Jonathan Hawley

EDHP 501: Curriculum Design

April 19, 2015
CURRICULUM TOPIC:
Preparedness of dental students entering the clinic.

AUDIENCE:
The intended audience is second year dental students, or any clinically inexperienced dental
students, that will be entering the clinic to treat patients for the first time.

PROBLEM STATEMENT:
The problem with the current curriculum is the students general unpreparedness and lack of true
clinic scenarios when entering the clinic to see live patients 1.

CURRICULUM GOALS:
1. By the end of the second year of dental school, students will posses the necessary knowledge,
understanding, and skills to provide adequate standard of care, as defined by the American
Dental Association, to live patients.
2. The students will be able to identify and recall the important aspects of pharmacology as
outlined in the D1 and D2 courses.
3. Students will be able to treat a patient in a clinical scenario.
4. The students will be familiar with new patient interview process and all aspects that are
involved.
5. Students will be confident in their education and skills from the first two years of training
before entering the clinic.

1 Students general unpreparedness and lack of true clinic scenarios is a statement that may be more subjective
from the student than objectively based on actual clinic events.

NEEDS ASSESSMENT
Dental students begin to see patients in the Summer between their second and third year of dental school.
Currently, the first two years of school are focused on didactic learning and recitation exams similar to
undergraduate studies, which is necessary for the basic understanding of both medicine & dentistry, as
well as students success of NDBE Part I. Student preparedness and expectations for clinical readiness is
extremely important to the student, the school, the state, the profession, and the patient. Clinic readiness is
a combination of both theoretical (didactic) and practical (clinical) skills. This knowledge of medicine,
dentistry, patient management, and clinic scenario is the foundation for the students future career.
Evaluation of the current curriculum was assessed by: 1) before-after questionnaires or interviews of
ninety-seven dental students, and 2) interviews of current faculty of the dental school that have direct
contact with new students in the clinic2. Currently, dental students are exposed to clinic-type scenarios in
the simulation lab (mannequin and typodonts) that provide opportunities to improve handskills, practice
ideal ergonomics, and treat the ideal patient (eg. perfect occlusion, no caries, no medical history, etc.).
Although this is a necessity that hones skills required to become a competent dentist, the exposure to true
clinic scenarios (eg. malocclusion, missing teeth, rotated teeth, caries, contraindications of pharmacology,
execution of patient interview, etc.) are extremely limited. Ideally, new students would be required to
observe senior students for a set amount of time in the clinic to learn real-world experience with patient
interviews, AxiUm navigation, real time treatment planning, faculty approval process, and other skills
expected of the student during their first clinic experience. The problem with the current curriculum is the
students general unpreparedness and lack of true clinic scenarios when entering the clinic to see live
patients.

CURRICULUM
1. Pharmacology Written exam
a. Goal
i. Identify and recall the important aspects of pharmacology as outlined in the D1
and D2 courses.
b. Objective
i. At the end of the second year of dental school, dental students will be able to
name the top ten most encountered drugs in the clinic, describe their mechanism
of action, and list contraindications with minimal to no errors.
c. Learning Activity3
i. Students will be given a written exam consisting of (50) fill-in-the-blank style
questions that focus on the aspects of pharmacology that are non-negotiable prior
to entering the clinic. The topics will include, but are not limited to, the top ten
most encountered drug types, their mechanism of action, contraindications,
dental analgesic interactions, and signs of drug abuse.
ii. 75 minutes will be designated for the exam.
d. Resources and Materials Needed

