Integrating oral health in the nursing curriculum: Formulating learning objectives using a Delphi-study.
Authors: Palmers Ellen , De Almeida Mello Johanna , De Langhe Astrid , De Visschere Luc , Declerck Dominique , Duyck Joke 
Published: January 2024

Background. Oral health and oral health care should be an integral part of the standard health care provision for care dependent individuals. Nevertheless, it is often neglected when confronted with limited time for daily hygiene care by  caregivers, and it is experienced as difficult, intimate, and sometimes even shameful for both the caregiver and the care dependent person. Previous research revealed that nurses had poor knowledge, skills and attitudes towards oral health. Recently, training programmes in oral health care are being developed for care-organisations and international research is exploring  the curriculum of caregivers. This research showed half of the respondents being aware of the relation between oral and general health and did not see the need to incorporate oral health care in the curriculum.

Aim. The aim of this study is to gain insight into the extent of oral health care education in the curriculum that is necessary and feasible to make nurses competent to provide good oral health care for dependent persons. This will be translated into learning objectives that can be implemented in the curriculum of nurses.

Method. First, to map the proportion of oral health care in the Flemish curricula for nurses, all European Credit Transfer System files (ECTS fiches) were evaluated. In addition, a survey was sent to teachers and curriculum coordinators to ask about the extent of oral health education in their program. Second, a Delphi study will be set up to build a consensus about the relevant oral health topics for nurses. The Delphi study consists of 3 rounds and an additional round with focus groups. Three target groups will be asked to participate: (1) oral health professionals, (2) teachers of the curriculum for nurses, and (3) nurses already employed in the field. A fourth round will discuss the ambivalent topics within and between target groups using several focus groups of important stakeholders.

Results. ECTS files of the academic year 2019-2020 were used in the analysis. About half of the organisations who offered a 4-year nursing bachelor mentioned oral health care related topics in their ECTS fiches. The organisations spent a little over 2 hours on oral health care theory and 1.5 hours of practical oral health care training during the 4-year bachelor training or in the school. Lack of time, difficulty of the subject and low relevance were the most important mentioned barriers. A practical training was mentioned about the performance of oral care during their internship. The Delphi study will be carried out between November 2022 and June 2023. Preliminary results will be discussed during the ICIC conference.

Discussion. Even though oral health care is an essential part of the daily care for patients, oral health care is seen as not so relevant and it is only minimally covered in their curriculum. With the reported barriers in mind, reaching a consensus between oral health professionals and caregivers is crucial for the introduction of oral health care learning objectives in the curriculum for nursing degrees.