Portraits of Assessment: Redesigning Geriatric Curriculum in a Practice Management Setting

Presented by ADEA Sections on Gerontology and Geriatrics Education and Practice Management Program Presentation

Moderator: Marcia M. Ditmyer, PhD, CHES Introduction Mildred McClain, PhD Presentation of Competencies: Connie Mobley, PhD, RD Global Picture: State of Geriatric Education Curriculum Georgia Dounis, DDS, MS Assessment Strategies and Redesigning Curriculum: Marcia M. Ditmyer, PhD, CHES Introduction

Shift in patient demographics over the past decade bring about a need for changes in dental education curriculum

“The life span of any civilization can be measured by the respect and care that is given to its elderly citizens, and those societies which treat the elderly with contempt have the seeds of their own destruction within them."

Arnold Joseph Toynbee Introduction

United States will rise to 438 million in 2050, from 296 million in 2005.

According to US Census Bureau projections, the elderly population will more than double between 2000 and 2030, growing from 35 million to over 70 million.

Much of this growth is attributed to the "baby boom“ generation which will enter their elderly years between 2010 and 2030. . Introduction

Students need training to be able to support the elderly population which will more than double by the middle of the next century.

Because of improved health of the elderly, this population is also more likely to retain their teeth than were their predecessors, so they will require increased and different future dental services. The Graying of America Percent of Total U.S. Population over 65 in 2000

Source of data: U.S. Census Bureau, State Interim Projections by Age and Sex: 2004-2030, 2005. Prepared by the UNC Institute on Aging The Graying of America Percent of Total U.S. Population over 65 in 2030

Source of data: U.S. Census Bureau, State Interim Projections by Age and Sex: 2004-2030, 2005. Prepared by the UNC Institute on Aging U.S. Population Pyramids

2000 2020 2040

Source of charts: U.S. Census Bureau, “65+ in the United States: 2005,” December 2005. Prepared by the UNC Institute on Aging The Oldest Old

 The "oldest old" – those aged 85 and over – are the most rapidly growing elderly age group.

 The oldest old represented 12.1% of the elderly population in 2000 and 1.5% of the total population. In 2050, they are projected to be 24% of elderly Americans and 5% of all Americans.

 Centenarians – those aged 100 or more – represent a small but growing number of elderly Americans. The 1990 census reported 37,000 centenarians, while Census 2000 reported 50,000 centenarians in the United States.

Prepared by the UNC Institute on Aging Increases in the Oldest Old U.S. Population Aged 85+ (in millions)

Source of data: U.S. Census Bureau, Americans with Disabilities: 2002, Current Population Reports, P70-107, May 2006. Older Adults More Likely to Have Disabilities Percent of Americans with Disabilities (2002)

Source of data: U.S. Census Bureau, Americans with Disabilities: 2002, Current Population Reports, P70-107, May 2006. Dental Needs of the Elderly

The dental needs of the elderly are changing.

Patient management of older patients requires an understanding of both the medical and dental aspects of aging.

Other factors also need to be considered: – Ambulation – Independent living – Socialization – Sensory function Dental Needs of the Elderly

Many barriers interfere with providing older patients dental care – severe dental complexity – multiple medical conditions – diminished functional status – loss of independence – uninformed attitudes about dental care in old age – limited finances Need for Geriatric Education References

 Yellowitz J and Saunders MJ. The need for geriatric dental education. Dent Clin North Am 1989;1:11-15.  Kress GD and Vidmar GC. Critical skills assessment for the treatment of geriatric patients. Spec Care Dent 1985;5(3):127-9.  Ettinger RM. Geriatric dental curricula and the needs of the elderly. Presented at the symposium on clinical Geriatric Dentistry: Biomedical and Psychosocial Aspects, June 1983.  World Health Organization Working Panel on Professional Training. The sociology of professional training and health manpower: summary report. Geneva: World Health Organization, 1972. Presentation of Competencies:

Connie Mobley, PhD, RD Current core competencies in geriatrics and practice management

 Patient care: assessment diagnosis and treatment planning  Competency 6.1 Manage the oral health care of the (Independent, dependent, and frail) older adults as well as the unique needs of women, geriatric and special needs patients. Elements of Core Competency

 6.1 Manage the oral health care unique needs of geriatric patients.  6.2 Prevent, identify, and manage trauma, oral diseases, and other disorders. 6.3 ASSESSMENT  6.4 DIAGNOSIS  6.186.5 Recognize the manifestations of systemic disease and how the disease and its management may affect the delivery of dental care.  6.6 TREATMENT PLAN Psychological/sociological/behavioral principles

 Knowledge of:  1. Special needs associated with cognitive and physical changes in aging  2. Psychology of Aging  3. Art and Science of tailoring Communication and Counseling techniques to the needs of aging populations  4. Effect of the dynamics among social, environmental, and economic factors and changing behavior  5. Social, community and federal programs to assist aging individuals in achieving quality of life Psychological/sociological/behavioral skills

 Skills in:  1. Communication sensitive to patient cognitive, physical & sensory impairment; possible care provider relationships; home environment; social financial status; etc.  2. Behavior modification, counseling and tailored patient education  3. Interdisciplinary treatment planning and referral to address multifaceted needs of elderly patients Biomedical/ Applied Sciences

 Knowledge of:  1. Biology of aging  2. Physiological & systemic consequences of aging  3. Synergy between systemic conditions and oral health status  4. Oral manifestations of aging Biomedical/ Applied Sciences

 Skills in:  1. Assessment of physical status  2. Screening techniques used to identify co- morbidities associated with oral health status  3. Discriminating oral manifestations of aging Preclinical Concepts/Techniques

 Knowledge of:  1. Diagnostic procedures for determining medical, mental, and physical status of elderly  2. Clinical indices for medical and extra and intraoral diseases/conditions  3. Risk Assessment/ Risk Reduction protocols for medical and dental diseases (medication, diet, oral hygiene behavior)  4. Pathology and intervention of dental caries in aging  5. Pathology and intervention of oral soft tissue diseases, including oral disease secondary to medical diseases/conditions  6. Publicly financed health care delivery for the elderly Preclinical Concepts/Techniques

