ADEA Allied Accredita-on Workshop June 11, 2013 William Hendricson Un. Of Texas HSC Dental School 2:00 – 4:00 pm Session June 11, 2013 1 Helping CODA Accredita2on Site Visitors Do Their Job Bill Hendricson MS, MA, MEd Assistant Dean, Educa-on & Faculty Development UTHSCSA Dental School [email protected](210) 5670436 ADEA Allied Dental Accredita.on Workshop June 11, 2013 Portland, Oregon 2:00 – 4:00 pm Agenda • Clarify language issues related to “competency” • How to report your program’s competencies and the methods you use to demonstrate students’ a[ainment of these competencies • Example: CODA standard – school competency linkage table • Example: competency assessment map • New DH Standard 219: Communica-on with Diverse Popula-on and Cultural Competence • New DH Standard 222: Ethics & Professionalism What is a “Competency”?
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ADEA Allied Accredita-on Workshop June 11, 2013
William Hendricson Un. Of Texas HSC Dental School
2:00 – 4:00 pm Session June 11, 2013 1
Helping CODA Accredita2on Site Visitors Do Their Job
Bill Hendricson MS, MA, MEd Assistant Dean, Educa-on & Faculty Development UTHSCSA Dental School [email protected] (210) 567-‐0436
ADEA Allied Dental Accredita.on Workshop June 11, 2013 Portland, Oregon
2:00 – 4:00 pm Agenda • Clarify language issues related to “competency” • How to report your program’s competencies and the methods you use to demonstrate students’ a[ainment of these competencies
• Example: CODA standard – school competency linkage table • Example: competency assessment map
• New DH Standard 2-‐19: Communica-on with Diverse Popula-on and Cultural Competence
• New DH Standard 2-‐22: Ethics & Professionalism
What is a “Competency”?
ADEA Allied Accredita-on Workshop June 11, 2013
William Hendricson Un. Of Texas HSC Dental School
2:00 – 4:00 pm Session June 11, 2013 2
Language When describing methods used to evaluate students’ a[ainment of competency, use: • Skill assessment • Progress assessment • Progression exam • Graded clinical evalua-on • Clinical progress evalua-on • Competency cer-fica-on
Schools/Programs Write Your Own “Gradua2on Competencies”
CODA DH Educa2onal Outcome Standard
Your Program’s Competencies
2-‐26 Graduates must be competent in problem solving strategies related to comprehensive pa-ent care and management of pa-ents.
4. Use cri-cal thinking skills and comprehensive problem-‐solving to iden-fy oral health care strategies that promote pa-ent health and wellness.
2:00 – 4:00 pm Agenda • Clarify language issues related to “competency” • Repor2ng your program’s competencies & methods to demonstrate students’ aQainment of these competencies
• Example: CODA standard – school competency linkage table • Example: competency assessment map
• New DH Standard 2-‐19: Communica-on with Diverse Popula-on and Cultural Competence
• New DH Standard 2-‐22: Ethics & Professionalism
ADEA Allied Accredita-on Workshop June 11, 2013
William Hendricson Un. Of Texas HSC Dental School
2:00 – 4:00 pm Session June 11, 2013 3
Competency Based Planning Process
4 Ques2ons
What do entry-‐level DDS need to KNOW & DO?
Competencies
What learning experiences help students obtain the competencies?
Curriculum
What EVIDENCE will we accept as proof of competency?
Provide dental hygiene care for child, adolescent, adult & geriatric pa2ent.
Assess treatment needs of pa2ents with special needs.
2-‐17 Provide the dental hygiene process of care
2-‐18
Provide dental hygiene care for all classifica2ons of periodontal disease including moderate to severe periodontal disease.
2-‐19
Demonstrate competence in interpersonal & communica2on skills to interact with diverse popula2ons & health care team.
2-‐20 Plan, implement & evaluate community oral health programs
2-‐21 Provide life support for medical emergencies in DH prac2ce.
2-‐22 Apply principles of ethical reasoning & decision making, professional responsibility for academic environment, research, pa2ent care & prac2ce mgmt.
2-‐23 Apply legal & regulatory concepts to provision of oral health care services.
