Mon. 1:00 - 3:00 PM
Tues. 8:00 - 12:00 NOON OR 1:00 - 5:00 PM
Thurs. 8:00 - 12:00 NOON
(All Tues. / Thurs. clinical sessions require arrival 30 minutes prior to start of the clinic)
COURSE PURPOSE: The purpose of this course is to further the student's clinical experience in the practical application of oral prophylaxis techniques. Emphasis will be placed on further development/refinement of skills acquired in Clinical Practice I, patient assessment and documentation, and sequencing of treatment according to patient needs and time factors.
Clinical Practice II consists of ten actual clock hours per week; students receive five credit hours
for successful completion of the course.
OBJECTIVES: Given the integration of didactic and clinical experiences, the prerequisite course Clinical Practice I
(DNHY 3114), and consistent student-instructor collaboration, upon completion of this course the student should be able to:
1. Position the dental chair, clinician=s stool, and dental light to insure patient/clinician comfort,communication and effective delivery of dental hygiene services.
2. Organize dental hygiene instruments and supplies in a manner that enhances clinician efficiency
and insures effective delivery of services.
3. Apply accepted standards of infection control at all times in the clinical setting.
4. Maintain a patient care delivery area that is organized, safe and follows proper infection
5. Sharpen and maintain instruments to insure effective instrumentation and preservation of
6. Utilize information obtained from the health history to determine possible modifications and/or
contraindications to treatment.
7. Accurately assess and document patients vital signs, making referrals to other health care
providers as appropriate.
8. Perform an extra-oral and intraoral inspection and accurately record significant findings.
9. Examine all oral tissues for signs of health or pathological changes and record the findings.
10. Perform and accurately document a periodontal evaluation for Class 2/2+/3 level patients: including
recession, pocket depths, loss of attachment, mobility, furcation involvement and bleeding sites.
11. 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 anomalies.
12. Apply principles of instrumentation and knowledge of tooth morphology in selecting appropriate
instruments to detect and remove deposits.
13. Develop treatment plan and present to Class 2/2+/3 level patients.
14. Obtain the patient informed consent based on a thorough case presentation.
15. Present appropriate oral health prevention programs based on patients individual needs.
16. Select and administer appropriate topical fluoride treatment including varnish, tray, rinse &
17. Complete all clinic paperwork legibly and in a timely manner with appropriate detail in documen-
tation, as is required for this level of clinical practice.
18. Demonstrate proper equipment maintenance.
19. Provide CPR Basic Life support as may be necessary in clinic.
20. Perform all Clinic Assistant duties utilizing correct techniques and infection control protocol.
21. Correctly and efficiently perform all Clinic Receptionist duties.
22. Properly take alginate impressions; pour and trim acceptable diagnostic casts.
23. 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
24. Electronically document one (1) patient assessment finding utilizing Dentrix computer software.
Dental Hygiene Honor System:
All Dental Hygiene courses adhere to the MSU Code of Conduct. In particular, academic dishonesty, however small, creates a breach in academic integrity. A student’s participation in this course comes with the expectation that his or her work will be completed in full observance of the MSU Code of Student Conduct. A student should consult the current Student Handbook for answers to any questions about the code.
Many components of dental hygiene courses are designed to be highly interactive with students helping each other learn. Students are encouraged to take full advantage of many resources available including course resources, Internet sites, other textbooks and journals, faculty, and peers when answering objectives. This interactive collegial learning environment is conducive for life-long learning.
Cheating includes, but is not limited to, (1) use of any unauthorized assistance in taking quizzes, tests, or examinations; (2) dependence upon the aid of sources beyond those authorized by the instructor in writing papers, preparing reports, solving problems, or completing other assignments; or (3) the acquisition of tests or other academic materials belonging to the university faculty or staff without permission.
Plagiarism includes, but is not limited to, the use of, by paraphrase or direct quotation without correct citation in the text and on the reference list, the published or unpublished works of another person. Students may NOT submit papers and assignments that they have previously submitted for this or other courses. The use of materials generated by agencies engaged in "selling" term papers is also plagiarism. Students are encouraged to review the tutorials and suggested websites for more information about plagiarism.
Academic dishonesty (cheating, plagiarism, etc.) will not be tolerated in this class. Whenever a student is unsure of whether a particular situation will be interpreted as academic dishonesty, he/she should ask the instructor for clarification. If students are guilty of academic dishonesty, a grade of zero (0) will be given for the quiz, assignment, etc. Cases may also be referred to the Dean of Students for possible dismissal from the university.
