Clinical Practice III

Course Details

Course Number: DNHY 4018  Fall 2011

Location: Bridwell Hall

Classroom Number: 109

Days & Times:

Mon. & Wed.    1:00 - 5:00 PM
Tues & Thur    8:00 - 12:00 NOON

Clinical Faculty:

Martha Crump, RDH,MEd

Barbara Curran, RDH, MEd

Fred Davis, DMD, MS

Barbara DeBois, RDH, MS

Sharon Hyde, RDH, MA

Ann Ezell, RDH, MEd

Debra Kelley, RDH, BS

                                           



Course Attachments

Textbooks

MSU Faculty Member
Barbara J DeBois RDH, MS   
view Profile »

Course Objectives

Given the integration of didactic and clinical experiences, and the prerequisite courses (Clinical Practice I-DNHY 3114 and Clinical Practice II -DNHY 3005) upon completion of this course the student should be able to:

1. Utilize information obtained from the health history in administering comprehensive patient care; determine need for special precautions, modifications and/or contraindications for treatment; manage emergency care, and make referrals to other health care providers, with limited instructor input.

2. Observe and document patient vital signs, counsel patients on any irregularities, and make appropriate recommendations or referrals, with limited instructor input.

3. Perform an extra-oral inspection and accurately document the findings with appropriate detail.

4. Thoroughly examine all oral tissues for signs of pathologic changes, correctly document findings (using appropriate terminology) and make appropriate recommendations and/or referrals with instructor input.

5. Graphically represent a patient's teeth with regard to caries, missing teeth or tooth structure, types and locations of restorations, fixed and removable appliances, and developmental abnormalities within a reasonable time frame.

6. Perform a periodontal evaluation and accurately document the findings; including recession, pocket depths, lost of attachment, mobility, furcation involvement, and bleeding sites within a reasonable time frame and with limited instructor input.

7. Determine need for radiographs based on evaluation of specific areas and/or entire dentition and make appropriate recommendations for such surveys based on patient history and assessment.

8. Position and expose intraoral x-ray films; process, mount, label, and critique technique.

9. Utilize available radiographs, assessment findings, etiologic factors and clinical data in determining the
 dental hygiene diagnosis.  

10. Utilize available radiographs, assessment findings, etiologic factors and clinical data to develop individualized and comprehensive dental hygiene treatment plans for each patient.

11. Obtain the patient=s informed consent based on a thorough case presentation.

12. Assess the outcomes of dental hygiene interventions using indices, instruments, examination techniques and patient self-report.

13. Position the dental chair, operator=s stool and dental light to insure patient/ operator comfort, communication and effective delivery of dental hygiene services.

14. Utilize effective infection control techniques according to MSU Infection Control Protocol.

15. Apply principles of instrumentation and knowledge of tooth morphology in selecting appropriate instruments to remove deposits, root plane, and reduce/ eliminate amalgam overhangs within a reasonable time frame.

16.  Control pain and anxiety during treatment through the use of accepted clinical and behavioral techniques.

17. Select and administer the most appropriate topical fluoride treatment based on patient need; and with
appropriate patient preparation/education.

18.  Select patients for which ultrasonic scaling is appropriate; demonstrate proper patient preparation/   education, equipment set-up and utilization.

19. Utilize assessment findings to determine the need for pit and fissure sealant placement; demonstrate proper application of chemical and light-cured sealants with appropriate patient preparation/education.

20. Provide CPR Basic Life Support, as may be necessary in the clinic.

21.  Properly take alginate impressions; pour and trim acceptable diagnostic casts.

22.  Correctly and efficiently perform all clinical receptionist duties with a positive attitude and in a professional manner.

23.  Correctly and efficiently perform all clinic assistant duties with a positive attitude and in a professional manner, utilizing correct technique and infection control protocol.

24.  Demonstrate proper equipment maintenance and care.

25.  Complete all clinic paperwork legibly and in a timely manner with appropriate detail in documentation, as is required for this level of clinical practice

26.  Demonstrate professional conduct during all clinical sessions.

27.  Identify candidates who would benefit from placement of localized chemotherapeutic agents and make
 appropriate referrals.  Demonstrate placement on typodonts to lab competency


Course Expectations

The grade for this course is based on QUALITY (instrumentation, assessment/documentation, patient management, radiographs, professionalism and clinic assistant/receptionist grades) AND QUANTITY (patient experience) requirements. Both play a significant role in the development of student competencies in patient care. 

