This study is a questionnaire survey to evaluate the attitude and awareness of medical and dental students toward collaboration between medical and dental practice in Hong Kong. The questions used in this study were adapted from the questions used by Hendricson and Cohen  and Migliorati and Madrid . The questions of the 2 studies were wide-ranging in medical-dental collaboration and education. We selected specific questions that related to the collaboration between medical and dental practice. A one page closed-ended questionnaire was employed and would be quick for the students to answer . The answers of different respondents would also be easy to compare and analyse statistically. However, the questions can force respondents to give simplistic responses to ‘complex’ questions and, therefore, interpretation of the results must be taken with caution.
Inviting the students to join this study by email would have been a low-cost and convenient method, but was not used because it generally leads to a low response rate . Instead, the questionnaires were distributed directly after the lesson in the lecture theatre and collected immediately after completion. A study found this method is efficient and effective for collecting responses from students . However, 56% of the students still did not participate in this study. One reason was that the fourth and final year medical students were on their clinical rotation period in small groups. Not all could be contacted in their residential halls and, therefore, could not respond to the questionnaire. This response rate may undermine the power of the study. The outcome of this study cannot, therefore, be taken to be conclusive. Without the characterization of the non-respondents, the study might suffer from response bias as participants may simply be those who have a positive disposition to the study objective. Therefore, results should be interpreted with caution.
In this study, the medical and dental students generally demonstrated good attitude to collaboration between medical and dental practice. Most students agreed that oral health is an integral part of general health and that dentist is a profession similar to medical practitioners. However, more than a third of the respondents did not agreed with the medical-dental rotation, which Hendricson and Cohen consider not only be beneficial but essential . Gender, regular dental check-up, and curriculum were associated with students’ attitudes. The results agreed with a previous study that reported that gender could affect a student’s attitude towards medical-dental collaboration . Studies found preventive health behaviours such as attending regular dental check-ups correlated with good attitudes towards learning [17,18]. This good attitude towards learning could be associated with a good attitude to collaboration between medical and dental practice. Curriculum was also found to be associated with students’ attitudes towards and awareness of collaboration between medical and dental practice. In Hong Kong, the dental curriculum emphasises problem-based learning, whereas the medical curriculum is a hybrid between problem-based and discipline-based learning. Dental students may have more opportunities to develop communication skills that encourage collaboration. This difference in curriculum may have affected the measured attitudes and awareness, since studies have shown that case-based learning can enhance the effectiveness of inter-professional collaboration [19,20].
Greater awareness of collaboration between medical and dental practice was found among senior students (year 4 and 5) than junior students (years 1–3). This may be explained by the level of education and age, which have a positive correlation with maturity . Furthermore, senior students have more exposure to clinical care and teamwork, which may have led to better awareness to collaboration between medical and dental practice. This study found students were most aware of the medical disciplines of ENT and general surgery in the collaboration between medical and dental practice. This might be due to the proximity of the oral cavity to the organs and the nature of the medical discipline to dental surgery. This finding implied the students did not have a complete understanding of the depth of the collaboration between medical and dental practice. Once the depth of that link is understood, the need for collaboration between medical and dental practice by both professionals would be clearer. Students should realize collaboration between medical and dental practice can involve any discipline not just pertaining to those related to the oral cavity. Dentists should identify their patient’s need of primary prevention strategies for cardiovascular disease . Patients with common systemic conditions, such as diabetes mellitus and pregnancy, often experience dental complications.
Interprofessional continuing education is a useful means of breaking down stereotypes about another professional’s identity, improving teamwork in clinical practice . The president of the Hong Kong College of Dental Surgeons has stated that physicians and dentists should have access to updated knowledge about the collaboration between medical and dental practice and that there should be guidelines and methods to increase confidence in providers’ ability to identify and appropriately refer patients who have diseases . It is important to enhance health care services through close collaboration between medical and dental professionals. Continuing education courses should emphasize the importance of interprofessional collaboration as and include methods to increase confidence in providers’ ability to identify and appropriately refer patients with disease . Medical-dental collaboration can be facilitated by medical and dental professional bodies, which should develop guidelines for the indications, timing, protocols, and responsibilities of referral and consultation among physicians and dentists. Public awareness should also be aroused so that patients and the community alike understand the relationship between oral and systemic health. In doing so, a better understanding of collaboration in the community may benefit all parties with improved professional cooperation and a better education of the public.