are at t he associate's level, or where bachelor's degrees account for less than 10 percent of all undergraduate degrees. (Carnegie Foundation for the Advancement of Teaching, n.d.) C OMMUNITY C OLLEGE (F LORIDA ) was a two year college in Florida based on the t raditional community college model where only associate degrees were offered. D ENTAL HYGIENE DEGREE COMPLETION PROGRAMS were designed for licensed dental hygienists who had completed their professional education and earned a certificate or ree. The baccalaureate degree awarded through these programs 2009a). D ENTAL HYGIENE ENTRY LEVEL PROGRAMS prepared graduates for the clinical practice of dental hygiene. Thes e included certificate, associate degree, and baccalaureate degree M ASTER OF S CIENCE IN D ENTAL H YGIENE programs prepared graduates for careers as educators, administrators, and researchers (Americ 2009a). One half of all current Master of Science in Dental Hygiene programs reported their current students were interested in teaching (American Dental S TATE C OLLEGE (F LORIDA ) was a two year college in Florida based on a new model where four degrees. The baccalaureate degrees offered were in critical need areas.

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17 CHAPTER 2 REVIEW OF THE LITERA TURE Background of th e Problem Florida was a very geographically large, diverse state. It spanned two time zones, from Pensacola to the Florida Keys. There were twenty eight community colleges that served its population. The degrees earned at these community colleges transferr ed to public, four year comprised of public and private universities and community colleges. In 2001, the state enacted Senate Bill No. 1162 which granted St. Petersburg Community College the ability to confer baccalaureate degrees in content areas that specifically addressed the workforce demands of private and public employers such as nursing, education, and information technology (Floyd, Falconetti, & Hra bak, 2009). The bill also renamed the college as St. Petersburg College. In 2007, the development of a state college system was recommended by a consulting group hired by the Florida Board of Governors. The recommendation was that a state college system w effective pathway to a conferring baccalaureates, while preserving the traditional open access mission of community loyd et al., 2009, p. 196). In 2008, the Florida Legislature passed into law Senate Bill No. 1716, establishing the Florida College System. The enactment of the bill designated nine of the twenty eight community colleges as pilot state colleges that were g ranted the authority to offer regional and statewide baccalaureates (Floyd et al., 2009) In order to ascertain the perceptions of dental hygiene program directors about graduate dental hygiene education and future faculty needs, Wilder, Mann and Tishk (19 99) conducted a survey. Seventy six percent of the dental hygiene programs at that time responded, for a total of

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18 161 responses. Wilder et al found that 61 percent of the respondents had had a full time faculty vacancy in their program between 1994 and 199 6, while 27 percent had their last vacancy between 1990 and 1993. Wilder et al found that nearly one half of the responding programs time tenure track faculty positions. Nearly 80 percent of program directors preferred m time non tenure track positions. At the time of her survey, just over half of the respondents believed that the number of Master of Science in Dental Hygiene programs was inadequate to meet the full time faculty needs of dental hygi ene education. Hygiene programs existed. Those eight programs graduated between sixteen and twenty four students per year, many of which pursued research or private indus try positions. Wilder et al thirty per year. Presumably, this number would not meet the faculty needs of all the dental p. 481 ). In 2009, there were fourteen Master of Science In 1999, Harrington (as cited in Haden et al, 2001) conducted a survey of allied dental educators focused on faculty recru itment and retention in allied dental education. Two hundred and fifty seven allied dental program directors responded, representing nearly fifty percent of all accredited allied dental education programs in the U.S. In addition, 402 allied dental faculty responded, approximately 30 percent of allied dental faculty at that time. According to time faculty members per program was small: four for dental hygiene. She noted that dental hygiene programs relied hea vily on part time

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19 faculty. Harrington reported that the mean faculty age in allied dental education was forty six years in 1998 (Haden et al, 2001). Harrington asked respondents about the number of faculty positions available in their programs over the pas t five years. The average number of vacant dental hygiene positions per program was 2.09, with a total of 182 full time positions available. Major reasons for faculty departure included retirement, relocation of a spouse or the faculty member, personal or family In 2002, the American Dental Education Association created a Task Force on the Status of Allied Dental Faculty in order to assess the current and future anticipated needs for allied dental fa culty (Nunn et al, 2004). A two part survey was sent out to 266 dental hygiene program directors in the United States. The first part of the questionnaire was comprised of twenty eight general questions about the current and future status of program facult y. The second part of the survey was only filled out by dental hygiene program directors that had vacant faculty position(s). The results of this survey indicated that the most common institutional requirement for full time and part time faculty appointmen t was that of a baccalaureate degree (Nunn et al, 2004). To meet the need for faculty, a number of dental hygiene programs were forced to hire faculty with less than minimum credentials while other programs redistributed workload to existing faculty in ord er to compensate for missing full time and part time faculty (Nunn et al, 2004). Sixty eight percent of the responding program directors stated that they would need to replace current full time faculty members within the next five years and 73 percent of t hose replacements would be due to retirement. At the time of the survey, thirty six percent of the responding dental hygiene program directors had unfilled faculty vacancies. Faculty vacancies had been unfulfilled for a mean of

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20 five months; the length of time the vacancies had been open ranged from 0 24 months. Fifty seven percent of the unfilled dental hygiene positions were for part time faculty. Program account ed for 23 percent of dental hygiene vacancies. In the majority (seventy one percent in dental hygiene) of the responding programs, the search was currently active at that time. The primary reason cited for the faculty positions remaining vacant was lack of qualified applicants (thirty eight percent) (Nunn et al, 2004). The results of this survey were clear: there was in fact not only a faculty shortage, but the dearth of qualified faculty would likely be of critical proportions in the very near future. The challenge now was to deal with the issue in practical ways that would alleviate the shortage without diluting the necessary academic rigor of dental hygiene education. There appeared to be many challenges in recruiting faculty with necessary and desired ac ademic credentials. Even the historic 2000 document, Oral Health in America: A Report of the Surgeon General noted that At the thi rty third annual American Dental Education Association National Dental program directors participated in a session to envision the future of dental education and t o develop strategies for moving toward this vision. One of the most prominent themes to emerge from this session was to establish higher levels of academic credentials for the practice of dental degree become the point of entry into dental hygiene. To accomplish this, it was acknowledged that more degree completion

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21 doctorates (Haden et al, 2001). The e ntry level dental hygiene accreditation standard had remained unchanged over the last six decades, even while the academic knowledge base, theory, techniques, and technology that students must acquire had expanded considerably. The American Dental Hygienis Association (ADHA) adopted a policy in 1986 supporting all levels of dental hygiene education, but declared the intent to establish the baccalaureate degree as the minimum entry level requirement for dental hygiene practice of the future (American Dent 2009c). To explore the range of viewpoints about the issues of the baccalaureate degree as the entry level degree in dental hygiene, a survey was developed in 2008 by the American Dental Program Directors Task Force. Three hundred dental hygiene directors of CODA accredited programs were invited to complete it. The response rate was 58 percent. Three percent) to advance entry level educational requirements for dental agreed and nearly one quarter (23 percent) somewhat agree that those completing dental hygien e programs should be required to earn baccalaureate degrees. The majority of all respondents (62 percent) agreed or strongly agreed that new educational models need to be created that incorporate both two year and four year schools (Okwuje, Anderson, & Han lon, 2010). These results echoed the strong emphasis at the June 2000 ADEA Dental Hygiene Program Directors Conference. Dental Hygiene The clinical practice of dental hygiene had changed dramatically from its inception in 1913. It consisted of a scope of functions, varying in complexity, that had been formally termed

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22 traditional and expanded. Yet, the educational process for preparing a dental hygienist had not expanded in length from the time the American Dental Association began accrediting programs in 1952. The professional community had, however, recognized and added more than 20 expanded functions to the scope of practice and altered supervisory conditions from jurisdiction ion (Wayman, 1985). The entry level accreditation standard had remained unchanged over the last six decades, while the academic knowledge base, theory, techniques, and technology that students must acquire had expanded considerably. Presently, the majority of students attended college to meet program admission requirements before entering a dental hygiene program. This was the case whether they planned to enter a two or four year college program. According to the most recent American Dental Association (AD A) survey of allied dental education (2008), fifty percent of programs indicated that graduation from high school or less than one year of college was the prerequisite admission requirement for entering the program, while 32 percent required one year of co llege and 11 percent required two years of college. In terms of actual college experience of students entering a dental hygiene program, 91 percent of students had one or more years of college, including 77 percent who had two or more years of college. Si nce the implementation of the first accreditation standards, the number of dental hygiene programs had increased. While the majority of programs in 1950 were housed in four year colleges and universities or dental schools, the majority were now found in tw o year college settings. However, the average number of credit hours required for graduation from an associate dental hygiene program was ninety credits (approximately three academic years); this included college level admission requirements and actual pro gram requirements. This average number of

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23 credit hours was twenty to thirty hours beyond the number typically required at the associate degree level in other disciplines and thirty credit hours below the number required to achieve a dental hygiene education, but declared an intent to establish the baccalaureate degree as the minimum entry level requirement for dental hygiene practice of the future (American Dental In 2008, the American Dental Education Association (ADEA) and the ADEA Council of Allied Dental Program Directors surveyed 300 allied progr am directors and asked them to share their perspectives, opinions, and experiences on educational requirements for dental hygienists level educational requirement for den hygiene program directors from community college and four year college educational settings. The resp onse rate was 58 percent (n=175) (Okwuje, et al, 2010). The majority of the respondents (56 percent) were located in community college settings (two year educational settings), while a university or four year college was the setting for 28 percent. Nearly 85 percent of respondents indicated that, at the completion of their dental hygiene program, an associate degree could be granted, and 18 percent granted baccalaureate degrees in dental hygiene. Three level educational requirements for dental hygiene

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24 educational setting in which the respondent works While nearly all those in four year settings thirds in community college settings felt that way. More than half of all respondents (54 percent) agreed and nearly one quarter (23 per cent) somewhat agreed that those completing dental hygiene programs should be required to earn baccalaureate degrees. Again, there were differences between respondents according to educational settings, with those in four year settings twenty five percenta ge points higher in terms of agreement with the statement. Considering all responses to the survey, the majority of all respondents supported advancing the entry level and requiri ng those completing dental hygiene programs to earn baccalaureate degrees. These responses echoed a strong emphasis at the June 2000 Annual National ADEA Dental bachelo sentiment was again confirmed at the 2006 ADEA Summit on Allied Dental Education (American Dental Education Association, 2007). However, there were significant differences within these opinions, dependent on the educational setting of the respondent. While the majority of all respondents were located in community colleges, overall positive support for these issues was due in large part to the very high percentage of responde nts from four year institutions who favored them. Other survey findings indicated that respondents from dental hygiene programs with educational requirements for admission that included more college courses were more likely to agree that a baccalaureate d egree should result for the education received. The report noted that while 11 percent of dental hygiene programs required two years of college prior to entering the