 Skill in:  1. Comprehensively assessing medical and extra and intraoral health status of aging patients  2. Conducting Risk Assessment protocols and developing risk reduction treatment plans for the elderly that include diet and oral hygiene counseling and instruction  3. Identifying relevant pathology (medical and dental) associated with dental diseases  4. Providing dental treatment as appropriate and sensitive to the special needs of the elderly  5. Providing appropriate referral and follow-up to elderly patients to support their quality of life Global Picture: State of the Geriatric Education Curriculum

Georgia Dounis, DDS, MS Pre-doctoral Geriatric Dentistry Curriculum Content – Assessment of Current Status

 Pan American—US, Brazil, Canada  EU27  Australia  China U.S. Dental Schools

In 2001  All schools taught some aspect of geriatric dentistry  2% did not have curriculum that requires didactic material

Mohammad AR, Preshaw PM, Ettinger RL. Current Status of Predoctoral Geriatric Education in US Dental Schools. J Dent Edu 2001; 67(5):509-14 US: Format used to teach geriatric dentistry

Mohammad AR, Preshaw PM, Ettinger RL. Current Status of Predoctoral Geriatric Education in US Dental Schools. J Dent Edu 2001; 67(5):509-14 US: pre-doctoral education didactic content

 Medical conditions  Prosthetic management  Barriers to dental care  Oral management of frail elderly  Oral and dental changes associated  Nutritional problems with aging  Oral management of  Psychosocial problems home/institutionalized/hospital  Oral manifestations of systemic  Visual and auditory loss in the elderly disease  Modifications of standard techniques  Socioeconomic problems  Neurological considerations  Oral management of healthy elderly  Adaptation/learning  Diagnosis and management of oral conditions  Home care  Demographic distributions of the  Geriatric assessment elderly  Other topics  Aging and theories of aging

Mohammad AR, Preshaw PM, Ettinger RL. Current Status of Predoctoral Geriatric Education in US Dental Schools. J Dent Edu 2001; 67(5):509-14 Mohammad AR, Preshaw PM, Ettinger RL. Current Status of Predoctoral Geriatric Education in US Dental Schools. J Dent Edu 2001; 67(5):509-14 US: Program Director Expertise

 37% no particular person in charge  63% had a geriatric program director – 45% schools - teaching was directors sole responsibility – 18% schools - multidisciplinary team responsibility

Program director’s training and/or specialty • 36% Formal geriatric training • 48% Prosthodontist • 2% Oral Medicine Departments responsible for teaching geriatric dentistry Brazil Demographics

 Population 195,423 thousands  14.5 million (8.6%) population are over the age of 60.  By 2025 projected that this number will double to 33.2 million  By 2050 the older population expected to triple

Hebling E, Mugayar L, Vendriamini Dias P. Geriatric Dentistry: a new specialty in Brazil Gerodontology 2007;24:177-180 United Nations Population Division. World population prospects 2008: United Nations Population Division Department of Economic and Social Affairs Brazil

 104 dental schools surveyed  Survey of senior dental students  Survey of course coordinator – 64 dental schools replied to the survey

de Lima Saintrain MV, de Souza EH, de Franca Caldas Junior A. Geriatric dentistry in Brazilian universities. Gerodontology 2006;23:231-236. Brazil: Coordinators reply

Yes Due to be No implemented

Is Geriatric dentistry offered 25 22 17 as a subject? Is an extension course in geriatric 16 21 27 dentistry offered ?

de Lima Saintrain MV, de Souza EH, de Franca Caldas Junior A. Geriatric dentistry in Brazilian universities. Gerodontology 2006;23:231-236. Brazil: School coordinators

de Lima Saintrain MV, de Souza EH, de Franca Caldas Junior A. Geriatric dentistry in Brazilian universities. Gerodontology 2006;23:231-236. Dental students who responded Geriatric dentistry subject incorporated in curriculum

7.30% Prosthodontics

41% 29% Special care discipline

Preventative/Social Dentistry

14% 14% Periodontics, Endodontics, Restorative Dentistry Individual geriatric dentistry

de Lima Saintrain MV, de Souza EH, de Franca Caldas Junior A. Geriatric dentistry in Brazilian universities. Gerodontology 2006;23:231-236. Canada Demographics

 Current population 33,890 thousands – 14.1% of population is over 65 years of age – 3.9% of population is over 80years of age  By 2025 population 38,659 thousands – 20.5% of population will be over 65years of age – 4.9% of population will be over 80 years of age  By 2050 population 44,414 thousands – 25.5% will be over 65 years of age

United Nations Population Division. World population prospects 2008: United Nations Population Division Department of Economic and Social Affairs Canada: 22% of Schools had specific course or series of courses 33% of Schools required didactic geriatric dentistry course

Saunders RH, Yellowitz JA, Dolan TA, Smith BJ. Trends in Predoctoral Education in Geriatric Dentistry. J Dent Educ 1998: 62(4);314-18 EU27 Demographics

 By 2060 30% of Europeans will be over the age 65  61.4 million Europeans will be over 80 years of age  Challenges EU: limited training of the pre-doctoral dental student regarding elderly oral care

Preshaw PM, Mohammad AR. Geriatric dentistry education in European dental schools. Eur J Dent Educ 2005;9:73-77. EU:194 Schools invited complete survey

 Albania  Greece  Portugal  Austria  Hungary Completed by  Romania  Belarus  Germany  82 schools in  Russia  Belgium Iceland  Ireland  Slovakia 27 countries  Croatia  Italy  Spain  Czech  Latvia  Sweden Republic  Lithuania  Switzerland  Denmark  Malta  The Netherlands  Estonia  Norway  Turkey  Finland  Poland  United Kingdom  France  Yugoslavia

Preshaw PM, Mohammad Geriatric dentistry education in European dental schools. Eur J Dent Educ 2005;9:73-77. EU: Format of teaching

 82% schools required geriatric dentistry  18% schools - geriatric dentistry was an elective Preshaw PM, Mohammad AR. Geriatric dentistry education in European dental schools. Eur J Dent Educ 2005;9:73-77. EU: Topics covered

 Oral manifestations of systemic disease   Diagnosis and management of oral Oral management of frail elderly  conditions Socio-economic problems in  Medical problems in the elderly elderly   Age changes in oral/dental tissues Prosthetic management:  Oral management of the healthy neurological considerations  elderly Barriers to dental care   Psychosocial problems Prosthetic management:  Demographic distribution of elderly copy/replica denture technique   Prosthetic management: Oral management of adaptation and learning institutionalized elderly   Theories of ageing Visual/auditory loss in the elderly   Nutritional problems in elderly Home care and use of portable  Prosthetic management – equipment  modification of techniques Geriatric assessment scales