Competency evaluations (Process Evals) ensure that students can perform procedures at the minimum level of expertise determined necessary for this point in time in their education.  Upon successful completion of the competency evaluations students can then work on improving their abilities with instructor assistance on patients in the Gaines Dental Hygiene Clinic.  Due to the substantial instructor-student collaboration during treatment QUALITY grades via Clinic Grade Sheets are not true indicators of student competency.

Quantity requirements are set to ensure that each student has appropriate experiences to develop entry level competencies in patient care.  QUANTITY (patient experiences) also reflects the student’s competency level as time management abilities are ultimately reflected in the number and type of patients upon which treatment is completed.  Therefore, the number/type of patients treated and the number/type of procedures performed have a significant bearing on the student’s final course grade for Clinical Practice 3 and 4.

 Student #1 has final Quality Grade (96) for 20 Class 2/2+ and 3 Class 3 level patients.
 Student #2 has final Quality Grade (96) for 20 Class 2/2+, 8 Class 3 and 1 Class 4 level patient.
 
 Which performance demonstrates a higher level of competency?
 The final Quality Grade (daily clinic grades earned with instructor input & assistance) are the same.  The greater number of  patient experiences demonstrates a higher level of self-sufficient performance by the second student – thus a higher  competency level.

 COURSE GRADING

QUALITY GRADE

 50% Instrumentation
 20% Assessment/Documentation
 20% Patient Management
   5% Radiographs
   5% Clinic Assistant/Receptionist
100% 

Clinic Assistant/Receptionist Grade: Students will start with 100 points in this area.  Infractions will result in
deduction of points from the applicable “100” starting points. Each infraction will incur a five (5) point deduction from the  initial 100 points.  (See Assistant/Receptionist Forms, objectives & criteria – Student Handbook/Clinic Manual, Section 6.7).  

Breach of Professionalism Protocol –During a clinical session a breach of the professionalism protocol not directly related to the treatment of a patient: will result in:   

       1st  Infraction -Formal warning 
       2nd Infraction- 5 point deduction from the FINAL clinic QUALITY grade
       See Student Handbook/Clinic Manual, Sections 2.8 & 2.9)

QUANTITY GRADE

Quantity Requirements have been set for each of the clinical procedures (Breakdown on the following pages).  Points will be deducted from the QUALITY GRADE for deficiencies in each of the areas.

    XX  Final Quality Grade  (Clinic Grade Sheets, Process Evals, etc.)   
-   XX  Deductions for shortages in Quantity Requirements  
 = XX  FINAL COURSE GRADE 

DENTAL HYGIENE DEPARTMENT GRADING SCALE
 A  = 92 - 100
 B =  83 -   91
 C =  75 -   82   Must earn 75 or above  to advance into Clinical Practice 4 
 D =  65 -   74   Failure in Dental Hygiene 

 

 COMPETENCY (PROCESS) EVALUATIONS   (Four competency evaluations in Clinical Practice 3):

  • Ultrasonic Scaling- On fellow students -To be scheduled by instructor
  • Pit & Fissure Sealant Placement -On fellow students - To be scheduled by instructor
  • Management of Class 2+ Level Patient Treatment - scheduled week of Oct 3rd, 2011
  • Management of Class 3-3+ Level Patient Treatment - scheduled week of Nov 7th, 2011

              Evaluation Forms/Criteria in Student Handbook/Clinic Manual: Section 7.0

 COMPETENCY EVALUATION PROTOCOL:    If student is unsuccessful in demonstrating the specified
  competency the following will apply:

1.  1st Remediation Session-     Prior to treating another patient in the Gaines Dental Hygiene Clinic, the student must remediate one-on-one with instructor outside of regular clinic sessions (on typodont).

2.   2nd Remediation Session-  Remediate on the eval patient or equivalent classification patient with instructor assistance during a regularly scheduled clinic session. No quantity points and/or grades are earned for treatment provided during this session.

3.  Competency Re-eval-  Re-eval on equivalent classification patient during a regularly scheduled clinic session.  No quantity points and/or grades are earned for treatment provided during this session. 

