development of foundational knowledge guidelines and revision and

ADEA – COS – 2004 – W. DavenportADEA – COS – 2004 – W. Davenport

Introduction by David ShawIntroduction by David Shaw

*****UPDATE**********UPDATE*****DEVELOPMENT OF FOUNDATIONAL DEVELOPMENT OF FOUNDATIONAL

KNOWLEDGE GUIDELINESKNOWLEDGE GUIDELINESand revision and update of theand revision and update of the

ADEA CLINICAL COMPETENCIESADEA CLINICAL COMPETENCIES


Presentor Bill DavenportPresentor Bill Davenport


ProposalProposal

• That a task force be formed to consider mechanisms for developing contemporary sets of foundation knowledge statements and for the revision of the existing ADEA clinical competencies.


Overall ObjectivesOverall Objectives

• Develop a contemporary document comparable to the "course guidelines" that were published years ago.

• Recommend a more appropriate domain-topic list for the ADA biannual clock-hour report.

• Recommend a more content specific domain-topic outline for National Board Exams.

• Develop an "integrated" competency approach to dental education.

• Update the current ADEA clinical competencies list.• Develop integrated biomedical sciences basic and

foundation knowledge statements to support the ADEA recommended clinical competencies.


GoalsGoals

• The development of a more focused, contemporary, and streamlined set of foundation knowledge statements should allow dental schools to modify and fine-tune their curricula so that foundation knowledge can be relatively consistent among dental schools.

• The foundation knowledge developed will be the underlying information necessary for competency-based education.

• In addition, National Board Test Construction Committees can use these sets to help ensure questions represent contemporary curricular content.


Phase IPhase I

• Data Available– the ADA biannual clock hour report domain-

topic list– the CODA standards for accreditation

(specifically standard 2)– the National Dental Board content outline– references to the old guidelines (too

voluminous to duplicate)

– ADEA existing clinical competencies


Phase IPhase I

• Section Activity– Updated NBD Content Outline– Updated ADA Domain-Topic

– Initial Basic/Foundation Knowledge Statements

– Revised/Updated ADEA Clinical Competencies


Phase IIPhase II

• Data to Task Force– Updated NDB Content Outline– Updated ADA Domain-Topic

– Initial Basic/Foundation Knowledge Statements

– Revised/Updated ADEA Clinical Competencies


Phase IIPhase II

• Task Force Activity– Collate/Integrate Data– Resubmit to sections for approval the following:

• Integrated Basic Knowledge Statements• Integrated Foundation Knowledge Statements• Clinical Competencies

– Recommend to ADA (after sections and COS approval)

• NDB content outline revision

• Domain-Topic list revision


Clinical Competencies

Integrated Knowledge

Basic Knowledge


Relationship Flow ChartRelationship Flow Chart

CODA

ADEA Competencies Domain-Topic NDB Content

Integrative Knowledge

Basic Knowledge

ADEA Comp

ADEA FK

ADEA BK

ADEA Comp

ADEA FK

ADEA BK


CDA Standard

National Board Content

ADEA Competenchy


Basic Foundation Knowledge

Domain-Topic List


Basic Foundation Knowledge - BFKBasic Foundation Knowledge - BFK

• A student must have command of certain basic or foundation knowledge. Gaining this information occurs throughout the life of the individual at every level of education. Students enter dental school with varying degrees of education and life experiences. It is assumed that all possess that level of knowledge contained in the courses required for admission. A dental school education must build on this awareness with additional foundation knowledge in the biomedical sciences from which the student can proceed toward the prescribed level of clinical competency in general dentistry.


Integrative Knowledge - IKIntegrative Knowledge - IK

• Once the basic principles of biomedical science (BFK) are understood, they must be supplemented with specific integrative knowledge upon which clinical competencies are based.

ExampleExample


CDA Standard 2-25CDA Standard 2-25At a minimum, graduates must be competent in providing oral health care within the scope of general dentistry, as defined by the school, for the child, adolescent, adult, geriatric and medically compromised patient, including:a. patient assessment and diagnosis;b. comprehensive treatment planning;c. health promotion and disease prevention;d. informed consent;e. anesthesia, and pain and anxiety control;f. restoration of teeth; g. replacement of teeth;h. periodontal therapy;i. pulpal therapy;j. oral mucosal disorders; k. hard and soft tissue surgery;l. dental emergencies;m. malocclusion and space management; and n. evaluation of the outcomes of treatment.


