Transcript Slide 1

Quality Assurance Program
Samples – Forms 6 and 7
6. CQI Activity Plan for the Year 20___
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
This is your Personalized Learning Plan.

Self-assess your dental hygiene practice yearly.

Identify areas of your practice that need enhancement.

Develop learning goals that will enhance your practice.
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Form 6 Sample
The number of
goals you select
will depend on
your needs and
the time and
learning that is
realistically
required to
complete them.
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7. CQI Activities Evaluation for Goal # _____
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
This form reports on your progress towards your goal.

A separate Form 7 must be completed for each goal.
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Form 7 Sample Goal #1
…Researching
and evaluating
the PSR system
as a periodontal
screening tool.
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Form 7 Sample Goal #1
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cont’d
Form 7 Sample Goal #2
…Investigating
dentin
hypersensitivity
to better help
clients who are
presenting with
tooth sensitivity.
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Form 7 Sample Goal #2
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cont’d
Form 7 Sample Goal #3
…Researching
ways to better
communicate
with my clients
so I can better
establish their
priorities and
expectations for
oral care.
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Form 7 Sample Goal #3
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cont’d

Continuing Competency
Means Making a Commitment
to Lifelong Learning

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