 Each unsuccessful demonstration of competency could have an effect on the final  course  grade as clinic sessions available to accumulate quantity points would be reduced, thus resulting in reductions of the quality grade

 
FAILURE OF COMPETENCY RE-EVALUATION

If a student is unsuccessful on 1st Competency Re-eval he/she can repeat the series of steps listed above two (2) more times.  If competency is not demonstrated at the 3rd Competency Re-Eval student will be given a grade of “D” (failure in Dental Hygiene), dropped from Clinical Practice 3 and not be permitted to advance into the next semester of the program.  In this situation the following will apply:

  • A student who successfully completes (C or better) ALL 3rd semester didactic courses may return in fall 2011 to retake Clinical Practice 3.  Student MUST audit ALL 3rd semester didactic courses running concurrently with Clinical Practice 3.
  • A student who DOES NOT successfully complete ALL 3rd semester didactic courses will be dropped from the Dental Hygiene Program.  If the Dental Hygiene Admissions Committee approves readmission the student will be required to return in spring 2012 to formally audit  ALL 2nd  semester courses (clinical and didactic) and then retake the 3rd  semester courses (clinical and didactic) in fall 2012.

The dental hygiene department reserves the right to make arrangements on an individual basis for students failing to maintain a passing grade in any course.  Whatever arrangements made will be based upon an examination of the individual student=s overall dental hygiene scholastic record. This will be decided by the Department Chair and at least two other Dental Hygiene faculty members.  Readmission is not automatic.


 

 

 

 


 


Submission Format PolicyNote: You may not submit a paper for a grade in this class that already has been (or will be) submitted for a grade in another course, unless you obtain the explicit written permission of me and the other instructor involved in advance.

Plagiarism Policy Plagiarism is the use of someone else's thoughts, words, ideas, or lines of argument in your own work without appropriate documentation (a parenthetical citation at the end and a listing in "Works Cited")-whether you use that material in a quote, paraphrase, or summary. It is a theft of intellectual property and will not be tolerated, whether intentional or not.

Student Honor Creed

As an MSU Student, I pledge not to lie, cheat, steal, or help anyone else do so."

As students at MSU, we recognize that any great society must be composed of empowered, responsible citizens. We also recognize universities play an important role in helping mold these responsible citizens. We believe students themselves play an important part in developing responsible citizenship by maintaining a community where integrity and honorable character are the norm, not the exception. Thus, We, the Students of Midwestern State University, resolve to uphold the honor of the University by affirming our commitment to complete academic honesty. We resolve not only to be honest but also to hold our peers accountable for complete honesty in all university matters. We consider it dishonest to ask for, give, or receive help in examinations or quizzes, to use any unauthorized material in examinations, or to present, as one's own, work or ideas which are not entirely one's own. We recognize that any instructor has the right to expect that all student work is honest, original work. We accept and acknowledge that responsibility for lying, cheating, stealing, plagiarism, and other forms of academic dishonesty fundamentally rests within each individual student. We expect of ourselves academic integrity, personal professionalism, and ethical character. We appreciate steps taken by University officials to protect the honor of the University against any who would disgrace the MSU student body by violating the spirit of this creed. Written and adopted by the 2002-2003 MSU Student Senate.

Students with Disabilities The Americans with Disabilities Act (ADA) is a federal anti-discrimination statute that provides comprehensive civil rights protection for persons with disabilities. Among other things, this legislation requires that all students with disabilities be guaranteed a learning environment that provides for reasonable accommodation of their disabilities. If you believe you have a disability requiring an accommodation, please contact the Disability Support Services in Room 168 of the Clark Student Center, 397-4140.

Safe Zones Statement The professor considers this classroom to be a place where you will be treated with respect as a human being - regardless of gender, race, ethnicity, national origin, religious affiliation, sexual orientation, political beliefs, age, or ability. Additionally, diversity of thought is appreciated and encouraged, provided you can agree to disagree. It is the professor's expectation that ALL students consider the classroom a safe environment.

Contacting your Instructor All instructors in the Department have voicemail in their offices and MWSU e-mail addresses. Make sure you add your instructor's phone number and e-mail address to both email and cell phone lists of contacts.

Attendance Requirements

ATTENDANCE:
The Dental Hygiene Faculty feel very strongly that maximum participation in all clinical and laboratory exercises is
critical to the development of clinical competencies. Therefore, more than two absences for any reason will result
in a loss of 5 points from the final course grade for each absence over 2. 

