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Appendix E: Minimum Procedural Experiences, Departmental Competency / Examinations & the Points ProgramRevised 09/03 Tufts University School of Dental Medicine’s Vision Statement is “Patient centered education committed to excellence”. Students’ comprehensive care of patients is an integral part of that vision. To assess patient care and to educate students, Minimum clinical experiences, Competency examinations, and a total Point program have been established. This document serves as a guideline to these measurements. The student must also accomplish other Department-specific required courses, rotations, seminars, and workshops. These are detailed in the Student Schedule and summarized in the Clinic Manual. NOTE: Students must prepare for each clinic session by studying in advance the relevant department manuals concerning the procedure that they have scheduled for the patient. Department faculty will expect students to be prepared to answer questions. Preparation is part of the daily clinical grade. For department patient procedures involving laboratory work, the laboratory work must be seen by a faculty member or laboratory technician before the visit. GOALS AND OBJECTIVES OF THE MCP PROGRAM GOALS OBJECTIVES 2. To list the clinical procedures requiring competency as defined by the TUSDM Competency Statements. Each Competency Statement represents the ability to perform a complex service or task. 3. To explain the point values system that supports comprehensive patient care.
One measure of experience is a student’s practice and the faculty’s evaluation of a MANDATORY minimum number of specific procedures. Department faculty has determined which procedures are necessary for a practicing dentist to know for appropriate patient care. These are outlined in the Competency Statements for Tufts University School of Dental Medicine. Performance of enough of these mandatory minimum experiences is necessary for the student to achieve enough skill to independently perform a competency examination for that procedure. Departments have “step sheets” to use for MPE’S. Students should turn in the completed card to the department, keeping a copy for themselves. Minimum Procedural Experiences = MPE’S = Minimum “number of completed procedures” in a department needed to graduate - (old term = “requirements”) DEPARTMENTAL COMPETENCY EXAMINATIONS (CE’S) Competency is defined as the behavior expected of a beginning practitioner. This behavior incorporates understanding, skill, and values in an integrated response. A competency examination (departmental competency examination) is an outcomes assessment measurement of the individual student’s ability to independently perform the competency related to specific parameters or criteria. These have been developed to evaluate a student’s ability to perform the procedure independent of faculty input. These are done after the student has completed enough experiences with the procedure to test competency in the procedure. TUSDM evaluates students’ clinical competency by means of several methods: 1. Clinical Case Presentations, e.g., the student performs a diagnosis and treatment planning procedure with the patient and is observed/graded by department faculty. 2. Clinical Patient Competency Examinations, e.g., the student performs a procedure such as an amalgam restoration on a patient. S/he is observed/graded by department faculty. 3. Manikin Examinations, e.g., the student performs a procedure such as endodontic therapy on a manikin tooth. Department faculty grades the manikin. 4. Objective Simulated Competency Examinations (OSCE’S): the student answers a series of clinical based questions as in the Orthodontics OSCE. This written examination is graded by scantron and reported to department faculty. 5. Oral Examinations, e.g., the student answers a series of questions about a subject such as in the Oral and Maxillofacial Surgery Oral Examination. Department faculty questions the student. Clinical competency examinations are done during regular patient treatment in the group practices on the student’s own patients (Note: on rare occasions, the Practice Coordinator may allow a student to take a CE on another student’s patient). The student simply requests at the beginning of the session that they would like to do this procedure as a competency examination. Many manikin competency examinations and Oral Examinations are scheduled for the student (see Student Schedule). Many OSCE’S are scheduled during a department’s seminars or rotations (see Student Schedule). For details about the format of the competency examinations, please see each Department’s competency examination step sheets and/or grading criteria forms. Students must keep up with Competency Examination completion by doing several competency examinations during each trimester. The Checkpoint Chart with this document outlines when each minimum procedural experience, competency examination, and point value must be achieved during a student’s clinical patient assignment years (Starting April of Year 2 and ending in April of Year 4). The objective is to gradually achieve procedures, competency, and points in all areas. Competency Examinations are timed carefully on the Checkpoint Chart to ensure that: 6. It is at the point in the student’s clinical program that s/he is doing a lot of the procedures so that s/he is confident to challenge the procedure by means of a competency examination. Explanation: The student starts a patient’s treatment usually with periodontology procedures such as Phase I therapy. Therefore, the first Non-Surgical Periodontal Therapy Clinical CE must be taken in the winter semester of Year 3. It is at this point that the student is doing and has completed enough non-surgical