Clinical - Dental Hygienist III Syllabus for 2011-2012
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Instructor Information

Office Location

West Campus Jones Hall 135

Office Hours

Wednesday 11-3 and Friday by appointment

 Appointments can be made at other times if needed.  Please contact either the supervising dentist or the clinic manger through email to set up a time.

Communication

The best way to contact all instructors is through email. We will check our emails Monday-Friday first thing in the morning and throughout the day as time allows. We will respond to your email within 24 hours.We will answer emails sent over the weekend the following Monday morning. Please remember the use of netiquette when corresponding with all faculty, staff, and peers.

Course Information

Recording Policy

Disability Statement

Any student who, because of a disabling condition, may require some special arrangements in order to meet course requirements should contact disAbility Services (Student Service Center room 119, phone 371-5436) as soon as possible.

Statement for Mental Health and Advocacy & Resource Center:

As a student you may experience a range of issues that can cause barriers to learning, such as strained relationships, increased anxiety, alcohol/drug problems, feeling down, difficulty concentrating and/or lack of motivation. These mental health concerns or stressful events may lead to diminished academic performance or reduce a student's ability to participate in daily activities. Amarillo College offers services to assist you with addressing these and other concerns you may be experiencing. If you or someone you know are suffering from any of the aforementioned conditions, you can learn more about the broad range of confidential mental health services available on campus by calling the AC Counseling Center at 806-371-5900. The AC Counseling Center website is https://www.actx.edu/counseling/ . Also, if you are in need of social services (affordable housing, utilities, transportation, food, clothing, childcare, medical/dental/vision, legal), please call the AC Advocacy & Resource Center at 806-371-5439. The AC Advocacy & Resource Center website is https://www.actx.edu/arc

Amarillo College Tutoring for Success Policy:

Administrative Drop Policy

N/A

Student Withdrawal Procedures

N/A

Privacy Statement

The Amarillo College Privacy Policy is found at https://www.actx.edu/-amarillo-college-privacy-notice , and applies to all Amarillo College students.  If you have questions about this privacy statement or you believe that your personal information has been released without your consent, send email to humanresources@actx.edu .

Course

DHYG-2360-001 Clinical - Dental Hygienist III

Prerequisites

Prerequisites: DHYG 1261

Course Description

A health-related work-based learning experience that enables the student to apply specialized occupational theory, skills and concepts. Direct supervision is provided by the clinical professional.

Student Resources Student Resources Website

Department Expectations

\N

Occupational License Disclaimer

Hours

(3 sem hrs; 18 clinic)

Class Type

On Campus Course

Syllabus Information

Textbooks

\ 1.  Current copy of Amarillo College Dental Hygiene Program Manual

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\ 2.  Patient Assessment Tutorials:  A Step By Step Guide for the Dental Hygienist, 2nd edition, Jill Neild-Gehrig; Lippincott, Williams & Wilkins

Supplies

\ Each student will furnish his/her own instruments and disposable supplies.

Student Performance

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\ Course Prerequisites

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\ DHYG  1261

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\ Course Description

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\ A health-related work-based learning experience that enables the student to apply specialized occupational theory, skills and concepts.  Direct supervision is provided by the clinical professional.  (3 sem hrs; 18 clinic)

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\ End-of-Course Outcomes

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\ As outlined in the learning plan; Apply the theory, concepts, and skills involving specialized materials, tools, equipment, procedures, regulations, laws, and interactions within and among political, economic, environmental, social, and legal systems associated with the occupation and the business/industry and will demonstrate legal and ethical behavior, safety practices, interpersonal and teamwork skills, and appropriate written and verbal communication skills using the terminology of the occupation and the business/industry.

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\ Course Meeting Days and Times

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\ Clinic: Monday & Wednesday 8:30-5:00 pm

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\ Tuesday, Thursday & Friday 8:30-12:00pm

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\ Jones Hall

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\ Dental Clinic Room 112

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\ Afternoon Report

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\ Wednesday 3:00-5:00pm

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\ Jones Hall

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\ Room 111

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\ Course Instructor

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\ Name:  Amanda Lester Chisum RDH, B.S.

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\ Office Location:  Jones Hall, Room127

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\ Office Phone:  (806) 354-6062

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\ Campus E-Mail: ajlester21@actx.edu

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\ Office Hours:  Tuesday & Thursday 1:00-2:00

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\  Friday by appointment

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\ Additional Faculty

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\ Nikki Darrah, RDH

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\ Madeline Borecki, DMD

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\ Erica Brassfield, RDH

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\ Donna Cleere, RDH, M.Ed.

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\ Jnita Collins, RDH, B.S.

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\ Jack Fong, DDS

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\ Gregory Harrison, DDS

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\ Bob Fowler, DDS

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\ Lynette Hayhurst, RDH, B.S.

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\ Mike Henderson, DDS

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\ Karen Lester, RDH, B.S.

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\ Jane McFarland, RDH, B.S.

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\ Pattie Shaffer, RDH  

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\ Method of Instruction

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\ In the clinic setting the ratio of faculty to students never exceeds 1:5.  Individual feedback will be provided for students verbally and in written form.  Direct observation will be utilized through process performance evaluation, while indirect observation will be used in end-product evaluations.

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\ Afternoon Report will be held each week to allow discussion of clinical issues, present additional clinical procedures, as well as, review previously presented procedures.  The forum setting is mandatory.  Student s will be counted absent for the entire day when the student does not attend clinic forums.  A student will be counted absent if he/she is not administered during Afternoon Report.

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\  Clinical Dental Hygiene 

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\ Clinical Dental Hygiene is that portion of the dental hygiene curriculum focused on developing the cognitive, affective, and psychomotor skills necessary for the delivery of preventive, educational, and therapeutic services to the public.  The delivery of comprehensive care is accomplished through adherence to the process of care: assessment of patient needs, formulation of a dental hygiene diagnosis, planning for the prevention and treatment of oral disease, implementation of various dental hygiene interventions (services) and evaluation of both the patient and practitioner efforts and oral health outcomes.

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\ Definitions

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\ A.    Preventive Services:  Clinical methods employed by the clinician and/or patient to promote and maintain oral health.

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\ B.    Educational Services:  Strategies developed for an individual or for groups to elicit behaviors directed toward health.

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\ C.    Therapeutic Services:  Clinical treatment designed to arrest or manage disease and maintain oral tissues in health.