Preshaw PM, Mohammad AR. Geriatric dentistry education in European dental schools. Eur J Dent Educ 2005;9:73-77. EU: Program directed

 28% had a geriatric program director – 14% had formal training – 45% were Prosthodontists – 4% were Oral medicine Specialist – 37% had combination training  64% taught in Prosthodontic Department  23% taught content in Preventative Dentistry  13% taught content in Comprehensive Care Preshaw PM, Mohammad AR. Geriatric dentistry education in European dental schools. Eur J Dent Educ 2005;9:73-77. Geriatric Dental Curriculum in 3 Countries

Ranking of Didactic Subject Matter

46 Australia demographics

 Population (millions) 21.5  Life expectancy(years) 82.2  By 2030 – Over 20% of the population will be 65+ years of age – (6%) of the population will be over the age of 80

United Nations Population Division. World population prospects 2008: United Nations Population Division Department of Economic and Social Affairs Chalmers JM. Geriatric oral health issues in Australia. International Dental Journal (2001) 51: 188-199. Australian geriatric dental education

 No registered specialty in geriatric dentistry in Australia  Geriatric dental education in most states was limited to theoretical teaching with a strong Prosthodontic focus  1990’s University of Sydney, Melbourne, Queensland and Adelaide attempted to integrate a clinically oriented geriatric/specialty care dentistry curriculum  No formal postdoctoral education in geriatric dentistry available in Australia

Chalmers JM. Geriatric oral health issues in Australia. International Dental Journal (2001) 51: 188-199. Demographics China

 Population over 1.3 billion people – 8.2% is over the age of 65 – 1.4% is over the age of 80  By 2025 – 13.4% population will be over 65 years of age – Over 2% of population will be over 80 years of age  By 2050 – 23.3% population will be over 65 years of age – 7.2% population will be over 80 years of age

United Nations Population Division. World population prospects 2008: United Nations Population Division Department of Economic and Social Affairs Dental education in China

 No report of geriatric dentistry training in China  Most dental education is didactic with limited improvement in clinical teaching methods.

Fu Y, Ling J, Jang B, Yin H. Perspective on dental education in mainland China. Int Dent J 2006; 56: 265-71. Assessment Strategies and Redesigning Curriculum:

Marcia M. Ditmyer, PhD, CHES Geriatric Dentistry in the Curriculum: Assessment Strategies and Curriculum Mapping

 Assessing curriculum…what areas of geriatric dentistry are missing or redundant in practice management curriculum.  Strategies for retooling practice management curriculum to meet the challenges that face us in Geriatric Dentistry Steps for Retooling Existing Curriculum  Rubric design to assess curriculum  Survey and Focus groups  Curriculum mapping  Redesign curriculum  Evaluate and follow-up

53 Curriculum Assessment

 Curriculum assessment is a process of gathering and analyzing information from multiple sources in order to improve student learning in sustainable ways. Why Conduct Curriculum Assessment Curriculum assessment can serve several major purposes: – To identify aspects that work and those that do not – To demonstrate the effectiveness of the current program – To asses effectiveness of changes – To meet regular program review requirements – To satisfy professional accreditations (CODA, Regional Accreditation, etc.) How should information be used?

 Curriculum/Course Design  Curriculum/Course Delivery  Assessment  Learning Environment Information Sources

 Students (applicants, undergrads, grads, alumni)  Faculty (Full and Part-time)  Staff  Employers (Dental Community)  Professional Associations (certification/accrediting bodies)  Colleagues from similar programs elsewhere Feedback Methods

 Opinion Gathering (Surveys, Focus Groups, Interviews, Departmental Meetings/Retreats, etc.)  Testing (Written, demonstration, pre-post, etc.)  Content (journals, concept mapping, assignments, exams  Experts (tours, external reviewers, etc.)  Archives (course outlines, evaluations, grades, reports, etc.) Replacement Model

 Curriculum mapping is not something you add to what you already do. It is a replacement model that means learning a new way of conducting the professional business of teachers improving student learning by designing rigorous, vertically aligned curriculum. Curriculum Mapping

 An ongoing, calendar-based process involving teacher-designed operational and planned-learning curriculum, collaborative inquiry, and data-driven decision making

 A technique for exploring the primary elements of curriculum: – What is taught – How instruction occurs – When instruction is delivered First Steps…Getting Started

 Formulate an Assessment/Mapping Committee  Does the school you want to undertake this? Why?, To what extent?, What are the goals?, What are the costs?  Create a mapping tool or investigate purchasing a mapping tools - select one.  Who design, make the decisions, complete data entry, monitor and update?  What is a reasonable timeline? What professional development is needed? Curriculum Review

