A framework analysis: male diversity in dental assisting.

"The promise of diversity in the workplace is to create an environment in which employees' different identities and abilities are not only respected but also appreciated'"

Introduction

Diversity (1) in the workplace is becoming an increasingly important issue for managers. Labor is predominantly a combination of people from different races, gender, cultures, or religions. The fact that labor is growing more diverse adds more challenges to managers. Diversity has become such an important issue in organizations that administrators should not only be aware of it, but also know how to manage it effectively. "Whether one looks at diversity as an internal employee relations issue, an external consumer marketing issue, or a sweeping societal issue, these broad demographic changes cannot be ignored" (2). Diversity adds rich resources into organizations. R. Roosevelt Thomas further supports this statement by claiming "the organization that utilizes these resources more efficiently and effectively will gain a competitive advantage" (3). In addition, he states, "In a company seeking competitive advantage in a global economy, the goal of managing diversity is to develop our capacity to accept, incorporate, and empower the diverse human talents of the most diverse nation on earth" (4). Meaning, managing diversity is to create an environment in which employee's differences are valued as an integral part of the organizational culture. Diversity is also needed to adequately represent the client/patient base and/or the community that the organization serves. Since diversity brings more positive advantages to organizations, promoting diversity is also crucial for an organization's prosperity as in the case of the Dental Assistant Program (DAP) at the New York University College of Dentistry.

This paper will illustrate how the management of the DAP addresses the lack of male students and recruitment of males into the program. The management of the DAP has implications in regards to stereotype, career issues, attractiveness of work, and salary of the dental assisting profession.

In an effort to asses the state of diversity and to promote diversity in the DAP, we use a conceptual framework called the "Developmental Stages of Diversity" (1). The framework categorizes organizations into three types on a continuum range from homogeneous (monolithic), to mixed (plural), to diverse (multicultural) (1). In the process of achieving diversity, the state of diversity in an organization can be placed in range from total exclusion (exclusionary phase) to considering (the club phase), to pursuing (compliance phase), to managing (affirmative phase), to maximizing (redefining phase), and to becoming fully diverse (1). To move from one phase to another, several strategies are recommended. For example, a diversity "audit" should be performed in order to move from the exclusionary stage to the considering stage.

The purpose of this paper is to analyze how the management of the DAP relates to gender diversity by using case analysis and Ospina's "Developmental Stages of Diversity" framework. The interesting aspect of this study is the role reversal in diversity--the DAP represents a field dominated by women. The program lacks diversity because there is little male representation in the student body, faculty and administration of the program. The framework will be used as a guide to determine which developmental stage the DAP exists within and to identify the managerial actions necessary for promoting diversity in the program.

Overview of the Dental Assistant Program

The New York College of Dentistry was founded in 1865 and renamed as the New York University College of Dentistry when it became an essential part of New York University (NYU) in 1925. The NYU College of Dentistry is the largest dental school in the United States and provides five unique programs. They are as follows:

I. Doctorate of Dental Science Programs (DDS)

II. Dental Hygiene (DH)

III. Dental Assistant Program (DAP)

IV. Post Graduate Programs

V. International Program

The Dental Assistant Program is one of many highly respected programs offered at NYU. It meets "the requirements of the American Dental Association's Commission on Dental Accreditation" (5). Upon successful completion of either the one-year full-time program or the three semester part-time program, students are awarded the nationally recognized NYU Certificate of Proficiency in Dental Assisting and qualify for New York State Licensure. Although graduates of the program are able to take the New York State Licensure exam, it is important to note that this license is not a requirement to practice dental assisting in New York.

The mission statement of the NYU Dental Assistant Program is "to partner with students to achieve academic excellence, research, community service, and offers comprehensive client care, utilizing critical thinking and evidence-based decision making skills" (5). The goals of the DAP specifically aimed at students are to "recruit and select the most qualified applicants for admission, with special efforts aimed at minority students; prepare competent dental assistants as defined by the mission statement", and to "promote higher education and continuing education of graduates" (5). The goals aimed for the faculty are to "promote further development of faculty teaching, research, and community service skills and the use of advanced technology", and to "provide opportunities for faculty enrichment, scholarship, and creative expression" (5). DAP director describes the program as a "vocational school in a university setting" (Interview: Director of Dental Assistant Program, 2000).