periodontal procedures that they feel confident and should take the CE. By summer of Year 3, most of the student’s patients have received their initial periodontal therapy (except for recare) and are now receiving other treatments, such as crowns and removable/fixed prosthodontics. Therefore, the student has fewer opportunities to accomplish the non-surgical periodontal competency examination. The second Non-Surgical Periodontal Therapy Clinical CE must be taken in Fall of Year 4. This is when the student is recalling many of the previously completed patients. It is at such a recare visit that the second Non-Surgical Periodontal Therapy CE is done. 7. TUSDM clinical competency completion does not occur too close to licensing examinations when patients are needed for licensing examination procedures. Explanation: By winter of Year 4, students are searching for Non-Surgical Periodontal Therapy patients to treat during the licensing boards such as NERB’S. If the student has failed to complete their Fall Non-Surgical Periodontal Therapy CE, they may have to search for 2 Non-Surgical Periodontal Therapy patients: one for the CE and one for the licensing examination. This is not an easy task, as the licensing examinations have strict guidelines regarding amounts of calculus; these types of patients are scarce. 8. The student learns and challenges competency examinations for less complex procedures first and more advanced procedures last. Explanation: In the winter of Year 3, the student is best able to challenge the CE’s in Periodontology Diagnosis and Treatment Planning or Oral Health Promotion. In the fall and winter of Year 4, the manikin interim fixed partial denture and endodontics CE’s are scheduled. Each department has competency examination Grading forms (with grading criteria), which the student/faculty uses during the examination. Completed CE forms must be turned into the department. The student should keep his or her own copy of all step sheets (for MPE’s) and all CE sheets. Competency Examinations and Grading For both the Year 3 and Year 4 clinical grades, departments will include not completing the necessary year-end competency examinations (see Checkpoint document) in the determination of the final clinical grades by a 100% rule. The following is the policy that will be used to determine clinical grades: 9. Departments will count 100% of the competency examinations in the determination of grades. 10. For any competency examination that was required to be completed by year’s end, but has not yet been completed, a grade of 70 will be averaged in for that competency examination in the overall department grade. 11. When a student does finally take any missing competency examination (after the deadline), the maximum grade that they can receive in that competency examination is a 70. The only exception to this rule is the Salud students, at the end of year 3. These students will receive an extension (until October of year 4). If they do not complete the required CE’s before they leave for Salud, they will receive a “Y” grade. Competency Examinations = “Tests” of the student’s independent ability NOTE: CE’s may become computer based in the future. POINTS An important component of a comprehensive care program for patients is attaching value to every procedure that the student accomplishes for the patient. This encourages treating individual patient needs. Toward this end, all procedures are given value. The name used for that value is points. All competency examinations and minimum procedural experiences have point values. The remaining clinical care experiences must total 1000 points. These points may be done in any combination of clinical treatment procedures listed for credit in the Clinical Procedure and Fee Schedule booklet. NOTE: In 2002, points were also assigned to Fluoride carriers (Code 5986= 2 points) and Nitrous oxide oxygen sedation techniques (Code 9230 = 1 point). The amount of clinical treatment performed by each student is reported as total points. Point reports are generated on a regular basis to allow students, faculty, and administrators to evaluate student progress. In each trimester, students’ point performance is evaluated at ten weeks. If a student is found deficient, procedures are initiated to help the student to rectify this deficiency. These procedures are outlined in the Student Handbook. Repeated failure to keep up with the Checkpoint Chart will result in serious consequences (See Student Handbook). A work effort of 1000 points is used for evaluating minimum experience in patient care during the patient assignment clinical years (Third Trimester Year 2; Years Three and Four). NOTE: International and Middlesex students must achieve 1075 points as they have no externship assignment (a 75-point value). NOTE: Students may lose points for failure to follow administrative requirements, for example: failure to follow financial, record, scheduling and attendance policies. Points = “Value” attached to all clinical experiences.
Together, the successful completion of departmental mandatory minimum procedural experiences and competency examinations are necessary to assure student competency in patient care. Competency examinations test a student’s ability to perform procedures independently and at levels satisfactory for licensing examinations and graduation (minimum competency). The achievement of 1,000 points assures that students have enough experiences and competency examination opportunities to attain the competency level required for graduation. THE MINIMUM PROCEDURAL EXPERIENCES AND COMPETENCY EXAMINATIONS BY TUSDM’S EIGHT ACADEMIC DEPARTMENTS I. CLINICAL AFFAIRS Quality Assurance: Ms. Susan Rodd Room 335 QUALITY ASSURANCE Record Audits – Year 3 or 4
Post Treatment Examinations - Year 4
Year 4.