Should be conducted annually for ever discipline and every grade Course Name Semester Current Credit Actual Reported Reporte Taught Credits Change Contact Contact d Lab Awarded Hours Hours Hours Cariology Fall 2 3 28 28 Oral and Systemic Manifestations of Disease Spring 4 56 56 Pharmacological Concepts Spring 3 4 42 65 Pathological Concepts Fall 4 6 62 62 Clinically Oriented Anatomy Spring 2 3 70 58 Oral Cancer Fall 2 28 28 Principles of Endodontics Lecture Spring 1 14 24 Applied Dental Materials I Fall 1 15 13 Principles of Endodontics Lab Spring 2 42 32 Introduction to Dental Implants Summer 2 82 Oral Surgical Principles and Techniques Spring 2 14 18 Pharmacotherapeutics I: Prescribing Medication Summer 1 14 14 Panoramic Principles and Advanced Fall 1 Radiographic Anatomy 28 21 Orthodontics Summer 3 56 47.5 Restorative Dentistry: Removable Spring 3 Prosthodontics 56 65 Pediatric Dentistry Principals & Techniques Summer 2 56 25 Intro to Periodontal Diagnosis and Initial Fall 3 Therapy 60 49 UNLV School of Dental Medicine Assessment Alignment Matrix June 2008 DS1 Course DS2 Course DS3 Course DS4 Course Alignment Alignment Alignment Alignment Stan ADEA ADEA Proposed SDM Comp DS1 DS1 DS1 DS2 DS2 DS2 DS3 DS3 DS3 DS4 DS4 dard CODA Standards SDM Competencies Domain Competencies Domain & No. Fall Spring Sum Fall Spring Sum Fall Spring Sum Fall Spring No. BIOMEDICAL SCIENCES 2-12 Biomedical science 6. Patient 6.3. Recognize the manifestations of 4. Evaluate, 4.02. Establish differential, DEN 7101; DEN 7101; DEN 7111; DEN 7200; DEN 7201; DEN 7226; DEN 7320; DEN 7327; DEN 7506; DEN 7425; DEN 7740; instruction in dental Care systemic disease and how the disease diagnose and provisional and/or definitive DEN 7102; DEN 7108; DEN 7122; DEN 7204; DEN 7203; DEN 7228; DEN 7321; DEN 7328; DEN 7325; DEN 7440; DEN 7455 education must ensure an and its management may affect the perform treatment diagnoses DEN 7109; DEN 7109; DEN 7129; DEN 7208; DEN 7205; DEN 7229; DEN 7324; DEN 7329; DEN 7333; DEN 7455 in-depth understanding of delivery of dental care. planning for DEN 7112; DEN 7110; DEN 7130; DEN 7220; DEN 7233; DEN 7230; DEN 7326; DEN 7340; DEN 7340 basic biological principles, 6.14. Prevent, idenitfy, and manage individual patients of DEN 7120; DEN 7502; DEN 7137; DEN 7223; DEN 7236; DEN 7235; DEN 7340; DEN 7355 consisting of a core of pulpal and periradicular diseases. all ages DEN 7123; DEN 7121; DEN 7138; DEN 7240; DEN 7240; DEN 7240; DEN 7514 information on the DEN 7124; DEN 7133; DEN 7139; DEN 7241; DEN 7241; DEN 7241; fundamental structures, DEN 7125; DEN 7136; DEN 7140; DEN 7242; DEN 7242; DEN 7242 functions and DEN 7140; DEN 7140 DEN 7152; DEN 7251; DEN 7512 interrelationships of the DEN 7154; DEN 7159 DEN 7512 body system DEN 7510

2-13 The biomedical knowledge 6. Patient 6.3. Recognize the manifestations of 4. Evaluate, 4.02. Establish differential, DEN 7101; DEN 7101; DEN 7111; DEN 7200; DEN 7201; DEN 7226; DEN 7320; DEN 7327; DEN 7506; DEN 7425; DEN 7740; base must emphasize the Care systemic disease and how the disease diagnose and provisional and/or definitive DEN 7102; DEN 7108; DEN 7122; DEN 7204; DEN 7203; DEN 7228; DEN 7321; DEN 7328; DEN 7325; DEN 7440; DEN 7455 oro-facial complex as an and its management may affect the perform treatment diagnoses DEN 7109; DEN 7109; DEN 7129; DEN 7208; DEN 7205; DEN 7229; DEN 7324; DEN 7329; DEN 7333; DEN 7455 important anatomical area delivery of dental care. planning for 9.01. Identify the clinical DEN 7112; DEN 7110; DEN 7130; DEN 7220; DEN 7233; DEN 7230; DEN 7326; DEN 7340; DEN 7340 existing in a complex 6.14. Prevent, idenitfy, and manage individual patients of features of oral mucosal DEN 7120; DEN 7502; DEN 7137; DEN 7223; DEN 7236; DEN 7235; DEN 7340; DEN 7355 biological interrelationship pulpal and periradicular diseases. all ages diseases and disorders. DEN 7123; DEN 7121; DEN 7138; DEN 7240; DEN 7240; DEN 7240; DEN 7514 with the entire body. 9. Treat or manage 10.04. Recognize complex DEN 7124; DEN 7133; DEN 7139; DEN 7241; DEN 7241; DEN 7241; oral mucosal. Bone, conditions requiring surgical DEN 7125; DEN 7136; DEN 7140; DEN 7242; DEN 7242; DEN 7242 and intervention(s) and explain DEN 7140; DEN 7140 DEN 7152; DEN 7251; DEN 7512 temporomandibular their management. DEN 7154; DEN 7159 DEN 7512 disorders. DEN 7510 10. Perform uncompliated oral hard and soft tissue surgical procedures.

2-14 In-depth information on 6. Patient 6.3. Recognize the manifestations of 4. Evaluate, 4.02. Establish differential, DEN 7101; DEN 7101; DEN 7111; DEN 7200; DEN 7201; DEN 7226; DEN 7320; DEN 7327; DEN 7506; DEN 7425; DEN 7740; abnormal biological Care systemic disease and how the disease diagnose and provisional and/or definitive DEN 7102; DEN 7108; DEN 7122; DEN 7204; DEN 7203; DEN 7228; DEN 7321; DEN 7328; DEN 7325; DEN 7440; DEN 7455 conditions must be provided and its management may affect the perform treatment diagnoses DEN 7109; DEN 7109; DEN 7129; DEN 7208; DEN 7205; DEN 7229; DEN 7324; DEN 7329; DEN 7333; DEN 7455 to support a high level of delivery of dental care. planning for 9.01. Identify the clinical DEN 7112; DEN 7110; DEN 7130; DEN 7220; DEN 7233; DEN 7230; DEN 7326; DEN 7340; DEN 7340 undestanding of the 6.12. Recognize and manage individual patients of features of oral mucosal DEN 7120; DEN 7502; DEN 7137; DEN 7223; DEN 7236; DEN 7235; DEN 7340; DEN 7355 etiology, epidemiology, developmental or acquired occusal all ages diseases and disorders. DEN 7123; DEN 7121; DEN 7138; DEN 7240; DEN 7240; DEN 7240; DEN 7514 differential diagnosis, abnormalities 9. Treat or manage 10.04. Recognize complex DEN 7124; DEN 7133; DEN 7139; DEN 7241; DEN 7241; DEN 7241; pathogenesis, prevention, 6.14. Prevent, idenitfy, and manage oral mucosal. Bone, conditions requiring surgical DEN 7125; DEN 7136; DEN 7140; DEN 7242; DEN 7242; DEN 7242 treatment, and prognosis or pulpal and periradicular diseases. and intervention(s) and explain DEN 7140; DEN 7140 DEN 7152; DEN 7251; DEN 7512 oral and oral-related temporomandibular their management. DEN 7154; DEN 7159 DEN 7512 disorders. disorders. DEN 7510 10. Perform uncompliated oral hard and soft tissue surgical procedures. UNLV School of Dental Medicine Assessment Alignment Matrix June 2008 DS1 Course DS2 Course DS3 Course DS4 Course Alignment Alignment Alignment Alignment Stan ADEA ADEA Proposed SDM Comp DS1 DS1 DS1 DS2 DS2 DS2 DS3 DS3 DS3 DS4 DS4 dard CODA Standards SDM Competencies Domain Competencies Domain & No. Fall Spring Sum Fall Spring Sum Fall Spring Sum Fall Spring No. Behavioral and Practice Management 2-16Graduates must be 3. 3.2 Apply psychosocial and 3. Promote oral 3.01 Identify services DEN 7157; DEN 7509; DEN 7140 DEN 7200; DEN 7203; DEN 7235; DEN 7340 DEN 7340 DEN 7506; DEN 7440; DEN 7440; competent in the Communicati behavioral principles in patient- and systemic available to promote oral DEN 7160; DEN 7161; DEN 7204; DEN 7223; DEN 7240 DEN 7340; DEN 7452; DEN 7450 application of the on and centered health care. health in health and assess the DEN 7140 DEN 7136; DEN 7208; DEN 7236; DEN 7354 DEN 7454; DEN 7140 DEN 7223; DEN 7240; DEN 7455 fundamental principles Interpersonal 4.1 Provide appropriate individual patients individual and DEN 7240; DEN 7512 of behavioral sciences Skills prevention, intervention, and and the community access to DEN 7512; as they pertain to 4. Health educational strategies. community these services DEN 7252 patient-centered Promotion 4.2 Participate with other health 3.02 Demonstrate approaches for care professionals in the methods of educating promoting, improving management and health and motivating patients and maintaining oral promotion for all patients. in the etiology and health. prevention of oral diseases