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\ D.  Process of Care:  Systematic approach to the delivery of dental hygiene care that supports comprehensive services to meet the individual needs of all patients.  The process of care requires defined problem solving and critical thinking skills and supports evidenced-based decision-making.

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\ E.    Dental Hygiene Diagnosis:  A statement of potential or actual patient need that can be addressed by dental hygiene intervention services or strategies.

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\ F.    Pre-Clinic:  That portion of clinical education during which the student does not have direct and primary responsibility for providing comprehensive dental hygiene care to a patient.  The student performs selected services on a patient, a partner or a laboratory manikin, but does not necessarily provide a full range of services.

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\ G.    Clinical Dental Hygiene:  The major portion of clinical education.  As primary provider, the dental hygiene student integrates preventive, educational, and therapeutic care in treating the patient.

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\ H.    Fundamental Clinical Dental Hygiene Skills:  Skills routinely performed by the dental hygienist and/or taught to clinical competency in most dental hygiene programs and/or legal in most states.

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\ Clinical Dental Hygiene:  Primary Educational Goals

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\ Clinical Dental Hygiene experience provides preventive and therapeutic care according to the process of care;  assessment, dental hygiene diagnosis, planning, implementation and evaluation.  This requires critical thinking and evidenced-based decision making skills that guide the provision of dental hygiene care within a focused scope of practice.  Upon the completion of the clinical curriculum, the student will be able to:

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\ A.     Apply the process of care to preventive and therapeutic oral health management to a diverse patient population.

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\ B.     Assess and analyze objective and subjective patient findings to formulate an evidence-based,patient-centered dental hygiene diagnosis.

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\ C.     Plan, implement and evaluate intervention strategies that will promote and maintain oral health including oral self care behaviors.

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\ D.    Demonstrate knowledge of and skill in applying dental hygiene methodology of care.

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\ E.     Apply the principles of professional and ethical behavior in providing care to individuals of all populations.

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\ Course Goals

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\ Upon successful completion of Clinic III, the student will be able to:

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\ 1.  Improve efficiency and maintain quality when collecting and analyzing data and selecting, performing, and evaluating oral health procedures for clinical patients, based on the concept from DHYG 1261.

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\ 2.  Improve efficiency and competency in performing the additional clinical skills introduced in DHYG 2360-001

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\ Specific Learning Objectives

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\ 1.     Collect data, record and assess a comprehensive health history, including social history.

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\ 2.     Recognize conditions that necessitate special consideration prior to or during treatment.

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\ 3.     Perform and record extraoral and intraoral examinations, clinical and radiographic assessment of the periodontium and dentition, and assessment of occlusion.

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\ 4.     Assess the need for, expose, develop, evaluate and interpret dental radiographs to support the clinical examination.

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\ 5.     Employ radiation safety principles and procedures requiring exposure to ionizing radiation.

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\ 6.     Expose and implement intraoral photography.

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\ 7.     Formulate a dental hygiene diagnosis and supportive, patient-centered dental hygiene treatment plan and case presentation.

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\ 8.    Obtain informed consent by discussing with the patient his/her oral health findings, goals and treatment strategies.

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\ 9.     Value the importance of patient centered care and concepts of health promotion.

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\ 10.    Assess, plan, implement and evaluate a dental hygiene treatment plan for the prevention and/or treatment of oral diseases.

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\ 11.    Assess the need for and perform initial and supportive periodontal therapies.

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\ 12.    Assess the need for and perform therapeutic hand and ultrasonic/sonic periodontal debridement therapies.

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\ 13.    Perform care and maintenance of procedures for dental implants.

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\ 14.    Assess the need for and perform extrinsic stain removal procedures.

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\ 15.    Assess the need for and apply adjunctive topical chemotherapeutic and controlled released agents.

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\ 16.    Assess the need for and apply pain and anxiety management strategies.

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\ 17.    Assess the need for and plan professional topical fluoride and/or self applied fluoride; apply professional topical fluoride.

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\ 18.    Apply principles of nutritional and/or tobacco cessation counseling to the management of oral health.

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\ 19.    Take impressions for, pour, and trim study models.

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\ 20.    Assess the need for and place pit and fissure sealants.

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\ 21.    Assess, plan and perform patient oral self care education.

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\ 22.    Apply standard precautions for the prevention of disease transmission.

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\ 23.    Follow all state and federal regulatory requirements when rendering patient care.

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\ 24.    Apply principles of comprehensive record keeping.

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\ 25.    Apply principles of professional and ethical behavior when providing patient care.

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\ 26.    Apply principles of evidence-based decision making.

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\ 27.    Demonstrate critical thinking and problem solving skills when providing patient care.

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\ 28.    Demonstrate professional communication skills in all aspects of patient care.

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\ 29.    Demonstrate concern and understanding of a variety of patient needs based on overall health, oral health, cultural, social and economic circumstances.

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\ 30.    Recommend a recare schedule for continued supportive care.

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\ 31.    Recommend referral for additional assessment and/or treatment.

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\ 32.    Value the importance of evaluation and monitor patient oral health.

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\ 33.    Assess overall patient satisfaction with care provided.

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\ 34.    Value the need for maintenance of thorough and accurate records.

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\ 35.    Apply the principles for maintaining comprehensive and accurate records of all information and services offered to and provided to the patient.

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\ 36.    Self-assess ability to perform dental hygiene services at a high standard of care.

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\ 37.    Value patient confidentiality and patient rights according to HIPAA guidelines.

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Students Rights and Responsibilities

Student Rights and Responsibilities

Log in using the AC Connect Portal

In order to receive your AC Connect Email, you must log in through AC Connect at https://acconnect.actx.edu .

If you are an active staff or faculty member according to Human Resources, use "Exchange". All other students, use "AC Connect (Google) Email".

Expected Student Behavior

\ Student Conduct and Responsibilities

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\ A high standard of conduct is expected of all Amarillo College students.  The Student Code of Conduct is defined in the Amarillo College Student Rights and Responsibilities publication.  The document may be located at www.actx.edu under the student tab.

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\ "Amarillo College expects a high standard of conduct from its students.  Students are expected to comply with the law, respect proper constitutional authority, and obey College policies, rules and regulations.  Unacceptable conduct is defined as an action or behavior that is contrary to the best interest of a fellow student or students, the faculty or staff, the College, or the teaching/learning process.  Students failing to perform according to established standards may be subject to disciplinary action.  Policies, standards, rules and regulations apply to students attending College activities whether the activity takes place on or off campus.  Each student shall be responsible for becoming knowledgeable of the contents and provisions of College policies, rules, and regulations concerning student conduct.  In some cases, individual programs may have approved policies for student conduct which also apply to student conduct in those programs.  Integrity and common sense will guide the actions of each member of the college community both in and out of the classroom.  Any student who fails to perform according to expected standards may be disciplined."

