This study describes examples of models and frameworks from other professions that could be applied toward creating environments of inclusion and belonging in dentistry. Examples are provided of activities, frameworks, and models that can serve to launch similar activities within dentistry. Selected models of inclusion from library science, medicine, nursing, dental hygiene, and social work can be used by the dental profession to help make definitive strides in the inclusion arena to combat challenges of access and inequitable oral health status.
Key points
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Existing models and frameworks of inclusion have been developed and are available for use in education, research, and patient care settings.
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Models of inclusion from other health professions can be considered for adaptation and implementation in dentistry to promote more inclusive environments.
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Dentists should explore more opportunities through “open access” as well as other venues to leverage the specialized knowledge and skills of colleagues.
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The models suggested while not all encompassing can provide pathways for continued transformation of the culture of dental education to ultimately improve oral health outcomes especially for marginalized and vulnerable populations.
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As oral health inequities continue to impact marginalized communities disproportionately, reimbursement models are needed for collaborative approaches centered on care coordination, quality of care, and health equity.
Introduction
Dentistry as a profession has over the last decade continued to expand efforts to promote diversity and inclusion. With significant changes in the makeup of learners and aging of the population, including practitioners, it has become clear that in order to be more competitive and patient centered, dentistry must better incorporate and embrace the concepts of diversity and inclusion to effectively educate and care for future generations. The American Dental Association along with other national dental organizations has outlined their approach to diversity and inclusion through their respective committees, strategic plans, and toolkits.
The focus of this article is to explore potential models and frameworks from other professions that can be adopted across academic institutions, professional organizations, communities, and practices to further enhance inclusion and belonging in dentistry. The opportunity to transport models and frameworks developed by other professionals, who have been more active in this area, can potentially expedite the movement toward social justice and health equity for dentistry and oral health while incorporating broader perspectives to influence change and transformation.
Models from other health professions
Library Sciences
Open information
The “Open Access” to information is one way to level the playing field and create inclusivity to provide access in a broader way than has been done before. Around the world, people are waking up to the idea that for researchers, scientists, or really anyone , to be accountable for their actions, information must be open and accessible. The silos of the world are coming down in the hope that we might one day be “global citizens”. Some countries in the world are opening up information accessibility creating avenues for inclusion and belonging. In 2022, the White House Office of Science and Technology Policy issued a memorandum that all federally funded research would need to become “open access” by December 2025. This edict, known as the Nelson Memo , created an uproar in the world of science and information. Perhaps this, more than any other initiative, created space to show inclusivity, braveness, and belief that to have progress many eyes, opinions; and ways of thinking must be involved. In addition, several innovative models have been created within the library science arena from conferences convened in 2021 and 2023, crafting a multifaceted way to advance diversity and inclusion. These models are highlighted by an international platform for open access and a manual helping to dispel diversity as two dimensional and binary. The overarching agreement from the discussions is that inclusiveness provides a way of creatively putting oneself in the place of another. ,
Toolkits and guides
On a more library-specific level, the library and archival professions have been working hard on developing effective strategies for combating non-inclusive and exclusive access to information and environments. Countless libraries have instituted cultural competence training and specialized focus groups to implement practices and help create both formal and informal ways of making sensitivity to others part of organizational culture. In other cases, they provide specific strategies for implementing practices, via toolkits or checklists. Vacek, Jaffer, and Adler provide practices such as workshops, implementing trans-appropriate design, and social groups for discussion in a non-formal way.
Similarly, libraries are creating online toolkits on inclusive collection development to help identify hidden voices in existing collections and/or voices and literature that has been omitted from the collections due to bias, aiding in more diversified and inclusive information sources. Often these also include ways to implement these practices in both digital and physical spaces.