2-‐24 Apply self-‐assessment skills for life-‐long learning.
2-‐25 Evaluate current scien2fic literature.
2-‐26 Solve problems in comprehensive pa2ent care & pa2ent mgmt.
ADEA Allied Accredita-on Workshop June 11, 2013
William Hendricson Un. Of Texas HSC Dental School
2:00 – 4:00 pm Session June 11, 2013 4
Write Your Competencies to Parallel CODA Standards CODA S2pulated Competencies # Your Parallel Competency
2-‐16
Provide dental hygiene care for child, adolescent, adult & geriatric pa-ent.
Assess Tx needs of pa-ents with special needs.
2-‐17 Provide dental hygiene process of care
2-‐18 Provide dental hygiene care for all classifica-ons of periodontal disease
2-‐19 Demonstrate competence in interpersonal & communica-on skills to interact with diverse popula-ons & health care team.
2-‐20 Plan community oral health programs
2-‐21 Provide life support for medical emergencies i
2-‐22 Apply principles of ethical reasoning & decision making & professional responsibility
2-‐23 Apply legal & regulatory concepts
2-‐24 Apply self-‐assessment skills
2-‐25 Evaluate current scien-fic literature.
2-‐26 Solve problems in comprehensive pa-ent care
Example for CODA 2-‐20 for One Program CODA # CODA Standard # Graduates of the program will be
demonstrate competency to:
2-‐20 Plan, implement & evaluate community oral health programs
3.1 3.2 3.3
• provide oral health services in a variety of community & ins-tu-onal segngs.
• Assess needs & resources, plan, implement & evaluate community oral health service learning programs.
• Implement Sealant Projects, Give Kids A Smile & school-‐based educa-onal events for underserved popula-ons in an IPE team format.
See Distributed Example from UT HSC DS
ADEA Allied Accredita-on Workshop June 11, 2013
William Hendricson Un. Of Texas HSC Dental School
2:00 – 4:00 pm Session June 11, 2013 5
Competency Based Planning Process
4 Ques2ons
What do entry-‐level DDS need to KNOW & DO?
Competencies
What learning experiences help students obtain the competencies?
Curriculum
What EVIDENCE will we accept as proof of competency?
Dental School Competency Domains: 5 & 6 5: Graduates must be competent in patient assessment and diagnosis (educational outcomes on PDEC pg. 9) 6: Graduates must be competent in comprehensive treatment planning and assessment of treatment outcomes (educational
outcomes on PDEC pg. 10)
DS 1 DS 2 DS 3 DS 4 • Assessments in Physical
Evaluation 1 • Case-based exams in systemic and
oral pathology • Patient assessment, Dx & TxP
progression assessment after TxP block at start of DS3
• DS4 Portfolio: Present and defend cases in GPG Wed conferences
• Assessments in Dental Radiography
• Case-based exams and OSCE in Clinical Medicine
• Case presentations (2): complex patient and implant patient
• DX / TxP planning GCE (complex case)
• DX / TxP planning GCE (patient with medical co-morbidity or special needs)
• Oral Medicine OSCE in Physical Evaluation 2
• DEC GCE for DS 3
• PA / Dx /TXP component on Mock WREB
• Radiographic Interpretation Exams (2)
• DS3 CATs case presentation • Monthly progress assessment for competency domains 5 & 6
2:00 – 4:00 pm Agenda • Clarify language issues related to “competency” • Repor2ng your program’s competencies & methods to demonstrate students’ aQainment of these competencies
• Example: CODA standard – school competency linkage table • Example: competency assessment map
• New DH Standard 2-‐19: Communica2on with Diverse Popula2on and Cultural Competence
• New DH Standard 2-‐22: Ethics & Professionalism
NEW 2-‐19 Graduates must be competent in interpersonal & communica2on skills to effec2vely interact with diverse popula2on groups & other members of health care team.
Intent: Dental hygienists should be able to effec-vely communicate with individuals, groups & other health care providers. The ability to communicate verbally and in wri[en form is basic to the safe & effec-ve provision of oral health services for diverse popula-ons. Dental Hygienists should recognize the cultural influences impac-ng the delivery of health services to individuals and communi-es
Examples of evidence to demonstrate compliance may include: • student projects demonstra-ng ability to communicate effec-vely with a variety of individuals, groups & health care providers.