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\ The Amarillo College Dental Hygiene Program has specific policies which apply to student conduct within the program.  These policies may be implied or written.  The course syllabus and the program manual are sources for specific student conduct policies for dental hygiene students at Amarillo College.

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\ Professional Standards

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\ The following are some factors which will be considered under professionalism.  Representative examples are given, but will not necessarily be limited to these examples.  The student is expected to demonstrate professional conduct and judgment.  Examples of positive professional conduct include:

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\ 1.     Student is prompt to Clinic/Rotation, both in the morning session and the afternoon session.

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\ 2.     Student is prepared for Clinic/Rotation Assignment.

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\ 3.     Student assumes responsibility for his/her own learning.

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\ 4.     Student is concerned with excellence in learning rather than just meeting minimal criteria.

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\ 5.     Student applies lecture material in the clinical setting.  The student will utilize the computer in the clinic to look up various diseases and medical conditions in which dental treatment may be altered.

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\ 6.     Student maintains his/her composure dealing with conflict in a constructive way.

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\ 7.     Student exhibits an attitude of respect for classmates, faculty, and staff.  If a student has a conflict with a grade given by  his/her instructor, the student must follow the grievance procedure as outlined in this      course syllabus.   Faculty will not change a grade given to a student from another faculty member.

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\ 8.     In order to maximum learning to occur, students should not be disruptive in the Clinic or Class.  Should this occur, the student will be asked to leave the Clinic immediately and receive an absence for the day.   Disciplinary action may also be taken.

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\ 9.     Student will not visit with other classmates during patient care.  Patients need your dedicated attention while receiving care. 

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\ 10.    Student will use the light system as well as Instant Messenger  in the Clinic to summon clinical instructors and assistants.

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\ 11.    Student will accept alternate assignments as needed and have an attitude of team spirit.  Teamwork is an essential component of the dental profession.

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\ 12.    Student will be responsible for broken or damaged equipment in the Clinic.

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\ 13.    Student will not leave the clinic before 12:00 noon or 5:00 pm without special permission from the clinical faculty.  Failure to receive faculty permission will result in an absence for the day and a 0 for the rotation, class and/or clinic assignments. Remember:  all student s must correctly log in and out of the computer each day for an accurate record of attendance.  Failure to do so will result in an absence for the day.   member supervising in his/her  clinic bay.  Should this occur, the student will receive an absence for the day.

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\ 14.  If a student has placed a "hold" on his/her clinic schedule, the Office Supervisor will schedule a patient if the "hold" is not filled two days prior to the appointment.  As in any dental practice, the office supervisor is responsible for keeping the appointment book filled.  Amarillo College is no exception.

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\ Professional Behavior Around Patients

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\ First and foremost confidentially and compassion are at the cornerstone of care.  Students are not to discuss private information regarding their patient with classmates.  Patient information relevant to patient care is only to be discussed with the supervising faculty and/or the attending dentist.  All patients should be treated with the utmost professional respect.  In turn, any inappropriate behavior demonstrated by patients should be immediately brought to the supervising faculty's attention. 

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\ As a matter of courtesy, patients should be addressed by their last name.  Students must be professional in his/her choice of language around patients.  Students must be professional and courteous at all times with patients, fellow students, staff and faculty.  Personal conversations with classmates must be keep to a minimum.  Students should avoid comments such as, "I've never seen this much calculus!" and "I've never used the air polisher".  If a student is unsure about a procedure, students should not discuss insecurity in front of the patient.  Students should discreetly speak with their faculty away from the chair.

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\ Quality Assurance of Patient Care
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\ Mechanisms utilized for assuring quality of dental hygiene care to the patient:
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\ 1)  Check in/out, evaluations and periodontal re-evaluations
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\ a.  Patient Confirmation - Patients are confirmed the day before the appointment.  Students should ask the patient about premedication needs and current medications.  Patients should be instructed to bring a list of the actual medications he/she is taking to the appointment with them.  This should include any prescribed,  OTC or herbal remedies.  The list should include the name, dosage and the amount of medication he/she is taking at the present time.
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\ b.  Attendance and Tardiness - All students are required to log in to the computer in the clinic no later than 8:45 am  for the morning clinic and no later than  12:45 pm  for the afternoon clinic.  Patients may be seated as soon as they are checked in by the front office.  Students' tardiness and/or absenteeism for clinic assignments, rotation assignments  and afternoon report will be monitored and recorded and will count toward the final grade. 
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\ c.  Medical History - Students must have faculty approval prior to beginning any treatment.  All medications must be referenced.  A Mosby's drug reference text or a current PDR may be utilized.  Students must be able to report to the clinical faculty what drug(s) the patient is taking, what it is utilized for, any oral manifestations as a result of taking the drug, and contraindications to dental treatment if applicable.
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\ d.  An Intra-oral and Extra-oral Exam will be performed on all patients with documentation of the findings in the patient record. 
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\ e.  Assessment - All patients will receive a full-mouth probing (with the exception of children under 18 unless indicated).  At the conclusion of the assessment interval, the student should determine a dental hygiene diagnosis and a patient-centered treatment plan to present to the faculty during the assessment phase of check in (process evaluation). 
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\ f.  Scaling - Students are expected to scale all teeth, debride, and remove all calculus and plaque.  Sharpening instruments before and/or during scaling is encouraged.  Extra-oral fulcrums may be utilized in Clinic III and Clinic IV.  End-product evaluations are utilized to assess calculus and plaque removal. 
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\ g.  Stain Removal - Students are expected to assess each patient's need for stain removal.  Air polishing can be employed in circumstances when polishing is indicated, not just for heavy stain.  Make sure no contraindications exist for air polishing such as hypertension, low sodium diet, kidney disorders etc.
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\ h.  Fluoride - Students should provide fluoride therapy at the end of each appointment as indicated.  First, dry the teeth with air, place tray in the mouth and evacuate excess saliva and fluoride with a saliva ejector.  Patients should never be left unattended during the fluoride treatment (especially young children).  Patients should be instructed to not eat, drink or rinse for 30 minutes.   
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\ 2).  Conclusion of the Appointment - Students must conclude patient treatment no later than 11:30 am, 3:30 pm unless given special permission by clinical faculty. 
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\ a.  Progress notes should be completed.  Progress notes should be comprehensive utilizing correct grammar and spelling.  A recall interval for a patient is established at the conclusion of the appointment with consultation from the faculty and student input.
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\ b.  Recall intervals are established according to the individual needs of the patient.  The patient is informed of his/her recall interval.
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\ c.  Patients must complete a Patient Survey before he/she is dismissed from the Clinic.   
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\ 3).  Tracking and Student Progress - Student progress is tracked by the Clinic Coordinator through mid-semester and final clinic progress meetings, as well as individual meetings requested by students throughout the semester.   Student progression toward his/her clinical requirements is noted on a clinical progress sheet handed out to each student throughout the semester.
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\ Statement of Confidentiality