INFECTION CONTROL II. ENDODONTICS DEPARTMENT 10 canals (one treated tooth must be a molar) Two “1/2” day Endodontic Assists in Postgraduate Endodontics: THE SECOND ASSIST MAY BE COMPLETED ANY TIME BEFORE GRADUATION. FIRST ENDODONTIC ASSIST, BEFORE TREATING YOUR FIRST ENDODONTIC PATIENT, MUST BE PERFORMED IN THE UNDERGRADUATE ENDODONTIC CLINIC. THE PREDOCTORAL ENDODONTIC STUDENT’S FIRST CLINICAL ENDODONTIC EXPERIENCE WILL BE MORE PRODUCTIVE AND MEANINGFUL IF S/HE HAS THE EXPERIENCE OBSERVING A FELLOW UNDERGRADUATE WORKING IN THE UNDERGRADUATE ENDODONTIC CLINIC. EXPOSING THE PREDOCTORAL STUDENT TO THE PROTOCOL, PAPERWORK, PATIENT MANAGEMENT AND ENVIRONMENT WILL CERTAINLY ENHANCE THE CLINICAL PREDOCTORAL ENDODONTIC EXPERIENCE. The second endodontic assist in the postgraduate endodontic clinic (anytime before graduation) will expose the predoctoral student to more advanced endodontic instruments and techniques. 12. After a student completes at least five canals, one canal will be done independently as a competency examination. Preferably, this should be done on a single canalled tooth.
i) The endodontic procedure must be finished.
The Final Grade in Endodontics Consists of: There is no Year 3 clinical grade in Endodontics. Year 4: A final Year 4 clinical grade in Endodontics is based on: 1) A minimum of 10 canals completed (one treated tooth must be a molar). Clinical cases are graded according to the completed “Clinical Endodontic Grading Criteria” form, approximately 65 points. 2) One clinical competency examination [to be performed after the student has completed at least five (5) canals]. This clinical examination will be graded according to criteria outlined in the “Clinical Endodontic Grading Criteria” form. 3) Two (2) completed assists in the postgraduate endodontic clinic. The first assist must be completed before initiating endodontic therapy on any assigned patient. The second assist may be completed anytime before graduation. 4) Initiation of the endodontic recall process (Endodontic recall cards must be submitted to the department for all completed cases). One endodontic recall competency examination. 5) The Manikin competency examinations. III. GENERAL DENTISTRY DEPARTMENT Clinical Oral Diagnosis and Treatment Planning: Dr. Donald Hanson Third floor
Year 3 B. DENTAL EMERGENCY Year 4 DIAGNOSIS AND TREATMENT PLANNING An XMRT (0150) is the equivalent of 4 points plus 1 point for oral hygiene and plaque control. An XMRV (0120) is the equivalent of 3 points. There are no minimum procedural experiences because the student must do what is necessary for the number of new patients assigned to him/her. Year 3 During the 2004-2005 academic year (your year 4) you must do a required case presentation in a small group seminar setting. The objective of this exercise is to help you to better integrate the various disciplines of dentistry, and gain an appreciation for comprehensive patient care. (This graded exercise will also be used for us to evaluate your ability to diagnose and treatment plan). Therefore, during the 2003-2004 academic year you should identify at least one patient who requires multidisciplinary treatment as a candidate for the case presentation. Ensure that you keep at least one set of pre-treatment study casts. We will also be introducing clinical photography during the 2003-2004 year, which will enable you to further document cases during the treatment phase. It will not be necessary for you to have completed the treatment by the time of the presentation, but significant progress should have been accomplished to make a meaningful presentation. (if you have any questions, please feel free to ask Dr. Hanson or your PC). Year 4 MEDICINE IN MEDICINE III COURSE (HOSPITAL CLERKSHIP) PROGRAM- YEAR 3 Medical Record Review – Year 3 Students work in groups of five for this. The presentation of the case is done orally. Problem-based learning – Year 3 IN CLINIC – Year 3 The student evaluates medically compromised random dental patients obtained from screening. They obtain a medical history, do a physical examination, and evaluate the medications the patient is taking. The student does a comprehensive medical evaluation and establishes the dental management of the patient, including determining which anesthetics, analgesics, and antibiotics can or cannot be used. Prescription writing is part of the CE. ORAL APPLIANCE Year 3 or 4 ORAL HEALTH PROMOTION Year 3 Year 4 ORAL AND MAXILLOFACIAL RADIOLOGY New Patient Encounter ROTATION – Oral and Maxillofacial RADIOLOGY SPECIFIC experiences: There are minimum procedural experiences that all students must meet while on assignment to the New Patient Encounter Rotation. If any of the following MPE’s are not met, the student receives an incomplete grade (I) for his/her NPE Rotation, which is not removed until the MPE is met.