2-17Graduates must be 3. 3.1 Apply appropriate 3. Promote oral 3.03 Communicate with DEN 7157; DEN 7509; DEN 7140 DEN 7200; DEN 7203; DEN 7235; DEN 7340 DEN 7340 DEN 7506; DEN 7440; DEN 7440; competent in managing Communicati interpersonal and and systemic diverse and special DEN 7160; DEN 7161; DEN 7204; DEN 7223; DEN 7240 DEN 7340; DEN 7452; DEN 7450 a diverse patient on and communication skills. health in populations. DEN 7140 DEN 7136; DEN 7208; DEN 7236; DEN 7354 DEN 7454; DEN 7140 DEN 7223; DEN 7240; DEN 7455 population and have the Interpersonal 3.3 Communicate effectively individual patients DEN 7240; DEN 7512 interpersonal and Skills with patients from diverse and the DEN 7512; communications skills to 4. Health populations. community DEN 7252 function successfully in Promotion 4.3. Recognize and appreciate a multicultural work 6. Patient the need to contribute to the environment. Care improvement of oral health beyond those served in traditional practice settings. 6.7. Manage the pediatric, adolescent, adult, geriatric and the special needs patient and prevent, identify, and manage trauma, oral diseases, and disorders in these patients.

2-18 Graduates must be 5. Practice 5.2. Evaluate and manage 3. Promote oral 3.01. Identify sercies DEN 7340 DEN 7340 DEN 7506; DEN 7440; DEN 7440; DEN 7340 DEN 7340 DEN 7506; DEN 7440; DEN 7440; DEN 7340 DEN 7340; DEN 7452; DEN 7450 DEN 7340; DEN 7452; DEN 7450 competent in Manageme different models of oral and systemic available to promote DEN 7354 DEN 7454; DEN 7354 DEN 7454; evaluating different nt and health care management health in oral health and DEN 7455 DEN 7455 models of oral health Informatics and delivery individual assess the individual care management patients and and community and delivery. the community access to these services. UNLV School of Dental Medicine Assessment Alignment Matrix June 2008 DS1 Course DS2 Course DS3 Course DS4 Course Alignment Alignment Alignment Alignment Stan ADEA Proposed SDM Comp DS1 DS1 DS1 DS2 DS2 DS2 DS3 DS3 DS3 DS4 DS4 dard CODA Standards ADEA Domain SDM Competencies Competencies Domain & No. Fall Spring Sum Fall Spring Sum Fall Spring Sum Fall Spring No. Cli ni Clinical Sciences 2- DEN 7101; DEN 7101; DEN 7111; DEN 7200; DEN 7204; DEN 7235; DEN 7320; DEN 7327; DEN 7506; DEN 7425; DEN 7740; patient 1. Critical 1.1 Evaluate and 4. Evaluate, 4.01. DEN 7102; DEN 7108; DEN 7502; DEN 7201; DEN 7205; DEN 7240; DEN 7340; DEN 7340; DEN 7325; DEN 7440; DEN 7455 25(a) assessment Thinking assess emerging diagnose Obtain/perform DEN 7109; DEN 7109; DEN 7122; DEN 7240; DEN 7240; DEN 7241; DEN 7514 DEN 7350; DEN 7340 DEN 7442; DEN 7112; DEN 7110; DEN 7129; DEN 7241; DEN 7241; DEN 7242 DEN 7355 DEN 7455 and diagnosis; 5. Practice trends in health care. and perform and record a DEN 7123; DEN 7501; DEN 7130; DEN 7242; DEN 7242; DEN 7124; DEN 7121; DEN 7137; DEN 7512 DEN 7252; Management 1.2 Utilize critical treatment comprehensive DEN 7125; DEN 7133; DEN 7138; DEN 7512 and thinking and problem planning for history, DEN 7140; DEN 7136; DEN 7139; DEN 7154; DEN 7140 DEN 7140; Informatics solving skills in individual examination of DEN 7510 DEN 7152; 6. Patient patient care. patients of orofacial DEN 7159 Care 5.2 Evaluate and all ages. structures and manage different 11. appropriate models of oral health Diagnose diagnostic tests. care management and manage 4.02. Establish and delivery. malocculusi differential, 5.3 Apply principles on and provisional of risk management, occlusal and/or definitive including informed disorders. diagnoses. consent and 15. Evaluate 11.01. Assesss appropriate record the the function of keeping in patient outcomes of the masticatory care. treatment system. 6.1. Obtain and provided by 11.02. Evaluate interpret patient data themselves and maintain the and use these and others. oral health of findings to accurately patients assess and manage undergoing patients. orthodontic 6.10. Develop and treatment. implement stratagies 15.00. Evaluate for the clinical the outcomes of assessment and treatment management of provided by caries. themselves and others. CODA ADEA Who Will Results/ SDM Competency Measures How to Measure When to Measure Data Analysis Distribution Status Standard Domain Measure Outcome Biomedical Sciences 2-12 6. Patient Care 4. Evaluate, diagnose and 1. Questions embedded in classroom 1. Course grades: classroom 1. Course Grades are reviewed 1. Course Director Descriptive 1. Reports submitted to perform treatment planning for exams and assessments examination scores and grades from at the end of each semester 2. Progress Statistics; Trend executive committee of SDM individual patients of all ages 2. Course projects, papers and classroom asignments 2. Progress committee meets at Committee Analyses; Kappa 2. Summary reports presentations and/or 2. Review by Student Progress the end of each semester Statistics for submitted to curriculum 3. Course examinations Committee calibration of committee as a means to examiners review and improve curriculum. 