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Partnering with Academic Institutions and Residency Programs to Develop Service Learning Programs
Strengthening the Oral Health Safety Net (SOHSN) Initiative June 29, 2015
Irene V. Hilton, DDS, MPH
NNOHA Dental Consultant
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Objectives
Describe at least two benefits for Health Centers of engaging in service learning partnerships
Describe at least two benefits for learners of engaging in service learning partnerships
Describe at least two benefits for academic institutions of engaging in service learning partnerships
List at least three planning considerations for Health Center dental programs considering service learning partnerships
Background
Health Center mission of providing training and employment for local community
1980’s random partnerships
2008 official ADEA policy statement
2001-2010
http://www.dentalpipeline.org
Results
Health Centers are the largest percentage (29%) type of community site where students perform pipeline program service learning (http://www.adea.org/policy_advocacy/federal_legislative_regulatory_resources/Documents/ IOMStatement01062011.pdf)
Poll
How many of you are currently hosting dental student rotations or dental residency programs in your Health Center?
1. Yes
2. No
3. N/A
Health Center Benefits
Recruit future oral health professionals to Health Centers
Allows Health Center to become familiar with strength & weaknesses
Creates professional development opportunities for oral health professionals employed at Health Centers
• More fulfilling professional life, increased job satisfaction
Recruitment tool to attract new oral health professionals to Health Center jobs, retention strategy
Health Center Teaching Faculty
Credentialed as faculty of the academic institution or residency program- same process as at home institution
Faculty development- teaching and mentoring techniques, evaluating and assessing student or resident performance.
Additional continuing education opportunities
• Latest knowledge, techniques
• On site CE
• Discounted CE
Increase Access to Care
Increase encounters/revenues if capacity
Access broad spectrum of dental specialists and specialty services
Expedited referral to the academic institution or residency program
Tele-dentistry consults
Poll
How many of you are currently hosting dental hygiene student rotations in your Health Center?
1. Yes
2. No
3. N/A
Benefits to Students and Residents
Exposed to individuals from culturally, linguistically, and economically diverse populations, including those with special health care needs, complex medical issues
Enhance cultural competence
Gain appreciation for social determinants of health
Interdisciplinary Environment
Co-location with primary care, behavioral health, pharmacy, optometry, podiatry, social workers, patient navigators
Students/residents observe the practical aspects of interprofessional collaboration
Improve Clinical Skills
Gain competence & speed at performing a wide range of clinical procedures
Obtain experience working with populations that access oral health care at lower rates than the general population, such as infants and children 0-5 and pregnant women
Practice Management
Learn day-to-day operations
Observe clinical, health-information-technology, and administrative systems
• Infection control
• Peer review
• Quality Assurance
Poll
How many of you are currently hosting dental assisting student rotations in your Health Center?
1. Yes
2. No
3. N/A
Benefits for Academic Institutions
Required by CODA
“Dental education programs must make available opportunities and encourage students to engage in service learning experiences and/or community-based learning experiences. Service learning experiences and/or community-based learning experiences are essential to the development of a culturally competent oral health care workforce.” (Commission on Dental Accreditation,
Accreditation Standards for Dental Education Programs)
More Benefits
Opportunity to offer students and residents a diverse clinical experience
Pilot models and approaches for developing community-based dental education curricula, clinical programs
Pilot methodologies for testing and evaluating programs and student competencies
Cost Savings
Dental schools choose not to construct direct patient care clinics or plan small clinics that will accommodate only a small number of students
Savings in facilities, faculty, and infrastructure associated with providing direct patient care in traditional academic institution clinics
Greater flexibility in allocating resources to other educational areas
Research
Offer academic institutions opportunities to conduct community-based research
Health center patients are typically from populations that have higher rates of oral disease than the general population and that are under-represented in research
Models
Pre-doctoral rotations
Post-doctoral residencies
Dental hygiene rotations
Dental assisting rotations
HC- academic institution clinic collaborations
Poll
How many of you have gone on to permanently hire someone who did a service learning rotation at your Health Center?
1. Yes, we have hired
2. No, we have not hired
3. We don’t host any service learning in our Health Center
4. N/A
Planning Considerations
Is service learning right for my dental program?
Assessing Organizational Readiness
Has the Health Center identified what it hopes to gain from a service learning partnership?
Is leadership willing to devote the required resources to the partnership?
Are oral health professionals who work at the Health Center willing to go through the faculty development and credentialing process and serve as engaged and enthusiastic teachers and mentors?
Ask/Learn
Academic Partner
Mission Alignment
Track record of successful partnering
Communication
Thorough orientation & understanding of division of responsibilities
Level of administrative and technical support
Space
Procedures/Requirements
Sufficient patients
Adequate procedure mix
Residency requirements
• At site or by arrangement
Systems to assess competence, identify deficient areas, and arrange remediation experience
Support Team Ratio
Engaged Health Center Staff
WIN-WIN NEGOCIATIONS
Hosting Students
Faculty Supervision
Academic institution or residency program faculty placed at the Health Center
Develop and credential Health Center oral health professionals as adjunct faculty of the academic institution or residency program
Faculty Development
Training in teaching and mentoring techniques
How to evaluate and assess performance in a standardized manner
Understanding of credentialing, faculty appointment, training, evaluation and supervisory requirements
Financial Considerations
Many different types of financial arrangements between Health Centers and academic institutions and residency programs
Health Centers need to negotiate a mutually agreeable arrangement
Must know current revenue & productivity data
Health Center Perspective
At minimum, revenue neutral
Current levels of productivity, anticipated student and supervising faculty productivity levels, number of chairs, availability of support staff, and additional costs
Expect productivity of supervising faculty will decrease owing to loss of operatory space and time spent in supervisory duties. Maybe offset by revenues and productivity by student/resident.
Examples of Arrangements
Health Center trained faculty, keeps revenues
Academic institution or residency program covers the salary and fringe benefits of post-doctoral residents, Health Center retains revenues
Academic partner places own faculty in Health Center. Health Center purchases faculty time and retains revenues
Health Center negotiates to pay the academic institution or residency program percentage of revenues
Successful Partnerships
Flexibility
Communications- each partner clearly understands their role & expectations
Champions
What have been the benefits of service learning rotations? (Discussion)
Challenges
Meeting CODA Requirements
Revenue Sharing
Productivity Changes
Lack of Communication
What have been the challenges?
(Discussion)
Conclusion
Service learning partnerships can provide benefits to Health Centers and patients served
Challenges inherent in developing and maintaining such programs can be addressed
Success when WIN-WIN
http://www.nnoha.org/nnoha-content/uploads/2014/06/Academic-Partnerships-Paper-final_2014-06-03.pdf
www.nnoha.org
Irene V. Hilton, DDS, MPH NNOHA Dental Consultant [email protected] San Francisco Department of Public Health 1525 Silver Avenue San Francisco, CA 94134 (415) 657-1708