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\ Confidentiality is the duty owed by dental hygiene professionals, including students enrolled in Dental Hygiene accredited programs, to protect the privacy of all patient information.   Dental Hygiene professionals clearly have an obligation to keep MEDICAL and PERSONAL information about patients in the strictest confidence at all times.  Unless disclosure is mandated by patient consent, statute, a duty to inform third parties, or special circumstances, dental hygiene professionals have a clear duty to maintain confidentiality of all patient information.

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\  Breach of the duty to hold such information in the strictest confidence, may cause liability for the individual student such as fines, imprisonment, and dismissal from the program.  In the professional "Code of Ethics," the American Dental Hygienists' Association Code of Ethics for Dental Hygienists has published the following statement which all dental hygiene professionals (including students) must always follow:

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\                         “We respect the confidentiality of client information and

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\                         relationships as a demonstration of the value we place on

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\                         individual autonomy.  We acknowledge our obligation to

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\                         justify any violation of confidence.”

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\ Electronic and Recording Devices

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\ In order to maximize learning, all electronic recording devices and cell phones are prohibited in this course. If a student is caught with a cell phone in hand or in a uniform pocket, or actively texting, talking, or surfing the internet during a clinic session, the student will immediately be dismissed from the Clinic and will receive a grade of “0” for the patient session or rotation, as well as an absence for the day. Those students who have children or who anticipate an emergency situation should give caretakers and family members the Office Supervisor’s phone number (806-354-6050) and have calls directed to her first. She will then act accordingly to inform the student. Patient care should not be interrupted unless a student is alerted from the Office Supervisor regarding an emergency.  Your children will not be allowed in the clinic.  No exceptions.

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\ Mailboxes

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\ Each student is assigned a mailbox located inside the student locker room.  Students are required to check their mailbox daily for various communication from faculty.

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\ Bulletin Board

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\ First and second year dental hygiene students have designated areas on a common bulletin board in the student locker room where various announcements may be posted.

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\ Emergency Contacts

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\ Phone numbers that family members may use to reach students only in case of emergencies are as follows:

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\ Dental Hygiene Office Supervisor:    354-6050

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\ Amarillo College Police:                     371-5163

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\ Academic Grievance Procedure

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\ A student who has a grievance concerning an academic course in which he/she is enrolled in is directed to appeal in the following order to the:  (1) Instructor  (2) Department Chair/Program Director  (3) Dean of Health Sciences  (4)   Vice President of Academic Affairs  (5) College President

Grading Criteria

\ General Clinic Guidelines

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\  1.  Certain standards of care apply to each patient (i.e.:  asepsis, patient management, professionalism, patient confidentiality, patient education, etc.) and are considered part of all aspects of patient treatment.

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\  2.  Although the Department of Dental Hygiene maintains a system for recalling patients and providing maintenance oral hygiene care, students will be responsible for recruiting new patients to the Dental Hygiene Clinic who will meet the student's needs for various dental hygiene requirements.  Additionally students will be expected to recruit and maintain a list of potential patients, who are available and willing to make an appointment on short notice. Students will also be required to select a patient which meets the criteria for the WREB and /or CRDTS or other regional clinical board in order to gain licensure to practice dental hygiene. 

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\  3.  It is important that each student understands the necessity in taking a pro-active and responsible role in obtaining his/her education.  Your signature on the "syllabus documentation form" is evidence of the fact that you understand your responsibility in recruiting the type(s) of patients you will need to complete your requirements in the Dental Hygiene Program at Amarillo College.

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\  4.  It is important for the student to seek faculty input regarding his/her performance so the student may:

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\ a.  correct techniques as necessary

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\ b.  determine problem areas and methods for improving those areas

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\ c.  gain confidence that his/her performance is correct and competent

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\ d.  attain competence in clinical skills

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\ All students are considered mature enough to seek faculty assistance and to monitor his/her own progress in meeting course requirements.  Students who continually fall below the recommended competency level in any area should seek remediation skills from the clinical faculty.

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\ Preclinical 

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\ The student will be required to satisfactorily complete and demonstrate basic dental hygiene skills on a typodont and/or student partner in Preclinical Dental Hygiene Laboratory for advancement to Clinic I. 

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\ Clinic I, II, III, IV 

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\ Students will be required to meet minimum requirements outlined on the STUDENT COMPETENCY RECORD for each individual clinic.

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\ Definitions

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\ 1.  Objective - given at the beginning of each procedure to define the procedure which must be mastered by the student.

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\ 2.  Performance Criteria - derived directly from the Objective given for each procedure or from criteria outlined in the applicable PROCESS EVALUATION.

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\ 3.  Evaluation Criteria - student will be evaluated as follows:  7 point deduction per error.  Sealant placement will be graded as competent or incompetent.  Panoramic radiographs will be 10 point deduction per error from categories I - IV and 1 point each for anatomical landmark not correctly identified and critiqued.  All evaluations must be graded by an instructor.

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\ 4.  Clinic Requirements - clinic requirements project the minimum number of learning experiences needed to obtain competency/proficiency in the performance of a procedure.  The clinic requirements increase in number (for some procedures) and patient difficulty as students progress from Clinic I to Clinic IV.  Each clinic requires both process and end- product evaluations.  Students must successfully complete (75%) of a procedure for it to count as one of the required minimums.  Clinic requirements must be completed by the final day of the semester.

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\ 5. Performance Levels - in addition to the minimum requirements, each procedure has been assigned a minimal level.  Performance levels are listed on the STUDENT EVALUATION RECORDS.