ANYONE MISSING MORE THAN FOUR (4) CLINICAL SESSIONS FOR ANY REASON WILL BE DROPPED FROM CLINICAL PRACTICE 3.  YOU CAN NOT MATRICULATE INTO THE SPRING SEMESTER WITHOUT
SUCCESSFULLY COMPLETING CLINICAL PRACTICE 3.

A student on Probationary Status will not be permitted absences for any reason until he/she is taken off of probationary status by the Dental Hygiene Admissions Committee.

When the student has an open appointment time due to a No-show, cancellation, or no scheduled patient the student will be expected to work on impression requirements, help the clinic assistant or receptionist as needed, or assigned a specific skill to practice.  YOU MUST REMAIN IN THE CLINIC AREA.  THE dressing/locker room is not considered a clinical area (See Professionalism Criteria - Student Handbook)

DO NOT SIT IN THE RECEPTION ROOM OR AT THE RECEPTION DESK unless you are the scheduled receptionist. If an instructor and/or the department secretary has to ask you to leave the reception desk FIVE (5) points for Breach of Professionalism WILL BE DEDUCTED FROM your FINAL clinic grade. You may study in your clinic unit with clinic instructor permission. 

ALL STUDENTS MUST CHECK WITH AN INSTRUCTOR BEFORE LEAVING THE CLINIC AREA. 
(See Professionalism Criteria - Student Handbook)


Other Policies

DENTAL HYGIENE DEPARTMENT PATIENT CARE POLICIES

The Midwestern State University Dental Hygiene Department is a facility that serves a dual purpose.  This institution provides the educational experience necessary to train competent dental health professionals, as well as providing an invaluable service to the people of the community.  It is our obligation to ensure that the needs of both the dental hygiene students and the patients are met.

Patients will receive respectful and considerate treatment in a clean, safe and friendly environment without discrimination as to race, religion, sex, national origin, disability, sexual orientation or source of payment.  Confidentially regarding their medical condition, oral health, and patient records will be maintained in accordance with the Health Insurance Portability and Accountability Act (HIPAA) 1996. Comprehensive treatment for each patient MUST be delivered.  It is the goal of this facility to ensure that treatment needs are met and/or appropriate referrals are given for each patient.

After initial patient assessment has been performed, the student will formulate a proposed treatment plan.  Before beginning treatment, the student MUST consult clinical faculty for approval of the tentative plan.  After treatment plan approval has been obtained, the student MUST present proposed treatment plan to the patient with an explanation of the assessment findings, recommended treatment, treatment alternatives, expected outcomes, costs, and the anticipated patient time commitment to complete treatment. Patients will indicate informed consent with signatures in the designated areas on the Informed Consent and Treatment Plan forms. Patients may refuse treatment and be told what effects this may have on their oral health.

Following completion of comprehensive treatment as verified by clinical faculty, patients must be informed in writing of their need for referral.  This referral is documented on the patient comprehensive chart and communicated verbally and in writing to the patient via the Patient Instruction/Referral Form. Clinical instructor must sign referral at final checkout or earlier in a series of appointments if need for immediate referral is needed.

Students must attempt to complete treatment for every patient under his/her care.  In the event that treatment can not be completed (patient terminates treatment or other circumstances arise that prevent completion of treatment) students must document circumstances on the treatment summary page of the patient record and full-time faculty and/or program director must sign off on the entry.  Students MAY NOT terminate treatment for any patient without the permission of the program director.  Students must document patient non-compliance in the patient chart to support suspension/termination of care and must turn in their Clinic Grade Sheet for that patient.

Recognizing that first year clinicians are in the initial stages of skill development, patients presenting in DNHY 3005 Clinical Practice II who require multiple appointments may be referred to the senior clinic (DNHY 4038 Clinical Practice IV) for completion.

 

MIDWESTERN STATE UNIVERSITY DENTAL HYGIENE DEPARTMENT PRIVACY PRACTICE PROTOCOL

Protocol to insure confidentiality regarding a patient’s= medical condition, oral health, and records in accordance with the Health Insurance Portability and Accountability Act (HIPAA) 1996. Any breaches in patient confidentiality or privacy may result in disciplinary actions including:    1.    Dismissal from the Dental Hygiene    AND/OR

                                                   2.    A monetary fine of $25,000 per HIPAA Violation

 INDIVIDUAL ACCESS TO PROTECTED HEALTH INFORMATION (PHI) :Faculty and students may access PHI for the purpose of :

  • Providing patient treatment in the Gaines Dental Hygiene Clinic (clinical and/or radiology areas).
  • Full-filling class assignments for didactic and/or clinical dental hygiene courses.  Only de-identified copies of PHI will be utilized by students for assignments in didactic and/or clinical courses outside of direct patient care.
  • PHI will NOT be electronically transferred via cell  phones, face book, etc.