2 See Appendix I for Needs Assessment Survey

3 See Appendix II for Activity Checklist & Implementation

i. Prior to the activity, completion of pharmacology D2 year, which includes

lectures, PowerPoints, handouts, and reading assignments from a designated
pharmacology textbook.
ii. Recommended textbook for this curriculum is Manual of Pharmacology and
Therapeutics by Goodman & Gilman, 2E (2014).
iii. Prior to the activity, access to a classroom with projector and qualified professor
will be needed.
iv. During the activity, a number 2 pencil is all that will be needed.
2. Endodontics Sim Lab Role Play
a. Goal
i. Student is able to treat a patient in a clinical scenario.
b. Objective
i. Prior to entering clinic, dental students will be able to execute the entire process
of Endodontic treatment, including radiographs, AxiUm, and
debridement/obturation, with minimal or no errors.
c. Learning Activity
i. Students will be given a virtual patient needing endodontic treatment.
ii. The students will treat the virtual patient as if it is 100% a clinical scenario (eg.
record vitals, radiographs, introduction to professors, use of AxiUm).
iii. Upon approval of adequate diagnosis, debridement and obturation will follow.
iv. The student will be scored based on their performance by the overseeing
professor.
v. 3 hours will be designated for the simulation.
d. Resources and Materials Needed
i. Prior to the activity, completion of the D2 endodontics course including lectures,
PowerPoints, laboratory exercises, and assigned readings out of the designated
textbook for the course.
ii. Recommended textbook for this curriculum is Pathways of the Pulp by
Hargreaves and Gohen, 10E (2011).
iii. Materials provided by the department will be the simulation lab with mannequin,
typodont for endodontic treatment, radiograph unit, access to AxiUm, and
qualified professors. The department will also provide PPE (eg. gloves, masks,
and chair coverings).
iv. Materials the student will provide are their access badge, instrument case for
endodontic treatment, and magnification if desired.
3. Patient Interview OSCE
a. Goal
i. Familiarity with the software AxiUm, the forms and questionnaires within the
program, and comfortable interviewing patients.
b. Objective
i. By the end of the second year of dental school, dental students will be able to
evaluate a patient's health based on questionnaires and clinical exams with no
errors.
c. Learning Activity
i. Students will execute an OSCE-styled interview with faculty to review the
patients medical and dental history using the designated questionnaires in
AxiUm.

ii. Students will be graded based on questions asked, their response to the patient,
how they direct the conversation, and investigative thoroughness, when
applicable.
iii. 30 minutes will be designated for the OSCE
d. Resources and Materials Needed
i. Prior to the activity, knowledge and use of the software AxiUm system, as well as
knowledge of both medical and dental as designated by the curriculum at the end
of D2.
ii. Materials provided by the department are access to the Oral Diagnosis clinic,
including operatory chair, AxiUm access, all PPE necessary, and a qualified
professor to act as patient.
iii. Materials needed by the student will be their access badge.

EVALUATION & FEEDBACK

1. Student Assessment
a. The student evaluation will be a combination of all three types of assessments:
i. Self-assessment through interviews and/or surveys will be given to students after
they have completed the curriculum. The student will be asked to identify skills,
competencies, and knowledge that they feel have been mastered well, as well as
areas that the curriculum did not prepare them for clinic.
ii. Professors and faculty will continually be observing students once they have
entered clinic. Any clinical aspects that a struggle for multiple students will be
reported to administration for evaluation of missed opportunities in pre-clinical
instruction and education.
iii. Students are always welcome to ask questions with professors and faculty about
procedures and practices that are unfamiliar.
iv. The pharmacology written exam, endodontic virtual patient, and OSCE style
learning activity will be used as assessments of mastery of necessary material.
2. Program Evaluation
a. The program evaluation will be based upon students confidence and proficiency in
treating patients within their first six months. The efficiency of the program will be based
on the learning activities, the students self-report confidence, the facultys evaluation of
the students skills and knowledge, and proficiency in patient care as outlined by the
American Dental Association or equivalent governing entity. Any misaligned curriculum
between pre-clinical education and clinical implementation will be immediately brought
to the schools Curriculum Board for necessary adjustments.

Appendix I
NEEDS ASSESSMENT SURVEYS (4)
Student Survey Before Clinic
Instructions:
Before entering the clinic and being assigned their own patient, the student should complete this survey
and return it to Room 139 within one week after delivery. This survey must be done before the After
Clinic survey is completed.
1. What is your current rotation schedule in the clinic?
2. Did you pass the NDBE Part I? (Yes/No)
3. Have you passed all curriculum courses in your dental school education thus far? (pass = greater
than a 75 average in the course) (Yes/No)
4. Do you feel prepared for clinic based on your dental school education thus far?
(Yes/No)
a. If yes, why do you feel prepared for clinic?
b. If no, why do you feel unprepared for clinic?
5. Which courses do you feel have prepared you best for clinic? Why?