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\ Guidelines

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\ To determine the evaluation criteria, minimum clinical requirements and performance levels for each procedure, see the appropriate forms:

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\ 1.  Evaluation =STUDENT EVALUATION CRITERIA (on Process and End- Product Evaluations)

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\ 2.  Minimum Clinical Requirements + STUDENT EVALUATION RECORDS FOR CLINICS I, II, III, AND IV

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\ 3.  Performance Level = STUDENT EVALUATION RECORDS FOR CLINICS I, II, III, and IV. 

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\ Clinical competency is obtained successfully by completing procedures in the following categories:

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\ Evaluation Criteria

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\ A student will be evaluated as follows:  7 point deduction per error on the process and end product evaluations.  Sealant placement will be graded as either competent or incompetent.  Radiographs will be evaluated as outlined in the Program Manual, and must be critiqued and turned in to be graded within 1 week.  If not graded within 1 week of being exposed, a 0 will be added to your average radiographic grade.  Half of the required radiographs of each category, (2) must be completed by the last clinic day in October or points will be deducted from your final clinic grade.  One point will be deducted per radiographic (set) not turned in and passed on time.  (October)  

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\ Clinical competency is obtained successfully by completing procedures in the following categories:

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\ Process Evaluation  (50% points earned)to include:

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\ Assessment

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\ Diagnosis

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\ Planning

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\ End Product Evaluation (50% points earned) to include:

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\ Implementation

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\ Evaluation

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\ Adjunct Procedures

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\ 8 Sealants

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\ 4 FMX (Competency Level of 75% or above)

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\ 4 Horozontal BWX (Set of 4 at a Competency Level of 75% or above)

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\ 1 Desensitization

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\ 1 Competency of Application of Chemotherapeutic Agents

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\ 1 Application of Chemotherapeutic Agents

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\ 1 Competency of Application of Topical Anesthetic/Oraqix

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\ 1 Application of Topical Anesthetic/Oraqix

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\ 4 Periodontal Assessment

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\ 1 Periodontal Re-evaluation of Oral and Perio Status

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\ 1 Case Presentation ( This will be a scored activity  and the student must achieve a minimum of 75% in order to meet the course 

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\    requirement)

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\ 4 Calculus Detection

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\ 1 Mock Board Patient Experience

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\ Entrance Exam

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\ Exit Exam

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\ Patient Photos/Intra-Oral Videos

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\ Rotations

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\ Ethics Modules 5 &6

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\ Course Goals

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\ Upon successful completion of Clinic III, the student will be able to:

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\ 1.  Improve efficiency and maintain quality when collecting and analyzing data and selecting, performing, and evaluating oral health procedures for clinical patients, based on the concept from DHYG 1261.

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\ 2.  Improve efficiency and competency in performing the additional clinical skills introduced in DHYG 1260.

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\  Clinic Requirements and Grading Criteria

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\ Both process and end -product procedures are graded in all clinics.  The grading is graduated and based upon a specified numerical deduction, points per error, as a student progresses from Clinic I to Clinic IV.  Additionally, the daily grade percentage (or weight point) favors process in Clinic I and increases to favor end -product in Clinic IV.  Each error in Clinic I will count as a minus 7points on the Clinic III grade sheet.

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\  The following are the Minimum Number of Successful (75% or greater) Learning Experiences Required for Clinic III

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\ 10    Patients with Case Difficulty Index Case A

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\        (10 Process Grades and 10 End Product Grades)

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\  8     Patients with Case Difficulty Index Case B

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\        (8 Process Grades and 16 End Product Grades, will be graded by the arch or half-mouth)

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\  2     Patients with Case Difficulty Index Case C

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\        (2 Process Grades and 8 End Product Grades; 8 quadrants)

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\  2     Patients with Case Difficulty Index Case D

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\        ( 2 Process Grades and 8 End Product Grades; 8 quadrants)

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\  1     Child Patient  ( age 11 and under)

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\        ( 1 Process Grade and 1 End Product Grade)

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\  1     Adolescent Patient ( age 12 through 18)

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\        ( 1 Process Grade and 1 End Product Grade)

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\  1     Adult Patient ( age 19 and up)

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\        ( 1 Process Grade and 1 End Product Grade)

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\  1     Special Needs Patient

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\        ( 1 Process Grade and 1 End Product Grade)

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\ Adjunct Procedures

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\  4     Periodontal Assessment ( Must be on a Case Difficulty Index Case C or D)  Complete the Perio Exam in Eaglesoft which    includes noting all periodontal readings, bleeding, suppuration, furcation involvement, mobility, clinical attachment loss (CAL), clinical descriptors, and periodontal diagnosis.  Faculty will evaluate each periodontal probe reading to help student assess probing accuracy.

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\  1     Periodontal Re-evaluation of Oral and Perio Status Patient  ( must be a moderate or severe periodontal classification.  You must have completed the scaling and root planing of at least two quadrants within the last month.)  Complete the Perio Exam in Eagle Soft which includes noting all periodontal readings, bleeding, suppuration, furcation involvement, mobility, clinical attachment loss (CAL), clinical descriptors, and periodontal diagnosis.

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\  4     Calculus Detection  (one quadrant)

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\  1     Case Presentation  (2 weeks after the completion of the Periodontal Re-evaluation of Oral and Perio Status of a patient.  Student must make a minimum grade of 75% on the case presentation to meet competency requirement. (The due date is November 16, 2012

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\  1     Mock Board Patient Experience.  In order for the student to count the Mock Board Patient Experience as a competency, the patient MUST meet Board Criteria and the student must achieve a minimum of 75% on the skill evaluation.  If a student fails the Mock Board Exam, he/she will be required to remediate on a typodont and/or clinical patient by the end of the semester with his/her clinical advisor.  Remediation must be completed and documented in order to pass Clinic III.  (The due date is December 4, 2012

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\        Rotations- Numerical Grade will be given and will be counted as part of the Process Evaluation.   DA rotations will be evaluated both by faculty and your peers. 

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\        Entrance Exam (If competency level of 75% is not achieved, a student must complete mandatory remediation with faculty)

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\        Exit Examination (If competency level of 75% is not achieved a student must complete mandatory remediation with faculty)

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\        Intraoral Video Exam - All C and D patients must have an Intraoral Video exam completed.  No credit will be given for a C or D patient if the intraoral video is not completed. 

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\          Patient Photos:  All new patients must have the patient series of 4 photos found under the Patient Record completed.  No credit will be given for a new patient check-in if the photographs are not taken. 

