2013 Predoctoral Educators Workshop

The Art and Science of Educating to Competency

Eros S. Chaves, DDS, MS, DMD, MBADiplomate, American Board of Periodontology

Professor and Chair Department of Periodontics

The Art and Science of Educating to CompetencyDental Education Program (DEP) Standards

Competent – The levels of knowledge, skills and values required by the new graduates to begin independent, unsupervised dental practice

Competency - Written statement describing the levels of knowledge, skills and values expected of graduates

Cultural Competence – having the ability to provide care to patients with diverse backgrounds, values, beliefs and behaviors, including tailoring delivery to meet patient’s social, cultural and linguistic needs

The Art and Science of Educating to CompetencyNew CODA Pre-Doctoral Standards

• Critical Thinking• Lifelong and Self Directed Learning• Humanistic Environment• Scientific Discovery and the Integration of Knowledge• Evidenced-Based Oral Health Care• Assessment• Faculty Development• The Health Care Team• Diversity

Standard 2 – EDUCATIONAL PROGRAM • Instruction• Curriculum Management (clinical exams – OSCE,

availability of patients)• Critical Thinking• Self Assessment• Biomedical and Behavioral Sciences• Practice Management and Health Care Systems• Ethics and Professionalism• Clinical Sciences

The Art and Science of Educating to CompetencyNew CODA Pre-Doctoral Standards

• Critical Thinking• Lifelong and Self Directed Learning• Humanistic Environment• Scientific Discovery and the Integration of Knowledge• Evidenced-Based Oral Health Care• Assessment• Faculty Development• The Health Care Team• Diversity

Standard 2 – Education program

2-5 The dental education program must employ student evaluation methods that measure its defined competencies.

Examples: Objective structured clinical examination (OSCE)Clinical Skills testing

The Art and Science of Educating to Competency

1. Prevalence of periodontitis underestimated in this country by as much as 50%.

CODA - Scientific Discovery, Integration of knowledge, Critical thinking, lifelong and self-directed learning, assessment, diversity

The Art and Science of Educating to Competency

1. Prevalence of periodontitis underestimated in this country by as much as 50%.

The AAP has been stressing the need for Comprehensive Periodontal Examination

The Art and Science of Educating to Competency

1. Prevalence of periodontitis underestimated in this country by as much as 50%.

Expected Action - requiring competency in CPE in predoctoral education

The Art and Science of Educating to CompetencyChallenges

Electronic periodontal charting leading to incorrect CAL and Periodontal Diagnosis

The Art and Science of Educating to CompetencyChallenges

Faculty calibration – aggressive periodontitis recommended Tx in predoctoral clinic

Initiall

The Art and Science of Educating to Competency

2. Potential mechanisms, epidemiologic evidence and association between periodontitis and systemic conditions

CODA – Faculty Development, Scientific Discovery and integration of Knowledge, Lifelong and Self-Directed Learning, The Health Care Team, Evidence-Based Oral Health Care.

The Art and Science of Educating to Competency

2. Potential mechanisms, epidemiologic evidence and association between periodontitis and systemic conditions

The AAP has been instrumental in organizing national and international meetings among experts, discussing the role of periodontal infection and inflammation in systemic conditions and future research.

The Art and Science of Educating to Competency

2. Potential mechanisms, epidemiologic evidence and association between periodontitis and systemic conditions

Expected Action – Educating our dental students to competency in diagnosis, prevention, risk assessment, treatment plan and initial therapy of periodontal diseases including comprehensive care and referral.

The Art and Science of Educating to CompetencyChallenges

Maintenance of periodontal disease in predoctoral clinic – no referral

Periodontal maintenance for more than 2 years in the undergraduate periodontal clinic

3 weeks after proper scaling and root planing

The Art and Science of Educating to Competency

3. Changing periodontal referral patterns or GP’s tendency to refer patients in late stages of periodontitis to the periodontist.

CODA – Health Care Team, Diversity, Evidence Based Oral Health care, Critical Thinking

The Art and Science of Educating to Competency

3. Changing periodontal referral patterns and GP’s tendency to refer late stages of periodontitis to the periodontists.

AAP has been creating opportunities for periodontists to maintain a closer contact with general dentists and other specialists

The Art and Science of Educating to Competency3. Changing periodontal referral patterns or GP’s tendency to refer late stages of periodontitis to the periodontists.Expected Action – Educating our dental students to competency in periodontal referrals at the initial, reevaluation and maintenance visits (comprehensive periodontal examination) and increasing elective periodontal seminars for dental students and their interactions with periodontal residents

The Art and Science of Educating to Competency

Periodontal Competencies including periodontal referrals was presented and discussed before by the AAP, Education Committee and Predoctoral Educators in 2002

The Art and Science of Educating to Competency

2009 AAP PreDoctoral Program Directors Organization Workshop“Periodontal Diagnosis, Classification and Guidelines for Referral: Are We all on the Same Page”

What has prevented us (predoctoral educators) to implement the periodontal competencies discussed in 2002, and proper diagnosis and referrals in 2009?

The Art and Science of Educating to Competency

What has prevented us to implement value in periodontal competencies and referrals?

Are we leaning to a culture of conformity in periodontal education?

Are we supporting periodontal faculty and students to truly be what they should and can be?

Are we just creating “stupid rules”?

The Art and Science of Educating to CompetencyGroups and Discussion – Avoiding “Stupid Rules”

• Keep competencies and assessments simple - Critical errors, Pass/Fail, S/U, 2nd. attempts etc.• Competencies are clear and apply equally to everyone• Competencies are meaningful and with a purpose – All involved know what the rules are for• Competencies have value• Competencies provide chance for development• Students should desire to exceed our minimum clinical competencies• Students and faculty should believe that they are accomplishing something worthwhile

Adapted from “Creating the Best Workplace on Earth” in HBR, pg.99-106, May 2013

The Art and Science of Educating to CompetencyGroups and Discussion

• Be creative, be innovative and direct Clinical Competencies towards the goals of periodontal education and clinical periodontics, and not only national and regional testing agencies.

• “..we (periodontists) must lead the conversation with our dental colleagues and establish ourselves as their resource to help them better manage their patients and therefore see the value of referral and working together for optimal outcomes”.

Dr. Donald Clem III, AAP President Address 2009

After Perio + Ortho + Prostho