Impact of reflective writing assignments on dental students' views of cultural competence and diversity.

To respond to widespread disparities in access to oral health care, the Institute of Medicine, the Commission on Dental Accreditation (CODA), and the U.S. surgeon general have stressed that prospective dentists should become culturally competent, socially responsible practitioners. The aim of this study was to examine linguistic differences in dental students' reflective writing assignments before and after interviewing an individual who was culturally different from themselves. The authors analyzed 160 documents from 80 first-year dental students at the University of Florida in 2012. This cohort consisted of 36 male (45%) and 44 female (55%) students; 26 (32%) were from underrepresented minority (URM) groups and 54 (68%) were identified as white non-minority. Text analysis software identified word counts, categories, frequencies, and contexts. Significantly positive differences occurred for interviews between assignments 1 and 2 (p=0.005 to p<0.001) in five areas of cultural diversity. Differences were observed for Factor 1 ("important others' influence") between assignments (p<0.001), assignments by interview categories (p=0.033), and URM/majority participants by assignments by interview category (p=0.018). Factor 4 ("my social world in relation to others") was statistically different between assignments for URM/majority participants (p=0.019). Factor 5 ("wrong because") was statistically different for gender (p=0.041), suggesting that males may have experienced a rebound effect from stereotype suppression. The findings suggest that the use of reflective writing and interviews affected the students' awareness of how important others had influenced their lives and attitudes and facilitated their questioning preconceived assumptions. Reactions to coursework focusing on social and personal domains warrant further investigation.