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\       Modules 7 and 8 in the Work Ethics Section of the Program Manual will be completed during Clinic III.  Turn in the Activities Assignments.   Ethic Modules will be graded as either satisfactory or unsatisfactory.  This assignment needs to be hole punched and handed in by November 16, 2012.  A student who does not complete and turn in the required Ethic Modules will be given a grade of 0.  The Work Ethics Modules are geared toward self-responsibility and taking a proactive role in your own learning.                

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\ In addition to treating patients at the Amarillo College Dental Hygiene Clinic, the students must participate in the following enrichment rotations:  All guidelines set forth in the Program Manual will apply to rotation assignments.  Absences and tardies will be recorded for each rotation assignment.  Any missed rotation will be recorded as a ) for the rotation and will also be counted as an absent for the day.  

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\ Office Assistant

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\ Sterilization Assistant

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\ Dental Assistant (Faculty and Peer Reviewed)

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\ Screening Rotation

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\ Chair Side Observation Rotation

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\ Wyatt Dental Clinic, On Site Clinical Enrichment Rotation

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\ Veteran's Hospital, Clinical Enrichment Rotation

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\ To determine the clinic grade; average of all process grade sheets (to include Rotation Assignments), end-product grade sheets (to include radiographs, quizzes, entrance and exit exams, and online quizzes)  Grades will be multiplied by the point weight for each clinic.  Add up the percentage points for both clinical areas  ( process and end-product grade sheets) to determine the final clinic grade for the semester.  Minimum requirements must be at a 75% level or above.

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\ Critical Errors may drop a student's grade.  Examples of critical  errors may include:  breach of infection control, critical Medical History error, unprofessional conduct toward a patient, student, or faculty/staff member, dishonesty, a breach of confidentiality, etc.  The result of performing a critical error will result in a 0 percent credit for the patient  and or dismissal from the clinic or rotation(s).

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\ The final course grade will be computed as follows:

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\ A = 93-100%

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\ B = 83-92%

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\ C = 75-82%

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\ F = Below 75%

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\ Note: A grade of "D" is not possible in this course.

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\ Course  Remediation Policy

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\ If a student fails to attain the required minimum requirements for Clinic III and has less than 3 absences during the semester, an "I (incomplete) may be given.  The "I" (Incomplete) will be removed and a grade of "C" will be given for the course after the student completes the required work.

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\ If an "I" is received in the first (spring) semester, it must be removed by the end of the first four weeks of the following second (summer) semester.  If an "I" (incomplete) is received in the summer session, it must be removed during the fall session before the student can register for the subsequent academic year.  If a student fails to remove the "I" grade from his/her record in the allotted time, a grade of "F" will be posted automatically.  No "I"s can be given the final semester before graduation.

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\    Entrance and Exit Examinations

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\  All students are required to complete both an Entrance and Exit Examination with a competency level of 75% level or above.

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\ The Examinations will include the demonstration of the following instrumentation skills:

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\ Explorer 11/12

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\ Periodontal Probe

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\ Nevi 1 H5

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\ Nevi 4

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\ H6/H7

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\ 204S

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\ Columbia 13/14

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\ YG 7/8

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\ Barnhart 1/2

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\ Mini Gracey 1/2

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\ Gracey 1/2

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\ Gracey 7/8

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\ Gracey 11/12

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\ Gracey 13/14

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\ Gracey 17/18

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\ A student who does not achieve 75% competency on the Entrance and/or Exit Examination must complete mandatory remediation and an opportunity to retest until 75% competency is achieved.  However, the original exam score will be counted in computation of the final grade.

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\ Assignments and Examinations

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\ The course will consist of several quizzes, online assignments, and an entrance and exit examination.  The quizzes that will be given may or may not be announced in advance.  All online assignments, quiz grades, entrance and exit exams will be added to your end-product evaluation.  All grades count and none will be dropped.   The competency level is 75% or above.

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\ Make Up Policy

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\ A student will not be allowed to make up quizzes or online assignments.  A zero will be given for each missed quiz or online assignment.

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\ All students are required to complete both an Entrance and Exit Examination with a competency level of 75% level or above.

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\ Course Remediation Policy

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\ If a student fails to attain the required competency or minimum requirements for clinic I, II, III, or IV, and has less than 3 absences during the semester, and “I” (incomplete) may be given.  The “I” (incomplete) will be removed and a grade of “C” will be given for the course after the student completes the required work.

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\ If an “I” is received in the first (spring) semester, it must be removed by the end of the first four weeks of the following second (summer) semester.  When a grade of “I” is received in the second (summer) semester, it must be removed during the fall session, before the student can register for the subsequent academic year.  When and “I” is received in the third (fall) semester, it must be removed during the first six weeks of the spring semester.

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\ Conversion of type A-D in requirements:

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\ 1 type B patient to 2 type A patients

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\ 1 type C patient to 3 type A patients

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\ 1 type D patient to 4 type A patients

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\ 1 type C patient to 1 type B patient

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\ 1 type D patient to 2 type B patients

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\ 1 type D patient to 1 type C patient

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\ Evaluation The final course grade will be computed as follows:

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\ Process Evaluation (50%)

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\ End-Product Evaluation (50%)

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\ A= 93-100 %

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\ B= 83-92%

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\ C= 75-82%

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\ F= Below 75%

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\ Note:  A grade of “D” is not possible in this course.

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Attendance

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\ Attendance Policy

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\ "Regular attendance is necessary for satisfactory achievement.  Therefore, it is the responsibility of the student to attend class in accordance with the requirements of the course as established by the instructor."  (Amarillo College Student's Rights and Responsibilities Publication)Due to the tremendous amount of information contained in this course, the student who plans to succeed should also plan to attend all course sessions regularly and promptly.  Without question, the clinical faculty expects each student to be present at each clinic/rotation assignment.  Unfortunately, no one has ever developed a short cut which will replace hours of actual experience needed to master a new skill;  therefore, students must be present to acquire the specific knowledge in this subject.  Attendance records will be kept on a daily basis during the semester.  Any absence from the clinic or scheduled rotations must be reported to the Dental Office Supervisor first.  The office number is 354-6050.   Each student is  required to complete a minimum number of clinic hours and requirements in order to graduate from the dental hygiene program. 

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\ The Office Supervisor is also responsible for all clinic schedule changes for patients and students.  Students are required to treat all patients assigned to them regardless of whether competencies have been met or not.  Students will also be required to treat patients who may be late getting tot he clinic.  The student at the very least can start the process of care.  Refusing to treat a patient will result in dismissal fro the clinic and disciplinary action will be taken.  The clinic setting is to prepare the student for the"real world" of work.  In a private office, a dental hygienist would never be allowed to tell a dentist he/she does not want to see a patient.  Disciplinary action would occur and most likely termination of the employee. 

