PROFILE AND COMPETENCES FOR THE GRADUATING EUROPEAN DENTIST AND CURRICULUM DESIGN Professor Heikki Murtomaa Institute of Dentistry Oral Public Health
Institute of Dentistry, University of Helsinki, Finland
Dental education • in 3 universities (in 4 starting 2010 ) • 5 yearcurriculum • 300 ECTS • annualadmission of 140 students (180 in 2010) • Oral hygienisteducation • in 4 polytechnics • 3,5 yearcurriculum • 210 ECTS • annualadmission of 120 students
The Humanistic Model of Professional Education Awareness Commitment Understanding Knowledge Skills Expertise
Agreed profile for the new European dentist according to the Association for Dental Education in Europe On graduation the new European dentist should: • have had a broad academic dental education and be able to function in all areasof clinical dentistry • be trained in biomedical science • be able to work together with other dental and health care professionals in the health care system • have good communicative skills • be prepared to undertake continuing professional development supporting the concept of life-long learning • be able to practice evidence-based dentistry based through a problem solving approach, using basic theoretical and practical skills
COMPETENCE 1. Dentistsareexpected to contribute through the achievement of a set of generic and subject specific competences – abilities essential to begin independent, unsupervised dental practice. 2. The competencesare the basic level of professional behaviour, knowledge and skills necessary for a graduating dentist to respond to the full range of circumstances encountered in general professional practice. 3. Competences should support integration and merging of all disciplines, which should benefit dentists in training and also patients who are receiving treatment.
COMPETENCES (2) • The graduating dentist should learn to undertake a holistic approach to the management of their patients. 2. They should have knowledge of and adhere to the concept of dental team working in their approach to patient management; all this should be supported by an ethos of achieving continuing professional development and promoting life long learning to achieve a continuum of education from undergraduate to retirement.
Domains • Seven domains have been identified that represent the broad categories of professional activity and concerns that occur in the general practice of dentistry. • The domains are interdisciplinary in orientation and must embrace an element of critical thinking; they may apply in differing ways to patients of all ages, including children, adolescents, adults and the elderly within a given population: I. Professionalism II. Interpersonal, Communication and Social Skills III. Knowledge Base, Information and Information literacy IV. Clinical Information Gathering V. Diagnosis and Treatment Planning VI. Therapy: Establishing and Maintaining Oral Health VII. Prevention and Health Promotion
MAJOR COMPETENCE • A major competence is the ability of a dentist on graduation to perform provide a particular, but complex, service or task. • Its complexity suggests that multiple and more specific abilities are required to support the performance of any major competence.
SUPPORTING COMPETENCE 1. The more specific abilities could be considered as subdivisions of a ‘major competence’ and are termed a ‘supporting competence’. 2. Achievement of a major competence requires the acquisition and demonstration of all supporting competences related to that particular service or task. 3. Some supporting competences may also contribute to the achievement of other major competences. The lists of ‘supporting competences’ are not intended to be prescriptive and are by no means exhaustive. The lists are included for use by individual schools or countries to complete and modify to meet particular national or regional needs. 4. ADEE envisages that all European schools will adhere to the major competences as described in this document, but that supporting competences may vary in detail between schools.
COMPETENCES: • Becompetent at: a dentist should on graduation demonstrate a sound theoretical knowledge and understanding of the subject together with an adequate clinical experience to be able to resolve clinical problems encountered independently or without assistance. • Haveknowledge of: a dentist should on graduation demonstrate a sound theoretical knowledge and understanding of the subject, but need/have only a limited clinical/practical experience. • Befamiliarwith: a dentist should on graduation demonstrate a basic understanding of the subject but need not have clinical experience or be expected to carry out procedure independently.
DOMAIN I: PROFESSIONALISM Major Competence 1: Professional Attitude and Behaviour On graduation, a dentist must be competent in a wide range of skills, including investigative, analytical, problem solving, planning, communication, and presentation skills and has to demonstrate a contemporary knowledge and understanding of the broader issues of dental practice. The dentist should understand the relevance of these issues, including research, team building and leadership skills in clinical dental practice.
Major Competence 2: Ethics and Jurisprudence DOMAIN I: PROFESSIONALISM On graduation a dentist must display knowledge of the content and have a thorough understanding of the moral and ethical responsibilities involved in the provision of care to individual patients, to populations and communities. The dentist must display knowledge of contemporary laws applicable to the practice of dentistry.