6. Which courses do you feel have not prepared you well for clinic? Why?

7. In your opinion, what would have better prepared you for clinic?

Student Survey After Clinic

Instructions:
After entering the clinic and having completed six months of patient treatment, the student should
complete this survey and return it to Room 139 within one week after delivery. The Before Clinic
survey must be done before this survey is completed.
1. How long have you been working in the clinic?
2. In your opinion, have you succeeded in the clinic? (Yes/No)

3. Based on your clinic experience with patients and faculty, do you feel you were prepared for
clinic? (Yes/No)
a. If yes, why were you prepared for clinic?
b. If no, why were you not prepared for clinic?
4. Which courses prepared you best for clinic? Why?

5. Which courses did not prepare you well for clinic? Why?

6. In your opinion, what would have better prepared you for clinic?

Interview with Dental Student that has spent greater than 1 year in clinic
Instructions:
After entering the clinic and having completed one year of patient treatment, the student should
complete this survey and return it to Room 139 within one week after delivery. This survey can be used as
a stand-alone survey or as the third survey following the Before Clinic and After Clinic surveys.
1. Please describe your feelings and execution of skills taught in the first years of dental school prior
to entering clinic.
2. Please describe your feelings and execution of skills taught in the first years of dental school after
entering clinic.
3. Were you prepared for clinic with the current curriculum?

4. What would have better prepared you for clinic?

5. What areas did you struggle with when you entered clinic?

Faculty Survey After Student Has Entered Clinic

Instructions:
After the student has entered the clinic and having completed one year of patient treatment, the
faculty should complete this survey and return it to Room 139 within one week after delivery. This survey
is to be used as a stand-alone survey.
1. How long have the new students been working in the clinic now?
2. In your opinion, have the students succeeded in the clinic? (Yes/No)

3. Based on your clinic experience with patients and students, do you feel the students were
prepared for clinic? (Yes/No)
a. If yes, why were the students prepared for clinic?
b. If no, why were the students not prepared for clinic?
4. Have any events in the clinic showed the students preparedness? Please describe.
5. Have any events in the clinic showed the students unpreparedness? Please describe.
6. Which courses prepared the students best for clinic? Why?

7. Which courses did not prepare the students well for clinic? Why?

8. In your opinion, what would have better prepared the student for clinic?

APPENDIX II
ACTIVITY CHECKLIST & IMPLEMENTATION
RESOURCES
Classroom with projector
Sim lab with mannequin, radiograph computer, Endo typodont, and Endo cassette
Designated class time during appropriate course
Faculty for appropriate course
Access to AxiUm (student badge)
SUPPORT
Internal support from faculty (assurance of student competency)
Internal support from students (confidence of knowledge and skills)
External support from administration (assurance students are learning curriculum)
External support from the state (assurance school is providing accurate education and student is
learning skills necessary to treat patients ethically and effectively)
External support from WREB or appropriate licensing institution (assurance school is providing
accurate education and student is learning skills necessary to treat patients ethically and effectively)
ADMINISTRATIVE MECHANISMS
PowerPoints, handouts, syllabi, and lectures for education of topics for appropriate course
Handouts for instructors for learning objectives and learning activities
All information for courses and learning activities will be available through BlackBoard
Survey students and faculty after course is complete
INTRODUCTION (IMPLEMENTATION)
Pilot with small group to gain feedback for effectiveness, efficiency, and education value
Full implement after pilot and adjustments are made
BARRIERS
Potential areas of backup during learning activities (eg. radiograph computer during endo procedures)
o Solution spilt class into groups that are designated specific computers or split class into
groups with activities scheduled on different days
Overlap of topics for student presentations of top 10 drugs
o Solution sign up in groups prior to presentation
Faculty availability during classtime
o Solution each faculty will be assigned a certain number of students in the class