3. Aggregate data reported 2-13 6. Patient Care 4. Evaluate, diagnose and 1. External tests with national norms 1. National Board Review Scores: Part 1. When students take the 1. Scores received to faculty during faculty forum perform treatment planning for (National Board, Part 1 and Part 2) 1 and Part 2 National Boards, Part 1 is taken from Nevada State individual patients of all ages 2. Successful completion of clinical 2. Course grades: skill simulation in summer between DS2 and Board 9. Treat or manage oral mucosal. competencies course completion grades, competency DS3. Part 2 is taken in the 2. Course Bone, and temporomandibular 3. Skill simulations grades, and classroom exams and Spring of DS4 year. Directors disorders. 4. Questions embedded in classroom assignments 2. Scores of simulations and 3. Team Leaders 10. Perform uncompliated oral exams and assignments 3. Group evaluation of Faculty within types of exams and hard and soft tissue surgical Team; Review by Student Progress assignments procedures. Committee 3. Team Leader submission of student evaluations at middle and end of each semester 2-14 6. Patient Care 4. Evaluate, diagnose and 1. External tests with national norms 1. National Board Review Scores: Part 1. When students take the 1. Scores received Practice Managementperform treatment planning for (National Board, Part 1 and Part 2) 1 and Part 2 National Boards, Part 1 is taken from Nevada State 2-18 5. Practice Mgt 3.individual Promote patients oral and of systemic all ages 1.2. QuestionsSuccessful embedded completion in of classroom clinical 1.2. Course grades: classroomskill simulation 1.in summer Course Gradesbetween are DS2 reviewed and 1.Board Course Director Descriptive 1. Reports submitted and health9. Treat in or individual manage patientsoral mucosal, and examscompetencies and assignments examinationcourse completion scores grades, and grades competency from atDS3. the Partend 2of is each taken semester in the 2. Progress Course Statistics; Trend to executive committee Informatics thebone, community and temporomandibular 2.3. PortfoliosSkill simulations classroomgrades, and asignments classroom exams and 2.Spring Progress of DS4 committee year. meets at CommitteeDirectors Analyses; Kappa of SDM disorders. 3.4. EvaluationsQuestions embedded from community in classroom 2.assignments Review by Student Progress the2. Scores end of eachof simulations semester and 3. Team Leaders Statistics for 2. Summary reports 10. Perform uncompliated oral membersexams and on assignments presentations and Committee3. Group evaluation of Faculty within types of exams and calibration of submitted to hard and soft tissue surgical program implementation Team; Review by Student Progress assignments examiners curriculum committee procedures. Committee 3. Team Leader submission of as a means to review student evaluations at middle and improve and end of each semester curriculum. 4. Health 3. Promote oral and systemic 1. Questions embedded in classroom 1. Course grades: classroom 1. Course Grades are reviewed 1. Course Director 2-19 3. Aggregate data Promotion health in individual patients and exams and assignments examination scores and grades from at the end of each semester 2. Progress reported to faculty 5. Practice Mgt the community 2. Portfolios classroom asignments 2. Progress committee meets at Committee 2-15 1. Critical 2. Access, evaluate, and 1. Questions embedded in classroom 1. Course grades: classroom 1. Course Grades are reviewed 1. Course Director during faculty forum andThinking incorporate into practice new 3.exams Evaluations and assessments from community 2.examination Review by scores Student and Progress grades from theat the end end of eachof each semester semester 2. Progress Informatics5. Practice Mgt knowledge, techniques, and members2. Course onprojects, presentations papers and Committeeclassroom asignments 2. Progress committee meets at Committee and materials programpresentations implementation and/or 2. Review by Student Progress the end of each semester Informatics 3. Course examinations Committee

Ethics & Professionalism 2-20 2. 1. Understand and apply ethical 1. Questions embedded in classroom 1. Course grades: classroom 1. Course Grades are reviewed 1. Course Director Descriptive 1. Reports submitted Professionalis codes and laws and regulations exams and assessments examination scores and grades from at the end of each semester 2. Progress Statistics; Trend to executive committee m governing dentistry. 2. Course projects, papers and classroom asignments 2. Progress committee meets at Committee Analyses; Kappa of SDM presentations and/or 2. Review by Student Progress the end of each semester Statistics for 2. Summary reports 3. Course examinations Committee calibration of submitted to examiners curriculum committee as a means to review and improve curriculum. 2. 1. Understand and apply ethical 1. Questions embedded in classroom 1. Course grades: classroom 1. Course Grades are reviewed 1. Course Director 2-21 3. Aggregate data Professionalis codes and laws and regulations exams and assessments examination scores and grades from at the end of each semester 2. Progress reported to faculty m governing dentistry. 2. Course projects, papers and classroom asignments 2. Progress committee meets at Committee during faculty forum presentations and/or 2. Review by Student Progress the end of each semester 3. Course examinations Committee