The following requirements must be completed before graduation. The rotation is designed to provide ample opportunity for students to satisfy these requirements if the student attends all assigned rotations.
NOTE: New patient full mouth survey radiographic interpretation is currently completed in the Group Practices under the guidance of Practice Coordinators, and therefore, radiographic interpretation is included as a component of the Diagnosis and Treatment Planning Case Presentation competencies. New Patient Encounter Rotation Grading 3rd and 4th year NPE Rotation grades are based upon the following criteria:
Professionalism will be determined by the following criteria:
Specific instances of unprofessional behavior will be recorded and incorporated into the final clinical rotation grade. The letter grades for full-mouth surveys are A+ through F and are determined on a continuum, taking into consideration the following: the number of punched radiographs indicating that retakes are required, the number of different technical errors, the severity of the technical errors, the difficulty of the survey which can be determined without the operator’s help or with the operator’s assistance (i.e., gagging, tight lingual frenum, tongue thrusting, sensitivity to discomfort, excessive saliva, shallow palate, lack of cooperation), in addition to other factors. Guidelines concerning ideal full mouth surveys, periapical, bitewing, and panoramic radiographs can be found in the NPE Rotation guidelines. Third and Year 4 Grades in General Dentistry 50% of the final grade is derived from the averages of the grades of all competency examinations taken. The other 50% of the grade is derived by the evaluation of the student’s daily treatment of patients (diagnosis and treatment planning) and his/her management of patient care. IV. ORAL & MAXILLOFACIAL PATHOLOGY DEPARTMENT: Dept Extension: 6510 Elaine Pigeon Staff Asst. Competency Examination V. ORAL AND MAXILLOFACIAL SURGERY (OMFS) DEPT. Predoctoral Director: Dr. Tony Woo The Department of Oral and Maxillofacial Surgery has minimum procedural experiences and competency examinations that are performed during the students’ clinical rotation assignments (See Student Schedule). Rotations: The students are assigned to OMFS clinical rotations. These rotations consist of seminars and patient care: a. For 2 weeks (5 sessions each, ½ day per session) in Year 3 and 1 week (5 sessions, ½ day per session) in Year 4 at the dental school A one-hour seminar is given at the beginning of each rotation session. Material covered in these seminars will be tested in a written examination in Year 4 starting with the class of 2005. Competency Examinations and MPE’s: 1. Competency Examinations (2) in Dental Extractions During their clinical rotations in OMFS at TUSDM (“a” above), the students must obtain and keep an Oral and Maxillofacial Surgery Procedure Card (see OMFS Procedure Card located in the department). On this card, the students fill in the indicated information every time they treat a patient in the OMFS Clinic. They must complete at least five extractions with Faculty signatures as a prerequisite to the Dental Extraction Competency Examination. Each student must successfully complete two Competency Examinations in Management of Patient Having Dental Extraction(s). This Competency Examination is graded on the criteria listed on the competency examination form. The grade is given as either Pass or Fail. If the examiner finds it necessary to terminate the examination in the patient’s interest or if the student is unable to complete the procedure, it is considered a failure and must be retaken. Students are cautioned to select the patient carefully for the examination and to become familiar with the requirements for successful completion before attempting this clinical competency examination. 2. Minimum Procedural Experience in Sedation The student will be assigned to a mandatory session in year 4. 3. Competency Examination in Local Anesthesia All students have to demonstrate competency in local anesthesia technique and practice before graduation. The student can accomplish this competency examination during the course of patient care in scheduled oral surgical rotations in the school, Chelsea Soldiers Home, or other sites staffed by members of the department of OMFS. This CE can be accomplished at the same time as one of the Dental Extraction CE’s. 4. Competency Examination in Surgical Management of Soft Tissue Students have to demonstrate competency in the management of soft tissue either through the department of Oral & Maxillofacial Surgery or Periodontology. The one soft tissue competency examination consists of three parts: 1. Suturing Workshop Competency Examination A student must first pass part #1. The student can then take parts 2 and 3 in any order. One competency examination form contains all three parts. This examination can be taken with the Department of Oral or Maxillofacial Surgery and/or the Department of Periodontology. The two departments must each receive a copy of the completed Examination form from each student, even if a student did all three parts of the examination within only one department. The white copy and the yellow copy go to Oral Surgery and Periodontology respectively. Year 3 Grade: The Year 3 grade in OMFS is the didactic course grade. Year 4 Grade: The 4th year grade will