Few general dentists feel comfortable treating very young children 0-5-years old due to inadequate training and exposure. Over the past few years, there is an increasing demand on providers to be culturally competent and meet the health needs of the culturally diverse population. OBJECTIVE: Assess the gained knowledge, perception and confidence in providing clinical dental care to vulnerable populations, pregnant adolescents and to very young children 0-5-years old following the enhancement of the predoctoral pediatric dental curriculum and training which was aimed to prepare future practitioners to be culturally competent in providing pediatric dental care to the current culturally diverse population. METHODS: This is a retrospective cross-sectional analysis conducted among the predoctoral students including the Doctor of Dental Medicine-(DMD) and Advanced Standing-(AS) who underwent pediatric dental training between 2017-2022 at Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts. Predoctoral students participated in the pre/post training surveys of the implemented didactic training program in cultural competency and oral health literacy lectures. The students completed questionnaires on their knowledge and confidence level on treating children 0-5-years old following the novel simulation scenario discussion after the Haptic simulator training and following clinical training in the pediatric dental clinic. Descriptive statistics were calculated, univariate and multivariate analysis were used to analyze the differences in the level of knowledge gained by program type, year of training and demographic characteristics such as age and gender. Statistical significance was set at p-value<0.05. RESULTS: The cultural competency training improved the students’ knowledge and perception. DMD-students performed better to have a higher level of knowledge in the post training survey compared to AS-students (OR=4.724;p<0.001). Based on the post training questionnaires, the haptic simulator session and novel simulation scenarios increased the students’ knowledge and confidence to treat pediatric patients. Student’s confidence to treat children 0-5-years and pregnant adolescents improved after completing the trainings. CONCLUSION: The new enhanced training program increased the predoctoral students’ knowledge and confidence to treat children 0-5-years. This can be beneficial when used in dental departments to support predoctoral graduates to be culturally competent who can be better prepared to manage the diverse population.

Les arguments de sécurité sont couramment utilisés pour montrer que des efforts suffisants ont été faits pour atteindre les objectifs de sécurité. Ainsi, la sécurité du système est souvent justifiée par l'évaluation des arguments de sécurité. L'évaluation de tels arguments repose généralement sur l’avis d’experts sans s’appuyer sur des outils ou des méthodes dédiés. Ceci pose des questions sur la validité des résultats. Dans cette thèse, une approche quantitative est proposée, basé sur la théorie de Dempster-Shafer (théorie D-S) pour évaluer notre confiance dans les arguments de sécurité. Cette approche gère le problème à travers les aspects suivants: 1) Définition formelle de la confiance dans les arguments basée sur la théorie D-S; 2) Développement de règles d'agrégation des paramètres de confiance; 3) Proposition d'un cadre d'évaluation quantitatif des arguments de sécurité. Une application dans le domaine ferroviaire conduit à l'estimation des paramètres du cadre par une enquête auprès d'experts en sécurité. / Safety arguments, also called Safety Cases, are commonly used to present that adequate efforts have been made to achieve the safety goals. Thus, the system safety is often justified through assessing the safety arguments. The assessment of such arguments is usually implemented by experts without any dedicated tool or method. This leads to a questionable validity of the results. In this thesis, a quantitative framework is proposed based on Dempster-Shafer theory (D-S theory) to assess our confidence in Safety Cases. This framework manages the issue in following aspects: 1) Formal definition of confidence in arguments based on D-S theory; 2) Development of confidence aggregation rules; 3) Proposition of a quantitative assessment framework of safety arguments. An application in railway domain realises the parameter estimation of the framework by a survey with safety experts.