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25 dental hygiene program, over three quarters of students entering dental hygiene programs d id so with greater than two years of college already completed. Study recommendations included additional analysis to probe the level of support for a baccalaureate degree as related to the actual number of years of college with which dental hygiene studen ts entered programs. Doing this would have provided an additional level of understanding as to opinions on the academic recognition that dental hygiene students received upon graduation. Current and future oral health care needs must be addressed by well q ualified and appropriately credentialed providers to meet the oral health care needs and challenges of the future (Okwuje, et al, 2010). The need for dental hygienists with a baccalaureate degree was demonstrated by the 1) desire to advance the profession, 2) demand for dental hygiene faculty, 3) responsibility to address the oral healthcare needs of the nation, and 4) need for expanded dental hygiene Focus on Ad as entry level for dental hygiene would have provide d opportunity to prepare graduates for alternative career opportunities in education, administration, public health, and research, without overcrowding the curriculum. The failure to standardize entry le vel at the b accalaureate level had an adverse impact on the pace of development of advanced dental hygiene programs and the continued development of the dental hygiene body of knowledge. Given that some other professions and allied health professions have already moved beyond the baccalaureate degree as the entry to practice, dental hygiene must plan for the advanced degree as the entry to practice in

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26 the future (Darby, 2004; Henson, Gurenlian, & Boyd, 2008; Holt & Mitchell, 2009; Leonard, 2009) As the cur rent num ber of dental hygiene programs was examined, it beca me apparent that the demand f or educators across the nation wa s strong. Nunn and colleagues (2004) found that 68% of dental hygiene faculty need ed to be replaced within the next 5 years, primarily due to retirement. The predicted outcome of faculty shortages in dental hygiene impact ed the number of graduates, thus impacting the oral health of the United States. Students who graduated with a baccalaureate degree were further prepared for advanced ed ucation such as a master or doctoral level degree. The limited number of dental hygiene programs offering baccalaureate degrees combined with the demand for further education emphasized the need for more research examining interest in degree completion in the United States and desired educational venues. Numerous articles had reported that there was a national shortage of dental hygiene educators (Collins, et al, 2007a; Collins et al, 2007b; Gancarz Gojgini & Barnes, 2007; Darby, 2004; Haden, et al, 2001; H enson, et al, 2008; Holt & Mitchell, 2009; Leonard, 2009; Monson & Engeswick, 2007; Nunn, et al, 2004; Palmer, 2003; Rowe, Massoumi, Hyde, & Weintraub, 2008; Siladie, 2007). For numerous years there had also been a call to establish the baccalaureate degre e as the entry 2009c; Anderson & Smith, 2009; Gluch Scranton & Gurenlian, 1985; Haden, Morr, & Valachovic, 2001; Okwuje, Anderson, & Hanlon, 2010; Wayman, 1985). In 1986, the American education, but declared an intent to establish the baccalaureate degree as the minimum entry level requirement for dental hygiene practice of the future. But how will this be accomplished? A

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27 look at other professions and how they advanced their entry l evel degrees to higher degrees offer ed some insight. Occupational Therapy of ent 1999, the doctoral entry level degree was established. In 1997, the Commission on Education task force on entry level education articulated eight reasons for moving to post baccalaureate education (Coppar d, et al, 2009). These reasons we re: 1. Occupational therapists and new graduates must demonstrate and unprecedented need for advanced clinical reasoning. 2. New graduates must define and demonstrate the uniqueness of occup ational therapy. 3. New graduates must view themselves and function as autonomous practitioners. 4. The environment showed readiness to move to post baccalaureate education. 5. Postbaccalaureate education will better prepare therapists to conduct outcomes research and serve on interdisciplinary teams. 6. degree level education. 7. Postbaccalaureate education would assist in clarifying the role between 8. Postbaccalaureate education is in keeping with trends in related fields. (p. 30) At its April 1998 meeting, the Accreditation Council for Occupational Therapy Education ( ACOTE ) adopted the following position statement regarding the draft accreditation standards: Given the demands, complexity, and diversity of contemporary occupational therapy practice, in post baccalaureate degree progr ams. At the A merican O ccupational T herapy A ssociation (AOTA) April 1999 Annual Conference & Expo, the Representative Assembly passed

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28 called for the eventual instal lation of a postbaccalaureate requirement for entry level occupational therapy education. After an exhaustive evaluation of the short and long term impact of the decision to move to postbaccalaureate degree entry, ACOTE voted at its August 1999 meeting th at professional entry level occupational therapy programs must be offered at the postbaccalaureate level by January 1, 2007 to receive or maintain ACOTE accreditation status (American Occupational Therapy Association, 2009) In August of 2004, ACOTE voted to transition from accreditation of occupational therapy educational programs to accreditation of occupational therapy program degree levels, effective January 1, 2005. Any institution adding a new degree level or changing the current occupational therapy degree level was required to apply for and receive formal accreditation status for that degree level prior to the admission of students into the program (American Occupational Therapy Association, 2009) In August 2006, ACOTE formally adopted new Accredit Degree Level Educational Programs for the Occupational Therapist and new Accreditation Standards for Educational Programs for the Occupational Therapy Assistant. In December 2006, ACOTE formally adopted Accreditation Standards for a Doctoral Degree Level Educational Program for the Occupational Therapist. An effective date of January 1, 2008, was established for all sets of 2006 ACOTE Standards (American Occupational Therapy Association, 2009) O ccupational therapy had maintain e d two points of entry into the profession. This attract ed students who we re not able or d id not desire the additional time and financial obligation of an entry level doctorate, but wish ed to enter a health care profession. Both degree programs prepare d gra duates to be entry level practitioners.

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29 programs, students ha d the option to choose which level of education best met their needs and resources (Coppard, et al, 2009) Physical Therapy Originally designed as 9 month post baccalaureate certificate programs, physical therapist education ha d evolved over the last 80 years to its current design: programs that culminate in the awarding of a post baccalaureate degree. The evolution from certificate programs to baccal aureate programs occurred over the years between 1928 and 1970. Graduate programs postbaccalaureate degree (American Physical Therapy Association, 2009) Effective January 1, 2002, the Commission on Accreditation for Physical Therapy Education (CAPTE) no longer accredited baccalaureate level professional education programs. In addition, the CAPTE handbook stated in Part CC 7 that: "The institution awards the Doctor of Physical Therapy (DPT) as the first professional degree for physical therapists at completion of the program. [PROVISO: CAPTE will begin enforcing this criterion effective December 31, 2015. Consistent with CAPTE's expectation that all programs must com e into compliance within two years of being determined to be out of compliance, programs that do not meet this criterion as of December 31, 2015, will be required to come into compliance no later than December 31, 2017." As of February 2010, there were 212 (96%) accredited physical therapist professional degree programs (American Physical Therapy Association, 2010). This evolution occurred in response to changing expectations for graduates resulting from significant changes in practice. Two separate studie s of DPT programs, as well as data collected in the Biennial Accreditation Report, indicate d that, in the main, programs converting to offering the DPT we re making important, s ubstantial changes. Among them we re:

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30 Increased content in areas such as diagnost ics, imaging, pharmacology, advanced practice skills (manual therapy, pediatrics, geriatrics), basic sciences (histology, pathology), business practices, and health promotion. Changes in educational processes: evidence based practice, case based activities and emphasis on clinical decision making. Changes in the clinical education component such as increased hours, longer rotations, and more roles. Changes in expected student outcomes: increased practice autonomy, professionalism, clinical decision making and diagnostic skills. (American Physical Therapy Association, 2009, p. B iv) Members of the physical therapy academic and clinical communities ha d i dentified the following benefits among others for the DPT as the entry level degree: Professional (ent ry level) DPT programs more accurately reflect the scope, depth, breadth, and rigor of the high quality education preparation needed for current and future practice; The professional (entry level) DPT program offers a sound educational background that shou ld better equip the graduate to enter clinical practice able to examine, evaluate, diagnose, prognose, and intervene in the management of impairments, functional limitations, and disabilities of the cardiopulmonary, musculoskeletal, neuromuscular, and inte gumentary systems; The DPT degree will better facilitate the consumer's recognition of the physical therapist as a fully autonomous health care practitioner who is a point of entry into the health care system; The DPT degree will better facilitate interact ions with medical colleagues on an equal basis; The professional (entry level) DPT program offers greater knowledge, skills, and behaviors related to the administration and business aspects of physical therapy practice; Assuming an uncertain and unpredicta ble future, the DPT degree positions the physical therapist to advocate and negotiate more successfully on behalf of high quality health care, the consumer, and the profession. (American Physical Therapy Association, 2010, p. 2) By establishing the DPT as the entry level degree in physical therapy, the quality of physical therapy services and patient care was enhanced the granting of pervasive direct access

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31 and "physician status" for reimbursement was hastened and the profession's continued growth, matura tion, and services was ensured Physician Assistant The issue of a standardized degree requirement for the physician assistant (PA) profession continued to be a hot topic of debate. The rapidly changing healthcare environment, the expanding role for PAs in the delivery system and the proliferation of PA programs ha d renewed the interest among PA leaders to reevaluate this issue and develop recommendations that w ould guide the profession through this time of professional evolution. In 1999, a resolution was submitted to the American Academy of Physician Assistant s requesting the "AAPA to promote the requirement that all accredited PA programs confer a he baccalaureate degree as the current minimum degree for physician assistants and encourages all physician assistants to possess a minimum of a baccalaureate degree" (American Academy of Physician Assistant, 1999). Movement toward advancing the academic degrees associated with PA education first Between 1993 and 1997, 13 of the 45 (28.9%) new programs (either provisionally or initially) accredited by the Accreditation Review Committee on Education for the Physician Assistant (ARC (American Academy of Physician Assistants, 1999) In 2007, the AAPA House of Delegates adopted a new policy: AAPA recognizes that PA education is conducted at the graduate level and supports awarding the masters degree for new physician assistant graduates In 2009, there were 148 accredited physician assistant programs. Of these, 120 programs

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32 associate degree, and 4 programs offered the PA certificate (American Academy of Physician Assistants, 2009). Although the ARC degree as the entry level degree, accredited programs were clearly moving in that direction. Nursing Not all professions had been successful in changing the entry level degree to a higher one. One profession which had been unsuccessful in this endeavor is nursing. The move to university education for most professions occurred in the early decades of the 20 th century. The first official nursing school in a university was established in 1909 at the University of Minnesota, and by 1920, 180 schools of nursing honor society, was founded at Indiana University with the expectation that the baccalaureate degree was to be required for entry into practice (McBride, 1996). In 1964, the Comprehensive Nur se Training Act was signed into law, and it was within this framework that the American Nurses Association (ANA) undertook the study and examination of nursing practice, and the scope of preparation and responsibilities of nurses. As a result of this study on education for nursing. The committee identified that nursing practice had become complex, would continue to do so, and that nursing education, like that of any oth er profession, should be determined by the structure of society and its prevailing values. The committee proposed that education for those who work in nursing take place in institutions of learning within the general system of education (American Nursing A ssociation, 1965). The proposals were met with tremendous controversy within the nursing community and after years of debate and revisions, the recommendations outlined in the position paper were not adopted by the profession (Jacobs, DiMattio, Bishop, & F ields, 1998).

