University of Manitoba - Faculty of Dentistry - Information and New Initiatives

Information and New Initiatives

"Traditions of Excellence: Horizons of Change" not only represents our proud and accomplished history but also describes our vision for the future. As the Faculty of Dentistry pursues the "Drive for Top Five" it seeks to establish a reputation as an innovator in dental education. This requires that we develop and implement opportunities for our students to become outstanding oral healthcare practitioners and life-long learners, continuously improve our educational and patient services environments, and constantly challenge ourselves to be the best we can be.

This "Information and New Initiatives" section provides an archive of the Department Head Council meeting agendas/synopsis, information related to the Academic Structure Initiative within the Health Sciences Cluster, and updates regarding specific projects underway within the portfolio of the Dean and Associate Deans.

The information and visions for change are presented as part of an iterative process that is all-inclusive. We welcome your feedback and ideas; we will also be engaging in various area and town hall meetings to further discuss these emerging issues. Please do not hesitate to contact us with suggestions, ideas, or concerns:

Dr. Doug Brothwell, Associate Dean Academic
brothwel@cc.umanitoba.ca

Dr. Mel Sawyer, Associate Dean Clinical
sawyerm@cc.umanitoba.ca

Reference: DHC Agendas &: DHC Summary of Meetings

Visions and Potential Areas of Change

Student Tardiness Strategy
Please click on the above link to access a Planning Document outlining the consultation process and the "Final Draft" of a strategy to help students arrive on-time for class/lab. Implementation date for the pilot strategy is January 7, 2013.

Curriculum and Clinic Operations

Fall Mini-Term

Please click on the above link to access a Planning Document outlining the consultation process and “Draft #3" of a strategy to help decompress our curriculum by creating a Mini-Term at the beginning of the dentistry academic year. This document has been posted for the purpose of communication and consultation, and to give everyone an opportunity to provide input into the direction we proceed on this issue. Please send your input directly to Doug.Brothwell@ad.umanitoba.ca.

Interdisciplinary Case Studies Course: In response to student feedback, this fourth-year course will be rewritten to incorporate and place more emphasis on regularly scheduled small group learning sessions where discussion of treatment plans, informed consent, ethical dilemmas and other issues arising out of patient clinical care will take place. Cases will be followed throughout the year with discussion centered around the progression of the cases. The course will continue to address and assess student abilities in communication, informed consent, and evidence-based practice, but do so with a less onerous assignment workload.

Patient Screening, Selection/Assignment and Urgent Care: In order to help streamline our patient intake, thought is being given to having specific faculty members responsible for patient screening in the main clinic (screening not to be confused with proper history and examination). Patient assignments would be coordinated by our patient management administrator following screening and a patient ‘needs assessment’ by our screening faculty. Students who in the past had been participating in screenings would be rotated through Oral Medicine Specialty faculty members to gain a meaningful and a more calibrated experience related to patient history and examination. Urgent care clinics would be run in the main clinic area, with students being placed on a regular rotation through urgent care where these patients would be seen.

To best ensure that multiple stakeholders have input into decisions made on this issue, the Ad Hoc Committee for Patient Screening, Treatment; Planning, and Urgent Care was formed. This Committee is tasked with considering the need for, and subsequent directions for change in the Faculty's current systems in this area, and will advise the Dean, and Dental Faculty Council on its findings. _{(The following articles posted: Nov, 2011)}

Definitions: Screening, Diagnosis, Treatment _{[pdf 1 p. 29 kb] 11.16.2011}
Needs, Principles and Goals _{[pdf 1 p. 28 kb] 11.29.2011}
Terms of Reference _{[pdf 2 pp. 87 kb] 10.04.2011}
- Reference Ad Hoc Committee for Patient Screening, Treatment; Planning, and Urgent Care Meetings - Synopsis - pdf files

Group Managers: We are hoping to implement 2-3 “group managers” to support and mentor our students as they move through their clinical years. The managers would be experienced faculty members who would be involved in a number of processes:

Monitor student progress/clinical experience and work with our patient management administrator to help in the assignment of new patients and transfer of existing patients to optimize the breadth of the student clinical experience and the efficiency of patient services.
Help maintain and review students’ patient lists to provide quality assurance in patient care and student experience.
Hold regular group and individual meetings to discuss different issues that may arise in the clinical years.
Act as a liaison between students, patients and other faculty members (including instructors and support staff).
Assist in treatment development and planning outside of clinic sessions.
Conduct chart and patient audits to ensure quality assurance of treatment.
Not be responsible for assignment of any grades, but report any issues of concern to Clinic Director or Associate Dean, Clinics.

Restructuring of Existing "Oral Diagnosis Clinic: Transform the existing OD space into a "specialty clinic" area encompassing many disciplines such as Oral Medicine and Pathology, TMD and Sleep Disorders, Oral Implantology, CAD/CAM and "high tech" dentistry clinic. These may be accommodated through rotations of 10 available sessions/week. It is also possible that a Graduate prosthodontics Program may eventually be developed.

Electronic Health Record: Our vision is to increase and maximize the use of the AxiUm program to its fullest potential, eliminating duplication and loss of valuable time. While it is recognized that the goal of going "paperless" may be a long-term, the more modest goal of "less paper" can certainly be a reality in the short-term, and built upon each year.

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Kit and Dental Stores: The transition of the kit as we know it to reflect which items in a kit should be considered student-owned items is well underway. A concurrent pre-clinic/clinic education fee will allow for some overall student cost savings as well as help to streamline our instrument sterilization and reprocessing protocol to better facilitate student access to instruments for patient care. Dental stores will cease to become a “dental reselling depot” and act as a “just-in-time” conduit of dental instruments and supplies from the supplier/manufacturer to the end user. This “virtual warehouse” concept will allow for next day delivery of instruments, sundries and supplies at existing low costs and essentially no shipping costs. Students would still be able to access needed supplies on an ad-hoc basis, but will be billed directly to their student accounts for any consumable items or instruments used that fall outside of what is typically needed for their pre-clinical/clinical education.

Service Lab: It is our vision to restructure the “service lab” to a model that reflects one of a commercial lab. With the help of a support staff coordinator (allows more time for Ken, our expert technician, to do what he does best in the realm of top quality lab work and teaching), all incoming and outgoing cases will be vetted through the lab for quality assurance and either done in-house or sent out for part or total fabrication. Lab work will be billed appropriately to reflect to the student the true cost of the case.

Curriculum Decompression: An important goal for the Faculty is to find methods to effectively distribute the overall work burden experienced by students while maintaining or improving their educational attainment. In order to achieve this goal, we are looking to identify and reduce/eliminate unproductive student work. Targets for change may include:

student “busy-work” (i.e., student involvement in patient screening)
unnecessary course content duplication
teaching beyond the ACFD competencies
excessive lab work
combining assignments from 2 courses so as to meet the requirements of both

Three Clinic Sessions per Day: One of our visions is to change the fact that the number of clinic sessions available to our students is currently determined by the number and availability of dental chairs in the Undergraduate Clinic. To address this, we are working towards piloting one day per week where there would be 3 clinic sessions during the day. The logistics of this suggestion are considerable and will require input from individuals from each of the many areas involved. We will form an ad-hoc working group to discuss and detail a subsequent plan for Faculty consideration. As an example, here is what a 3-session day could look like:

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8:00-11:00 DH2 Classes	D3 Clinic 27 chairs	D4 Clinic 27 chairs	54 chairs*
11:00-11:30
11:30-2:30 DH2 Clinic 13-22 chairs	D3 Classes	D4 Clinic 27 chairs	40-49 chairs
2:30-3:00
3:00-6:00 DH2 Clinic 13-22 chairs	D3 Clinic 27 chairs	D4 Classes	40-49 chairs
Note: 65 chairs available in clinic. Additional chairs can be filled by pink card, D1, D2, and DH1 classes.