DOMAIN II: INTERPERSONAL, COMMUNICATION AND SOCIAL SKILLS On graduation a dentist must be competent to communicate effectively, interactively and reflectively with patients, their families, relatives and carers and with other health professionals involved in their care, irrespective of age, social and cultural background. Major Competence: Communication
DOMAIN III: KNOWLEDGE BASE, INFORMATION AND INFORMATION LITERACY On graduation a dentist must be competent to apply knowledge and understanding of the basic biological, medical, technical and clinical sciences in order to recognise the difference between normal and pathological conditions/disorders relevant to clinical dental practice and understand the bases of these. Major Competence 1: Application of Basic Biological, Medical, Technical and Clinical Sciences
Major Competence 2: Acquiring and Using Information DOMAIN III: KNOWLEDGE BASE, INFORMATION AND INFORMATION LITERACY On graduation, the dentist must be competent at demonstrating appropriate information literacy to acquire and use information from library and other databases and display the ability to use this information in a critical, scientific and effective manner. A dentist should demonstrate an ability to maintain their professional knowledge and understanding throughouttheirprofessional life.
DOMAIN IV: CLINICAL INFORMATION GATHERING On graduation, a dentist must be competent at obtaining and recording a complete history of the patient’s medical, oral and dental state. This will include biological, medical, psychological and social information in order to evaluate the oral and dental condition in patients. In addition, the dentist will be competent at performing an appropriate physical examination; interpreting the findings and organising further investigations when necessary in order to arrive at an appropriate diagnosis. Major Competence: Obtaining and Recording a Complete History of the Patient’s Medical, Oral and Dental State
DOMAIN V: DIAGNOSIS AND TREATMENT PLANNING On graduation, a dentist must be competent in decision-making, clinical reasoning and judgement in order to develop a differential, provisional or definitive diagnosis by interpreting and correlating findings from the history, clinical and radiographic examination and other diagnostic tests, taking into account the social and cultural background of the patient. A dentist must be competent at formulating and recording a diagnosis and treatment plan which meets the needs and demands of patients. For treatments that are beyond their skills, a dentist should be competent to be able to refer on for an appropriate specialist opinion and/or treatment. Major Competence: Decision-making, Clinical Reasoning and Judgement
DOMAIN VI: THERAPY: ESTABLISHING AND MAINTAINING ORAL HEALTH This domain may relate to patients from different age groups (children, adolescents,adults and the elderly) or specifically to one particular age group and to those patients with special needs and requirements. On graduation the dentist should be aware of their limitations and know when to refer a patient for specialist dental or medical care.
DOMAIN VII: PREVENTION AND HEALTH PROMOTION On graduation a dentist must be competent at promoting and improving the oral health of individuals, families and groups in the community. Major Competence: Improving Oral Health of Individuals, Families and Groups in the Community
TF IIto develop an agreed approach to the application of a modularized curricula, including ECTS that should not impose a single curricula or single educational approach • Curriculum structure and ECTS, Part I (published in EJDE 2006;10:123-130) • Curriculum structure and ECTS, Part II (published in EJDE 2007;11:125-136)
ADEE Curriculum Structure Requirements, guidelines and recommendations • Framework for a dental programme • Student exchange and ECTS • Teaching and learning • Traditional teaching versus Student directed learning • Use of Internet and e-learning • Assessment Procedures and Performance criteria
OUTCOME AND CONTENT REQUIREMENTS • CONTENT SHOULD BE RELATED AND CONTRIBUTED TO PROFILE AND COMPETENCES BY ADEE • EVIDENCE-BASED DENTISTRY SHOULD BE INTEGRAL • ELECTIVES SHOULD BE INCLUDED • EARLY PATIENT CONTACT SHOULD TAKE PLACE • A RESEARCH PROJECT BY EVERY STUDENT • (BIO)MEDICAL SUBJECTS SHOULD BE LEARNED IN AN INTEGRATED WAY
STRUCTURAL REQUIREMENTS • STRONG LINK OR PART OF A UNIVERSITY WITH CLEARLY DEFINED ORGANIZATIONAL STRUCTURE • EDUCATIONAL PRINCIPLES SHOULD BE STUDENT- AND PATIENT CENTERED • MODULES (5 -20 ECTS) WITH INFO ON LEARNING OBJECTIVES • STUDY TIME • LEARNING METHODS AND MATERIALS • ASSESSMENT PROCEDURES
ECTS European Credit Transfer and AccumulationSystem • a student-centeredsystembased on the studentworkloadrequired to achieve the objectives of a program • objectivespreferablespecified in terms of the learningoutcomes and competencies to beacquired
Key features of ECTS • 60 creditsis a measure of the workload of a full-timestudentduringan academicyear • workloadamounts 36-40 weeks a year • onecreditstands for 24-30 workinghours • totalworkload to obtain a dentaldegree is 300 creditsfollowingADEE/DentEdmodel • creditscanonlybeobtainedaftercompletion of workloadrequired and appropriateassessment of learningoutcomesachieved
Workload and ECTS • refers to notionaltime an averagelearnermightbeexpectedto complete the requiredlearningoutcomes • workloaddepends on the student’sability, teaching and learningmethods, resources, curriculum design etc. • calculation is largelydisciplinerelated and shouldbeperformedbyacademicstaff • consists of timerequired to completeallplannedlearningactivites (lectures, seminars, independentstudy, practicalsessions, preparations of projects, examinations, etc.)
