Online Education for Oral Health Professionals and Students: A Work

in Progress

Richard K. Fleming, PhD

University of Massachusetts Boston

Today’s objectives

 Describe the development and evaluation of a Phase I (feasibility) online course to introduce dentists, dental hygienists and other oral health professionals to the needs and treatment of patients with intellectual and developmental disabilities (ID/DD)

 Obtain audience feedback for Phase II development of a what will be a 6-course media-supported online curriculum offered for continuing education units.

Developmental Disabilities Dentistry Online Funding: NIDCR, R42DE020979-01A1

 Small Technology Transfer Research (STTR) FastTrack grant  “To support scientific excellence and technological

innovation through the investment of federal research funds in critical American priorities to build a strong national economy…..one small business at a time” (NIDCR)

 Phase I feasibility, or “proof of concept”  Phase II full implementation

An ID/DD community-engaged effort

  Richard Fleming, PhD, PI, psychology, UMASS-Boston

  Charles Hamad, PhD, psychology; Melissa Maslin, MEd & Helen Hendrickson, MPH, project management, E. K. Shriver Center at UMASS Medical School

  Harold Lobo, PhD, instructional design, Cindy Fleming, MS, formative evaluation & writing; Angela Robinson, MEd, writing; Lacey Hebert, MEd, editing, Praxis, Inc.

  John Morgan, DDS and Kathy Dolan, RDH, Med, content development, Tufts University School of Dental Medicine

  Malcolm Johnstone and Jin Chyung, learning objects development, LearnObject, Inc.

Professional Advisory Board (alphabetical)

  Robert Ducoff, DMD, Drs. Rubenstein & Ducoff, Inc.   Vincent Filanova, DDS, FADPD, DABSCD, NY State Office for People with Developmental

Disabilities, Special Dentistry Taskforce   David Fray, DDS, MBA, Chief, Developmental Disabilities Division, Hawaii Department of

Health   Steven Perlman, DDS, MScD, DOHL (hon), Clinical Professor of Pediatric Dentistry, Boston

University Henry M. Goldman School of Dental Medicine   Maureen Romer, DDS, MPA, Director of Special Care Dentistry, A. T. Still University   Allen Wong, DDS, EdD, DABSCD, Director, Hospital Dentistry Program, University of the

Pacific

Special assistance from:   Maura Buckley, MPA, Product Manager, UDiscovering   Paul Farsai, DMD, Associate Professor, Department of General Dentistry, Boston

University Henry M. Goldman School of Dental Medicine   Patrick Gleason, MA, Staff Writer, E. K. Shriver Center, UMASS Medical School

Phase I and Phase II courses

  Introduction to Oral Health Care for People with Intellectual and Developmental Disabilities (ID/DD)- feasibility

  Preventive Dentistry for People with ID/DD  Medical Considerations and Syndromes   Treatment Planning and the Comprehensive Patient

Care Experience   Behavior Management Strategies  Oral Health Care for People with Autism Spectrum

Disorders

Development Protocol

 Assess needs, expectations  Develop learning objectives  Specify outcomes (education vs. training)  Select instructional methods, media, technology  Produce content - team   Implement and evaluate  Revise

Instructional approach

  Video Stories – caregivers, staff, professionals, compelling

  Video demonstrations – behavioral guidance   Learning objects   Interactive video cases: simulations w/branched

decision-making   Self-assessments   Traditional: text, personal note taking, glossary,

resource links to organizations and materials, etc.

Video Stories – Parent’s Perspective

Maura Buckley, MPA, UDiscovering and Parent

Video Stories – Dentist’s Perspective

Learning Objects

Field Test Sample

Preliminary Field Test

17 were enrolled 13 completed the PFT:

8 dentistry students 4 dental hygiene student 1 dental hygiene educator

Summative Field Test

22 enrolled 15 completed the SFT:

12 dentistry students 1 dental hygiene student 1 full-time faculty at dental

school and practicing dentist

1 dental assistant and dental hygiene student

Knowledge gain

Overall sample: Mean percent correct scores improved significantly from pre-test (M = 55.58, SD = 11.07) to post-test (M = 79.24, SD = 7.805), z = -4.474, p < .0001. PFT: Mean percent correct scores improved significantly from pre-test (M = 55.29, SD = 10.47) to post-test (M = 82.70, SD = 8.52), z = -3.194, p = .001. SFT: Mean percent correct scores improved significantly from pre-test (M = 55.83, SD = 11.92) to post-test (M = 76.25, SD = 5.882), z = -3.191, p = .001.

Course 2 Preventive Dentistry for People with ID/DD

Selected objectives

  Examine the risk for oral disease in patients with ID/DD, including the ways in which these risks differ from those of other patients

  Describe methods for individualized, patient-centered prevention planning, taking into account unique needs and modifications

  Assess the patient’s home environment, skills, and available resources, in order to design an individualized homecare program.

Course 3 Medical Considerations and Syndromes for People with ID/DD

Selected objectives

  Identify common syndromes in ID/DD and explain their impact on oral health and treatment

  Describe how characteristics common across disabilities (e.g., sensory impairment, polypharmacy, communication skills or modalities) may affect oral health and treatment.

Course 4 Treatment Planning and the Comprehensive Patient Care

Experience

Selected objectives

  Identify psychological, behavioral, sensory, and anxiety factors in ID/DD that may impact treatment planning and treatment

  Describe the need to develop individualized, patient-centered care plans, taking into account the unique needs of a specific individual with ID/DD.

  Learn and apply decision-making processes for patients with ID/DD

  Describe best-practice approaches to communication and decision-making with individuals with ID/DD and their care team, including obtaining informed consent.

Course 5 Behavioral Guidance Strategies

Selected objectives

  Understand behaviors patients with ID/DD might exhibit, including their function, and effect on treatment

  Identify behavioral guidance strategies for use with patients with mild/moderate ID/DD, such as tell-show-do, reinforcement, gradual exposure (shaping), relaxation training, and systematic desensitization

  Identify environmental modifications to control stimulation, including alterations to sound, light, movement.

  Determine strategies used in logical combinations for particular scenarios to achieve comprehensive treatment

Course 6 Oral Health Care for People with Autism Spectrum Disorders

Selected objectives

  Describe the prevalence, characteristics and diagnostic categories of ASD

  Describe common challenges and impacts on dental care associated with sensory, behavioral, communication and anxiety issues in individuals with ASDs

  Explore treatment accommodations and behavioral supports needed to provide effective dental care with individuals with ASDs, including utilizing and referring to outside consultants and professionals

Questions for Phase II

  Should we target just children, at least for now?   Should this team focus more narrowly on parent/caregiver

training and behavioral guidance?   Target practicing dentists, dental hygienists, etc. vs. students?

(Is it possible to do both?)   What instructional methods or mix is most appealing?

 Video stories of triad members?  Video demonstrations and exercises (interactive), e.g., of

behavioral guidance?  Video case studies (interactive)?   Learning objects (interactive)?  Video/audio guide to courses?  Other

Thank you!