PROFILE AND COMPETENCES FOR THE GRADUATING EUROPEAN DENTIST AND CURRICULUM DESIGN

Professor Heikki MurtomaaInstitute of DentistryOral Public Health

City of Helsinki

University of Helsinki

Institute of Dentistry, University of Helsinki, Finland

Dental education

• in 3 universities (in 4 starting 2010 )

• 5 year curriculum• 300 ECTS• annual admission of 140

students (180 in 2010)

Oral hygienist education

• in 4 polytechnics• 3,5 year curriculum• 210 ECTS• annual admission of 120

students

The Humanistic Model of Professional Education

Commitment Understanding

Expertise

Awareness

KnowledgeSkills

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. Dentists are expected to contribute through the achievement of a set of generic and subject specific competences – abilities essential to begin independent, unsupervised dental practice.

2. The competences are 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)

1. 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.

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. ProfessionalismII. Interpersonal, Communication and Social SkillsIII. Knowledge Base, Information and Information literacyIV. Clinical Information GatheringV. Diagnosis and Treatment PlanningVI. Therapy: Establishing and Maintaining Oral HealthVII. Prevention and Health Promotion

Domains

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:

Be competent 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.

Have knowledge 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.

Be familiar with: 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.

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 1: Professional Attitude and Behaviour

DOMAIN I: PROFESSIONALISM

Major Competence 2: Ethics and Jurisprudence

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 I: PROFESSIONALISM

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

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 throughout their professional life.

DOMAIN III: KNOWLEDGE BASE, INFORMATION AND INFORMATION LITERACY

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

1. Framework for a dental programme2. Student exchange and ECTS3. Teaching and learning4. Traditional teaching versus Student directed

learning5. Use of Internet and e-learning6. 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 Accumulation System

a student-centered system based on the student workload

required to achieve the objectives of a program

objectives preferable specified in terms of the learning

outcomes and competencies to be acquired

Key features of ECTS

60 credits is a measure of the workload of a full-time

student during an academic year workload amounts 36-40 weeks a year one credit stands for 24-30 working hours total workload to obtain a dental degree is 300 credits

following ADEE/DentEd model credits can only be obtained after completion of workload

required and appropriate assessment of learning outcomes

achieved

Workload and ECTS

refers to notional time an average learner might be expected to complete the required learning outcomes

workload depends on the student’s ability, teaching and learning methods, resources, curriculum design etc.

calculation is largely discipline related and should be performed by academic staff

consists of time required to complete all planned learning activites (lectures, seminars, independent study, practical sessions, preparations of projects, examinations, etc.)

Key features of ECTS

student performance documented by national/local

grade ECTS grade recommended

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 CURRICULUM

Learning entity ECTSContact hours

Independent studies TST

1st preclinical year 44 321 848 1169

2nd preclinical year 53 431 971 1402

Growth of the masticatory system 6 75 75 150

General diagnostic methods 7 82 92 174

Development and guidance of the occlusion 6 93 55 148

Function of the masticatory system 6 80 70 150

Reconstruction and rehabilitation of the bite function 13 224 114 338

Infectous diseases of the teeth and periodontium 32 552 307 859

Oral and maxillofacial surgery 11 142 142 284

Oral medicine 19 253 264 517

Oral public health 6 80 80 160

Clinical studies 55 1476 1476

Personal and professional growth 7 124 76 200

Language studies 7 84 90 174

Scientific project 20 30 500 530

Electives 10 270

300 8001

Helsinki Curriculum

HELSINKI CITYDENTAL SERVICES

GOODCLINICALPRACTICE

HELSINKI INSTITUTE OF DENTISTRY

EBD

STUDENTS QUALITY CARE COMPETENT DENTISTS

ACADEMICSTAFF

CLINICAL TEACHERS

SBU 1st year 2nd year 3d year 4th year 5th year1680 scientific training Research electives1600 project1520144013601280 Professional12001120 Training1040960880800720640560480400320 electives240160 Free electives

80

Total patient care

General medicine and oral biology

Diagnostics

All-around education

Society and administration

Humanity and interaction

Acquisition of information and evaluation

Materials

Manual skills

DENTIST

CORE CONTENT ANALYSIS IN PRACTICE

1. Core content analysis means that those responsible for study modules at the Faculty, with a group consisting of teachers from different fields, make note of what they teach in each period

2. The content of the cources is classifield according to the relevance of content and how these contents should be mastered

THE OBJECTIVES OF CORE CONTENT ANALYSIS

to guarantee logical and comprehensive studies with essential contents that are familiar to everyone

to serve as a tool for teachers

the database allows for teachers to see what the study module has previously included.

the teaching staff sees their own teaching as a part of the whole training programme.

RELEVANCE – How relevant is the knowledge?

1. Must be mastered completely (the essential content of the study module)

2. 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”)

PERFORMANCE MANAGEMENT BALANCED SCORE CARD (BSC) Kaplan and Norton 1996

A STRATETIC PERFORMANCE MANAGEMENT TOOL PROVIDES THE INSTRUMENTATION NEEDED TO

NAVIGATE TO FUTURE COMPETIVE SUCCESS INCORPORATES ALL QUANTITATIVE AND ABSTRACT

MEASURES OF TRUE IMPORTANCE TO THE

ENTERPRISE HELPS ORGANIZATIONS TO ACHIEVE A DEGREE OF

BALANCE IN SELECTION OF PERFORMANCE

MEASURES

Implementing Balanced Scorecards typically includes four processes:

Translating the vision into operational goals Communicating the vision and linking it to individual performance Business planning Feedback and learning and adjusting the strategy accordingly

STRATEGIC MANAGEMENT BSC Kaplan and Norton 1996

BASELINE ANALYSIS WHERE WE ARE, SWOT

REALISATION OF THE NEED FOR CHANGE WHAT WOULD WE LIKE TO IMPROVE

VISION WHAT WOULD WE LIKE TO ACHIEVE

MAKING OF THE ACTION PLAN WHAT HAS TO BE DONE AND HOW

RESPONSIBILITIES, TIMETABLE, PRIORITIES

STARTING THE ACTION AND INFORMING THE STAFF INTERMEDIATE ASSESSMENT

HOW ARE WE DOING

FINAL ASSESSMENT FURTHER ACTIVITIES – HOW TO GO ON

STRATEGIC LEADERSHIP BSC Kaplan and Norton 1996

PERSPECTIVES

Financial/ServicesCustomer/Students, University, SocietyInternal process/Staff, CurriculumInnovation and learning

perspective/Development

STRATEGIC LEADERSHIP BSC Kaplan and Norton 1996

PERSPECTIVES

Innovation and learning perspectiveHuman capitalInformation capitalOrganization capital

TASKFORCE IV – GLOBAL CONGRESS