ADEA Clinical CompetencyADEA Clinical Competency

#49

Perform uncomplicated endodontic procedures.


Integrative KnowledgeIntegrative Knowledge

• The student, therefore, must understand the:– structure, function, and metabolism of

collagen, proteoglycans, and other proteins in connective tissue, including bone, dentin, and cementum.

– normal structure of teeth and supporting structures, including enamel, dentin, pulp, and cementum;

– mechanism of pain modulation;


BFKBFK

• In order to proceed to the SFK necessary to attain the level of competency expected of a dental graduate, the student must first understand the:– structure and function of the normal cell and

the basic types of tissues comprising the human body;

– general principles of the etiology and natural history of disease processes.


CDA Standard


ADEA Competenchy



Domain-Topic List


Workshop – Proposed AgendaWorkshop – Proposed AgendaWelcome and Introductions Goals of the Workshop

Develop a strategy or producing discipline foundation knowledge statements.Integrate foundation knowledge statements to the clinical competencies.

Keynote SpeakersWorking SessionsRoom 1 – Part I Disciplines Room 2 – Part II Disciplines

Anatomical Sciences PharmacologyMicrobiology Operative DentistryPathology ProsthodonticsBiochemistry OrthodonticsPhysiology PedodonticsDental Anatomy and Occlusion Periodontics

• Endodontics• Oral Pathology/Radiology• Oral Surgery/Pain Control• Behavioral Sciences• Dental Public Health• Occupational Safety


CDA Standard


ADEA Competenchy



Domain-Topic List


NDB – P2 - EndodonticsNDB – P2 - EndodonticsENDODONTICS (27)

I. Clinical Diagnosis, Case Selection, Treatment Planning, and Patient Management (6)

A. PulpalB. PeriradicularC. PeriodontalD. Non-odontogenicE. TherapeuticsF. Clinical examinationG. Testing proceduresH. Radiographic interpretationI. Medical emergencies


BFKBFK• In order to proceed to the specific foundation knowledge necessary to attain

the level of competency expected of a dental graduate, the student must first understand the:

• structure and function of the normal cell and the basic types of tissues comprising the human body;

– structure and function of cell membranes and the mechanism of neurosynpatic transmission;

– major anabolic and catabolic pathways for proteins, carbohydrates, and lipids;– mechanisms of biologic energy transduction;– role of nucleic acids, DNA and RNA, in heredity and metabolic regulation;– structure of the human body in general and the craniofacial (head and neck)

region in particular;– structure and function of sensorimotor pathways of the central nervous system;– basic structure and function of the major organ systems of the body;– basic principles of pharmacokinetics;– fundamental properties of the major groups of microorganisms;– function and dysfunction of the immune system;– general principles of the etiology and natural history of disease processes.


SFKSFK

• The following SFK is integral to obtaining clinical competency. The student, therefore, must understand the:– basic principles of nutrition and its importance in health and

disease;– role of enzymes in bodily functions;– chemical components of normal blood and its role in the

diagnosis of disease;– structure, function, and metabolism of collagen, proteoglycans,

and other proteins in connective tissue, including bone, dentin, and cementum.

– calcium and phosphorus metabolism, including the formation of biological hydroxyapatite and its role in the mineralization that occurs in the hard tissues of the human body;

– sources of vitamins and their role in dental disease;


SFK – Cont’dSFK – Cont’d

• SFK Continued– process of tooth development of both the primary and

permanent dentitions;– normal structure of teeth and supporting structures, including

enamel, dentin, pulp, and cementum;– normal structure of the periodontium;– structure and function of the major muscles of mastication and f

acial expression;– structure and function of the temporomandibular joint, including

major and accessory ligaments and muscle attachments;– anatomical and functional relationships of clinical and surgical

landmarks of the oral cavity and contiguous regions;


SFK – Cont’dSFK – Cont’d

• SFK Continued– mechanism of pain modulation;– structure and function of salivary glands, including the

production, secretion, content, and function of saliva;– microflora of the oral cavity;– components of and formation of dental plaque and its role in the

etiology of dental caries and periodontal disease;– role of specific bacterial groups in the production of dental caries

and periodontal disease;– role of bacteria in production of pulpal and periapical pathology;– role of the immune system in the pathogenesis of periodontal

disease and the effective of immunization in the prevention of dental infection;

– impact of systemic diseases on the treatment of dental patients;


SFK Cont’dSFK Cont’d

• SFK Continued– modes of action of the major classes of antimicrobial drugs and the

mechanisms by which microorganisms become resistant to some drugs;– the proper methods for taking and submitting a clinical specimen for

submission to a diagnostic microbiology laboratory and how to interpret the reported results;

– various modes of infection control;– mechanisms of inflammation and tissue repair;– mechanisms and systemic repercussions of fluid and hemodynamic

derangements;– concept of neoplasia and the clinical features of the most commonly

encountered neoplastic conditions;– mechanisms, clinical features, and dental implications of the most

commonly encountered metabolic systemic diseases;– principles of genetic transmission of inherited diseases and their clinical

features.