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33 The ANA battled the entry into practice issue for more than 40 years. In 1985, the ANA the baccalaureate degree in nursing as the minimum educati onal requirement for licensure to practice professional nursing, (2) to retain the legal title of registered nurse for professional nurses and the associate degree in nursing as the educational requirement for licensure to practice technical nursing, and ( 3) to go on record as supporting the legal title of associate nurse for the technical level of nursing (American Nurses Association, 1995). baccalaureate degree in nursing as the educational requirement for the registered nurse. The ANA also stated that they would develop and provide resources to assist and support SNAs in their efforts (1) to persuade nurses, educational and health care institutions, legislators, and the p ublic of the importance of adopting this educational standard, and (2) to develop and implement strategies to facilitate nurses obtaining baccalaureate preparation in nursing to enhance their marketability in a highly competitive, restructuring health care delivery system (American Nurses Association, 1995). The ANA maintained its position on entry into practice since the position paper in 1965. However, the ANA had been unable to mandate this requirement because of opposition from the SNAs. Many SNAs requi red membership in the ANA for nurses belonging to unions, and many of these nurses were graduates of associate degree in nursing (ADN) programs. In return, the ANA acted as the collective bargaining unit for these nurses. If the ANA mandated the BSN as ent ry into practice, they could lose the support of many SNAs. According to Aydelotte (1991), the system of nursing education today is the result of unplanned and undirected evolution, compromise, timidity, and lost opportunity! There had been some effort on the part of certain

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34 nursing organizations to establish the baccalaureate degree as entry level into the profession, but the ANA had remained stagnant on the issue. North Dakota was the only state that had successfully implemented the requirements of a BSN degree for entry into practice as an RN and an AND for those practicing as LPNs. This policy had been in existence since 1987. These changes were implemented through the North Dakota Board of Nursing by rewriting the regulatory rules. The new regulations i ncluded a 1987. This regulation allowed these nurses to continue to practice in North Dakota regardless of their educational credentials. The students entering nur sing programs after 1987 were required to be BSN prepared to practice as an RN and ADN prepared to practice as an LPN in North Dakota (Milburn & Lambeth, 1994). For more than fifteen years, these changes were successfully implemented in North Dakota. Howev er, in 2003, a number of opposing healthcare groups successfully sponsored legislation to rescind the new educational requirements (Smith, 2010). Audiology The Doctor of Audiology (Au.D.) was the first professional degree for audiologists and was rapidly b ecoming the required degree for entry into the practice of Audiology in state licensure statutes, as these laws come up for review in the legislative cycle. Previously the ver, as of late States (Academy of Doctors of Audiology, 2009a; Academy of Doctors of Audiology, 2009b). A professional doctorate was the highest post baccalau reate degree given in a particular profession for the purpose of clinical practice. This was in contrast to the Ph.D. degree which was earned and awarded to students pursuing careers in research and academia. Ph.D. candidates might have previously earned the Au.D. degree if they were practicing audiologists.

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35 The following was a brief history of the recent evolution of the professional doctorate in Audiology. In 1978, the American Speech Language Hearing Association (ASHA) Task Force on Science discussed th e need for a professional doctorate to free Ph.D. programs from becoming adequate professional preparation and in 1984 an ASHA Task Force recommended a professional d octorate. In 1986 the ASHA Audiology Task Force recommended the Au.D. become the entry level degree by 1998. In 1988, ADA sponsored the first Conference on Professional Education for Audiology, which called for Audiology training to move to a doctoral leve l. Out of this effort, in 1989 the Audiology Foundation of America (AFA) was formed with a charge to "transform Audiology to a doctoral profession with the Au.D. as its distinctive designator." In the same year, an ASHA Task Force recommended that "ASHA sh ould strongly endorse the concept of the professional doctorate" and recommended that it should be post baccalaureate, not a post masters degree. In the period from 1990 1992, six independent surveys reported that the majority of audiologists supported th e concept of the Au.D. degree. In 1992, the ASHA Ad Hoc Committee on Professional Education recommended the Au.D. as the entry level degree to practice setting the year 2001 as a target date for implementation. Several Audiology related professional organi development and implementation (Academy of Doctors of Audiology, 2009a; Academy of Doctors of Audiology, 2009b). In 1994, the AFA awarded a $25,000 grant to Baylor College of Medicine for establis hing the first Au.D. program. In 1995, the AFA sponsored the Au.D. Standards and Equivalency (S&E) Conference. Numerous audiology organizations participated, including ADA. The goal of

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36 the S&E Conference was to develop mechanisms to recognize the experient ial equivalency of current practitioners and to develop standards of education for the Au.D. degree programs. In 1995, ASHA recommended a doctoral degree for entry level to practice Audiology (not necessarily the Au.D.). However, in 1997, ASHA postponed th e transition to a doctoral degree as entry to the year 2012. In 1997, ADA helped AFA sponsor fellowships for Au.D. students in 4 universities. By 1998, six residential Au.D. programs were available. That same year, ADA voted to change its bylaws to require the Au.D. degree for new Fellow members by the beginning of 2001 (Academy of Doctors of Audiology, 2009a; Academy of Doctors of Audiology, 2009b). For current practitioners who wanted to be part of this professional transition, a mechanism for earning a post In 1999, Nova Southeastern University began the first distance learning Au.D. program for practicing audiologists. Shortly following, the University of Florida, Central Michigan University, Pennsylvania C ollege of Optometry and the Arizona School of Health Sciences opened up other distance learning programs for practicing audiologists. Ph.D. degrees earned their Au.D. degree before these transitional p rograms began to be phased out. In 2009, only the Arizona School of Health Sciences and the University of Florida still accepted practicing audiologists into their distance learning program (Academy of Doctors of Audiology, 2009a; Academy of Doctors of A udiology, 2009b). In 2009, there were more than 70 programs offering a residential Au.D. degree, and efforts continued to strengthen the educational curriculum and training e xperience through a strong accreditation body that was independent of any membership organization (Academy of Doctors of Audiology, 2009a; Academy of Doctors of Audiology, 2009b). It was the hope of the

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37 Academy of Doctors of Audiology that through this p rocess (helped along with some consolidation), fewer (but more robust) professional programs would emerge to train future Doctors of Audiology. Summary d that dental hygienist s w ould prosper in our global, knowledge ba sed economy. Professions had to be educationally competent to earn societal trust and recognition. As a whole, dental hygienists we re generally less educated than practitioners in occupational therapy, physical therapy, physician assistant, and audiology. Some allied health professions ha d worked to require advanced degrees for entry into practice. Advanced levels of education within the ranks of the profession increase d the value of the profession to society and advance d the credibility of the profession i n the eyes of the consumer. Goals such as self regulation, direct reimbursement for services, and practice autonomy would have be en more achievable if the public view ed the profession as highly educated.

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38 CHAPTER 3 METHODOLOGY This chapter examines the re search methods used to answer three questions: Was there a difference in perceptions among Florida state college dental hygiene program directors and Florida community college dental hygiene program directors that a baccalaureate degree should result from a dental hygiene education program? Was there a difference in perceptions among Florida state college dental hygiene program directors and Florida community college dental hygiene program directors about the need for the establishment of additional dental hygiene baccalaureate degree completion programs in Florida? Was there a difference in perceptions among Florida state college dental hygiene program directors and Florida community college dental hygiene program directors about their ins t dness to establish a dental hygiene baccalaureate degree completion program ? This chapter includes four sections: (a) research design, (b) study participants and rationale for selection, (c) instrumentation: Florida and (d) data collection. IRB approval was obtained from the University of Florida to conduct this study. Research Design The research design was an electronic survey instrument e mailed to ten Florida state college dental hygiene program directors and se ven Florida community college dental hygiene program directors using www.kwiksurveys.com The survey consisted of two parts. The first part of the questionnaire, completed by all responding Florida dental hygiene program directors, was comprised of 15 general questions about the current and future status of program faculty, as well as basic program demographic questions and student program admission requirements. The second part of the questionnaire was comprised o f 14 questions directed to the program directors

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39 regarding their perceptions about dental hygiene baccalaureate degree completion programs in Florida. The survey instrument can be found in Appendix A. With the assistance of a statistician, all data were en tered into an Excel 2010 spreadsheet program and analyzed using SAS software program version 9.2. To further explore issues beyond basic descriptive statistics, an independent samples t test was used to compare responses between the state college dental hy giene program directors and the community college dental hygiene program directors. Since the sample size was small (N 1 =7, N 2 =7), the Mann Whitney U test (Wilcoxon rank sum test) was used to test whether the center of the data set of the state college dent al hygiene program directors was the same as the center of the data set of the small sample size, was used to compare those responses from state college dental hy giene program directors and community college dental hygiene program directors that could be placed in a 2 x 2 contingency table and tested for statistical significance. For those comparative responses that could not be placed in a 2 x 2 contingency table, square test was used. The =0.05 level was chosen for significance. In this report, all data have been rounded to whole numbers. To facilitate the t test, Mann square test, some survey variables of int erest were recoded. Institutional settings were parsed into two categories (state college and community college). Credentials required for full time or part time faculty appointment were divided into three categories (discipline experience, academic degree and teaching experience). Two of these categories were further subdivided: discipline experience (1 2 years, 3 number of years of education required for admission to a pr ogram was also sorted into two

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40 categories (less than one year of college or high school diploma/GED, and one or two years of college. Finally, responses to the questions on perceptions/opinions were recoded into 5 point wa s done with attention to the underlying distribution of the variables. Study Participants and Rationale for Selection Seventeen Florida dental hygiene program directors were asked to participate in this study; ten were program directors at Florida state c olleges, seven were program directors at Florida community colleges. Florida dental hygiene program directors were appropriate for this study as the focus was on the differences in the perceptions of Florida state college and community college dental hygie ne program directors. Dental hygiene program directors were in the best positions to respond to questions regarding dental hygiene faculty needs and requirements within their own programs. They were also in the best position to assess the need for more den tal hygiene baccalaureate degree completion programs and whether their programs were prepared to establish a dental hygiene baccalaureate degree completion program. Of the seventeen Florida dental hygiene program directors asked to participate, fourteen re sponded: seven were state college dental hygiene program directors and seven were community college dental hygiene program directors, for a response rate of 82 percent.

