Student Dentists

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Project Objectives/Competencies

In designing the individual case modules included in this program, our goal has been to teach several core objectives regarding treating persons with developmental disabilities in a health care environment. While in many ways these are similar to the objectives that are taught student dentists for the treatment of any patient, we believe that they bear specific relevance to the needs of persons with disabilities.

Competencies for the Pediatric Module (Hunter)

Student Dentist Cognitive Competencies The student dentist/dentist will:	Notes/Comments
1. Characterize the physical, cognitive, emotional and oral circumstances typically associated with a child having Down syndrome.	Note how the dentist in the Hunter module demonstrates competency in an exceptional manner. It is imperative for the dentist to become thoroughly educated concerning the issues of children with special needs.
2. Communicate effectively with parents about how the child’s overall health status affects the provision of dental care.	The dentist in the Hunter module takes the time to investigate pertinent medical history with Hunter’s dad and explain the reasoning behind antibiotic prophylaxis.
3. Communicate effectively with parents on how the child’s disability impacts the course of care for the child.	In the Hunter module, the dentist stresses to the father the need to be aware of any signs of wear on Hunter’s teeth due to bruxism. The dentist also stresses to the dad the importance of ensuring good oral hygiene with Hunter.
4. Communicate effectively with parents about how the child’s emotional and cognitive development affects the provision of dental care.	Note in the Hunter module how the dentist does not prematurely suggest sedation for Hunter, but rather takes the time to investigate Hunter’s social and cognitive development with Hunter’s dad.
5. Effectively query the parent as to what approaches to gaining cooperation from the child have been found to be effective.	Note how the dentist interacts with Hunter’s father throughout the module, enlisting his aid in understanding the best way to gain Hunter’s cooperation.
6. Prepare his/her practice staff for the care of the child with special needs.	Observe as the dentist in the Hunter module educates his dental assistant concerning what she may expect in caring for Hunter - an intervention which, in effect, increases comfort for all involved.
7. Prepare for initial diagnosis of a child with special needs.	Note how the dentist carefully takes Hunter’s history to determine overall status of dental health, critical to making a plan of care at this initial visit.
8. Employ effective management techniques to gain a child’s cooperation and provide the required care.	In the Hunter module, note how the dentist participates in this process by effectively building working rapport with Hunter.
9. Appropriately prepare the child for what is coming next during the course of treatment.	Note how the dentist deals with this issue in a sensitive manner by explaining each step of the dental visit to Hunter via the “tell, show, and do” technique.
Student Dentist Attitudinal Competencies The student dentist/dentist will:	Notes/Comments
1. Be sensitive to and empathic with the unique circumstances and issues of the parents and children with special health care needs.	Again, note how the dentist in the Hunter module fosters Hunter’s participation in his own oral hygiene while conveying respect to Hunter’s father concerning the difficulties he has expressed in achieving this.
2. Routinely provides care for children with special needs in his/her practice.	Notice the obvious comfort level displayed by the dentist in the Hunter module - this speaks to his level of experience in providing care to children with special needs.
3. Actively seek to expand his/her knowledge and skills in providing care for individuals with special needs.	Completion of interactive training materials such as the Hunter module increases both the awareness and skills necessary to provide competent, empathic care for children with special needs.

Competencies for the Adult Module (Daniel)

Student Dentist Cognitive Competencies The student dentist/dentist will:	Notes/Comments
1. Characterize the communicative, social, and sensory circumstances typically associated with an individual having one or more sensory impairments (e.g., vision, hearing, or deafblindness).	Observe as the office staff in the Daniel module demonstrate proper orientation and mobility techniques with Daniel. Additionally note the application and use of an FM hearing system in the context of the visit.
2. Communicate effectively with a patient with sensory impairments about how the patient's overall health status affects the provision of dental care.	Note the interaction as the dentist takes a careful health history and investigates current medications which may influence treatment.
3. Identify the appropriate role for a personal care assistant in providing support to the individual with sensory impairments.	Observe as the dentist is careful to ask Daniel his preferences concerning the presence and/or assistance of the personal care assistant throughout the visit.
4. Effectively query the patient as to what approaches have been most effective in establishing accurate communication.	Notice as the dentist and Daniel discuss previous interactions in the dental setting, and what has worked and not worked in the past.
5. Prepare his/her practice staff for the care of the adult with sensory impairments.	The dentist is careful to educate the dental assistant who will be assisting in Daniel's treatment before the visit.
6. Prepare for initial diagnosis of an adult with sensory impairments.	Observe as the dentist thoughtfully conveys his exam findings to Daniel using a tactile demonstration.
7. Employ effective management techniques to provide care and maximal comfort for the patient with sensory impairments.	The dentist and his assistant convey sensitivity to Daniel's unique concerns by keeping him informed of their physical location, use of tactile demonstrations, and appropriate demeanor.
8. Appropriately prepare the patient for what is coming next during the course of treatment.	Notice that the dentist and his assistant are careful to keep Daniel informed, with both verbal and physical cues, as the visit progresses to treatment.
9. Make appropriate modifications in communication approaches/ interviewing techniques to take a thorough dental and health history with the patient having sensory impairments.	Observe that the dentist follows Daniel's cue on whether or not he desires the presence of his personal assistant during the history/interview. Also note how the dentist gathers information on how Daniel's FM system operates and how that will impact care.
10. Effectively explore issues of guardianship, where applicable, to secure appropriate consent for treatment.	Notice in the video that the dentist does not assume that Daniel is incapable of signing the consent for treatment for himself.
11. Effectively insure that patients with sensory impairments understand post-visit instructions and follow-up care.	The dentist takes extra time to carefully explain instructions to Daniel, as well as demonstrate proper brushing technique. The dentist also offers to email post-visit instructions, so that Daniel may Braille these.
12. Effectively address orientation/ navigation issues within the dental office/operatory setting.	Observe in the module that the dental assistant demonstrates the proper way to offer mobility assistance to a patient with blindness (i.e., sighted guide technique).
Student Dentist Attitudinal Competencies The student dentist/dentist will:	Notes/Comments
1. Be sensitive to and empathic with the unique circumstances and issues of patients with sensory impairments.	Notice in the module that the dentist takes the time to prepare his assistant about both communication and orientation/mobility concerns before they begin Daniel's visit.
2. Routinely provide care for the needs of individuals with sensory impairments in his/her practice, and recognize the need for extended time for visits and appropriate scheduling.	The attentive attitude and demonstrated skill of both the dentist and assistant in caring for Daniel may encourage him to return for much needed regular checkups.
3. Actively seek to expand his/her knowledge and skills in providing care for individuals with sensory impairments.	The dentist's performance during Daniel's visit suggests adequate preparation for providing appropriate care to individuals with sensory impairment.
4. Demonstrate strategies to allay fear and apprehension in the adult patient with sensory impairments.	Observe as the dentist carefully works out a system of nonverbal communication with Daniel to use for conveying discomfort prior to beginning treatment.