BS-BCR-D/T ListBS-BCR-D/T List

• Gross Anatomy (excluding material taught in Head and Neck)– Blood and lymph vascular systems (MPS/RES)– Neuroanatomy/neuroscience

• Head and Neck Anatomy (excluding material taught in Gross Anatomy– Blood and lymph vascular systems– Connective tissues– Neuroanatomy– Special senses– Craniofacial growth and development

• General Anatomy – Microscopic– Blood and lymph vascular systems– Connective tissues– Neuroanatomy

• Oral Histology– Teeth (development and structure)– Supporting structures


BS-BCR-D/T ListBS-BCR-D/T List• Biochemistry

– Cell biology– Nucleotides, DNA, RNA, replication, synthesis– Body fluids and acid-base balance– Blood clotting mechanisms– Biochemistry of specific dental interest (calcified tissues, fluorides, plaque, calculus, caries, saliva,

periodontal disease, pain)• Microbiology

– Microbial physiology, metabolism, and structure– Cultivation of microorganisms– Antimicrobial chemotherapy– Microbial infections– Sterilization, disinfection, and asepsis

• Immunology– Immune responses– Antigen-antibody reactions– Antibody structure and function– Complement– Allergy and hypersensitivity– Antibody mediated and cell-mediated reactions– Non-specific and specific host defenses in the oral cavity


BS-BCR-D/T ListBS-BCR-D/T List

• Pathology – general– Basic cellular and vascular pathology processes– Inflammation and repair (including immunopathology)

• Pharmacology– Pharmacodynamics– Drug laws and prescription writing– Autonomic nervous system– Central nervous system (including analgesics and local anesthesia)– Cardiovascular (including agents affecting coagulation)– Clinical pharmacology in dentistry– Adverse interactions of drugs

• Physiology– Basic nerve, muscle and membrane potentials– Cardiovascular– Nervous system (ANS, somatosensory point system, motor function, special

senses, higher brain functions)– Oral physiology


CS-BCR-D/T ListCS-BCR-D/T List

• Anesthesiology/pain and anxiety control– Local anesthesia techniques– Intravenous analgesia – anesthesia indication/techniques– Nitrous oxide analgesia indication/techniques– Hypnosis and acupuncture

• Dental materials science– Materials used intraorally– Materials used extraorally (gypsum products, polishing agents used outside

the mouth, etc.)• Dental emergencies

– Acute oral pain– Acute oral infection– Acute traumatic injury– Post-operative complications (excluding oral surgery complications)

• General medical emergencies– Drug reactions and anaphylaxis– Cardiopulmonary emergencies


CS-BCR-D/T ListCS-BCR-D/T List• Pathology – Oral

– Oral injuries and repair– Oral aspects of specific tissues or organs (including bone, joints, blood, skin, nerve, and muscle)– Oral medicine, clinical evaluation of differential diagnosis/disorders of diseases of dentition and periodontium– Clinical evaluation differential diagnosis of disorders/diseases of the soft tissue and bone

• Physical evaluation/data collection– Vital signs

• Tooth morphology– Permanent dentition– Pulpal morphology

• Endodontics– Pulpal biology– Non-surgical endodontics– Surgical endodontics

• Oral diagnosis (treatment planning, oral medicine)– Examination of head, neck, and oral soft tissues (excluding radiographic examination)– Diagnosis, treatment alternatives– Clinical examination of dental and periodontal tissues (excluding radiographic examination)– Treatment planning for disorders/diseases of the dentition and periodontium– Treatment planning for disorders/diseases of the oral soft tissues and bone

• Radiology (roentgenology)– Intraoral radiographic techniques– Interpretation of radiographs

• Behavioral/social sciences principles of dental practice– Patient management

development of foundational knowledge guidelines and revision and

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