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41 Description of the Sites All seventeen dental hygiene programs in Florida were located throughout various parts of the state. The ten state colleges were: Broward College (Ft. Lauderdale), Daytona State College (Daytona Beach), Edison State College (Ft. Myers), Florida State College at Jacksonville, Indian River State College (Fort Pierce), Miami Dade College (Miami), Palm Beach State College (Lake Worth), Pensacola State College (Pensacola), Santa Fe College (Gainesville), and State College of Florida Manatee/Sarasota (Bradenton). The seven community colleges were: Brevard Community College (Cocoa), Gulf Coast Community College (Panama City), Hillsborough Community College (Tampa), Pasco Hernando Community College (New Port Richey), South Florida Community College (Avon Park), Tallahassee Community College (Tallahassee), and Valencia Communi ty College (Orlando). All of the programs granted Associate of Science (A.S.) in Dental Hygiene degrees to students upon graduation. The three dental hygiene program directors who did not respond to the survey were from state colleges; these schools were F lorida State College at Jacksonville, Santa Fe College (Gainesville), and Edison State College (Ft. Myers). St Petersburg College was excluded from this study as it was the only Florida institution that offered its students a dental hygiene baccalaureate d egree completion program (Baccalaureate of Applied Science in Dental Hygiene, B.A.S.D.H.) in addition to an Associate of Science (A.S.) in Dental Hygiene program. Perceptions Survey The Florida Den baccalaureate degree completion programs in Florida and if the program directors were prepared

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42 to establish a dental hygiene baccalaureate degree completion program at their own institutions should the need arise. Some questions used a 5 point Likert scale which reflect ed the response in the blank, Yes/No, and questions that asked the respondent to choose all applicable responses. Completion time wa s approximately 25 minutes. Instrument Design The survey instrument was designed based in part on a survey instrument designed by Collins et al (2007a), which was extrapolated from the 1999 National Study of Postsecondary Faculty (NSOPF) published by the N ational Center for Education Statistics. Other questions were extrapolated from the survey instrument used in the November 2008 ADEA Dental A formal pilot testing of the survey was conducted, using t hree current full time dental hygiene faculty members and one dental hygiene clinical supervisor at a state college, the Dean of Health Sciences from St. Petersburg College, and the Director of Baccalaureate Programs from Indian River State College. Some o f the questions on the survey were also previously tested by considering the previous validation of the NSOPF items during the 1993 and 1999 cycles by Abraham et al. (2002) and Selfa et al. (1997). This study began after receiving approval from the Univers ity of Florida Institutional Review Board. A list of existing Florida dental hygiene Florida Allied Dental Educators (2009). Data Collection Data was collected from fou rteen Florida dental hygiene program directors (seven state college, seven community college) using an electronic survey instrument. The survey instrument was e mailed to the program directors using www.kwiksurveys .com Along with the link to the

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43 survey instrument, a cover e mail and instructions for completing the survey were sent. Participants were given more than four weeks to complete and submit the survey electronically. Two weeks after the original survey dea dline, nonresponders were reminded via e mail with an embedded survey instrument link and given additional time to respond. With the advent of security fire walls placed onto campus computer networks, the researcher called each dental hygiene program direc tor who had not responded to the survey four weeks after the initial mailing. The message left for the dental hygiene program directors simply stated that if the director had received the e mail requesting participation in the study and the director was ch oosing not to participate, then thanks were given for their time. If, however, they had not mail, then they were asked to please e mail or telephone the researcher so a new e mail with the survey link could be sent out again. This action resulted in many more surveys being received by the researcher. Participation in the survey was voluntary, and failure to respond after the second e mailing and follow up phone call was considered as a choi ce not to participate.

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44 CHAPTER 4 RESULTS Fourteen Florida dental hygiene program directors responded (seven state colleges and seven community colleges, as shown in Table 4 1), for a response rate of 82 percent. Characteristics of state colleges and comm unity colleges were addressed separately to provide a comprehensive profile of each institution. Table 4 1. Institutional setting of responding Florida dental hygiene program directors. Institutional setting Dental Hygiene Program (N=14) n Percent State College 7 50 Community College 7 50 Institutional Demographics All responding Florida dental hygiene program di rectors were female. All responding directors indicated that all students in their programs graduated with eighty eight college credits. Table 4 2 reflected that six state college dental hygiene program directors indicated that the minimum number of years of education required for student admission into their program was one or two years of college (86%), while three community college dental hygiene program directors stated the same (43%). Only one state college dental hygiene program required less than one year of college or high school diploma/GED for admission (14%), whereas four community college dental hygiene programs required the same (57%). Table 4 2. Minimum number of years of education required for student admission to dental hygiene programs, by institutional setting. State College (N=7) Community College (N=7) n Percent n Percent Less than one year of college or high school diploma/GED 1 14 4 57 One or two years of college 6 86 3 43

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45 Number of Full Time F aculty In Table 4 3, state college dental hygiene program director respondents indicated that the number of full time dental hygiene f aculty in their programs ranged from 1.5 to 5 faculty, for a total of 22.5 full time faculty in all responding Florida state college dental hygiene programs. Of these 22.5 f ull time faculty, 12.5 (56%) had baccalaureate degrees in dental hygiene; the other ten (44%) faculty ha d baccalaureate degrees in a wide variety of disciplines, including Health Services Administration, Education, Nursing, Vocational Education, and others. One (10%) of these latter full time fa culty wa s a dentist. Table 4 3. Total numbe r of full time dental hygiene faculty, number of full time dental hygiene faculty with baccalaureate degrees in dental hygiene, and number of full time dental hygiene faculty with baccalaureate degrees in a discipline other than dental hygiene, by institut ional setting (N=14). State College (N=7) Community College (N=7) n Percent n Percent Total number of full time faculty 22.5 100 21.5 100 Total number of full t ime faculty with baccalaureate degrees in dental hygiene 12.5 56 4 19 Total number of full time faculty with baccalaureate degrees in a discipline other than dental hygiene 10 4 4 17.5 81 Community college dental hygiene program directors indicated that the number of full time dental hygiene faculty in their programs ranged from 2 to 5 faculty, for a total of 21.5 full time faculty in all responding Flori da community college dental hygiene programs. Of these 21.5 full time faculty, only four (19%) ha d baccalaureate degrees in dental hygiene; the other 17.5 (81%) faculty ha d baccalaureate degrees in a wide variety of disciplines, including Accounting, Frenc h, Political Science, Environmental Science, Information Systems, and others. Three (17%) of these latter full time faculty we re dentists.

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46 Number of Part Time F aculty In Table 4 4, responses from Florida state college dental hygiene program directors indic ated that the number of part time faculty in their programs ranged from 4 to as many as 22 faculty, for a total of 65 part time faculty in all responding Florida state college dental hygiene programs. Of these 65 part time faculty, sixteen (25%) ha d baccal aureate degrees in dental hygiene; the other 49 (75%) faculty ha d baccalaureate degrees in a wide variety of disciplines, including Science, Liberal Arts, Health Sciences, Business, Arts, and others. Five (10%) of these latter part time faculty we re denti sts. Table 4 4. Total number of part time dental hygiene faculty, number of part time dental hygiene faculty with baccalaureate degrees in dental hygiene, and number of part time dental hygiene faculty with baccalaureate degrees in a discipline other than dental hygiene, by institutional setting (N=14). State College (N=7) Community College (N=7) n Percent n Percent Total number of part time faculty 65 100 49 100 Total number of part time faculty with baccalaureate degrees in dental hygiene 1 6 2 5 2 4 4 9 Total number of part time faculty with baccalaureate degrees in a discipline other than dental hygiene 49 75 2 5 5 1 Responses from Florida community college dental hygiene program directors indicated that the number of part time faculty in their programs ranged from 3 to 12 faculty, for a total of 49 part t ime faculty in all responding Florida community college dental hygiene programs. Of these 49 part time faculty, twenty four (49%) ha d baccalaureate degrees in dental hygiene; the other 25 (51%) faculty ha d baccalaureate degrees in a wide variety of discipl ines, including Vocational Education, Biology, Speech/Communications, Information Systems, Health Education, and others. At least seven (28%) of these latter part time faculty we re dentists.

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47 F ull Time Faculty Required C redentials Each of the seven state c ollege respondents indicated a completely different set of credentials required for full time faculty appointment at their institution. Four (57%) state colleges required 3 5 years of experience working in the field of dental hygiene as a requirement while three (43%) state colleges required more than 5 years of field experience. None (0%) of time appointment. Three (43%) state colleges required a baccalaureate degree for full time appo intment while four (57%) time appointment. On the other hand, full time appointment credentials for the responding community colleges were slightly different fr om those for state colleges, although each community college (except for two) indicated completely different requirements from each other. Three (43%) community colleges required only 1 2 years field experience while only one (14%) school required more tha n 5 years field experience. Three (43%) community colleges did not require any baccalaureate degree for full time appointment. Four (57%) community colleges required only a required teaching experience for full time appointment, which differ ed greatly from the only two (29%) state colleges that did. A summary of full time faculty credentialing requirements by institutional setting were found in Table 4 5. Part Time Faculty Required C redentials Three of the seven (43%) responding state college s had the same credentials requirements for part time faculty appointment (3 5 years field experience and baccalaureate degree). The

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48 other four responding state colleges each had different credentials requirements for part time faculty appointment: Two (2 9%) state colleges required 1 2 years field experience, one (14%) required 3 5 years field experience, and one (14%) required more than 5 years field experience for part time faculty appointment. Associate degrees were required at two (29%) state colleges and baccalaureate degrees were required at two (29%) state colleges; none (0%) of the state time faculty appointment. None (0%) of the state colleges required teaching experience for part time faculty appointmen t. Table 4 5. Credentials required for full time dental hygiene faculty appointment by institutional setting. State College (N=7) Community College (N=7) n Percent n Percent Dental Hygiene Field Experienc e None 1 2 years 3 5 years >5 years 0 0 0 0 4 57 3 43 3 43 3 43 0 0 1 14 Education None Associate Baccalaureate Master 0 0 0 0 3 57 4 43 0 0 0 0 5 71 2 29 Teaching Experience Yes No 2 29 5 71 5 71 2 29 Two of the seven (29%) responding community colleges had the same credentials requirement for part time faculty appointment (1 degree). The other five responding community colleges each had different creden tials requirements for part time faculty appointment: one (14%) community college required 1 2 years field experience, 2 (29%) required 3 5 years field experience, none (0%) required more than 5 years field experience, and two (29%) did not require any fie ld experience at all for part time faculty appointment. Two (29%) community colleges required an associate degree and two