By enrolling in this course, the student expressly grants MSU a “limited right” in all intellectual property created by the student for the purpose of this course. The “limited right” shall include but shall not be limited to the right to reproduce the student’s work product in order to verify originality and authenticity, and for educational purposes. Specifically, faculty may submit student papers and assignments to an external agency to verify originality and authenticity, and to detect for plagiarism
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:
SEE COHSHS WEB SITE FOR A COMPLETE COPY OF THIS POLICY
The American with Disabilities Act:
Midwestern State University 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.
The grade for this course is based on QUALITY (instrumentation quality, assessment / documentation quality, patient management, professionalism, and clinic assistant/ receptionist rotations) and QUANTITY (patient experiences) requirements. Quality and quantity both play a significant role in the development of student competencies in patient care. Competency evaluations ensure that students can perform procedures at the 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 considerable instructor assistance, on patients in the Gaines Dental Hygiene Clinic (Quality grades). Due to the instructor assistance provided for each student based on his/her needs with each patient QUALITY grades alone are not indicative of student competency.
Competency and QUALITY evaluations ensure that students can perform procedures at the determined level of competence. Quantity requirements are set to ensure that each student has appropriate experiences to develop entry level competencies in patient care. Student abilities in management of patient care are ultimately reflected by the number of patients in each classification level for which the student completes treatment. Therefore, the number and type of patients treated have a bearing on the student=s final course grade for Clinical Practice 2, 3 and 4.
The QUALITY portion of the Clinical Practice 2 grade is broken down as follows:
40% Instrumentation (From Clinic Grade Sheets & Process Evaluations)
30% Assessment/Documentation (From Clinic Grade Sheets)
20% Patient Management (From Clinic Grade Sheets)
5% BW X-rays
5% Clinic Assistant/Receptionist
100% = QUALITY GRADE
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
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)
There are six competency evaluations in Clinical Practice 2:
COMPETENCY EVALUATION PROTOCOL:
If student is unsuccessful in demonstrating the specified competency the following will apply:
1st Remediation Session: Remediate one-on-one with instructor outside of regular clinic session (Instrumentation on typodont)
2nd Remediation Session: Remediate on the eval patient or equivalent classification patient during a regular clinic session. No quantity points and/or grade are earned for treatment provided during this session.
1st Competency Re-eval: Re-eval on equivalent classification patient during a regular clinic session.
No quantity points and/or grade are earned for treatment provided during this session.
If 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 dropped from Clinical Practice 2 and not be permitted to advance into the next semester of the program. The remediation required by unsuccessful demonstrations of competency result in reduced patient experiences, which could in turn result in reductions to the final QUALITY grade. All competency eval & re-eval grades will be included in student=s average.
The dental hygiene department has 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. Readmission is not automatic.
Patient Equivalency Number
During Clinical Practice II, emphasis is placed on skill development rather than speed (within reason). Due to the extensive collaboration between student and faculty during all patient treatment, the Clinic Grade-sheet grades alone are not an accurate assessment of competency levels. How proficient a student is in the overall management of patient care is reflected in the number and type of patients for which the student completes treatment. A student must have adequate patient experiences for his/her QUALITY grade to accurately reflect level of competency. Patient Equivalency Numbers (PEN) have been established for Clinical Practice 2.
A student must provide treatment for a minimum of 12 patient equivalencies (only 4 of which should be Class 1 level- 16 quads). A Patient Equivalency Number (PEN) less than 12 will result in point deductions from the final Quality Grade as indicated below:
PEN = 12 No points deducted from Quality Grade
PEN = 10-11 4 points deducted from Quality Grade
PEN = 8- 9 8 points deducted from Quality Grade
PEN < 8 10 points deducted from Quality Grade
COMPUTATION OF PATIENT EQUIVALENCY NUMBER (PEN)
Add total quads treated and divide by 4 (4 quads to a patient) to compute the Patient Equivalency Number (PEN)
The Patient Equivalency Number (PEN) is rounded up to the next level, if greater than a whole number, for the student=s benefit. This is unique for this course only and this policy will not be duplicated for any other dental hygiene course.
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 2. YOU CAN NOT MATRICULATE INTO THE SECOND YEAR WITHOUT SUCCESSFULLY COMPLETING CLINICAL PRACTICE 2.
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)
RADIOLOGY GRADING FOR CLINICAL PRACTICE 2
Bite-Wing Series – (95 Minimum passing grade)
A five (5) point deduction will be made for each major error as listed on the film grade form.
A five (5) point deduction will be made for each unnecessary BW film exposed.
(Ex: 4 films exposed when only 2 are needed on a child will result in a loss of 10 points from technique grade)
Minimum passing grade is 75 points. A FIVE (5) point deduction will be made for each omission/error.
1. ALL X-RAYS MUST BE GRADED and the findings sheet attached to the patient’s chart.
Radiographic surveys MUST be evaluated & turned in for grading within one (1) week of exposure.