2-22 1. Critical 2. Access, evaluate, and 1. Course projects, papers and 1. Course grades: classroom 1. Course Grades are reviewed 1. Course Director Thinking incorporate into practice new presentations examination scores and grades from at the end of each semester 2. Progress 5. Practice Mgt knowledge, techniques, and 2. Course examinations classroom asignments 2. Progress committee meets at Committee and materials 3. Skill simulations 2. Review by Student Progress the end of each semester Informatics 4. Evaluate, diagnose and 4. Successful completion of clinical Committee perform treatment planning for competencies individual patients of all ages. 5. External tests with national norms (National Board, Part 1 and Part 2) 67 CODA ADEA Data SDM Competency Measures How to Measure When to Measure Results/Outcomes Distribution Status Standard Domain Analysis Biomedical Sciences 2-12 6. Patient Care 4. Evaluate, diagnose and perform 1. End of Course 1. Online Surveys 1. End of each Descriptive 1. Reports treatment planning for individual Student evaluations 2. Faculty/Course course Statistics; submitted to patients of all ages 2. Faculty evaluations Surveys 2. Each Trend executive committee of courses 3. Face-to-face course/faculty once Analyses; of SDM 3. Mid-program interviews year Kappa 2. Summary reports interviews (DS2/DS3) 4. Face-to-face 3. Summer between Statistics for submitted to 2-13 6. Patient Care 4. Evaluate, diagnose and perform 4. Exit interview interviews DS2 and DS3 calibration of curriculum treatment planning for individual 5. Alumni Survey 5. Phone interviews 4. May of DS4 year examiners committee as a patients of all ages 6. Employer survey 6. Mail or internet 5. One year and means to review 9. Treat or manage oral mucosal. 7. Surveys of surveys Five years after and improve Bone, and temporomandibular Supervisors of 7. Mail surveys graduation curriculum. disorders. Community-based 8. Face-to-face 6. Every 2 years 3. Aggregate data 10. Perform uncompliated oral hard educational sites interviews and surveys 7. After each activity reported to faculty and soft tissue surgical procedures. 8. Patient Satisfaction where a student during faculty forum 2-14 6. Patient Care 4. Evaluate, diagnose and perform Surveys participates treatment planning for individual 8. Annually, but patients of all ages never the same time 9. Treat or manage oral mucosal. each year Bone, and temporomandibular disorders. 10. Perform uncompliated oral hard and soft tissue surgical procedures. 2-15 1. Critical 2. Access, evaluate, and incorporate Thinking into practice new knowledge, 5. Practice Mgt techniques, and materials and Informatics Practice Management 2-18 5. Practice 3. Promote oral and systemic 1. End of Course 1. Online Surveys 1. End of each Descriptive 1. Reports Mgt and health in individual patients and Student evaluations 2. Faculty/Course course Statistics; submitted to Informatics the community 2. Faculty Surveys 2. Each Trend executive evaluations of 3. Face-to-face course/faculty Analyses; committee of SDM courses interviews once year Kappa 2. Summary 2-19 4. Health 3. Promote oral and systemic 3. Mid-program 4. Face-to-face 3. Summer Statistics reports submitted Promotion health in individual patients and interviews interviews between DS2 and for to curriculum 5. Practice the community (DS2/DS3) 5. Phone interviews DS3 calibration committee as a Mgt and 4. Exit interview 6. Mail or internet 4. May of DS4 of means to review Informatics 5. Alumni Survey surveys year examiners and improve 6. Employer survey 7. Mail surveys 5. One year and curriculum. 7. Surveys of 8. Face-to-face Five years after 3. Aggregate data Supervisors of interviews and graduation reported to faculty Community-based surveys 6. Every 2 years during faculty educational sites 7. After each forum 8. Patient activity where a Satisfaction Surveys student participates 68 8. Annually, but never the same time each year BioMedical Sciences - Courses and Clinical Sciences - Courses and Instructors Professional Studies - Courses and Instructors Instructors Course Course Course Class Course Name ProfessorSemester Class Course Name Professor Semester Class Course Name Professor Semester # # # DS I 7120 Introduction to Infection Control Simmons Fall DS I 7140 General Clinic Streamline I Webberson Fall DS I 7101 Cellular & Molecular Concepts Davenport Fall DS I 7123 Diagnosis and Treatment Planning I Simmons Fall DS I 7154 Health Care Delivery: Patient Record and HIPPA Regulations Webberson Fall DS I 7101 Cellular & Molecular Concepts Davenport Fall DS I 7124 Dental Anatomy and Occlusion Lab Nelson Fall DS I 7157 Patient Communications and Cultural Compatability McClain Fall DS I 7102 Microbiological & Immunological Concepts Galbraith Fall DS I 7125 Dental Anatomy and Occlusion Lecture Nelson Fall DS I 7160 Biostatistics in Oral Health Ditmyer Fall DS I 7108 HIV/AIDS & Oral Disease Galbraith Fall DS I 7140 DSI General Dentistry Clinic Webberson Fall DS I 7510 Critical Thinking in Contemporary Health Care Ditmyer, Mobley, Zoller Fall DS I 7109 Head and Neck Anatomy Zoller Fall DS I 7121 Principles of Clinical Dentistry: Operative Dentistry Woodall Spring DS I 7140 General Clinic Streamline II Webberson Spring DS I 7109 Head and Neck Anatomy Zoller Spring DS I 7133 Principles of Clinical Dentistry Lab Woodall Spring DS I 7151 Healthcare Financing and Public Health Sandoval Spring DS I 7110 Oral Pathogens & Oral Immunology Galbraith Spring DS I 7136 Basics of Periodontal Instrumentation and Preventive Intervention Lockhart Spring DS I 7156 Community Outreach: Pediatric Education McClain Spring DS I 7111 Oral Developmental Anatomy and Histology (Oral Histology) Davenport Spring DS I 7140 DSI General Dentistry Clinic Webberson Spring DS I 7161 Epidemiology in Oral Health Ditmyer Spring DS I 7112 Introduction to Human Development Davenport Spring DS I 7122 Applied Clinical Dentistry: Restorative Richards Summer DS I 7509 Professional Studies Integration Seminar McClain Spring DSI 7501 Integration Seminar I Kingsley Spring DS I 7126 Local Anesthesia and Nitrous Oxide Sedation Nattestad Summer DS I 7140 General Clinic Streamline III Webberson Summer DSI 7502 Integration Seminar II Kingsley Summer DS I 7129 Diagnosis and Treatment Planning II Simmons Summer DS I 7152 Patient Communication (Spanish for Health Professional) McClain Summer DS I 7130 Principles of Dental Materials Nelson Summer DS I 7159 Practice Management Technology Davenport Summer DS I 7135 Periodonal Anatomy and Pathogenesis of Periodontal Disease Lockhart Summer DS I 7358 Applied Human Nutrition Mobley Summer DS I 7137 Foundations in Fixed Prosthodontics Lab Richards Summer DS I ?? Dummer Enrichment Sandoval Summer DS I 7138 Preclinical Dentistry Lab Tozzi Summer DS I 7153 Specialty Practices I [INACTIVE] DS I 7139 Clinical Occlusion Nelson Summer

