Graduate-student team puts the “i” in interprofessional with iFloss

From left, graduate students Gloretha Wilcots, Keith Byrd, Sandra Calderon, Genevieve Green and Jasleen Kaur impact oral health with iFloss, an innovative interprofessional project.

Failing to provide adequate preventive oral health care for millions of people, today the primary care system is in the midst of transformation bringing new opportunities for providers. So an interprofessional team of graduate students at the Betty Irene Moore School of Nursing at UC Davis developed a new approach to make oral health preventive care more accessible and combat a silent epidemic.

“It’s difficult to expect primary-care providers to focus on every aspect of the mouth, but I thought we could incorporate a few basic questions into the routine at the clinics,” said Sandra Calderon, a nurse practitioner student who also served as a dental hygienist in the U.S. Army for six years. “If you ask a patient to take a quick look at their gums, if they have pain when they chew or bleed when they brush their teeth, that quick question could point to significant problems."

Studies indicate that oral bacteria and gum disease can contribute to various health issues including cardiovascular disease and diabetes. Through their iFloss project, the team embarked on an innovative approach to health education that is interprofessional, person-centered, team based and culturally sensitive.

Providing patient resources

iFloss ― word play on a key component of oral hygiene, flossing, and the letter i in interprofessional education ― involves three major objectives: to advocate for oral health in the community; to provide patients with resources; and to educate students and future providers on this element of health care.

“The physician assistant curriculum on the national level includes very little in the way of oral health, focusing more on other parts of the body. Yet the mouth is the gateway to the gut,” explained Gerald Kayingo, assistant clinical professor and physician assistant. “We recognized an opportunity to serve as leaders for oral health and act as change agents on our campus and in our community.”

Video: An interprofessional team of physician assistant and nurse practitioner graduate students at the Betty Irene Moore School of Nursing at UC Davis develop iFloss -- an innovative approach to make oral health preventive care more accessible.

“Leadership is needed in this area,” explained Keith Byrd, a physician assistant graduate student. “It’s great to know there’s a group of primary-care learners coming together to work collaboratively to battle the problems we have with oral health in health care today.”

Bridging gap between classroom and experience

The student-born and -driven initiative bridges the gap between classroom instruction and experiential learning. Byrd and classmate Jasleen Kaur serve as leaders in the student-run clinics operated by UC Davis School of Medicine and located throughout Sacramento. Partnering with fellow physician assistant graduate student Genevieve Green and nurse practitioner graduate students Calderon and Gloretha Wilcots, they developed a program to bolster students’ oral-health knowledge, skills and attitudes, which could transform them into change agents in the community.

“With our enthusiasm about oral health and knowing it is something our program lacks, we wanted to introduce the community to the importance of it,” Wilcots added. “Coming together with our diversity and our different personalities, we figured we could bring a lot to the table.”

Collaboration sparks leadership

The team produced a two-minute video illustrating the interaction between a provider and a person with tooth-and-gum problems. Based on the video and their project, they were invited to the Interprofessional Leadership Program of the Physician Assistant Education Association in the District of Columbia. Led by Kayingo, team members learned new skills and renewed their attitudes about health equity, advocacy and change management to promote interprofessional leadership.

“We have nurses, physician assistants, technicians and scribes, but the diversity of our jobs and careers and goals brings a lot to the table,” Kaur said. “The main thing is we were all cohesive on our goal for patient care.”

Kayingo hopes to build on the iFloss initiative and develop a module that can be rolled into community clinics and campuses across the nation.

“The Betty Irene Moore School of Nursing puts a huge focus on teamwork and making sure that you are a capable leader of multiple different practices,” Green said. “It’s definitely been an enlightening experience.”