Community-Based Education
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Transcript Community-Based Education
“New Dental Schools”
What Are They Doing Out
There?
(And Do We Really Need Them?)
Overview
1986 – 2001:
7 Dental Schools Closed
1997 – 2009:
5 Dental Schools Opened
2011-2014:
7 new schools
Future:
8 new schools being considered
There are still many in the profession who remember
the last time the system was expanded
Influence of practicing profession on applicant pool
Perspective
1980 – 6,000 graduates; 227 million = 1:38,000
1990 – 4,000 graduates; 250 million = 1:62,500
2000 – 4,200 graduates: 281 million = 1:67,000
2010 – 4,800 graduates: 308 million = 1:64,000
2020 – 5,600 graduates: 335 million = 1:60,000
Why Connected to Osteopathic
Medicine?
• The Osteopathic Philosophy
• Health is more than the absence of disease
• Health involves the whole person (body, mind
and spirit) and the person’s relationship to
others and the world
• Oral Health is essential to Overall Health
Framing the Debate
“Do We Need New Dental Schools?
Vs
“If We Are Going to Have New Schools, How Can
We Take Advantage of the Opportunity?”
Opportunities for New Dental
Schools
Many reports/articles/discussions about the need to
reinvent dental education
Similar documentation of the slowness of real change
Dozens of presentations over the years about new
ways of doing things but progress seems slow
Don’t new schools have an obligation to help move the
profession forward?
Are these really “New Models?”
Or, is it that the new schools have a better chance?
Opportunities for New Dental Schools
A “Blank Slate”
Responsibility to the Profession to Lead Change
Innovative Curriculum models
Efficient/Effective Patient Care models
Community-Based Education models
Inter-Professional Education
Oral – Systemic Connection
UNE - Mission
University
The University of New England provides students with a
highly integrated learning experience that promotes
excellence through interdisciplinary collaboration and
innovation in education, research and service.
College of Dental Medicine
The mission of the University of New England College of
Dental Medicine is to improve the health of northern New
England and shape the future of dentistry through
excellence in education, discovery and service.
Hallmarks
• Holistic Admissions Criteria
• Humanistic Environment: student and patient friendly
• Strong Foundation in Science
• Curriculum built around patient care
• Integrated teaching and learning model that is innovative
and evidence-based (use of varied methods)
• Appropriate use of modern technology and Realistic
Simulation
• Early and Extensive Clinical Experiences
• Comprehensive Care in Group Practice Model
Hallmarks
Prevention-Oriented Teaching and Practice
Promotion of community and dental public health
Significant community-based education experience
Development of strategic partnerships to help achieve
mission and goals
Research and critical inquiry, inter-professional practice, lifelong learning
Professionalism, Ethics, Leadership, Communication,
Business Management Skills
UNE CDM Graduates
Will be ethical, caring people;
Will be life-long learners;
Will be capable clinical practitioners who will have the
ability to provide complex, high-quality care in an interprofessional health care delivery system;
Will embrace scientific and technological advances ;
Will understand the connections between oral health
and general health;
UNE CDM Graduates
Will be partners in the inter-professional health care
delivery systems of the future;
Will be leaders of their own oral health care teams, as
they enhance and extend the quality of life in their
communities.
Will collectively engage in clinical oral health care,
public health practice, biomedical and health services
research, education and administration;
Will fulfill their professional obligation to improve the
oral health of all members of society;
CDMI
Behaviorally oriented Whole File Admissions Reviews
Use of Multiple Mini Interview (MMI) protocol
“Single Pillar” Organizational Structure
No departments or divisions
Generalist model of education and practice
Competency based
Integration of Pre-Clinical Curriculum
Hi-tech Simulation based on clinical case scenarios
Integrated Oral Health Science Curriculum
General Dentistry based supported by specialists
Patient Centered, Group Practice, Grand Rounds Approach
CDMI (Continued)
Use of varied teaching learning methodologies
Small groups
Case-based
Problem based
Biomedical Sciences integrated and system based
Connected to Oral Health Sciences where facilitated by timing
and scheduling
Spiral model of curriculum progression in which basic concepts
are revisited throughout curriculum
Capstone, team-taught course in Yr. 2, 2nd Sem
Review and reinforce prior learning in B.S.
Motivate critical thinking through use of cases
Provide better preparation for NBDE
CDMI (continued)
Interprofessional Learning and Practice
Core inter-professional course attended by all first year
students from nine professional programs
Second year course in Head and Neck Diagnosis codirected by Osteopathic Medicine and Dental Medicine
Inter-professional health care facility with dentistry as
“anchor tenant” but with all other professional programs
included
USN Educational Model –
Mastery Education
Contemporary
Classroom
Complex
Active and
Collaborative
Learning
Block System
Assessment/
OutcomesBased
Education
USN
Block system for didactic courses
36 hr course = six 6 hr. days
Supported by contiguous breakout room configuration to
allow for small group, PBL, and active collaboration
Immediate exploration and clarification of core concepts
with faculty
USN
Mastery Education Model
Criterion Referenced and Competency Based
Pass/No Pass
90% passing grade
Assessments occur within block on Friday with
remediation the following Monday
Additional remediation opportunity in summer for those
with three or more “no pass”
General Dentistry Group Practice Teams
Community-based education for most of 4th year
Focused approach to research
1 Individual Course
Block System:
Advantages
Focused Learning / 1 Topic
Mastery of Topic
Increase Active Learning
Rapid Instructor Assessment/Feedback
Peer Teaching
Remediation
Contemporary Classroom
Complex
Classroom “in the round”;
No one more than 4 rows away from teacher;
5 Breakout rooms – small-group teaching/discussion;
USN’s Classroom
Complex
Typical Teaching Day
8-9 am:
Formative Assessment / Prior Day
9-10 am: New Material (lecture)
10-11 am: Team Activities + Feedback
11-Noon: Lunch
12 – 1 pm: New Material
1-2:30 pm: Team Activities
2:30-3:00 pm: Feedback, Wrap-up, Loose Ends
Western University of Health Sciences
College of Dental Medicine
Vision
Western University College of Dental Medicine will be a premier
center for integrative educational innovation; basic and
translational research; and high quality, patient-centered,
interprofessional health care, all conducted in a setting that utilizes
advanced technology and promotes individual dignity and potential
for personal and professional growth.