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Use of technology in teaching: An important goal for future effort includes ensuring that instructors make effective use of technology in their teaching. One important target for effort in this area will be for ALL instructors to host their courses on-line using Angel. Our goal is 100% of courses online in 3 years.

Policy on Industry/Corporate Interactions with Faculty and Students: Effort is currently underway to draft a document, for consideration by Faculty, to act as a guide to appropriate interaction between faculty members, students, and corporate/industry partners. It is envisioned that once approved by DFC, this policy will guide appropriate corporate/industry interactions related to research, education, and potential conflict of interest.

Having GP Instructors Lead GP Clinic: One of our visions is to create graduates who, immediately upon graduation, are able to function effectively in the GP role. To better facilitate this vision, we wish to change the current system where specialists have a primary role in approving and guiding patient care to one where generalists assume this primary role. Under the envisioned system, specialist consults will be limited to cases where a reasonably prudent GP would be expected to seek a consultation. The student will be expected to initiate the consultation and access it through a written consultation request. The specialist’s input in these cases will be provided in writing but the final decisions regarding appropriate treatment will be made by the student in consultation with the supervising GP instructor. Instructor calibration would be a key component of this concept. Mandatory calibration would be required for all instructors so that they would be familiar with course/treatment modalities and expectations, working knowledge of all aspects of the EHR and record keeping, Medical/ Dental histories, complete examinations, radiographic interpretation and making referrals as needed, treatment option lists, treatment planning, patient informed consent, and treatment supervision with meaningful formative assessments.

Student Infection Prevention and Control System: We are looking to establish a new system for assessing student knowledge and compliance with our infection prevention and control system. We are looking to implement this system in the pending 2011-2012 academic year.

NDEB Preparation: One important vision we have is to better prepare our students for success on the NDEB exams. Several issues are under consideration to facilitate this including establishing an on-line and on-demand mock written board examination that incorporates the 6,000 NDEB released questions with our in-house questions submitted by instructors. Envisioned is a system where, upon student request, the on-line program generates a practice (mock) examination of 150 questions. Students would choose between a formative examination, where they receive feedback immediately after each question, or a summative examination where they receive feedback after completing the entire exam. We will also look to establish an online OSCE examination following the format of the Dalhousie on-line OSCE (http://www.dentistry.dal.ca/NDEB_OSCE/)

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Objective Student Evaluation: Arguably the most important thing being targeted by the Associate Dean Academic is the issue of subjective student evaluation. It has become increasingly clear that the perception of subjectivity is a major cause of student and alumni dissatisfaction. As part of an ongoing curriculum review process, we will be working to ensure that appropriate objective grading rubrics are created and used for all student assessment, both didactic and clinical. Please note that the following example is NOT considered to be an objective grading rubric as it retains subjectivity in what constitutes “expectation”:

1	2	3	4

Does not meet expectation	Minimally meets expectation	Meets expectation	Exceeds expectation

Revise Requirement System: Our students have clearly communicated to us the fact that the existing “requirement-based” system forces them to prioritize care and appointments to patients who best help them achieve requirements. They are unhappy that this is done at the expense of other patients, to an extent that it may be considered by some as patient neglect. Regardless, we can do better and our students and patients deserve better. Under the newly proposed “group manager” system, we will be able to move to a “completed treatment” system where each student is expected to complete the treatment on all patients assigned to him/her. It is then a “group manager” duty, and not a student duty, to ensure that each student is assigned a patient load that includes the required range of patient needs to equal our current requirements system. The student’s duty is simply to complete all treatment.

Instructional Excellence System: We are working towards a new system to help ensure instructional excellence at the Faculty. The envisioned system will integrate curriculum design and monitoring with instructor evaluation and development. A set of key performance indicators will be used as objective indicators of a successful educational system, and a set of educational best practices will be defined for use within the Faculty. The new system will look to supplement our existing instructor evaluation that relies exclusively on student input, with expert and peer evaluation. These sources will be used to establish professional development sessions to further enhance instructor effectiveness. The following draft pie chart demonstrates the intended flow starting from the 1:00 position.