be based on the following: 1. Clinical Performance, Competency Examinations and Written Examination of Topics (starting with the Class of 2005 in year 4) Covered in Seminars during rotations in the Department of Oral and Maxillofacial Surgery = 60% Class of 2005: a. Clinical performance – 20% The Clinical performance grade starts with the full 20%, and deductions will be given for incidents of tardiness, violation of clinical procedures/policy, unprofessional behaviors, and other violation of departmental/school policy. This grade includes the grades in all clinical competency examinations done in the rotation while treating patients. A written examination based on the seminar material will be scheduled in Year 4 after the student completes all the OMFS rotations. Oral Examination This is to test the Students’ ability to communicate verbally the oral surgery knowledge required to effectively treat patients. It draws on the knowledge base built from the didactic course, the topic/cases covered in Clinical Seminars and Workshops, and the experience gained in clinical rotations. This is given during the month of March and covers all Seminar Topics discussed during the 3rd and 4th year Oral and Maxillofacial Surgery Clinical Seminars and Workshops. VI. ORTHODONTICS DEPARTMENT Dr. Omar Salem (Dept extension: 6887) As part of the predoctoral orthodontic curriculum, Year 3 dental students are required to attend a rotation and a seminar in the department. There is one competency examination in Year 3. Year 4 students will have an MPE in orthodontics. Year 3 Rotation Year 3 Seminar Competency Examination - Year 3 1. The ability to diagnose a malocclusion using the Angle Classification. This OSCE is given in the Year 3 seminar. Minimum Procedural Experience – Year 4
Predoctoral Director: Dr. Tsamtsouris As part of the rotations in the Pediatric Dentistry Clinic, students must complete a defined number of procedures, which may include comprehensive diagnosis and treatment planning, oral prophylaxis, fluoride applications, pulpal therapy, restorations, extractions, and/or pit and fissure sealants. During the Year 3, all students are clinically evaluated by the faculty while treating patients. They are clinically evaluated in diagnosis, treatment planning, prophylaxis, fluoride application, pit and fissure sealants and restorative procedures. Step cards are used for these procedures. Competency Examinations In the third or Year 4, the student must take one oral health promotion competency examination and one diagnosis and treatment planning case presentation competency examination on clinical patients. During the Year 4, four manikin competency examinations are taken on a mixed dentition manikin and one oral dental emergency competency examination is taken during a seminar. Summary: The student is expected to independently perform the following: 1. One Pit and fissure sealant on a first primary molar- manikin Third and Year 4 grades in Pediatric Dentistry consists of the following: 1. Daily Grades. These are recorded on daily grade or step cards/sheets (small colored cards completed by instructor and given a grade that is posted in a book kept by the department assistant). The student MUST keep a copy of their grade sheets, daily evaluation sheets, and competency examinations. VIII. PERIODONTOLOGY DEPARTMENT: Predoctoral Program: Dr. Robert Rudy
16 quadrants of scaling and root planing. Within these is a patient care minimum procedural experience of completing (i.e. returning a patient to clinical periodontal health) 6 patients diagnosed with periodontitis and 6 diagnosed with gingivitis. To achieve the minimal procedural experiences and points in Periodontology above, and for the best clinical experience in Periodontology, it is suggested that the following variety of procedures be the goal for each student: Suggested number of experiences Full mouth scaling 13-15 Predoctoral points for Periodontal Surgeries: Predoctoral students are encouraged to provide periodontal surgical therapy for their patients of record in cooperation with postgraduate periodontal residents in the PG Periodontal Clinic on the second floor. This can be done in a number of ways: 1. The student can refer the patient to a periodontal resident who will then assume total responsibility for the patient’s periodontal therapy. The patient is then referred back to the predoctoral student for his/her continued care. 2. The student can coordinate the surgical therapy with a periodontal resident and participate in the patient’s surgical therapy including all postoperative care. 3. The student can also do the surgery in the group practice with periodontal faculty. This must be arranged in advance. In choosing option #1, the student does not receive credit or points for the surgery. Using option #2, the student will receive credit or points for the procedure if, in the opinion of the attending faculty member in the PG Clinic, the student has participated in a significant portion of the procedure (i.e. more than just assisting). The student and PG resident must participate in the patient’s postoperative care. This includes all postoperative appointments to the point that healing of the surgical site(s) is complete and periodontal health has been established (final periodontal release). In order for the student to receive credit or points, the PG faculty member (not the periodontal resident) must sign the encounter form. Students can only receive credit or points for their patients of record and cannot receive credit or points for participating in the periodontal rotations. Grading and Competency Examinations Students must complete assigned rotations in Periodontology in the third and Year 4. NOTE: Only periodontal faculty and not PG students can oversee CE’s. Year 3 clinical grade in Periodontology is based on:
The Year 4 clinical grade in Periodontology is based on: 1. Competency examinations 2. Completion of one manikin simulated clinical licensing examination competency examination, which is scheduled in the Board Review III Course. 3. [NOTE: The 3 periodontitis cases have been suspended for the class of 2005 until more faculty are available to participate.] 4. Procedure formula: plus or minus based on median number of quadrants of scaling & root planing, full mouth scalings, surgeries, and or gingivitis and periodontitis case completes. 5. Points: plus or minus based on median of the class. 6. Successful completion of Periodontal Rotations NOTE: Future procedures may be added concerning microbials/systemic treatments. IX. PROSTHODONTICS & OPERATIVE DENTISTRY DEPARTMENT Operative Division Head: Dr. Gardner Bassett It is advisable that the Competency Examinations in Restorative Dentistry be taken after students complete: 3 Amalgams A. OPERATIVE DENTISTRY BLEACHING Year 3 Students must complete 2 arches (maxillary or mandibular) of bleaching as a minimum procedural experience. Operative Procedures It is recommended that, at a minimum, each student complete at least nine (9) Class II amalgam restorations, nine (9) Class III or Class IV composite restorations, and four (4) Class II composite restorations. (The average TUSDM student completes about 20 of each). Students will be required to complete a total of eight (8) operative competency examinations in their third and Year 4s. They must pass all eight examinations (minimum score=70) or they will be required to retake them. Retaken examinations will be given a maximum score of 70. 1. Five (5) Operative Competency Examinations are required in Year 3. a. One (1) clinical posterior Class II composite competency examination must be done by the end of Year 3. b. Three (3) amalgam/composite operative competency examinations (Class II amalgams or Class III or IV composites) must be accomplished in Year 3. These can be done as either two amalgams and one composite or as two composites and one amalgam. NOTE: One (1) amalgam or composite operative competency should be accomplished by the end of the fall semester in Year 3. c. One (1) OSCE CE in year 3. This will be scheduled during the Board Review II course in the Year 3. If the student does not do well in the OSCE, or does not score higher than the national average on the actual National Board Part II Examination, they will have to do well in an alternative examination, a one-hour operative oral examination in Year 4. 2. Three (3) Operative Competency Examinations are required in Year 4. a. Two (2) amalgam/composite operative competency examinations (Class II amalgams or Class III or IV composites) must be accomplished in Year 4. These can be done as either two amalgams and one composite or as one amalgam and two composites. One (1) of these amalgam/composite operative competency examinations will be a SIMULATED CLINICAL LICENSING COMPETENCY EXAMINATION (students will be assigned a date in their Year 4). b. One clinical posterior Class II composite competency examination must be accomplished in year 4 (this can be done in year 3). 3. Students, if they desire, may complete up to seven (7) of the required Operative Competency Examinations before their Year 4 (if they pass them). The SIMULATED CLINICAL LICENSING COMPETENCY EXAMINATION must be taken in the Year 4. B. FIXED PROSTHODONTICS Fixed Partial Dentures 2 Alginate impression CE’s – 1 upper; 1 lower 1 fixed partial denture MPE. 5crowns (exclusive of fixed partial denture abutments), plus 2 competency examinations = seven crowns. NOTE: The tooth must have at least two surfaces of contact: one surface of interproximal contact (which can be a removable partial denture tooth) and one surface of occlusal contact. Do not use a severely damaged or extensively restored tooth. A tooth with a parapost and core build-up is okay to use. A tooth with a cast post and core is not. An existing defective crown cannot be used for these CE’s. 2 posts: 1 prefabricated or one cast post plus 1 manikin post competency examination = two posts. 3 competency examinations in the manikin exercise for the state licensing board. 8 crown form/function wax-ups plus 2 competency examinations = 10 wax-ups. Crown Wax-up Form and Function Preparatory to this you would do modification of wax patterns of the required 10 minimal units of fixed Prosthodontics – rather than the five units from beginning to completion that are the current requirement – so that you can practice development of form for function and esthetics. Faculty members would be available for advice as to how the wax-up modifications were being accomplished. The two competencies in wax modification for occlusion and esthetics would be completed on a single unit in 3 hours in either the 3rd or 4th year under the supervision of a faculty member. The evaluation would be based on the criteria on the competency evaluation form.