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49 degree for part time faculty appointmen t. One (14%) community college indicated no educational requirement for faculty appointment. Two (29%) of the community colleges required teaching experience for part time faculty appointment. A summary of part time faculty credentialing requirements by in stitutional setting were found in Table 4 6. Table 4 6. Credentials required for part time dental hygiene faculty appointment by institutional setting. State College (N=7) C ommunity College (N=7) n Percent n Percent Dental Hygiene Field Experience None 1 2 years 3 5 years >5 years 0 0 2 29 4 57 1 1 4 2 29 3 43 2 29 0 0 Education None Associate Baccalaureate Master 0 0 2 29 5 7 1 0 0 1 14 4 57 2 29 0 0 Teaching Experience Yes No 0 0 7 100 2 29 5 71 Other I nstitutional Dental Hygiene P rogram D emographics When asked if their institution had to hire individuals for thei r program whose credentials were lower than thei r minimum required credentials in order to f ill a critical faculty position (see Table 4 7). Question 7 asked responden ts if their institution had to redistribute workload to existing faculty in order to compensate for an unfilled full time position ; two (29%) state college (see Table 4 8). Question 8 was the same as question 7, but with regards to part time faculty;

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50 9). Table 4 7. Institutional need to hire dental hyg iene faculty with credentials lower than minimum requirement in order to fill critical dental hygiene faculty positions, by institutional setting. State College (N=7) Community College (N=7) n Percent n Pe rcent Yes 0 0 1 14 No 7 100 6 86 Table 4 8. Institutional redistribution of workload to existing dental hygiene faculty in order to compen sate for unfilled full time dental hygiene faculty positions, by institutional setting. State College (N=7) Community College (N=7) n Percent n Percent Yes 2 29 4 57 No 5 71 3 43 Table 4 9. Institutional redistribution of workload to existing dental hygiene faculty in order to compensate for unfilled part time dental hygiene faculty position s, by institutional setting. State College (N=7) C ommunity College (N=7) n Percent n Percent Yes 1 14 4 57 No 6 86 3 43 Question 9 asked those surveyed if they anticipated a need for replacement of full time faculty within the next five years : Table 4 10 reflects that two (29%) state college answered time faculty they anticipated to replace; all time faculty would be replaced. Quest reasons why they would expect to replace any full time faculty: both state college respondents indicated faculty retirement as the reason for replacement, while two community college respondents indic ated retirement as the reason and one community college respondent indicated

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51 the anticipated return of the availability of a full time position at her institution. Responses were summarized in Table 4 11. Table 4 10. Anticipated need for replacement of ful l time dental hygiene faculty within the next five years, by institutional setting. State College (N=7) Community College (N=7) n Percent n Percent Yes 2 29 3 43 No 5 71 4 57 Table 4 11. Reasons for anticipated replacement of full time dental hygiene faculty within the next five years, by institutional setting. State College (N=2) Community College (N=3) n Percent n Percent Faculty retirement 2 100 2 67 Return of full time dental hygiene faculty positions available at institution 0 0 1 33 When respondents were asked if there were currently any unfilled full time faculty (0%) of the c unfilled part time positions at their institutions; one (14%) state college respondents answered 1 2 for a summary of the responses to questions 12 and 13). Table 4 12. Currently available unfilled full time and part time dental hygiene faculty positions, by institutional setting. State College (N=7) Community College (N=7) n Percent n Percent Full time Yes No 2 29 5 71 0 0 7 100 Part time Yes No 1 14 6 86 2 29 5 71

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52 Perceptions on Dental H ygiene Baccalaureate Degree Completion P rograms The second part of the survey asked the dental hygie ne program directors about their perceptions about dental hygiene baccalaureate degree completion programs. There were fourteen questions included in the second part of the survey. Nearly four 36%) that a baccalaureate degree should result from a dental hygiene educational program. There was no statistically significant difference in responses between state college dental hygiene program directors and community college dental hygiene program dir ectors (p=0.7333, Mann Whitney U test; do not reject H 01 ). While no state college dental hygiene programs directors responded negatively to this question, two out of seven (29%) community college dental hygiene program 4 13 summarized these data. Table 4 a dental hygiene education program, by institutional setting. State College (N =7) Community College (N=7) n Percent n Percent Agree Somewhat agree Neither agree nor disagree Somewhat disagree Disagree 2 29 4 57 1 14 0 0 0 0 4 57 1 14 0 0 1 14 1 14 Median (Interquartile Range) 2 (1 2) 1 (1 4) p value 0.733 When asked how important it would be to their institution to advance the entry level quarters of all though six out of seven (86%) state college dental hygiene program directors answered in the positive compared to four out of seven (57%) community college dental hygiene program directors answering in the

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53 positive, the difference was not statistically sig nificant (p=0.1212, Mann Whitney U test). No state college dental hygiene program directors responded negatively to this question, while three 14 summarized these data. Similarly, when asked how important it would be to their community to advance the entry level educational requirement significant difference between responses from state college dental hygiene program directors and community college dental hygiene program directors (p=0.1329, Mann Whitn ey U test). Interestingly, four out of seven (57%) of community college dental hygiene program directors to advance the entry level educational requirement for dent while one out of seven (14%) state college dental hygiene program directors felt that way. Table 4 15 summarized these data. Table 4 institution to advance the entry degree, by institutional setting. State College (N=7) Community College (N=7) n Percent n Percent Important Somew hat important Neutral/No opinion Somewhat unimportant Unimportant 3 43 3 43 1 14 0 0 0 0 1 14 3 43 0 0 2 29 1 14 Median (Interquartile Range) 2 (1 2) 2 (2 4) p value 0.121 Ninety ase the availability of dental hygiene baccalaureate degree completion programs in Florida, yet there was no statistically significant difference between responses from

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54 Table 4 comm unity to advance the entry degree, by institutional setting. State College (N=7) Community College (N=7) n Percent n Percent Important Somewhat important Neutral/No opinion Somewhat unimportant Unimportant 3 43 2 29 1 14 0 0 1 14 1 14 1 14 1 14 2 29 2 29 Median (Interquartile Range) 2 (1 3) 4 (2 5) p value 0.133 state college dental hygiene program directors and community college program direct ors (p=0.4760, Mann Whitney U test; do not reject H 02 ). Table 4 16 summarized these data. Correspondingly, eighty five percent of all respondents indicated that if more Florida dental hygiene baccalaureate degree completion programs were available in Flori da, this would faculty. Again, there was no statistically significant difference between replies from state college dental hygiene program directors and community c ollege dental hygiene program directors Table 4 dental hygiene baccalaureate degree completion programs in Florida, by institutional setting. State College (N=7) C ommunity College (N=7) n Percent n Percent Important Somewhat important Neutral/No opinion Somewhat unimportant Unimportant 6 86 1 14 0 0 0 0 0 0 5 71 1 14 0 0 1 14 0 0 Median (Interquartile Range) 1 (1 1) 1 (1 2) p value 0.476 (p= 0.6526, Mann Whitney U test). In fact, there was no difference at all in responses, as six out of seven (86%) state college dental hygiene program directors and six out of seven (86%) community college dental hygiene program directors gave positive answers Only one

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55 community college dental hygiene program director responded negatively (14%), while zero state college dental hygiene program directors answered negatively (0%). Table 4 17 summarized these data. Table 4 e difficulty in finding qualified dental hygiene faculty would be eased if more Florida dental hygiene baccalaureate degree completion programs were available, by institutional setting. State College (N=7) Community College (N=7) n Percent n Percent Greatly Somewhat Neutral/No opinion Slightly Not at all 2 29 4 57 1 14 0 0 0 0 1 14 5 71 0 0 0 0 1 14 Median (Interquartile Range) 2 (1 2) 2 (2 2) p value 0.653 hat baccalaureate degree in dental hygiene. Not surprisingly, there was no statistically significant difference between responses from state college dental hygien e program directors and 18 summarized these data. When asked if there were currently enough other institutions in their service area which met the needs of their st udents (affordability, short traveling distance, etc.), and offered baccalaureate degrees for their students/graduates to be able to easily pursue a Table 4 their program s to have the opportunity to pursue a baccalaureate degree in dental hygiene, by institutional setting. State College (N=7) Community College (N=7) n Percent n Percent Important Somewhat important Neutral /No opinion Somewhat unimportant Unimportant 6 86 1 14 0 0 0 0 0 0 4 57 3 43 0 0 0 0 0 0

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56 baccalaureate degree (not necessarily in dental hygiene), seventy one percent of all respondents c ollege dental hygiene program directors and community college program directors (p=0.5594, The next part of the survey asked questions regarding the fourteen dental hygiene degree completion program at their institution. The program directors were informed that one of the first steps necessary to decide whether to offer a dental hygiene baccalaureate degree completion program is to conduct a feasibility study (surveying pote ntial employers, students, and graduate schools). Then the community coll significant difference was noted between responses from state college dental hygiene program t). Dental hygiene program directors were then informed that another step towards the path of offering a dental hygiene baccalaureate degree completion program is to create partnerships, nstitution prepared to develop partnerships with such departments as institutional technology (IT) staff, admissions staff, and the institutional research division within your institution, as well as external partnerships such as other higher education ins quarters of all respondents college dental hygiene program directors and community college dental hygiene progra m

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57 When asked if their institution ha d the financial resources available for new baccalaureate college dental hygi ene program directors and community college dental hygiene program directors (four out of seven, or 57%, each). As such, there was absolutely no difference in available to them for development of a dental hygiene baccalaureate degree completion program. Two out of seven (29%) state college dental hygiene program directors A statistically significant difference in responses between the two institutional settings was not Alt hough all of the community college dental hygiene program directors indicated that financial resources would NOT be available to them to develop a dental hygiene baccalaureate degree completion program at their institution, two (29%) of them DID indicate t hat their institution would be prepared to make the changes necessary to achieve the development and establishment of such a program, which was the next question in the survey. The two (29%) between responses from state college dental hygiene program directors and community college dental hygiene program directors (p=1. 03 ). Of the four respondents to the question a bout whether their institution wa s prepared to make the changes necessary to achieve the development and establishment of a dental hygiene baccalaureate degree completio n program, one state college dental hygiene program director