If the case involves retakes to be made at a later date from the original appointment, then the one-week clock
starts running from the retake date. It is therefore, important for the retake date to be stated on the grade form,
as well as the date of the original exposures. Failure to comply with this policy will result in the case NOT
COUNTING toward clinical requirements, even if technique grade is above the 95% level.
2. X-RAY AUTHORIZATION FORM MUST BE SIGNED by a clinical instructor PRIOR to exposure.
An UNAUTHORIZED set of films must be evaluated but WILL NOT count toward requirements.
IN ADDITION a 30 point deduction will be assessed against the critique/landmark/findings grade.
3. Patient's chart MUST be turned in with radiographs to be graded. MUST have Radiology Prescription,
proper notation on Treatment Summary, Disposition Form & Radiology History/Authorization Form and Mount
Complete documentation consists of:
a. Properly Labeled Mount - patient and student names and date of exposure
b. Completed Critique/Landmarks/Findings Forms. "Findings" must be in ink.
c. Essential data on Radiology Grade Form.
d. Patient Instruction / Referral Form –
When radiographic findings indicate that the patient will be referred for any reason (caries,
periodontal disease, etc) this MUST be indicated on the referral form BEFORE the radiographs are
turned in for evaluation, EVEN if treatment has not been completed on the patient & a faculty
member has not yet signed form.
e. Proper notation on Treatment Summary with Radiology RX form stapled to top of page.
f. Radiology paperwork/forms must be turned in for grading in the following order in the patient file:
2. Radiology Grade Form
3. Critique/Landmarks/Findings Forms
4. Referral Form
5. Treatment Summary w/ Radiology Rx form stapled to top of page
4. Films presented for grading with incomplete documentation or out of order (See #3 a-f) will have twenty
five (25) points deducted from the Landmark Grade.
5. ALL x-rays will be checked against the Radiology Film Check-Out Log.
Failure to annotate the log will result in disqualification of the films from Quantity requirements, even if set is at
CLINICAL RADIOLOGY PROTOCOL
In the MSU Dental Hygiene Program, patient=s needs take precedence over the grading and/or requirement needs of students at all times. All radiographs must be of the highest diagnostic quality possible. All precautions must be taken to ensure that patients/clients are exposed to the minimum necessary amount of radiation. Long-cone, paralleling technique produces the most accurate diagnostic films. Students should use this technique in all but extenuating circumstances.
An UNAUTHORIZED set of films must be evaluated but will not count toward requirements.
In addition a 30 point deduction will be assessed against the critique/landmark/findings grade
All cases should be completed as quickly as possible as we have the ethical and moral responsibility to inform the patient of any pathology that we note on their case. If a patient refuses retakes, this should be noted in the treatment summary and the case must be turned in for grading as-is. All cases must be evaluated by Dr. Davis regardless of the circumstances.
Radiographs will be kept in the patient=s file - files will be located in reception area file cabinets, student wall box, reappoint box, or in clinic operatory during treatment. At no time should files be kept in student lockers or treatment areas unless patient is in the chair.
1) Adult FMS - 20 films (12 #2-8 #1)
2) Adult BWS - 4 films (#2)
3) Mixed Dentition BWS - 2 (#2)
4) Pedo BWS - 2 (#0)
5) For special cases see your Instructor
FAILURE TO COMPLY WITH ABOVE PROTOCOL CONSTITUTES PROFESSIONAL DISHONESTY AND GROUNDS FOR DISMISSAL FROM THE PROGRAM.
6. IMPRESSIONS/DIAGNOSTIC CASTS
Each student must take two (2) maxillary and two (2) mandibular impressions (1 complete set per patient) at a 75% competency level according to the stated criteria. Impressions must be taken in a regularly scheduled clinical session utilizing proper infection control protocol. The clinician must be in scrubs. An instructor must watch the process of placing the impression trays. Diagnostic casts from impressions must be matched sets (a maxillary and mandibular from same patient) and must be on two (2) separate patients - each of whom will be a fellow student. Fewer than the required number will result in a TWO point deduction from the FINAL QUALITY GRADE for EACH MISSING SET OF CASTS.
CASTS MUST BE TRIMMED AND TURNED IN FOR GRADING WITHIN 7 DAYS OF POURING. CASTS TURNED IN AFTER 7 DAYS WILL NOT COUNT TOWARD REQUIREMENTS. ALL CASTS MUST BE TURNED IN NO LATER THAN 5:00 PM ON THURSDAY APRIL 25, 2013
FAILURE TO MEET THE MINIMUM NUMBER OF ASSESSMENT/ DOCUMENTATION, BITEWING RADIOGRAPHS, FLUORIDE APPLICATIONS AND DIAGNOSTIC MODEL REQUIREMENTS WILL RESULT IN A 2 POINT REDUCTION OF THE QUALITY GRADE FOR EACH MISSING REQUIREMENT.