Year 3 Year 4 C. REMOVABLE PROSTHODONTICS Removable Partial Dentures: Five competency examination parts must be done in the Year 4 (these can be done in year 3 if the student has the patients): 1. 1 competency examination in examination, diagnosis, and preliminary impression. Minimum Procedural Experience Complete Denture Prosthodontics
NOTE: Two laboratory relines and/or rebases of CDP can equal one CDP unit. However, a student can only do this for one of the four units or MPE’s. Any one of the following counts towards ONE complete denture MPE:
1. Preliminary Impression D. IMPLANT DENTISTRY The student must complete 1 implant minimum procedural experience. This can include any one of the following: a. Diagnosis and treatment planning (Implant Step Sheet) as “Mock” NOTE: Predoctoral students do not place implants. The step sheet for verification of this MPE is the Implant Step Sheet. The student must be present during their patient’s Stage I surgery in order to receive credit. Failure to appear for this appointment will also result in a 5-point deduction as per the rotation guidelines that are outlined later in the document. If the surgical template is not available at this appointment, the patient will be cancelled. If the student does not have a patient who agrees to have an implant, the step sheet procedures are completed on mounted diagnostic casts as an exercise (“mock” MPE). Effective April 2003: Students can book and treat their implant patients in the Implant Center (See Dr. Lou Rissin – fifth floor) The Year 3 and year 4 grade in Prosthodontics and Operative Dentistry is composed of: 1. An average of all of the competency examinations in the department of Restorative Dentistry required in Year 3 (see Checkpoint Chart). For each required competency examination not completed, a grade of 70 will be averaged in. If a student does not complete a competency examination at the required Checkpoint Chart time, the highest grade that they can achieve in that exam is a 70. 2. A modification of this average in #1 by adjustment relative to the student’s clinical production as measured by point achievement compared to the rest of the class. One point will be added or subtracted for each interval of 20% the student achieves above or below the class average ofpoints. A maximum of three points would be added or subtracted. 3. A normalization procedure for the point totals in #2. Between group practices, there are different point averages. The points in each practice will be normalized to the entire class’ point average. EXTERNSHIP
ATTENDANCE GUIDELINES UNEXCUSED ABSENCES FROM ROTATIONS
The director of the rotation reports all unexcused rotation absences to the Office of Student Affairs by use of the Point Deduction Form. In keeping with our Vision Statement “Patient Centered Education Committed to Excellence”, the report of an unexcused absence from a rotation will result in the following: 1. First offense 2. Second offense 3. Third offense The Department Chair or rotation head has the discretion to request that the student make up any session missed for any reason. All unexcused rotation absences must be made up. CLINIC ATTENDANCE In Year 3 and 4, all students are expected to attend for patient care activities for 10 of 14 sessions per week. “Patient Care Activities” as defined here include: participating in rotations; completing chart audits and insurance paperwork; completing laboratory work; and assisting within the group practice. Five of the 10 sessions should be devoted to providing patient care within the group practice. Students are required to work in the clinic until the Friday in April at the end of the scheduled Year 4 academic program, regardless of their point total. For those who have not achieved all minimum procedural experiences, competency examinations and points by the Friday before the Spring break, attendance will be required until they are completed. INCENTIVE PROGRAM GUIDELINES An incentive program for students achieving over 1000 points is detailed in a separate document. The Associate Dean of Academic Affairs, the Chair of the Student Promotions Committee and the Director of Educational Measurement coordinate this program. CLINICAL PROGRESS - CHECKPOINTS In order to help students meet the patient care objectives, a checkpoint program has been established. This checkpoint program outlines the number of points, minimum procedural experiences, and competency examination(s) (CE’s) that should be achieved by a given date. Student point totals will be reviewed one month before the deadline date for each trimester (or approximately ten weeks into the trimester). Deficient students will be notified as detailed in the clinical probation section of the Student Handbook. They will meet with the Remediation Subcommittee consisting of the Associate Dean of Academic and Student Affairs and the Chair of the Student Promotions Committee. A Checkpoint Chart has been developed that outlines all of the necessary checkpoints. It is included with this MCP document. Effective in January 2003, all of the checkpoint targets will be used to evaluate students for promotion. Students, who do not achieve the identified number of points, minimum procedural experiences and/or competency examinations by the deadline dates may be conditionally promoted to the next semester. Remediation procedures will be in effect for students identified as seriously deficient and deficient. Students who repeatedly fail to: NATIONAL BOARD EXAMINATION PART II Students must take the National Board Examination Part II by September 1 at the start of their Fourth Year. YEAR 2 STUDENTS WITH COURSE FAILURES · Students who fail the year 2 Crown and Bridge Course will not be allowed to start crowns or bridges on their patients until they have remediated and passed this course. Practice Coordinators will be informed of students with Year 2 failures so that they can modify their patient assignment and work load during periods of course remediation and study for the National Board Examination Part I. SNOW DAYS-SCHOOL CLOSED. NOTE: Since the student evaluation process and the curriculum is continually under review, the number, and format of the present competency examinations, minimum procedural experiences and points may change. The School reserves the right to make changes in any portion of this document as the need arises with sufficient advanced notice.