DS I 7140 DSI General Dentistry Clinic Webberson Summer DS I 7127 Introduction to Intraoral and Panoramic Radiology [INACTIVE] DS I 7128 Clinical Dentistry Seminar [INACTIVE] DS I 7131 Introduction to Clinical Dentistry I [INACTIVE] DS I 7132 Introduction to Clinical Dentistry II [INACTIVE] DS I 7134 Introduction to Digital Radiology [INACTIVE] DS II 7220 Principles of Endodontics Lecture ? Fall DS II 7251 Specialty Practices Webberson Fall DS II 7200 Cariology Davenport Fall DS II 7223 Principles of Endodontics Lab ? Fall DS II 7252 Community Outreach: Geriatric Population McClain Fall DS II 7201 Oral and Systemic Manifestations of Disease Herschaft Fall DS II 7240 DSII General Dentistry Clinic Ord Fall DS II 7512 Dental Research and Methodology I Mobley Fall DS II 7203 Pharmacological Concepts Hillyard Fall DS II 7241 Simulated Comprehensive Care Lecure Hill Fall DS II 7512 Dental Research and Methodology II Mobley Spring DS II 7204 Pathological Concepts Herschaft Spring DS II 7242 Simulated Comprehensive Care Lab Hill Fall DS II ?? Summer Enrichment Sandoval Summer DS II 7205 Clinically Oriented Anatomy Zoller Spring DS II 7221 Applied Dental Materials I Nelson Spring DS II 7254 Health Care Administration: Regulation and Finance [INACTIVE] DS II 7208 Oral Cancer Herschaft Spring DS II 7227 Oral Surgical Principles and Techniques Nattestad Spring DS II 7233 Restorative Dentistry: Removable Prosthodontics Dounis Spring DS II 7236 Intro to Periodontal Diagnosis and Initial Therapy Lockhart Spring DS II 7240 DSII General Dentistry Clinic Ord Spring DS II 7241 Simulated Comprehensive Care Lecure Hill Spring DS II 7242 Simulated Comprehensive Care Lab Hill Spring DS II 7226 Introduction to Dental Implants Kirit Summer DS II 7228 Pharmacotherapeutics I: Prescribing Medication Simmons Summer DS II 7229 Panoramic Principles and Advanced Radiographic Anatomy Danforth Summer DS II 7230 Orthodontics ? Summer DS II 7235 Pediatric Dentistry Principals & Techniques Hackmyer Summer DS II 7237 DSII Digital Radiology ?? Danforth Summer DS II 7240 DSII General Dentistry Clinic Ord Summer DS II 7241 Simulated Comprehensive Care Lecure Hill Summer DS II 7242 Hill Summer Simulated Comprehensive Care Lab DS II 7222 Patient Care II: Fixed Prosthodontics [INACTIVE] DS II 7225 Advanced General Dentistry: Surgical and Restorative Techniques [INACTIVE] DS II 7232 Patient Care IV: Clinic [INACTIVE] DS II 7238 Diagnosis and Treatment Planning Seminar [INACTIVE] DS III 7320 Clinical Medicine I Simmons Fall DS III 7514 Professional Ethics I Sandoval Fall DS III 7506 Growth and Developmental Abnormalitites (DS3) Davenport Fall DS III 7321 Principles of Periodonatal & 3rd Molar Surgery Lockhart Fall DS III 7350 Practice Administration I Sandoval/Devore Spring DS III 7324 Esthetic Dentistry: Principles and Techniques Nelson Fall DS III 7355 Hospital Dentistry Nattestad ?? Spring DS III 7326 Oral and Maxillofacial Pathology I Herschaft Fall DS III 7514 Professional Ethics II Sandoval Spring DS III 7340 DSIII General Dentistry Clinic Ord Fall DS III 7354 Contemporary Issues in Behavioral Science Sandoval/Mobley/Capp Summer elli DS III 7326 Oral and Maxillofacial Pathology I Herschaft Fall DS III ?? Summer Enrichment Sandoval Summer DS III 7327 Oral and Maxillofacial Pathology II Herschaft Spring DS III 7328 Clinical Medicine II Simmons Spring DS III 7332 Temporomandibular Disorders Nelson Spring DS III 7333 Principles of Removable Parital Dentures Dounis Spring DS III 7340 DSIII General Dentistry Clinic Ord Spring DS III 7325 DS III Advanced General Dentistry Seminar Nelson Summer DS III 7329 Advanced Techiques in Dental Radiology Danforth Summer DS III Summer 7333 Principles of Removable Partial Dentures Dounis DS III Summer 7340 DSIII General Clinic Ord DS III 7323 Digital and Convention Xray Production [INACTIVE} DS IV 7425 DSIV Advanced General Dentistry Seminar Nelson Fall DS IV 7452Practice Administration II Sandoval/Devore Fall DS IV 7440 DSIV General Clinic Ord Fall DS IV 7454Community Outreach: Disabled and Special Needs Population McClain Fall 69 DS IV 7441 Oral Histopathology (Elective) Herschaft Fall DS IV 7455Clinical Diagnostic Conference: Grand Rounds Sandoval/Herschaft/Fra Fall nco

DS IV 7442 Periodontal Regeneration and Case Management Lockhart Fall DS IV 7453Dental Jurisprudence Sandoval/Havins Spring DS IV 7453Clin. Diagnostic Conference: Forensics Sandoval/Ord Spring Outcomes

 Reduces meeting time focused on details once completed  Provides real information for the analysis of topics like assessment and skills  Assist new teachers with planning and understanding the curriculum  Reinforce the value of what is being taught  Provide a tool for communication with the larger community (faculty, students, decision-makers, grant providers, accreditation agencies) Barriers

 It is a time - arduous task  Lack of clearly defined goals  Lack of agreement about the mapping form itself  Lack of a consistent vocabulary  Is it as valuable to users as it was to creators? QUESTIONS!

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