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58 indicated that the most likely date of program implementation would be 2014; two state college dental hygiene program directors and two community college dental hygiene program directors indicate d this date would most likely be 2015. implement a dental hygiene baccalaureate degree completion program, what is the most likely onses from state college dental hygiene program directors indicated a blended format (mostly on line with a few face to face meetings) for three of them (43%), three (43%) responded the format would most likely be completely on line, and one (14%) responde respond to the two above questions as I do not know if my institution is prepared to make the changes. There are numerous bachelor degree options going forward at this time, but dental hygiene has not been one of them. nity college dental hygiene program directors responded as follows: one (14%) indicated the most likely format would be completely on line, another one (14%) answered the format would most likely be blended, a third (14%) indicated their institution is not interested in developing a dental hygiene baccalaureate degree completion program at this time. The last three (49%) community I can't speak about what the school would b e interested in We are currently investigating the potential of operating a BS in Health Information System Several of the questions above cannot be specifically answered without having first had an opportunity to speak with the College administ ration about such possibilities. If our college were to offer a baccaulaureate degree completion program, it would likely be online. Analysis of Research Questions Since there was strong support among Florida state college and community college dental hyg iene program directors for the advancement of the baccalaureate degree as the entry level

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59 requirement for dental hygiene, with no statistically significant difference in responses (p=0.7333, Mann Whitney U test), the first null hypothesis (H 01 : There was n o difference in perceptions among Florida state college and community college dental hygiene program directors that a baccalaureate degree should result from a dental hygiene education program) baccalaureate degree should result from a dental hygiene program were both dental hygiene asking whether financial resources would b e available to them for development of a dental hygiene baccalaureate degree completion program. It is interesting to note that both of the community colleges represented by these dental hygiene program directors we re not slated to become part of the Flori da state college system in the future; they r emain ed community colleges and never offer baccalaureate degrees to their surrounding community. It was speculated that the The second null hypothesis (H 02 : There was no difference in perceptions among Florida state college and community college dental hygiene program directors about the need for more dental hygiene baccalaureate degree completion programs in Florida) also failed to be re jected due to no statistically significant difference in responses when the dental hygiene program directors were asked how important it was to increase the availability of dental hygiene baccalaureate degree completion programs in Florida (p=0.4760, Mann Whitney U test). Of interest to note was that although thirteen of the fourteen total respondents answered in the positive to this question, the only dissenter was a community college dental hygiene program director. It is possible that this program direct or feels that having one baccalaureate degree

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60 completio n program available in Florida wa s enough, especially considering that the program wa s completely online and was readily accessible from anywhere within the state. Lastly, the third null hypothesis (H 0 3 : There was no difference in perceptions among Florida state college and community college dental hygiene program directors about their completion program) failed to be rejected as there also was no statistically significant differences in responses between state college and community college Florida dental hygiene program directors to the question that asked if their institution would be prepared to makes the changes necessary t o achieve the development and establishment of a dental hygiene baccalaureate degree e w attention to this data wa s how responses from both state college and community college dental hygiene program d irectors were exactly the same: two state college and two community college dental hygiene program directors respondent represent ed institutions located in large metropolitan areas, and one state college and areas. Table 4 19 summarized the se data. Table 4 19. Summary of analysis of research questions Null Hypotheses p value Statistical Test Status H 01 H 02 H 03 0.7333 0.4760 1.0000 Mann Whitney U Mann Whitney U Fail to reject Fail to reject Fail to reject

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61 CHAPTER 5 CONCLU SIONS Introduction This study investigated the current faculty needs at Florida dental hygiene programs and the perceptions of those program directors on possible future educational needs for their faculty, and determined whether those programs we re prepar ed to establish a dental hygiene baccalaureate degree completion program if the need ar o se. A 29 question electronic survey was e mailed to ten Florida state college dental hygiene program directors and seven Florida community college dental hygiene progra m directors. Fourteen Florida dental hygiene program directors responded to the survey (seven state colleges and seven community colleges). The survey instrument was designed based in part on a survey instrument designed by Collins et al (2007a), which was extrapolated from the 1999 National Study of Postsecondary Faculty (NSOPF) published by the National Center for Education Statistics. Other questions were extrapolated from the survey instrument used in the November 2008 A merican Dental Education Associa 2010). Survey responses were analyzed using SAS software program version 9.2. The study was conducted after approval was received from the University of Florida Institutional Review Boar d in November 2010. Discussion of F indings This research study answered three research questions: Was there a difference in perceptions among Florida state college dental hygiene program directors and Florida community college dental hygiene program direct ors that a baccalaureate degree should result from a dental hygiene education program? Was there a difference in perceptions among Florida state college dental hygiene program directors and Florida community college dental hygiene

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62 program directors about t he need for the establishment of additional dental hygiene baccalaureate degree completion programs in Florida? Was there a difference in perceptions among Florida state college dental hygiene program directors and Florida community college dental hygiene program directors about their ins t baccalaureate degree completion program ? Since there was strong support among Florida state college and community college dental hygiene program directors for the advan cement of the baccalaureate degree as the entry level requirement for dental hygiene, with no statistically significant difference in responses state college and c ommunity college dental hygiene program directors that a baccalaureate ult from a dental hygiene program were both dental hygiene program directors at community resources would be available to them for development of a dental hygiene bacc alaureate degree completion program. It wa s interesting to note that both of the community colleges represented by these de ntal hygiene program directors we re not slated to become part of the Florida state college system in the future; they remain ed commun ity colleges and never offer ed baccalaureate degrees to their surrounding community. It was speculated that the dental hygiene program among Florida state college and community college dental hygiene program directors about the need for more dental hygiene baccalaureate degree

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63 no statistically significant difference in res ponses when the dental hygiene program directors were asked how important it was to increase the availability of dental hygiene baccalaureate degree completion programs in Florida (p=0.4760, Mann Whitney U test). Of interest to note was that although thirt een of the fourteen total respondents answered in the positive to this question, the only dissenter was a community college dental hygiene program director. It was possible that this program director fel t that one baccalaureate degree completion program av ailable in Florida is e nough especially when it was consider ed that th e program wa s completely online and was readily accessible from anywhere within the state. state preparedness to establish a dental hygiene baccalaureate degree be rejected as there also was no statistically significant differences in responses between state college and community college Florida dental hygiene program directors to the question that asked if their institution would be prepared to makes the changes necessary to achieve the development and establishment of a dental hygi ene baccalaureate degree completion program ew attention to this data wa s how responses from both state college and community college dental hygiene program directors were exactly the same: two state college and two co and five state college and five community college dental hygiene program directors replied ed instit utions located in large metropolitan areas, and one state college and one community college

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64 Conclusions This was the first study done which wa s solely based on the perceptions o f Florida dental hygiene program directors. The proportion of responding Florida dental hygiene program directors was equal numbers from state colleges (N=7) and community colleges (N=7). The response rate was 82%. The majority of all respondents supported advancing the entry level echoed the four year institutional setting responses to the ADEA Council of Allied Program mission on Dental Accreditation (CODA) become the point of entry into dental hygiene (Okwuje et al, 2010). This sentiment was again confirmed at the 2006 ADEA Summ it on Allied Dental Education (American Dental Education Association, 2007). There was no statistically significant difference between Florida state college and community college dental hygiene program directors in the responses to the survey. This showed institutional setting. This was vastly different from the 2008 ADEA Council of Allied Program etermining responses: four year institutions scored higher than two year institutions in agreeing whether completing a dental hygiene program should result in a baccalaureate degree (Okwuje et al, 2010). The results of this study presented an interesting p aradox : while respondents agreed that a baccaulareate degree should result from a dental hygiene education program and that their institutions have the financial resources for new baccalaureate program development, few responded that their institutions wer e willing to use those financial resources for dental hygiene baccalaureate degree completion program development. At the same time, a number of dental

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65 hygiene program directors anticipate d the need to replace some full time faculty sometime in the next fi ve years due to faculty retirement. Moreover, many dental hygiene program directors had to hire dental hygiene faculty with credentials lower than the minimum requirement in order to fill critical dental hygiene faculty positions. CODA dental hygiene progr am accreditation standards require d that all dental hygiene program faculty must possess at least a baccalaureate degree. With only one dental hygiene baccalaureate degree completion program available in Florida, how will qualified dental hygiene faculty b e recruited in Florida in the future? Another future problem for Florida dental hygiene programs w ould be when the entry level for dental hygiene is nationally advanced to the baccalaureate degree. Not only w ould dental hygiene programs be forced to trans ition their associate degree programs to baccalaureate degree programs, the accre ditation standard for faculty would change. For baccalaureate degree granting institutions, faculty had to The results of this study show ed that the associate degree dental hyg iene programs in Florida had difficulty recruiting qualified dental hygiene faculty possessing at least a baccalaureate degree ; how much more difficult w ould it be to recruit qualified dental hygiene faculty possessin g at least a ? Florida must look ahead and be prepared for the changes in the dental hygiene profession. Implications for Dental Hygiene E ducation These results w ould be useful for the American Dental Education Association ( ADEA ) which nat ionally represent ed dental and allied dental education, for the A merican Dental Hygienists; Association (A DHA ) which nationally represent ed the interests of all dental hygienists, and for the American Dental Association ( ADA ) which annually survey ed and provide d accreditation standards for dental hygiene education through its Commission on Dental Accreditation (CODA) (2010). The former two organizations would be critical in overcoming

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66 the shortage of dental hygiene educators likely to result from the reti rement plans of current faculty. The latter organization would need to reconsider revising their accreditation standards to include accrediting dental hygiene baccalaureate degree completion programs. As of 2010, CODA only accredited entry level (associate certificate, and bachelor programs) dental hygiene programs in the United States. Dental hygiene baccalaureate degree completion programs were accredited by the regional accreditation agency for that program. For example, the only Florida school which of fered a dental hygiene baccalaureate degree completion program also had an entry level (associate degree) dental hygiene program that was accredited by CODA, while the dental hygiene baccalaureate degree completion program was accredited by the Southern As sociation of Colleges and Schools (SACS), not CODA. Making the baccalaureate degree the only accepted entry level degree for dental hygiene opened doors of opportunity for graduates who were otherwise be limited to clinical practice. It also i mpact ed the s hortage of dental hygiene educators by supplying graduates who were qualified to enter the ranks of academia. Implications for Higher Education L eaders Florida was in a unique situation in that it had essentially been a national pioneer in offering baccala ureate degrees through their community colleges; these colleges had been differentiated from traditional community colleges by being called state colleges. With the projected shortage of dental hygiene educators in Florida, and the availability of only one completely online baccalaureate degree completion program within Florida, it behooved higher education leaders to consider allowing other state colleges to develop and establish additional dental hygiene baccalaureate degree programs in Florida. Those pro grams would be offered in different formats from the model used by the only college which offered a dental hygiene baccalaureate degree completion program, as students w ould have had a variety of program delivery options made available to them. Blended (so me face to face meetings with the rest of