In terms of organizational composition, the DAP has a hierarchical structure with six full-time instructors (one male), four part-time instructors and one administrative assistant (male), who report to the Director of the Dental Assisting Program. The Director of DAP ultimately reports to the Associate Dean of Allied Health. The organization's internal stakeholders include administrators, faculty, staff, students and the NYU community. The external stakeholders are comprised of patients, potential students, and employers of dental assistants including dentists, administrators and institutions (hospital, correctional facilities, etc.). At the time of the study, the DAP has 80 students enrolled, including both part-time and full-time students. The 62 female students represent 88% of the student population. Males represent 12%, with only 18 students enrolled in the program. The DAP educates and prepares potential qualified individuals to become the dentist's "second pair of hands" as well as becoming an important part of an allied health profession team (5).

The fact that females hold the majority of the student body in the Dental Assistant Program is not an accident. Nationwide, the number of females in dental assisting programs makes up 97% of the total enrollment (6). Charles Faust noted that dental assisting has "been one of the more notable professions which has unofficially restricted itself to females for the most part" (7). Historically, health professions such as nursing, physical therapy, and dental assisting have been "genderized" as female. "Genderization is the process by which a profession or occupation becomes recognized as being appropriate for either females or males" (8). While currently the population of practicing male dental assistants remains below 2%, Eleanor McIntyre feels that the population of males practicing dentistry (dentist) has created the gender divide in this field. She states, "With dental assistants being female and dentists being male, a sexual division of labor has been created within the dental health professions" (8). Ric DuRand, a dental assistant trained in the United States Navy, agrees that this division has fostered the belief that dental assistants are stereotyped as female. He feels that "until dentists have a change of attitude toward male assistants, the field of dental assisting will remain virtually closed to men" (9).

Case Analysis

Ospina's "Developmental Stages of Diversity" framework was used as a guideline in developing interview questions and in conducting the survey questionnaire. Questions such as "What is the objective of the program in recruiting students?" "How does the program's objective relate to gender diversity?" and "Are male students in the program perceived as being tokens?" were asked to see if gender diversity would be a key factor in the DAP. Simply "diversity varies considerably from one organization to the next", therefore, "a specific organizational diversity profile becomes the logical point of reference to decide the characteristics and priorities of a diversity agenda" (1). With specific questions focused on gender diversity, "stages of development in the diversity agenda" for the DAP could be assessed (1). The interview objectives were tailored to find out at what managerial stage in Ospina's "Developmental Stages of Diversity" framework (from Exclusion, Considering, Pursuing, Managing, Maximizing, to Diversity) the DAP would fall under in achieving gender diversity (1) Also of concern were the types of strategies the DAP should focus on to recruit more males into the program. "Many diversity strategies fail because they are not integrated into a broader managerial approach that considers where the organization is and where it wants to be in the future" (1). For this reason, it is crucial that diversity is pursued in the stages outlined in the model and that diversification becomes a process to be achieved one step at a time.

A total of six individual interviews were conducted with six different members as follows:

I. Associate Dean of Allied Health

II. Director of Dental Assistant Program

III. Male Alumni, Class of 1996

IV. Female Alumni, Class of 1998

V. Male Student, 1st semester part-time

VI. Female Students, 2nd semester full-time

From the interview results with the Associate Dean and Director, it was found that the administration recognizes the benefits of having more males in the DAP, although gender diversity is not included in the Dental Assistant Program's mission statement. The primary objective of the program is to recruit more students in general, regardless of gender. "The only objective is to recruit students. If there are no students, there is no program. The only objective is to fill a class. The objective of the Dental School is to provide enough dental assistants to support the dental students" (Interview: Director of Dental Assistant Program, 2000).

The administration has seen the benefits of having males in the program. The Director of the DAP gives the following example: "Many of the female students are single parents and come from low-income families. There are a lot of behavioral problems and having males in the class helps to decrease the behavioral problems. Female students act better if there are male students in the class" (Interview: Director of Dental Assistant Program, 2000). The Associate Dean adds, "More males in the profession will bring more long-term financial stability. Having more males will increase the level of professionalism of the field. The profession will become more attractive if more males are in the field" (Interview: Associate Dean of Allied Health Programs, 2000). Further benefits of having more male students are that they provide better balance in the classroom and increase salaries in the field of dental assisting (Interview: Director of Dental Assistant Program, 2000). This notion is supported by a study conducted by Ric DuRand. DuRand discovered that "men weren't being hired as assistants because their employment would force up the wages paid to assistants. When men, as the traditional breadwinners, entered a particular field of employment, they would change from a part-time or temporary job to a full-time profession and wages would be forced up" (9).

Female dental hygienist Eleanor McIntyre adds, "There is consensus amongst feminist theorists that women's work in the labor market is devalued. The devaluation is linked and based on the unpaid labor of women in the home. Hence, there is a direct connection between women's unpaid labor for men in the household and women's under paid labor in the workforce. The sexual division of labor in the household supports and reinforces the sexual division of labor in the marketplace and, in particular, the feminized professions" (8).