• examples of individual & community-‐based oral health projects implemented by students during previous academic year
• evalua2on mechanisms designed to monitor knowledge and performance
Expose Explore Engage Evidence of Competence
Demonstrating Compliance with CODA 2-19
ADEA Allied Accredita-on Workshop June 11, 2013
William Hendricson Un. Of Texas HSC Dental School
2:00 – 4:00 pm Session June 11, 2013 9
2-‐19: Assessing Students’ Competency for Mul2-‐Cultural Health Care • Qualita-ve assessment • Quan-ta-ve assessment • Observed performance / professional judgment • Self-‐Assessment
Gregorczyk & Bailit. Assessing the Cultural Competency of Dental Students and Residents. J Dent Ed. 2008; 72(10): 1122-‐1127.
Pilcher, Charles & Lancaster. Development & Assessment of a Cultural Competency Curriculum. J Dent Ed. 2008; 72(9): 1020-‐1028.
Gozu, et al. Self-‐administered Instruments to Measure Cultural Competence of Health Professionals: A Systema-c Review. Teach Learn Med. 2007; 19(2): 180-‐190.
Describe the pa-ent popula-on that students encounter in dental clinics & extramural sites. Provide pa-ent demographic data.
How does your program ensure that all students have experiences func-oning in a mul-cultural work environment?
Describe how student interpersonal skills & communica-on skills are assessed in a mul-cultural work environment.
Qualita2ve Assessment • Case presenta-ons – mul-cultural care • Pormolios – CSL projects & diverse pa-ent care • Cultural or language dilemma analysis essays • Reflec-on journals • Assessment rubrics for above • Debriefing seminars
Quan2ta2ve Assessment for MCC Buyer Beware: Many Instruments; Few Validated
• Providers Guide to Quality & Culture Quiz HRSA; 23 items; assess CC knowledge
• Cultural Competence of Health Prac22oners’ Assessment
HRSA / Na-onal Center for Cultural Competence Assess cross-‐cultural communica-on & decisions
• Home-‐grown CC tests – be careful! Nunn, et al. Mul--‐cultural Competency Instrumenta-on: Review and Analysis of Reliability. J Counsel Dev.2006;84: 471-‐482.
ADEA Allied Accredita-on Workshop June 11, 2013
William Hendricson Un. Of Texas HSC Dental School
2:00 – 4:00 pm Session June 11, 2013 10
Assessment of Observed Performance Probably Best Pay-‐Off!
Cultural Competency in Medical Educa3on: A Guidebook for Schools.
HRSA. 2004 www.HRSA.Gov
hQp://www.hrsa.gov/culturalcompetence/index.html
An OSCE is a sta2on exam
Examinees rotate from sta-on to sta-on at -med
intervals
Perform tasks at each sta-on
ADEA Allied Accredita-on Workshop June 11, 2013
William Hendricson Un. Of Texas HSC Dental School
2:00 – 4:00 pm Session June 11, 2013 11
Cultural Competency OSCE Resources Aeder L, Altshuler L, Kachur E. et al. The “Culture OSCE” – Introducing A Forma-ve Assessment into a Postgraduate Program. Educa3on for Health. 2007. 20(1): h[p://www.educa-onforhealth.net Robins L, White C, Alexander G, Gruppen L, et al. Assessing Medical Students’ Awareness of and Sensi-vity to Diverse Health Beliefs Using a Standardized Pa-ent Sta-on. Acad Med. 2001. 76(1): 76-‐80.
Pa2ent Encounter Observed
WriQen Report Findings & Plan
Verbal Exam Comprehension & Reflec-on
Triple Jump Smith R. The triple-‐jump exam as an assessment tool in the medical curriculum at the University of Hawaii. Acad Med. 1993 May;68(5):366–372.
Self-‐Assessment Inventories Buyer Beware: Many Instruments; Few Validated
• Example: Clinical Cultural Competency Ques-onnaire Echeverri. Am J Pharm Ed. 2010; 74(10) 181-‐187.