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67 the content online, or a 50/50 offering), traditional (all in the classroom with 100% face to face meetings, or some other delivery options w ould have been considered for other format offerings. This would have ens ured that tuition dollars were more evenly distributed among the state colleges, instead of one college receiv ing all of the dental hygiene baccalaureate degree completion program dollars. Recommendations for Future S tudies With the opening of more dental hygiene programs across the state of Florida, and fewer clinical employment positions available to dental hygiene program graduates due to the national economy, opening more dental hygiene baccalaureate degree completion programs would have aid ed in givin g licensed dental hygienists the opportunity to be eligible for employment in education, public health, research, corporate settings, and hospitals, and not be limited to clinical private practice. The se degree completion programs w ould have be en evenly di stributed across Florida, and offered in a variety of delivery options so that prospective students could choose the learning format they prefer. Additional r esearch studies which assess currently licensed Florida eed for more Florida baccalaureate degree completion programs should conducted in the future. It would be interesting to discover if the dental community would support the notion of the baccalaureate becoming the entry level degree for dental hygiene. A re search study which surveyed dentists would ascertain the answer to this question. To increase graduate opportunities in dental hygiene, and to address the dental hygiene ributed across Florida for improved student access. These programs should focus on preparing future faculty and leaders of the profession in multiple roles such as teaching, research, service, and program administration. A dental hygiene doctoral program c ould also be developed in Florida.

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68 perceptions about the need for more Florida baccalaureate degree completion and dental hygiene in the future. In addition, since there were no dental hygiene doctoral programs in the United States, research which would assess the need for the establishment of dental hygiene doctoral programs would also be indicated. Other research to consider would be to contemplate whether the possibility of flooding the job market with too many baccalaureate degree earned individuals would be a wise decision in the face of a poor economic situation, and what would be the return to the institution in this instance, and what would be the return to the student. Another area for further research would be whether institutional administrators should support or oppose the creation of more baccalaureate programs. Given that some other health professions ha d already moved b eyond the baccalaureate degree as entry to practice and developed mechanisms for individuals to pursue advanced education more easily, dental hygiene must have plan ned for the baccalaureate as the entry to practice in the future and put mechanisms in place that allow ed easy access to advanced have offer ed dental hygiene practitioners the opportunity for advancement and expansion in a number of career opportunities. Creating more Florida dental hygiene baccalaureate degree completion programs represented an exciting challenge for the profession. Choosing to elevate dental hygiene education to the level attained by other health professions to advance dental hygiene education, research, and leaders hip wa s a course that require d further discussion, action, and commitment. Movement to advance the entry level educational requirement depend ed on the courage and tenacity of dental hygiene educators, researchers, clinicians, and leaders.

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69 APPENDIX FLORIDA DENTAL HYGIENE PROGR QUESTIONS Program Name: _____________________ Program Location: _______________________ Program and Faculty Demographics 1. What is the institutional setting for your program? a. State college b. Community college 2. How many full time faculty does your program have? ___________________ a. How many possess a baccalaureate degree in dental hygiene? _______ b. How many possess a baccalaureate in a discipline other than dental hygiene? ______ i. What is the baccalaureate degree in? ______ ___________________________________________ _________________________________________________ 3. How many adjunct faculty does your program have? ___________________ a. How many possess a baccalaureate degree in dental hygiene? ______ b. How many possess a baccala ureate in a discipline other than dental hygiene? ______ i. What is/are the baccalaureate degree(s) in? ________________________________________________ ________________________________________________ 4. Please identify the credentials REQUIRED for full time a ppointment in your program. Please circle ALL that apply. a. 1 2 years experience in discipline b. 3 5 years in discipline c. >5 years in discipline d. e. f. g. Teaching experience h. Other Please explain _____________________ _____________________

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70 5. Please identify the credentials REQUIRED for part time appointment in your program. Please circle ALL that apply. a. 1 2 years experience in discipline b. 3 5 years in discipline c. >5 years in discipline d. e. f. g. Teaching experience h. Other Please explain _________________________________________ 6. Has your institution had to hire individuals for your program whose credentials are lower than your minimum required credentials in order to fill a critica l faculty position? a. Yes b. No 7. Has your institution had to redistribute workload to existing faculty in order to compensate for an unfilled full time position? a. Yes b. No 8. Has your institution had to redistribute workload to existing faculty in order to com pensate for an unfilled part time position? a. Yes b. No 9. Do you anticipate a need for replacement of full time faculty within the next five years? a. Yes b. No 10. If you expect to have to replace full time faculty within the next five years, how many replacements of full time faculty do you anticipate? ______________________

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71 11. If you expect to have to replace full time faculty within the next five years, please list the reason(s) why you expect the need to replace the faculty member(s). ____________________________ ____________________________________________ ________________________________________________________________________ 12. Does your program currently have any unfilled full time faculty positions ? a. Yes b. No 13. Does your program currently have any unfilled part t ime faculty positions? a. Yes b. No 14. What is the minimum number of years of education required for student admission to your program? a. Less than one year of college or high school diploma/GED b. One or two years of college 15. How many college credits will a stud ent from your program have earned upon graduation? ____________ credits Perceptions on Dental Hygiene Baccalaureate Degree Completion Programs 1. program? a. Agree b. Somewhat agre e c. Neither agree nor disagree d. Somewhat disagree e. Disagree

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72 2. In your opinion, how important would it be to your institution to advance the entry level a. Important b. Somewhat important c. Neutr al/No opinion d. Somewhat unimportant e. Unimportant 3. In your opinion, how important would it be to your community to advance the entry level a. Important b. Somewhat important c. Neutral/No opinion d. So mewhat unimportant e. Unimportant 4. Currently, the only dental hygiene baccalaureate degree completion program in Florida is at St. Petersburg College. In your opinion, how important is it to increase the availability of dental hygiene baccalaureate degree comp letion programs in Florida? a. Important b. Somewhat important c. Neutral/No opinion d. Somewhat unimportant e. Unimportant 5. In your opinion, if more Florida dental hygiene baccalaureate degree completion programs were available, would this ease the difficulty in fin ding qualified dental hygiene faculty? a. Greatly b. Somewhat c. Neutral/No opinion d. Slightly e. Not at all

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73 6. In your opinion, how important is it for recent graduates from your program to have the opportunity to pursue a baccalaureate degree in dental hygiene? a. I mportant b. Somewhat important c. Neutral/No opinion d. Somewhat unimportant e. Unimportant 7. needs of your students (affordability, small traveling distance, etc.) that offer baccalaureate level degrees for your students/graduates to be able to easily pursue a baccalaureate degree (not necessarily in dental hygiene)? a. Yes b. No 8. One of the first steps necessary to decide whether to offer a dental hygiene baccalaureate degree comp letion program is to conduct a feasibility study (surveying potential employers, students, and graduate schools). Is your institution prepared to do this? a. Yes b. No 9. Another step towards the path of offering a dental hygiene baccalaureate degree completion p rogram is to create partnerships, both within the institution and externally. Is your institution prepared to develop partnerships with such departments as institutional technology (IT) staff, admissions staff, and the institutional research department wit hin your institution, as well as external partnerships such as other higher education institutions? a. Yes b. No 10. Does your institution have the financial resources available for new baccalaureate degree program development? a. Yes b. No

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74 11. estion 10, would those financial resources be available to you for development of a dental hygiene baccalaureate degree completion program? a. Yes b. No 12. Would your institution be prepared to make the changes necessary to achieve the development and establishme nt of a dental hygiene baccalaureate degree completion program? a. Yes b. No 13. implementation? a. 2012 b. 2013 c. 2014 d. 2015 14. If your institution were to implement a dental hygiene baccau laureate degree completion program, what is the most likely format for instructional delivery? a. Completely on line b. Blended (mostly on line with some face to face meetings) c. Traditional (all classes meet in the classroom on campus) d. Other (Please describe). ________________________________________ e. Our institution is not interested in developing a dental hygiene baccalaureate degree completion program

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75 REFERENCES Abraham, S.Y., Steiger, D.M., Montgomery, M., Kuhr, B.D., Tourangeau, R., Montgomery, B. (2002). 1999 national study of postsecondary faculty (NSOPF:99) methodology report NCES Publication No. 2002 154. Washington, D.C.: U.S. Department of Education, National Center for Education. Academy of Doctors of Audiology. (2009a). Au.D. history. Retrieved A pril 13, 2010 from http://www.audiologist.org/aud history.html Academy of Doctors of Audiology. (2009b). Au.D. timeline. Retrieved April 13, 2010 from http://www.audiologist.org/historical reflections/aud timeline.html Accreditation Review Commission on Education for the Physician Assistant, Inc. (2009). Program data. Retrieved April 8, 2010 from http://www.arc pa.com/acc_programs/program_data.html American Academy of Physician Assistants. (1999). The d egree i ssue: A literature r eview and a nalysis Retrieved March 31, 2010 from http://www.aapa.org/advocacy and practice resources/clinical issues/aapa clinical council s/clinical education/703 -the degree issue a literature review and analysis American Academy of Physician Assistants. (2010). 2009 2010 AAPA Policy Manual Retrieved March 31, 2010 from http://www.aapa.org/images/stories/documents/about_aapa/policymanual/Profession.pdf American Dental Association Survey Center. (2008). 2007/08 survey of allied dental education Chicago: American Dental Association. Ame rican Dental Education Association. (2007). An ADEA summit on allied dental education Washington, D.C.: American Dental Education Association. Dental hygiene: Focus on advancing the profession Retrieved M arch 15, 2010 from http://www.adha.org/downloads/ADHA_Focus_Report.pdf National dental hygiene research agenda Retrieved March 26, 2010 from http://www.adha.org/downloads/Research_agenda%20 ADHA_Final_Report.pdf Dental hygiene education program director survey: Executive summary 2006 Retrieved April 3, 2010 from http://www.adha.org/downloads/AD exec_report 2008.pdf cation facts. Retrieved March 18, 2010 from http://www.adha.org/downloads/edu/dh_ed_fact_sheet.pdf