Coordinators: Associate Dean Arbree, Dr. Thompson and Ms. Jennifer Littke Purpose: This program was developed for those students who will achieve their 1,000 points earlier than the end of the scheduled Year 4 academic program, which is in April on the Friday immediately before spring break. The purpose of this Incentive Program is to reward these students and to provide them opportunities for exposure to advanced clinical, didactic and teaching experiences.
To be eligible for the Year 4 Incentive Awards, a student must: The application deadline to participate in Year 4 Elective Honors Programs is March 1 of
Students with more than 1,000 points: 1. receive a letter at graduation noting high patient care (point) achievement. See # 1 through 3 above. Students with 1,500 points: See #1 through 6 above. Students with 1,700 points: See # 1 through 7 above.
1. Students who achieve a grade of 85 or higher on the examination will receive: a. A letter from the Dean recognizing their achievement. 2. Students who achieve a grade of 87 or higher on the examination will receive: 3. Students who achieve a grade of 90 or higher on the examination will receive See “a”, “b”, “c”, and “d” above. Students in the Incentive Program who achieve the above National Board Part II scores AND who also achieve over 1,100, 1,300, 1,500 or 1,700 points will receive the letter to acknowledge their achievement, but will not get double monetary awards noted above. Students requesting licensure examination fee reimbursement should present a copy of the receipt to Associate Director of Student Affairs, Donna Carey. For cap and gown, graduation and Year 4 recognition function, also see Associate Dean Gonthier or Associate Director of Student Affairs, Donna Carey for waiving of fees. ELECTIVE HONORS PROGRAM - See Appendix F for more details Individual Program Descriptions Incentive students may apply for an Elective Honors Program in spring of Year 3. The Incentive Coordinators hold meetings with potentially eligible students (PC or other relevant faculty recommendation) in the fall of Year 4 to review available programs. The programs run from April, Year 3 to May, Year 4. The student is assigned to Department Elective Honors Programs for several half-days per week for 3-4 weeks. Students may participate in more than one program. The Elective Honors Program does not exempt the student from their usual rotation/seminar/workshop assignments or Externship. Students apply for their area of interest. The Incentive Coordinators, with the relevant department faculty, will select the student and the month that they participate. A limited number of students can participate at any given time. Note: In order to be recognized as an Elective Honors Program participant in the commencement booklet, you MUST complete Academic and Administrative clearance by April 15, 2005. A) Departmental Elective Honors Program for additional advanced experience: The following are the currently available Elective Honors Programs: 1. Esthetic Dentistry, Pg. 10 Details of these programs can be found in the Appendix on the specified page numbers. B) Student’s own justifiable independent project. STUDENT TEACHER PROGRAMS - See Appendix F for more details Students who participate in the Student Teacher programs: 1. will be called upon to assume some faculty-level administrative This is a paid position. International Students – Student Teacher Role: All accredited program Specialty Degree international students will be required to teach and/or provide/supervise advanced patient care in their discipline. Prosthodontic specialty international students will be required to accomplish the majority of this during the April to August (Year 1) timeslot. For their teaching/advanced patient care assignment, Specialty Degree international students should report to the Department Chair for their specialty. The Chair will decide their schedule and assign them to a supervising Course/Clinical Director. If the IS student is specialty training in a US/Canadian accredited program they are able to sign off on most predoctoral procedures, except for e.g., competency examination or quality monitoring steps. If the specialty program was international, a meeting with the head of the department is necessary before sign off responsibilities are granted. |
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