• Accuracy of self-‐appraisal / report?
• Untested psychometric proper-es
• May be useful as learning ac2vity Gozu, et al. Self-‐administered Instruments to Measure Cultural Competence of Health Professionals: A Systema-c Review. Teach Learn Med. 2007; 19(2): 180-‐190.
ADEA Allied Accredita-on Workshop June 11, 2013
William Hendricson Un. Of Texas HSC Dental School
2:00 – 4:00 pm Session June 11, 2013 12
Competency in Health Care Team Par2cipa2on / IPE
OSLO Objec2ve Structured
Leadership Observa2on
SPP Rota2on Student “Chiefs” Peer Teachers
Team Self-‐Assess Team RRR
“Lessons” Case Present Team Planning
Project
IPE Opportuni2es – Best Bet If Feasible IPCSL Clinical Teams IPE rota-ons at protected popula-on ctrs
2:00 – 4:00 pm Agenda • Clarify language issues related to “competency” • Repor2ng your program’s competencies & methods to demonstrate students’ aQainment of these competencies
• Example: CODA standard – school competency linkage table • Example: competency assessment map
• New DH Standard 2-‐19: Communica-on with Diverse Popula-on and Cultural Competence
• New DH Standard 2-‐22: Ethics & Professionalism
ADEA Allied Accredita-on Workshop June 11, 2013
William Hendricson Un. Of Texas HSC Dental School
2:00 – 4:00 pm Session June 11, 2013 13
NEW CODA 2-‐22: Graduates must be competent in the applica2on of the principles of ethical reasoning, ethical decision making & professional responsibility as they pertain to the academic environment, research, pa2ent care & prac2ce management.
Intent: Dental hygienists should understand & prac2ce ethical behavior consistent with the professional code of ethics throughout their educa2onal experiences. Examples of evidence to demonstrate compliance may include: • documents which ar-culate expected behavior of students such as policy manuals, college catalog, etc. • evalua-on of student experiences which promotes ethics, ethical reasoning and professionalism • evalua-on strategies to monitor knowledge & performance of ethical behavior If you don’t know where you’re going, you’ll end up someplace else.” Yogi Berra
Competency Based Planning Process
4 Ques2ons
What do entry-‐level DDS need to KNOW & DO?
Competencies
What learning experiences help students obtain the competencies?
Curriculum
What EVIDENCE will we accept as proof of competency?
Harden, Crosby, Davis. AMEE Guide 14: Outcome-‐based educa-on. Part 1: Introduc-on to outcome-‐based educa-on. Med Teacher. 1999; 21(1): 7-‐14
2-‐22: Apply principles of ethical reasoning, decision-‐making & professional responsibility
“IDEALS” Model 6 Ques2ons for Effec2ve Thinking • Iden2fy problem. What’s the real ques-on we’re facing? • Define context. What circumstances frame this problem? • Enumerate choices. What are our most plausible op-ons? • Analyze op2ons. What is our best course of ac-on, all things
considered? • List reasons explicitly. Why are we making this choice? • Self-‐assess & correct. Let’s review. What was missed?
Facione. Thinking & Reasoning in Human Decision Making. Millbrae, CA: California Academic Press, 2007.
applica-on of an analysis process such as IDEALS 2. Reflec-on journals / logbooks with reflec-ve comments 3. Ethical case presenta-ons based on 1 & 2 4. Scoring rubrics exist for 1, 2 & 3 5. Scenario-‐based wri[en tests (I don’t favor) 6. Ethical dilemma sta-ons during OSCEs 7. RRR – Research, wRite, Report (oten a team project) 8. Longitudinal observa2on (session, daily, monthly by
clinical faculty with rou-ne feedback & documented incident reports) – Specific criteria on eval forms
9. Program has documented, distributed protocol for determining when student has “crossed the line”
• Exemplary (best) work vs. representa-ve work? • Linked to CODA standards • What types of evidence & how much? • Self assessment & reflec2on exercises • Student generated learning plan / objec2ves • High % of assessment – must have grading “teeth” • Final review panel & criteria