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76 tatistics. Retrieved March 18, 2010 from http://www.adha.org/downloads/edu/dh_programs_stats.pdf Association. (2009c). Policy manual Retrieved March 15, 2010 from http://www.adha.org/downloads/ADHA_Policies.pdf 19, 2010 from http://www.adha.org/careerinfo/entry/fl.htm American Nurses Association. (1965). Educational preparation for nurse practitioners and assistants to nurses: A position paper Washington, D.C.: Author. American Nurse s Association. (1995). Compendium of position statements on education Washington, D.C.: Author. American Occupational Therapy Association. (2009). History of AOTA Accreditation. Retrieved April 4, 2010 from http://www.aota.org/Educate/Accredit/Overview/38124.aspx American Physical Therapy Association (200 9 ). CAPTE accreditation handbook, appendix B: Evaluative criteria for accreditation of education progr a ms for the preparation of physical therapists. Retrieved April 8, 2010 from http://www.apta.org/AM/Template.cfm?Section=Accreditation_Handbook&TEMP LATE =/CM/ContentDisplay.cfm&CONTENTID=19980 American Physical Therapy Association. (2010). Doctor of p hysical t herapy (DPT) degree f requently a sked q uestions. Retrieved March 31, 2010 from http://www.apta.org/AM/Template.cfm?Section=PT_Programs1&CONTENTID=16984 &TEMPLATE=/CM/ContentDisplay.cfm#BM5 the bachelor of science in dental hygiene and the oral health practitioner. Journal of Dental Education 73(10) 1222 1232. Aydelotte, M.K. (1991). Nursing education: Shaping the future. In L.H. Aiken & C.M. Fagin (eds.). Philadelphia: Lippincott. Bader, J., Rubinstein, L., Friedman, J., Miller, K., Simon, E., Wallace, J. (1989). Task force on innovation in dental hygiene curricula. Journal of Dental Education 53 ( 12 ), 731 737. Barnes, W.G., Gancarz G ojgini, A., Jenkins, S., Arruda, J. Neely, J. (2007). ADHP and access to Journal of Dental Hygiene 81(1) 30. Retrieved March 15, 2010 from http://adha.publisher.ingentaconnect.com/content/adha/jdh Cameron, C.A., Fales, M.H. (1988). Outcome comparisons of traditional and degree completion baccalaureate dental hygiene graduates. Journal of Dental Education 52(8) 470 472.

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77 C arnegie Foundation for the Advancement of Teaching. (n.d.). Classification description: Public 4 Retrieved July 8, 2011 from http://classifications.carnegiefoundation.org/descriptions/basic.php Collins, M.A., Zinskie, C.D., Keskula, D.R., Thompson, A.L. (2007a). Characteristics of full time faculty in baccalaureate dental hygiene programs and their perceptions of the academic work environment. Journal of Dental Education 71(11) 1385 1402. Collins, M.A., Zinskie, C.D., Keskula, D.R., Thompson, A.L. (2007b). Institutional responsibilities and workload of faculty in baccalaureate dental hygiene programs. Journal of De ntal Education 71(11) 1403 1413. Commission on Dental Accreditation. (2010) Accreditation standards for dental hygiene education programs American Dental Association. Chicago, IL. Coppard, B., Berthelette, M., Gaffney, D., Muir, S., Reitz, S.M., Slate r, D.Y. (2009). Historical and current perspectives on two points of entry into the profession for occupational therapists. American Occupational Therapy Association. Retrieved April 4, 2010 from http://www.aota.orgEducatePoints of Entry.aspx Darby, M.L. (2004). Opening the door to opportunity. Dimensions of Dental Hygiene 2(9), 12 14, 16. Retrieved April 14, 2011 from http://www.dimensionsofdentalhygiene.com/print.asp?id=335 Florida Allied Dental Educators. (2009). Dental hygiene programs. Retrieved April 15, 2010 from http://www.fadeedu.org/dentalhygiene.htm l Floyd, D.L., Falconetti, A.M.G., Hrabak, M.R. (2009). Baccalaureate community college: The new Florida college system. Community College Journal of Research and Practice, 33 195 202. Retrieved July 8, 2011 from EBSCOhost database. Gancarz Gojgini, A. Barnes, W.G. (2007). Development and implementation of a web based BSDH degree completion program. Journal of Dental Hygiene 81(1) 35. Retrieved March 15, 2010 from http://adha. publisher.ingentaconnect.com/content/adha/jdh Gluch Scranton, J., Gurenlian, J.R. (1985). A model for two year and baccalaureate clinical dental hygiene education. Journal of Dental Education 49(2) 95 99. Haden, N.K., Morr, K.E., Valachovic, R.W. (20 01). Trends in allied dental education: An analysis of the past and a look to the future. Journal of Dental Education 65(5) 480 495. Henson, H. A., Gurenlian, J. R., Boyd, L.D. (2008). The doctorate in dental hygiene: Has its time come? Access 4 10 14. Holt, L., Mitcehll, T. V. (2009). Advanced education: The opportunity to open more doors. Access 7, 12 15.

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78 Jacobs, L.A., DiMattio, M.J.K., Bishop, T.L., Fields, S.D. (1998). The baccalaureate degree in nursing as an entry level requirement for prof essional nursing practice. Journal of Professional Nursing 14(4) 225 233. Retrieved April 10, 2010 from EBSCOhost database. Kraemer, L G.(1985). The dental hygiene entry dilemma: An issue of prestige, image, and professional credibility. Journal of Den tal Hygiene 49(3) 117 20. Leonard, K. (2009). Entry level degrees in dental hygiene. Access 7, 8 9, 30. McBride, A.B. (1996). Professional nursing education: Today and tomorrow. In G.S. Wunderlich, F.A. Sloan, & C.K. Davis (eds.). Nursing staff in hosp itals and nursing homes: Is it adequate? Washington, D.C: National Academy Press. McKinnon, M., Luke, G., Bresch, J., Moss, M., Valachovic, R.W. (2007). Emerging allied dental workforce models: Considerations for academic dental institutions. Journal of Dental Education 71(11) 1476 1491. Mescher, K .D. ( 1984). A new look at the educational preparation of dental hygienists: Exploding the myth. Journal of Dental Hygiene 58(2) 69. Metzger, C T. Forrest, J L. (1980). Career preparation role of baccaluare ate dental hygiene programs. Journal of Dental Hygiene 44(1) 25 7. Milburn, L.T., Lambeth, S.O. (1994). Entry into practice studies: An update. Prairie Rose 63(3) 6 7. M Journal of Dental Hygiene 81(2) 53 65. Retrieved March 15, 2010 from http://adha.publisher.ingentaconnect.com/content/adha/jdh Nati onal Center for Education Statistics. (1999). 1999 national study of postsecondary faculty: faculty instrument Washington, D.C.: U.S. Department of Education. Neumann, L.M. (2004). Trends in dental and allied dental education. Journal of the American Den tal Association 135, 1253 1258. Nunn, P.J., Gadbury Amyot, C.C., Battrell, A., Bruce, S.I., Hanlon, L.L., Kaiser, C., Purifoy Seldon, B. (2004). The current status of allied dental faculty: A survey report. Journal of Dental Education 68(3) 329 344. Okwuje, I., Anderson, E., Hanlon, L. (2010). A survey of dental hygiene program directors: Summary findings and conclusions. Journal of Dental Education 74(1) 79 87. Palmer, P.R. (2003). Career recruitment, finding the future of the profession. Access 17(9) 16 23.

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79 Rowe, D.J., Massoumi, N., Hyde, S., Weintraub, J.A. (2008). Educational and career pathways of dental hygienists: Comparing graduates of associate and baccalaureate degree programs. Journal of Dental Education 72(4) 397 407. Selfa, L. A., Suter, N., Myers, S., Koch, S., Johnson, R.A., Zahs, D. (1997). 1993 national study of postsecondary faculty methodology report NCES Publication No. 97 467. Washington, D.C.: U.S. Department of Education, National Center for Education Statistics. S Journal of Dental Hygiene 81(1) 34. Retrieved March 15, 2010 from http://adha.publisher.inge ntaconnect.com/content/adha/jdh Smith, T.G. (2010). A policy perspective on the entry into practice issue. Online Journal of Issues in Nursing 15(1) Retrieved April 13, 2010 from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/ OJIN/TableofContents/Vol152010/No1Jan2010/Articles Previ ous Topic/Policy and Entry into Practice.aspx Tobian, M S. (1989). Relationship between educational level of dental hygienists and their perceptions regarding post certificate/post associate degree programs. Journal of Dental Hygiene 63(9) 438 45. U .S. Department of Health and Human Services. (2000). Oral health in America: A report of the surgeon general. National Institute of Dental and Craniofacial Research. Rockville, MD. Walsh, M.M., Heckman, B.L., Hannebrink, R., Kerner, J., Ishida, H. (1988). degree as the entry level credential for dental hygiene practice. Journal of Dental Hygiene 62(10) 509 513. Wayman, D.E. (1985). Baccalaureate dental hygiene education: Creating a reality. Journal of Dental Education 49(3) 136 138. W endel, O.T., Glick, M. (2008). Lessons learned: Implications for workforce change. Journal of the American Dental Association 139, 232 234. graduate dental hygien e education and future faculty needs. Journal of Dental Educatio n 63, 479 483.

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80 BIOGRAPHICAL SKETCH Rebecca Margarite Smith is an Associate Professor of Dental Hygiene at Miami Dade College in Miami, FL A native Miamian, s he received her Associate of Sci ence in Dental Hygiene degree from Miami Dade Community College in 1991 and became a Florida licensed registered dental hygienist in August 1991 She then worked as a public health dental hygienist for the Miccosukee Tribe of Indians of Florida from 1991 2001. In 1998 she earned her Bachelor of Health Services Administration from Florida International University. Ms. Smith then worked as a dental hygienist in clinical private practice from 2001 2005 dividing her time between general dental and periodonta l practice s and continuing attend ing school. She earned her Master of Public Health degree from the University of Miami in 2005. In August 2005, she began her full time employment as an Assistant Professor at Miami Dade College. The major courses which she is responsible for are Preclinical Dental Hygiene, Dental Hygiene 1, P eriodontology 1, and Periodontology 2 She is the clinic al coordina tor for P reclinical Dental H ygiene Laboratory and D ental H ygiene 1 Clinic a s well as the P eriodontology 2 L aboratory coordinator. Ms. Smith is active in the dental hygiene profession She ha s serv ed in several leadership positions at the local level, and has served as a delegate to the state and national meetings of the entor for dental hygiene students in her capacity as a co at Miami Dade College. She volunteers for several dental hygiene events throughout the year. Ms. Smith is proud to be t he product of a Floridian father and Cuban mother She has spent the last 18 years being a single mother to her 19 year old daughter Arielle In her spare time, Ms. Smith enjoys traveling, fishing, boating, reading, movie watching, gardening, and taking c are of her seven dogs and five cats.