PHYSICAL FACILITY SAFEGUARDS

  • PHI will be kept in file cabinets behind reception desk (out of the flow of traffic) Doors to the reception area will be locked when department personnel are not readily available to insure security of file cabinets containing PHI.
  • Inactive PHI that is to be eliminated from the files will be shredded prior to placing in the recycle bins.
  • Reception desk computer monitor will be turned away from public viewing.  Screen saver will be set at 20 seconds. Computer will be turned off every evening and whenever department personnel are not readily available to insure security.
  • Patient Referral Forms will be mailed in envelopes addressed to a specific individual and clearly marked confidential.
  •  When confirming appointments for the Gaines Dental Hygiene Clinic messages left on answering machines will be limited in content to patient name, date and time of appointment.
  • All other calls in which a message must be left on an answering message will be limited to a request that the individual contact the MSU Dental Hygiene Department
  • In the clinical setting as well as the reception area, special attention will be given to communication in a way that minimizes inadvertent disclosures of PHI.
  • PHI will not be electronically transferred via cell phone, face book, etc.

 

The American with Disabilities Act:

Midwestern State Uversity does not discriminate on the basis of an individual=s disability and complies with Section 504 and the Americans with Disabilities Act in its admission, accessibility, and employment of individuals in programs and activities. MSU provides academic accommodations and auxiliary aids to individuals with disabilities, as defined by law, who are otherwise qualified to meet academic employment requirements. For assistance call (940) 397-4618 or (940) 397-4515.

It is the student=s responsibility to declare any disabilities.  After declaration, preferably at the beginning of each semester, the student needs to contact individual instructors to determine any reasonable accommodations that may be required.


MSU COHSHS Student Conduct Appeals Committee

All Midwestern State University (MSU) students may legitimately appeal a course grade if 1) the student has not be evaluated according to the same criteria as his or her classmates, or 2) an error has been made in grading and/or posting (MSU Student Handbook, p. 37.) In addition, the Office of the Dean of Students has the responsibility to enforce standards of conduct for students as outlined in the MSU Student Handbook (p. 70-80).

When enrolled in the College of Health Sciences and Human Services (COHSHS), students are often assigned to community agencies, such as health care facilities, social service agencies, or athletic environments, as part of their academic process. During these experiences, the student is expected to behave in a manner required of professionals working in this environment. COHSHS students may also be required to successfully complete a licensing/certification process following graduation. As a result, students in these programs are often held to a different academic and/or behavioral standard than students in other MSU programs. For example, students may not be allowed to progress in a program if they have been unsuccessful (D or F) in a certain number of courses in the major. In these circumstances, COHSHS faculty and administration, all of whom have had similar professional experience, may make decisions which negatively impact students’ programmatic progress.

COHSHS students have a right to a review of decisions made by the program faculty, which prevent individuals from progressing in their program in a timely manner. However, those who participate in the review must understand the context of the professions involved. Therefore, issues concerning the professional conduct of students in the COHSHS will NOT be brought to the University Grade Committee, but to the COHSHS Student Conduct Appeals Committee. Specifically, the COHSHS Student Conduct Appeals Committee will review faculty decisions related to:
• Student conduct in a clinical experience, internship, or other work-related environment that negatively impacts the student’s academic progress. This conduct may include behavior which is prohibited by licensing and/or professional standards or departmental policy.
• Student removal from a program because of a) professional conduct issues or b) failure to maintain academic standards required specifically by the program*

SEE COHSHS WEB SITE FOR A COMPLETE COPY OF THIS POLICY


Writing Proficiency Requirement All students seeking a Bachelor's degree from Midwestern State University must satisfy a writing proficiency requirement once they've 1) passed English 1113 and English 1123 and 2) earned 60 hours. You may meet this requirement by passing either the Writing Proficiency Exam or English 2113. Please keep in mind that, once you've earned over 90 hours, you lose the opportunity to take the $25 exam and have no option but to enroll in the three-credit hour course. If you have any questions about the exam, visit the Writing Proficiency Office website at http://academics.mwsu.edu/wpr, or call 397-4131.