Medicine
When considering models of inclusion the goal in medicine, as in any profession, is to move toward inclusive excellence. Inclusive excellence is a journey in ensuring that diversity, equity, and inclusion are incorporated in all aspects of the academic environment and that equity exists for all. It is recognizing that the success of the organization depends on the diversity and inclusion of its members and that engaging, valuing, and encouraging all members, including those with marginalized or minoritized identities, are a must for the optimization of the organization. Two models are shared along with our own designed figure that demonstrates structural needs to promote diversity, equity, inclusion, and belonging (DEI) in academic environments. Also, the need for preparatory work that provides underpinning and breaks down barriers to success is incorporated. Barriers that need overcoming include the minority tax, gate blocking of faculty, institutional racism, and the impacts of historical injustices against minoritized people no matter the profession.
Addressing these barriers makes it clear that there are foundations that are critical for any model of inclusion. Building on this foundation also requires an understanding of needed actions to move organization toward inclusion, after creating a diverse environment, but before attempts at inclusive excellence. Steps are defined toward creating an inclusive environment. Fig. 1 demonstrates a pathway from diversity to inclusion in a way that is measurable and delineates outcomes that build toward inclusive excellence.
Marjadi and colleagues provide a model of inclusion for inclusive practice in the health care setting from medicine that includes multiple domains of inclusion involving advocacy, education, commitments, signage, language, inclusive built environments, and inclusive labeling. The model presents five underpinning concepts with inclusion as the center in which they define tips that promote inclusion in the health care environment ( Fig. 2 ). Another model of inclusion from medicine takes on a departmental approach within the academic health center and provides a model for others to follow if seeking to create a committee to focus on diversity, equity, and inclusion. Lingras and colleagues provide six considerations for creating a departmental-based DEI committee, which they formed in a department of psychiatry.
The first part of this departmental approach is ensuring support from institutional leadership, followed by a process that leads to guideline creation and ongoing evaluation. The belief is that such models as shown in Fig. 3 , bring forward critical elements of inclusion. They not only include the programming and acts of making sure that diversity is included in the academic environment, but commonalities speak to the need for committed leadership and ongoing evaluation as important to ensuring a true inclusion that is evidenced by an equitable work environment as described by those who are marginalized or minoritized in the organization.
Nursing
A diverse nursing faculty and staff workforce promote an environment of inclusion and belonging within the academic environment. Parallel to the need for representative leadership teams and faculty, a representative student body that resembles the health care population is needed as well. Just as patients relate better to health care providers who resemble them, students likewise feel a sense of belonging in the presence of faculty and staff.
To achieve diversification of the nursing workforce, comprehensive plans to focus on the recruitment and retention of diverse student populations are needed. These plans should assure that students are not only admitted but retained to the point of academic program completion and transition into practice. A diverse student body brings into the academic institution a population of students with various life experiences, backgrounds, and learning styles. The development and implementation of inclusive student-centered pedagogies are essential to the promotion of student engagement ( Box 1 ) and expanding capacity in the workforce. The inclusive excellence framework developed by the National League of Nursing outlines components essential for recruiting and retaining a diverse student body and workforce. Implementation of the framework by academic leaders in dentistry along with faculty and staff could provide a more comprehensive approach to promoting inclusive environments within the dental profession ( Fig. 4 ).
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Student-centered pedagogies
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Multisensory approaches that include visual, auditory, kinesthetic, and tactile
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Active participation structures
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Communal note-taking
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Student learning communities
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Long-term memory strategies such as mnemonics
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Breaking content down to promote absorption overtime—chunking
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Formative informal assessments
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Metacognition strategies such as reflection
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The American Organization for Nursing Leadership (AONL) also has developed guiding principles that are consistent with their organizational mission, the American Nurses Association Code of Ethics for Nursing, and the Future of Nursing 2020 to 2030 recommendations. Fig. 5 presents the AONL DEIB principles and strategies/action steps. Additionally, AONL has been able to influence leadership practice and development through the establishment of leadership competencies. Leadership competencies are the knowledge, skills, and abilities expected for effective leadership. These leadership competencies are expected of nursing leaders in various roles such as nurse executive, chief nurse executive, post-acute care, nurse manager, and nurse executive in population health. The opportunity for application of these competences in dentistry to potentially assist academic and organizational leaders is compelling as the challenges of building inclusive spaces within the dental profession continue.
VIDEdental - Online dental courses