The WesternU College of Dental Medicine will realize this vision by
educating and training highly competent, diverse groups of clinical
practitioners who have the ability to provide complex, integrative,
high-quality, evidence-based care for patients, families and
communities.
Western University of Health Sciences
College of Dental Medicine
Mission
WesternU College of Dental Medicine will produce graduates who
will be ethical, caring life-long learners; who will collectively engage
in clinical oral health care, public health practice, biomedical and
health services research, education and administration; and who will
fulfill their professional obligation to improve the oral health of all
members of society, especially those most in need. They will
embrace scientific and technological advances and understand the
connections between oral health and general health. They will be
partners in the interprofessional health care delivery systems of the
future, as well as leaders of their own oral health care teams, as
they enhance and extend the quality of life in their communities.
Guiding Principles
Critical Thinking
Self Assessment
Lifelong Learning
Science Based Curriculum
Integration of basic/behavioral/clinical sciences
Focus on Overall Health/Oral Health Connections
Early entry into clinic
Use of appropriate technology
Professionalism/Ethics/Values
Leadership/Communication/Management Skills
Curriculum Highlights
Basic/Behavioral Sciences
Systems based approached to basic sciences
Challenges with simply taking med school curriculum
Evolving into dental school ownership of biomedical sciences
with integrated case based approach
Interprofessional Experiences
Case-base instruction, didactic coursework, community
education as well as clinical training and rotations
Integrated Dental Sciences
Essentials of Clinical Dentistry
“Bucket approach” based upon patient care
Close juxtaposition of didactic material with simulated
exercises and patient care
Learn procedure, practice to competency, apply in patient
care
Curriculum Highlights
Comprehensive Patient Care
Group Practice Model
Evidence-Based
Patient Centered
Competency Driven
Community-Based Education
Real Life Experiences
Practice Management
Service to Community
Faculty
Coming from private practice or directly from residency programs
Possibly contributing to a net gain in faculty?
Will require well planned faculty development programs
Inter-Professional Patient Care Center
Interprofessional Clinic
Western University
Evidence-Based Decision Making and Clinical
Research – First Year Course
Course Topics and Objectives:
Introduction to Epidemiology
Introduction to Clinical Trials
Introduction to Biostatistics
Ethical and Regulatory Issues in Clinical
Investigation
Introduction to evidence-based practice
Developing a precise question
Western University
Introduce students to clinical research methods as well as basic
and advanced concepts of evidence-based practice in the
health professions.
Train students to appropriately utilize and evaluate the
biomedical literature across health professions.
Prepare students to engage in evidence-based decision
making, providing the skills needed to locate relevant online
scientific/medical information as well as to evaluate the quality
of the research methodologies and statistical analyses reported
in the clinical research literature.
Focus is from a clinical practitioner/researcher standpoint rather
than that of a basic sciences researcher. This is an introduction
to several key concepts, and students are not expected to have
a deep mastery of statistics, research methodology, or online
bibliographic databases prior to taking the course.
Western University
Develop and utilize effective evidence-based practice search
strategies
Critically appraise the evidence for its validity and importance
regarding diagnosis and screening, prognosis, therapy and
etiology/harm
Apply the results to practice
Instill in the student an approach to health care that requires the
judicious integration of systematic assessments of clinically
relevant scientific evidence in the context of patient treatment
needs and preferences.
Other Initiatives
University owned remote clinics
Community Service Learning Centers
Located in Rural, Underserved areas
Faculty, residents, dental students, staff practicing
together
Expose students to patients with more complex medical
and oral health needs
One goal is to have the dental graduates go back to those
rural areas to practice
General Thoughts
The more I learn, the less I’m sure of
This is simply an overview
CCI principles do form the basis for much of what is happening
“New” schools, like existing schools, are unique, with individual
missions and goals
Doing “new” things or doing “old” things differently will require
paradigm shifts, risk taking, extreme flexibility, and willingness to
“fail”
Possible to create a different culture, but can it be maintained?
When the going gets tough, will we revert back to what we know?
Special Thanks To:
Dr. Lex MacNeil, Midwestern University-Illinois
Dr. Rick Buchanan, University of Southern Nevada
Dr. Steve Friedrichsen, Western University of Health
Sciences
Dr. Rick Valachovic, ADEA
The thousands of people who have taught me over the
years, both formally and informally
Questions?
Discussion