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\ Absences will be monitored and evaluated to determine a students' final clinic grade...A student may have no more than 1 absence in this course without affecting his/her final grade.  Beginning with the 2nd absence, 2 points will be deducted from the final grade; after the 3rd absence, 3 points will be deducted; after the 4th absence, 4 points will be deducted.  On the occurrence of the 5th absence, the student will be required to repeat Clinic III.  Attendance will be taken at the beginning of each clinic and rotation session.  Attendance will be taken at the beginning of each clinic, class and rotation session.  Students who are not present when attendance is taken will be counted as absent.  A student will receive 2 bonus points to the final clinic grade for perfect attendance.  Leaving clinic/rotation early will result in an absence.  In clinic, students must log into the computer no later than 8:Bam and log out no earlier than 12:00 pm.  After lunch the student must log back in no later than 12:45 pm and log out no earlier than 5:00 as a record of hi/her attendance.  Students who do not log in to the computer correctly in the morning or afternoon will be counted absent.  Also, students who leave early without special permission from a faculty member will be counted as absent.  The office supervisor will monitor student time logged in at the computers in the clinic and  will report this information to the faculty.

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\ Example for Bonus Points:

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\ Student has a final clinic average of 91% = B

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\ Student attends all scheduled clinics and passes all rotations.

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\ Final Clinic Grade = 93% = A

Calendar

\ Week 1     Mon, Tues, Wed, Thurs,  and Fri        Clinical Patient Care of CDI types A-D

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\                                                                                     Afternoon Report - Wed

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\ Week 2    Mon, Tues, Wed, Thurs, and  Fri         Clinical Patient Care of CDI types A-D

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\                                                                                     Afternoon Report - Wed

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\ Week 3    Mon, Tues, Wed, Thurs, and Fri         Clinical Patient Care of CDI  types A-D

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\                                                                                    Afternoon Report  - Wed

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\ Week 4    Mon, Tues, Wed, Thurs, and Fri          Clinical Patient Care of CDI types A-D

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\                                                                                    Afternoon Report - Wed

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\ Week 5    Mon, Tues, Wed, Thurs, and Fri         Clinical Patient Care of CDI types  A-D

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\                                                                                   Afternoon Report - Wed

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\ Week 6    Mon, Tues, Wed, Thurs, and  Fri         Clinical Patient Care of CDI types A-D

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\                                                                                    Afternoon Report - Wed

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\ Week 7    Mon, Tues, Wed, Thurs, and  Fri         Clinical Patient Care of CDI types A-D

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\                                                                                     Afternoon Report - Wed

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\ Week 8     Mon, Tues, Wed, Thurs, and Fri        Clinical Patient Care of CDI types A-D

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\                                                                                    Afternoon Report - Wed

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\ Week 9    Mon, Tues, Wed, Thurs, and  Fri         Clinical Patient Care of CDI types A-D

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\                                                                                     Afternoon Report - Wed

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\ Week 10   Mon, Tues, Wed, Thurs,  and  Fri       Clinical Patient Care of CDI types A-D

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\                                                                                     Afternoon Report - Wed

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\ Week 11   Mon, Tues, Wed, Thurs, and  Fri       Clinical Patient Care of CDI types A-D

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\                                                                                    Afternoon Report - Wed

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\ Week 12   Mon, Tues, Wed, Thurs, and  Fri       Clinical Patient Care of CDI types A-D

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\                                                                                    Afternoon Report - Wed

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\ Week 13   Mon, Tues, Wed, Thurs, and  Fri        Clinical Patient Care of CDI types A-D

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\                                                                                     Afternoon Report - Wed

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\ Week 14   Mon, Tues, Wed, Thurs, and  Fri       Clinical Patient Care of CDI types A-D

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\                                                                                    Afternoon Report - Wed

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\ Week 15   Mon, Tues, Wed, Thurs, and  Fri       Clinical Patient Care of CDI types A-D

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\                                                                                    Afternoon Report - Wed

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\ Week 16   Final Exams in Classes

Additional Information

\ Criteria for Case Presentation
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\ (A student must achieve a grade of 75% or higher to fulfill clinic requirement)

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\ Purpose

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\ The purpose of this periodontal case development and documentation is to provide upper level dental hygiene students the opportunity to select a periodontally involved patient and complete the case documentation, treatment, and post-therapy evaluation for discussion and learning purposes.

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\ Audience

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\ The audience for the case presentation will be a student's peers and faculty.  All case presentations will be presented two weeks after the completion of the Post-therapy Assessment appointment.

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\ Goal or Expected Outcome

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\ This exercise will provide students with the opportunity to work through a difficult periodontal case, actually implementing treatment and evaluating the efforts of their treatment.  The exercise provides students with the opportunity to share their case, strategies, and ideas with classmates.  As a result of this exercise, the overall goal is to provide valuable learning experiences and increase understanding of the variety and complexity of treating periodontal cases.  Ideally this exercise benefits the student developing the case and the students who view the case presentation.

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\ Patient Selection Guidelines

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\ The patient selected must present with active periodontal disease and a plan for periodontal therapy.  Ideally, the patient should present with some unique case feature(s), treatment, or outcome aspect that provides learning opportunities.  Students need to complete the assessment, planned treatment, and post-therapy evaluation on the patient to complete case documentation and presentation requirements for this course.

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\ Case Documentation Guidelines

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\ Section 1:  Patient information

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\ This section is intended to introduce the patient to the audience.  Thorough summaries of each of these components provide relevant background information that may affect oral health outcomes.

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\ Demographics and Health History Assessment

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\      a.     Patient profile:  summary of basic information about the patient

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\      b.     Patient's chief concern (cc): summary of primary purpose of the dental visit

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\      c.     Health History:  comprehensive summary of health related findings

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\      d.     Dental History:  comprehensive summary of dental related findings

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\      e.     Diet History:  comprehensive summary of diet-related findings

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\      f.     Health beliefs and behaviors: summary of behavioral characteristics noted during discussion and treatment

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\ Section II:  Clinical Assessment

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\ Thorough summaries of each of these components provide descriptive information about the case.

