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Online Education for Oral Health Professionals and Students: A Work
in Progress
Richard K. Fleming, PhD
University of Massachusetts Boston
Today’s objectives
Describe the development and evaluation of a Phase I (feasibility) online course to introduce dentists, dental hygienists and other oral health professionals to the needs and treatment of patients with intellectual and developmental disabilities (ID/DD)
Obtain audience feedback for Phase II development of a what will be a 6-course media-supported online curriculum offered for continuing education units.
Developmental Disabilities Dentistry Online Funding: NIDCR, R42DE020979-01A1
Small Technology Transfer Research (STTR) FastTrack grant “To support scientific excellence and technological
innovation through the investment of federal research funds in critical American priorities to build a strong national economy…..one small business at a time” (NIDCR)
Phase I feasibility, or “proof of concept” Phase II full implementation
An ID/DD community-engaged effort
Richard Fleming, PhD, PI, psychology, UMASS-Boston
Charles Hamad, PhD, psychology; Melissa Maslin, MEd & Helen Hendrickson, MPH, project management, E. K. Shriver Center at UMASS Medical School
Harold Lobo, PhD, instructional design, Cindy Fleming, MS, formative evaluation & writing; Angela Robinson, MEd, writing; Lacey Hebert, MEd, editing, Praxis, Inc.
John Morgan, DDS and Kathy Dolan, RDH, Med, content development, Tufts University School of Dental Medicine
Malcolm Johnstone and Jin Chyung, learning objects development, LearnObject, Inc.
Professional Advisory Board (alphabetical)
Robert Ducoff, DMD, Drs. Rubenstein & Ducoff, Inc. Vincent Filanova, DDS, FADPD, DABSCD, NY State Office for People with Developmental
Disabilities, Special Dentistry Taskforce David Fray, DDS, MBA, Chief, Developmental Disabilities Division, Hawaii Department of
Health Steven Perlman, DDS, MScD, DOHL (hon), Clinical Professor of Pediatric Dentistry, Boston
University Henry M. Goldman School of Dental Medicine Maureen Romer, DDS, MPA, Director of Special Care Dentistry, A. T. Still University Allen Wong, DDS, EdD, DABSCD, Director, Hospital Dentistry Program, University of the
Pacific
Special assistance from: Maura Buckley, MPA, Product Manager, UDiscovering Paul Farsai, DMD, Associate Professor, Department of General Dentistry, Boston
University Henry M. Goldman School of Dental Medicine Patrick Gleason, MA, Staff Writer, E. K. Shriver Center, UMASS Medical School
Phase I and Phase II courses
Introduction to Oral Health Care for People with Intellectual and Developmental Disabilities (ID/DD)- feasibility
Preventive Dentistry for People with ID/DD Medical Considerations and Syndromes Treatment Planning and the Comprehensive Patient
Care Experience Behavior Management Strategies Oral Health Care for People with Autism Spectrum
Disorders
Development Protocol
Assess needs, expectations Develop learning objectives Specify outcomes (education vs. training) Select instructional methods, media, technology Produce content - team Implement and evaluate Revise
Instructional approach
Video Stories – caregivers, staff, professionals, compelling
Video demonstrations – behavioral guidance Learning objects Interactive video cases: simulations w/branched
decision-making Self-assessments Traditional: text, personal note taking, glossary,
resource links to organizations and materials, etc.
Field Test Sample
Preliminary Field Test
17 were enrolled 13 completed the PFT:
8 dentistry students 4 dental hygiene student 1 dental hygiene educator
Summative Field Test
22 enrolled 15 completed the SFT:
12 dentistry students 1 dental hygiene student 1 full-time faculty at dental
school and practicing dentist
1 dental assistant and dental hygiene student
Knowledge gain
Overall sample: Mean percent correct scores improved significantly from pre-test (M = 55.58, SD = 11.07) to post-test (M = 79.24, SD = 7.805), z = -4.474, p < .0001. PFT: Mean percent correct scores improved significantly from pre-test (M = 55.29, SD = 10.47) to post-test (M = 82.70, SD = 8.52), z = -3.194, p = .001. SFT: Mean percent correct scores improved significantly from pre-test (M = 55.83, SD = 11.92) to post-test (M = 76.25, SD = 5.882), z = -3.191, p = .001.
Course 2 Preventive Dentistry for People with ID/DD
Selected objectives
Examine the risk for oral disease in patients with ID/DD, including the ways in which these risks differ from those of other patients
Describe methods for individualized, patient-centered prevention planning, taking into account unique needs and modifications
Assess the patient’s home environment, skills, and available resources, in order to design an individualized homecare program.
Course 3 Medical Considerations and Syndromes for People with ID/DD
Selected objectives
Identify common syndromes in ID/DD and explain their impact on oral health and treatment
Describe how characteristics common across disabilities (e.g., sensory impairment, polypharmacy, communication skills or modalities) may affect oral health and treatment.
Course 4 Treatment Planning and the Comprehensive Patient Care
Experience
Selected objectives
Identify psychological, behavioral, sensory, and anxiety factors in ID/DD that may impact treatment planning and treatment
Describe the need to develop individualized, patient-centered care plans, taking into account the unique needs of a specific individual with ID/DD.
Learn and apply decision-making processes for patients with ID/DD
Describe best-practice approaches to communication and decision-making with individuals with ID/DD and their care team, including obtaining informed consent.
Course 5 Behavioral Guidance Strategies
Selected objectives
Understand behaviors patients with ID/DD might exhibit, including their function, and effect on treatment
Identify behavioral guidance strategies for use with patients with mild/moderate ID/DD, such as tell-show-do, reinforcement, gradual exposure (shaping), relaxation training, and systematic desensitization
Identify environmental modifications to control stimulation, including alterations to sound, light, movement.
Determine strategies used in logical combinations for particular scenarios to achieve comprehensive treatment
Course 6 Oral Health Care for People with Autism Spectrum Disorders
Selected objectives
Describe the prevalence, characteristics and diagnostic categories of ASD
Describe common challenges and impacts on dental care associated with sensory, behavioral, communication and anxiety issues in individuals with ASDs
Explore treatment accommodations and behavioral supports needed to provide effective dental care with individuals with ASDs, including utilizing and referring to outside consultants and professionals
Questions for Phase II
Should we target just children, at least for now? Should this team focus more narrowly on parent/caregiver
training and behavioral guidance? Target practicing dentists, dental hygienists, etc. vs. students?
(Is it possible to do both?) What instructional methods or mix is most appealing?
Video stories of triad members? Video demonstrations and exercises (interactive), e.g., of
behavioral guidance? Video case studies (interactive)? Learning objects (interactive)? Video/audio guide to courses? Other
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