The Integration of Community BasedPartnerships into Dental Education

Western University of Health Sciences

UCSF DPH PresentationFebruary 21, 2012

Timothy S. Martinez, DMD

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Western University of Health Sciences

Graduate Health Sciences– Medicine– Pharmacy– Veterinary Medicine– Physical Therapy– Physician Assistant– Graduate Nursing– Optometry– Podiatric Medicine– Dental Medicine– Biomedical Sciences

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College of Dental Medicine

• Inaugural Class Fall of 2009

• Integrated Approaches– Biomedical Sciences– Dental Sciences– Clinical Education Program– Community Based Dental

Education– Interprofessional

Education

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Today’s Topics• CDM Partnerships

– Sites– Array of Affiliations

• CDM Community-Based Curriculum– Activities by Class Year– Example of Procedures Performed

• Other College Partnerships• Keys for Successful Dental Partnerships

– Primary Care Viewpoint– Education Viewpoint– The Details

Community Based Partners

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ASite: AIDS Project of Los AngelesPopulation Type: HIV/AIDSBSite: Alta-Med Health ServicesPopulation Type: General DentistryCSite: Assistance League of Pomona Valley Dental CenterPopulation Type: ChildrenDSite: C.A.R.E. ProgramPopulation Type: HIV/AIDSPhysical Address 2: Ste. CESite: Children's Dental Practice of MenifeePopulation Type: ChildrenFSite: Community Health Network of San FranciscoPopulation Type: Low IncomeGSite: Community Health Systems, Inc.Population Type: Low IncomeHSite: Desert Friends of the Developmentally DisabledPopulation Type: Special Needs

ISite: Dr. Bertha AlarconPopulation Type: General DentistryPhysical Address 2: Ste. #7JSite: East Valley Community Dental CenterPopulation Type: Low IncomeKSite: Glenn DentalPopulation Type: General DentistryLSite: Hani Nasr, DDSPopulation Type: General DentistryMSite: Hurtt Family Health ClinicPopulation Type: Low IncomeNSite: Los Angeles Christian Health CenterPopulation Type: Low IncomeOSite: Pacific Dental ServicesPopulation Type: General DentistryPSite: San Gabriel Pomona Regional CenterPopulation Type: Special Needs

QSite: San Gabriel Valley Foundation for HealthPopulation Type: Low IncomeRSite: Simjee PeriodonticsPopulation Type: PeriodonticsPhysical Address 2: Ave #205SSite: Student Run Health Center - RiversidePopulation Type: Low IncomePhysical Address 2: 3504 Mission Inn Ave.TSite: Toiyabe Indian Health ProjectPopulation Type: Indian CommunitiesUSite: UCSD Student-Run Free Clinic ProjectPopulation Type: Low IncomeVSite: Victor Valley Community DentalPopulation Type: Low Income

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Array of Affiliations (WUHS)

• FQHC• CHC Look-alike’s• School Districts• Homeless Shelters• Assistance League Clinics• Focused assistance organizations (Angels for Sight, Lions

Club)• Indian Health Services Sites (tribal affiliations)• Military (USAF, USN)• VA

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CDM Model

• Belief: Students can learn to provide quality care in a variety of clinical settings

• Goal: Students will participate in patient care experiences in a number of community-based settings over the course of their four years. The experiences will be progressive (increasing complexity) and integrated (part of curriculum).

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D1 Year• Service Learning Course– Communication skills, Data gathering, Patient Education,

Chairside assisting and Dental Terminology

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D2 Year

• Clinical Service Learning Course– Review of medical history, prophylaxis, sealants,

fluoride application, preventive resin restorations + D1 expectations

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D3 Year

• Clinical Service Learning -> CBDN– Basic restorations, non-surgical periodontal therapy,

simple extractions, D1 and D2 expectations

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Example of D3 Procedures Performed

• January 2012• Data Gathered in E*Value System

31.64%

21.29%22.94%

1.95%

2.55%

3.90%1.50%

11.99% 2.25%

Procedure Group

Diagnostic 211Preventative 142Restorative 153Endodontics 13Periodontics 17Removable Prosthodontics 26Fixed Prosthodontics 10Oral Surgery 80Miscellaneous 15

N = 667

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D4 Year

• Community Based Dental Network– Restoration and Replacement of teeth, basic and

moderate oral surgery, endodontic treatment, minor periodontal surgery and D1-D3 expectations

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Evaluation of Student/Rotation Day• Students and Clinical Faculty on site have

access to evaluations through online portals• Grading Criteria listed under each value

(Exceeds, Meets, and Below Expectations)Preparation and Processes Criteria related to preparation and processes involved with the encounter. Includes the student’s including understanding of relevant foundational material, communication with faculty, organization of instruments, materials and supplies, maintenance of work environment and required authorizations and approvals

Exceeds Expectations (E) Meets Expectation (M) Below Expectations (B)

Technical Performance Skills Criteria for technical performance skills throughout the encounter include infection control and isolation, application of pain / anxiety control measures, established procedural requirements and clinical standards of care.

Exceeds Expectations (E) Meets Expectation (M) Below Expectations (B)

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Evaluation ContinuedClinical Judgment, Ethics and Professionalism Criteria areas clinical judgment (applied critical thinking) the level of balance between independence / guidance as well as demonstrated ethics and professionalism throughout the encounter. Integration of knowledge, skills and values; understanding self-limitations; ability to gather and utilize information; evidence-based decisions; purposeful and reflective judgment. Application of foundational knowledge, critical thinking, appropriate balance of seeking guidance with independence, ethics and professionalism.

Exceeds Expectations (E) Meets Expectation (M) Below Expectations (B)

Appraisal of Patient Care Outcome Criteria for evaluating the outcome of the patient care encounter. Includes reviewing the quality of the patient experience, adequacy of patient communications and overall outcomes demonstrating quality care for the patient.

Exceeds Expectations (E) Meets Expectation (M) Below Expectations (B)

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Our Approach

• Master the 10 week experience– D1 1 week(intermittent)– D2 2 weeks(intermittent)– D3 3 weeks

(intermittent)– D4 4 week(block rotation)

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Other College Involvements

• Optometry– School Districts, Angels for Sight, Homeless

shelters, Casa Colina, Torrence Center for Partially Sighted, VA, IHS

• Physician Assistant– Private Practices, FQHC’s, Community Centers,

Free clinics and Hospitals

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Keys for Successful Dental Partnerships

• Goal is to merge the primary care mission of patient care with the educational goals of the various students

• All parties from all sides indicated that open communication was the most critical element for success

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Primary Care Viewpoint

• Dr. Carolyn Brown – Native American Health Center – San Francisco

• Communication – Rotation Goals, Student capabilities, Procedures,

Assessment Input, Institutional follow-through• Incentives – Training with CE credit, Library access, Students

with necessary skills to be efficient providers

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Education Viewpoint

• Communication • Patient and Procedure mix, • Site capacity (critical for dental rotations)• Commitment and advocates at all levels

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The devil is in the details

Faculty appointmentSite selectionCalibration of cliniciansContinuity of care for students who are away and for patients of the practiceProtocols and policies

-attendance-post-exposure protocols for off-site locations

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Thank You