Moreover, the administration is aware that males are a minority in the DAP and is considering further means to increase the attractiveness of the program. Currently, the DAP recruits students through newspaper and subway advertisements. The administrators make an effort to focus on the male population. "I insist on one male being in all our ads because if there are not any males shown, it will be portrayed as a female oriented profession" (Interview: Director of Dental Assistant Program, 2000). Male dental assistants are also prominently displayed in DAP application brochures and on the website to appeal to more male applicants. In fact, the website includes photos of two males and only one female in the program description page. The assessment was that the administration had increased awareness in gender diversity by incorporating males in advertisements, and had recognized the benefits of having more males in the program. It was concluded that in achieving gender diversity in the DAP, the managerial tasks have moved beyond the "Considering" stage, according to Ospina's framework. "First, organizational stakeholders must become aware of the benefits of increased work force diversity. Only then can they engage in the second task, a serious pursuit of diversification in the workplace" (1).

The administration has not yet entered the "Pursuing" stage because "pursuing diversity involves using strategies to ensure representation of members from different social categories at all levels of an organization" (1). At the present time, the administration has hired a marketer to develop a new recruitment plan to identify target populations for the DAP. The Associate Dean anticipates that the results of the marketing plan will lead to greater enrollment of males in the program. "Hopefully the new marketing plan will capitalize on acquiring more male students" (Interview: Director of Dental Assistant Program, 2000).

Additional interview results were obtained from two alumni (one male and one female) and two currently enrolled students (one male and one female). Commonly, they all did not realize that the dental assisting field is a predominately female health profession before entering the program. However, even if they realized the gender gap in the field, it would not have affected their decision to join the program. The male and female interviewees did recognize the benefit of having males in the program, although the two females did not feel any tension or hostility in having males in the program. In fact, one of the two females said that the administration "should try to get a balance in student body, half male and half female" (Interview: Female Student, 2nd semester full-time, 2000). She felt that "if there was a balance, the males would not feel shy, intimidated, or withdrawn and this may help them do better academically."

The two males had different views of gender diversity in the DAP. They did feel tension and intimidation by being one of the few males in the program, and would feel more comfortable if there was a larger male presence. The male student felt discouraged during orientation due to the female majority. However, he did not change his mind because he noticed two other males and felt optimistic about continuing the program (Interview: Male Student, 1st semester part-time, 2000). Furthermore, responses from the survey questionnaire from a total of 26 students were collected and analyzed. A large number of the respondents were female (80.7%); only 15.3% were male. Because dental assisting is a female dominated field, 84% said it had no affect in their decision to join the program. 30.7% responded that they joined the program because of personal interest. A majority of the students (76.9%) think administrators should recruit more males, but only 23% of them felt it was an important issue. In general, gender was not an issue nor did it have any affect in the students' decisions to join the program. However, a significant percent of the students did agree that the administration should recruit more males into the program.

Conclusion

Based on the results of the case analysis, it can be concluded that the DAP fits between the "Considering" and "Pursuing" stages of Ospina's model. The Dental Assistant Program demonstrates passage from the "Considering" stage but has not fully reached the "Pursuing" phase for the reasons outlined in the case analysis. The DAP has not clearly identified strategies due to the anticipation of the marketer's proposal. The lack of clear strategies prevents the managers of the DAP to move forward in achieving greater gender diversity. In addition, it is important to note that Ospina warns managers that not all strategies are successful. Many diversity strategies fail because they are not integrated into a broader managerial approach that considers where the organization is and where it wants to be in the future. Such a diagnosis is required in order to design appropriate diversity strategies for each stage of organizational development" (1). The DAP has definitely looked within their organization and to the future of the organization in developing new strategies to attract diverse students. The much anticipated marketing plan is being formed based on their current structure and needs. Although they would like to become more diverse, their main goal is to attract students. However, the new marketing plan will make an effort to take both diversity and the need for more students into account.