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\      a.     Extraoral exam:  summary of findings

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\      b.     Intraoral exam:  summary of findings

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\      c.     Current dental conditions:  summary of existing restorations, occlusal classification, dental caries risk assessment, or edentulous conditions

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\      d.     Radiographic exam:  summary of periodontal, restorative, and pathologic findings

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\      e.     Periodontal exam:  general summary of periodontal status including probing depths, furcation involvement, mobility, clinical attachment loss, gingival description, American Academy of Periodontology (AAP) classification and bleeding index

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\ Specific guidelines for clinical evidence:

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\ Clinical evidence is intended to provide visual or tangible representation of the patient's clinical findings.  Clinical accuracy and thoroughness provide visual information and clinical data relating directly to the case.

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\      a.     Intraoral photographs.  Includes all photos necessary to adequately provide documentation and visualization of patient's existing gingival and periodontal condition.

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\      b.     Intraoral radiographs.  Based on diagnostic need of patient; must be of diagnostic quality and mounted correctly.

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\              1.     Current or previous complete radiographic series.  Include all radiographs necessary to adequately assess the patient's oral health status

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\              2.      Current bite-wing series (vertical or horizontal).  Includes radiographs that appropriately assess the proximal status of all teeth

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\      c.     Complete an accurate dental and periodontal chart.

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\              1.     Existing restorations

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\              2.     Existing pathologic condition

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\              3.     Probe depths (PD).  Initial visit, post therapy follow-up visit

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\              4.     Clinical attachment levels

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\              5.     Gingival recession.  Clinician should draw in gingival margin and identify mucogingival discrepancies when applicable

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\              6.     Furcations.  Presence, location, and extent properly identified

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\              7.     Mobility.  Classified as I, II, or III

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\              8.     Bleeding.  Noted on chart and summarized as a percentage score

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\              9.     Exudate.  Presence and types determined

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\             10.    Presence and distribution of plaque biofilm and calculus.  Plaque index (PI) summarized as a percentage score

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\             11.    Gingival description.  Color, contour, consistency, location, and extent of involvement (mild, moderate, or severe)

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\      d.      Oral health management by risk assessment.  Completed and assessed according to oral risk assessment guidelines;  identifies systemic and oral behavioral risk factors that may contribute to periodontal condition or may influence periodontal therapy.

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\ Section III:  Planning Phase

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\ Thorough summaries of each of these components provide insight strategies in therapy and patient instruction.

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\      a.     Rationale for case selection:  summary

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\      b.     Treatment goals and desired outcome:   summary

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\      c.     Initial therapeutic strategy:  must accurately reflect patient's chief complaint, treatment needs, psychosocial needs, and/or pain management.

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\      d.     Prevention education strategy:  oral healthcare aids to be introduced (when and why)

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\      e.     Instrumentation strategy:  must accurately reflect patient's needs and operator skill level.

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\      f.     Discussion points with patient:  possible therapeutic alternatives, potential complications, expected results, patient's responsibility in treatment outcomes, and consequence of no treatment

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\      g.     Consent:  informed and/or written consent of treatment strategies

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\ Section IV:  Implementation Phase

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\ Thorough summaries of each of these components provide descriptive information about the actual therapeutic and preventive care of the patient during the implementation phase:

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\      a.     date of appointment and number of appointments in series:  necessary to provide information on spacing interval of treatment and  timeline of therapy

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\      b.     Actual service completed or treatment performed:  what was actually accomplished on this date and appointment number

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\      c.     Treatment revisions with rationale:  identifies changes in treatment plan and discusses reasons why changes to original therapeutic strategies were implemented

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\      d.     Patient care:  identifies how the patient is responding to care and answer questions such as the following:  Is the patient more or less motivated?  Is the patient evaluating or noticing his/her own progress and healing?  Is the patient having postoperative pain or sensitivity, and is that concern being addressed during the appointment?

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\      e.     Self care:  summarizes patient's progress with preventive education plan and discusses rationale for home care aids being introduced or changed to meet therapeutic and psychosocial goals

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\ Section V:  Post treatment assessment  (4 to 6 weeks)

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\ The clinician should thoroughly describe the patient's post therapy clinical evaluation findings.  Summaries of each of these components provide descriptive information about the therapeutic and preventive outcomes and identify future needs of the patient, as follows:

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\      a.     Intraoral photographs:  as indicated

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\      b.     Review of chief complaint, health history, and extraoral/intraoral exam, summary of health history update, and changes in extraoral/intraoral exam.  Whether completed care addressed goals, risks, and patient concerns; summary of health history update; and changes in extraoral/intraoral exam noted

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\      c.     Periodontal examination.  Summary of PDs, bleeding on probing (BOP), PI, and gingival description

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\      d.     Oral home care outcomes.  Summary of patient's understanding and effectiveness of oral hygiene, current recommendations based on caries management by risk assessment, biological indicators (Bls), PI, PDs and gingival description

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\      e.     Therapeutic outcomes.  Summary of effectiveness of previously performed periodontal therapy and assessment of patient's response

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\      f.     Discussion points with patient.  Based on results of examination, status of patient's disease, therapeutic alternatives, potential complications, expected results, and patient's responsibilities regarding treatment; explanation of consequences of no treatment

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\      g.     Future care recommendations.

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\              1.    Indications for referrals.  Clinician should specify referral protocol

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\              2.    Active therapy continued.  Possible need for further active therapy, in which dental caries or periodontal management might include antimicrobial therapy (site-specific or systemic) or further therapeutic strategy for continued active therapy

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\              3.    Dental caries management and periodontal maintenance therapy, maintenance of a healthy periodontium

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\  Section VI:  Student Evaluation of Therapeutic and Preventive Outcomes

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\ This section is intended to provide the student an opportunity to discuss planning, implementation, and evaluation of the therapeutic and preventive strategies as applied to the case.  Supporting documentation from current scientific literature may be introduced at this time to validate the therapeutic strategies.  Thorough summaries of each of these components provide self evaluation opportunities and appraisal of lessons learned, as follows;

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\       a.    What we learned from treating this case?   (summary)

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\      b.     Which modifications would enhance treatment outcomes?   (summary)

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\ Section VII:  Study Questions and Answers

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\ A minimum of three study questions will need to be included in every section.  This exercise is intended to identify discussion topics and items of clinical interest that may be addressed with the case.  Evidence-based support for therapeutic strategies may be considered to encourage decision-making skills based on current scientific literature.  ( Three questions  from each of the three sections are developed that can be drawn from the case as a learning or discussion point.)

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Syllabus Created on:

11/30/-1 12:00 AM

Last Edited on:

11/30/-1 12:00 AM