Key features of ECTS • studentperformancedocumentedbynational/localgrade • ECTS graderecommended • A best 10% • B next 25% • C next 30% • D next 25% • E next 10
METHODS OF LEARNING AND TEACHING REQUIREMENTS • AIMS AND LEARNING OUTCOMES OF ALL TEACHING SHOULD BE CLEARLY DEFINED • ACTIVITIES SHOULD BE BASED ON EDUCATIONAL NEEDS OF STUDENTS AND ORAL HEALTH NEEDS OF PATIENTS AND COMMUNITY • LEARNING AND TEACHING STUDENT-CENTERED • VARIETY OF LEARNING STYLES • IT AND VIRTUAL LEARNING MATERIALS
PROBLEM BASED LEARNING SESSION • A QUICK TEST OF KNOWLEDGE BY TEN RIGHT-WRONG STATEMENTS • SEVEN STEPS ARE PROCESSED • CASES ARE MAINLY COMMON CLINICAL PATIENT CASES OR DESCRIBING A PHENOMEN RELATED TO THE ISSUE • A STUDENT CHAIR AND SECRETARY AT A TIME • DISCUSSION IMPORTANT • FORMULATE EXPLANATION FOR THE PHENOMEN OF THE CASE
PROBLEM BASED LEARNING PROCESS • CASE • PROBLEM • BRAIN STORMING • EXPLANATION MODEL • LEARNING GOALS • SELFDIRECTED STUDYING • CLOSING SESSION • ASSESSMENT OF KNOWLEDGE LEARNED AND ITS IMPLEMENTATION
PROBLEM BASED LEARNING TUTOR • PEDAGOGICAL EDUCATION IN PBL REQUIRED • SUBSTANCE SPECIALIST BUT NOT EXPERTS • A TUTOR GUIDE FOR EVERY CASE WITH THOROUGH DISCUSSIONS IN TEACHER MEETINGS • DETAILED LEARNING GOALS • THOROUGH EXPLANATION OR MODEL FOR TEH CASE AND PRINCIPLES BEHIND IT • REFERENCES TO TEXTBOOKS AND INTERNET ADDRESSES
ASSESSMENT PROCEDURES AND PERFORMANCE CRITERIA REQUIREMENTS • CRITERIA FOR LEARNING OUTCOMES, ASSESSMENT AND GRADING SCHEMES KNOWN TO ALL • MULTIPLE METHODS OF ASSESSMENT FOR STUDENTS TO RECEIVE FEEDBACK • TOOLS TO PROMOTE REFLECTION, CRITICAL THINKING AND CONTINUED LEARNING EX. SELF-/PEER- ASSESSMENT AND PORTFOLIOS SHOULD BE IN PLACE • CLINICAL ASSESSMENTS ON COMPETENCE • KNOWLEDGE, SKILLS,BEHAVIORS, SAFETY • QUANTITY AND QUALITY
ASSESSMENT METHODS • SUMMATIVE ASSESSMENT • TRANSITIION TO THE NEXT STAGE OF THE COURSE • FORMATIVE ASSESSMENT • INFO ON PROGRESS BEING MADE BY A STUDENT • SELF, PEER AND COLLOBORATIVE ASSESSMENT • PORTFOLIO • OBJECTIVE STRUCTURED CLINICAL EXAMINATION OSCE • CLINICAL EXAMINATION
HELSINKI CITY DENTAL SERVICES CLINICAL TEACHERS GOOD CLINICAL PRACTICE QUALITY CARE COMPETENT DENTISTS STUDENTS ACADEMIC STAFF EBD HELSINKI INSTITUTE OF DENTISTRY
All-around education General medicine and oral biology Society and administration Diagnostics DENTIST Manual skills Humanity and interaction Materials Acquisition of information and evaluation
CORE CONTENT ANALYSIS IN PRACTICE • Corecontentanalysismeansthatthoseresponsible for studymodules at the Faculty, with a groupconsisting of teachersfromdifferentfields, makenote of whattheyteach in eachperiod • The content of the cources is classifieldaccording to the relevance of content and howthesecontentsshouldbemastered
THE OBJECTIVES OF CORE CONTENT ANALYSIS • to guaranteelogical and comprehensivestudieswithessentialcontentsthatarefamiliar to everyone • to serve as a tool for teachers • the databaseallows for teachers to seewhat the studymodulehaspreviouslyincluded. • the teachingstaff sees theirownteaching as a part of the wholetrainingprogramme.
RELEVANCE – How relevant is the knowledge? • Must be mastered completely (the essential content of the study module) • Must be mastered adequately (information significant for the study module) 3. Special knowledge (advanced knowledge)
LEVEL OF COMPETENCE – How well should the content be mastered? A.Application (”can treat or apply in the clinical phase”) B. Comprehension (”can diagnose”) C. Knowledge (”has heard/seen”)