It should also be noted that Ospina's "Developmental Stages of Diversity" framework neither attempts to predict behavior nor describes characteristics of managers. The framework provides a guideline using developmental stages to achieve a diverse workforce. This framework could be applied to almost any organization, and is particularly useful in assessing where an organization currently exists in its quest for diversity. It also attempts to explain the steps the managers of an organization would need to take in order to achieve its highest level of diversity: the "Multicultural Organization" stage. Ospina recognizes that a "truly multicultural organization may never be fully accomplished" (1). Managers must continuously reassess their strategy. "Each of the managerial tasks involved in promoting diversity--considering, pursuing, managing, and maximizing diversity--requires a creative combination of strategies and tools" (1). Many organizations will find that particular strategies do not apply to their organizational culture or environment. The administration of the Dental Assistant Program will need to define and test several before finding one that best applies to the NYU College of Dentistry. The most critical point of Ospina's article is that the managerial commitment to diversity must be rooted in the "pragmatic acknowledgement that diversity makes good business sense" (1). Ospina (1996) also believes "every diversity tool and activity must be chosen and implemented not only in reference to multiculturalism but also with the goal of enhancing organizational performance".

In addition to any strategies that the managers of the Dental Assistant Program put in place, they must find ways to compliment those strategies to maintain increased enrollment of males. "This effort [must be] accompanied by new policy initiatives that stress the principles of participation, sustainability, collaboration, and integration" (1). Merely implementing a strategy would not suffice without adequate follow-up and heightened importance. This factor (the lack of males in the program) needs to be valued at a greater level and consideration in outreaching males should be imperative.

It is important to realize that the "Developmental Stages of Diversity" framework is not flawless. There are limitations to the framework and additional challenges beyond what the guidelines could anticipate. The framework is limited by anecdotal references. Ospina describes each developmental stage by providing examples in various organizational situations. These references are helpful, but do not provide concrete data on the successfulness of the proposed strategies at each stage. Ospina recognizes the challenges beyond what the framework could anticipate: it does not guarantee that managers will be convinced of the benefits of diversity and does not promise to change inherent attitudes or biases towards diversity.

For the Dental Assistant Program, this has been the major struggle: bias towards men in the field of dental assisting. In a study conducted by Charles Faust, it was found that job placement for males in dental hygiene and dental assisting was challenged more by societal gender stereotypes than actual discrimination (7). Dental hygiene has always been associated with females, and even though men are beginning to enter the profession, patients, dentists and the general public still view it as a predominately female profession" (7). Both the Associate Dean of the Allied Health Programs and the Director of the Dental Assistant Program recognize that these perceptions from society have been and will continue to be a deterrent for men to participate in the program. These are factors that could not simply be addressed by referring to the "Developmental Stages of Diversity" framework; these issues are unique to the reverse diversity situation of the profession. Ospina's framework may not have been intended to be used to achieve a greater male presence in a female dominated field; an issue often referred to as "reverse gender roles in non-traditional occupations". This posed challenges in utilizing Ospina's framework, but ultimately the outcome was correct.

Clearly, the mangers of the DAP need to be more aggressive in outreach and recruitment of males in order to achieve gender diversity in the program. However, this organization will have a very hard time achieving true diversity, not only because of the market and realities of the dental assisting field, but also because of the limitations they face. The administrators are handicapped by monetary restraints. They need students, regardless of gender, so achieving diversity becomes an issue placed on the "back burner" for mangers of the Dental Assistant Program.

Bibliography

(1.) Ospina, Sonia M., "Realizing the Promise of Diversity," Handbook of Public Administration. San Francisco: Jossey-Bass Publishers, 1996.

(2.) Loden, M. and J.B. Rosner, Workforce America: Managing Employee Diversity as a Vital Resource. Illinois: Business One Irwin, 1991.

(3.) Thomas, Jr., R. Roosevelt, "Managing Diversity: A Conceptual Framework," Diversity in the Workplace. New York: The Guilford Press, (1992):306-317.

(4.) Thomas, Jr., R. Roosevelt, "From Affirming Action to Affirming Diversity," Differences that Work: Organizational Excellence Through Diversity. Boston: A Harvard Business Review Book, (1994):27-41.

(5.) New York University College of Dentistry (2000, November). Available: http://www.nyu.edu/dental

(6.) American Dental Association, Survey Center, 1998/1999 Survey of Allied Dental Education.

(7.) Faust, Charles C., "A Qualitative Study of Male Dental Hygienist" Experiences After Graduation," Journal of Dental Hygiene. Summer 1999; 73(3):143-148.

(8.) McIntyre, Eleanor, "Dental Hygiene: The Consequences of a Feminized Profession," Canadian Dental Hygiene/Probe. 1989; 23(4): 186-189.

(9.) DuRand, Ric, "Unwanted: Male Dental Assistant," The Dental Assistant, Nov-Dec 1982; 2(2):38-39.

Salim S. Rayman, RDH, BS, is an instructor of theoretical and clinical dental materials and office management for the Office of Allied Health Programs at New York University College of Dentistry and is a current candidate for a Master in Public Administration degree at New York University's Robert Wagner School of Public Service.