Strategic Partnership for Interprofessional Collaboration and Education in Pediatric Dentistry SPICE-PD. Course Curriculum

Strategic Partnership fr Interprfessinal Cllabratin and Educatin in Pediatric Dentistry SPICE-PD Curse Curriculum

TABLE OF CONTENTS Prject Abstract ------------------------------------------------------------------------------------------------------------------------- 2 Prgram Year One and Tw Overview -------------------------------------------------------------------------------------------------- 4 Curse Syllabi: Cmmunity Partners ------------------------------------------------------------------------------------------------------------------------- 6 Statistics & Research Methds ------------------------------------------------------------------------------------------------------------ 10 Plicy & Advcacy ---------------------------------------------------------------------------------------------------------------------------- 15 Disease Management/Risk Assessment ------------------------------------------------------------------------------------------------- 21 Ethics & Prfessinalism -------------------------------------------------------------------------------------------------------------------- 27 Cultural Cmpetency ------------------------------------------------------------------------------------------------------------------------ 32 Quality Imprvement ------------------------------------------------------------------------------------------------------------------------ 38 Interprfessinal Educatin (IPE)/Training Schl f Medicine Interprfessinal Partnership ------------------------------------------------------------------------- 43 Schl f Nursing Interprfessinal Partnership --------------------------------------------------------------------------- 52 Special Needs Children Autism Spectrum Disrder ------------------------------------------------------------------------------------------------------- 62 The Cmplex Special Needs Patient Multidisciplinary Apprach ---------------------------------------------------- 69 This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 1

PROJECT ABSTRACT Prject Title: Strategic Partnerships fr Interprfessinal Cllabrative Educatin in Pediatric Dentistry (SPICE-PD) Organizatin Regents f the University f Califrnia, Ls Angeles Address 11000 Kinrss Avenue, Suite 211, Ls Angeles, CA, 90095-1406 Prject Directr Name: Francisc Rams-Gmez, DDS,MS,MPH Cntact Phne Numbers: 310-794-0165 E-Mail Address: frg@dentistry.ucla.edu Website www.uclachatpd.rg The University f Califrnia, Ls Angeles (UCLA) Schl f Dentistry has been awarded its secnd five-year Health Resurces and Services Administratin grant t prepare dentists fr the cmplex and cmprehensive needs f pediatric patients within rapidly changing demgraphics and a paradigm shift in dentistry. The PI, Dr. Rams-Gmez carries verall administrative and financial respnsibility f this prject. Dr. Rams-Gmez has ver 30 years f experience in pediatric ral health. He is a pediatric dentist, researcher and full prfessr at UCLA and has wrked n numerus cmmunity and research prjects ver the past 25 years. He has authred well ver 25 articles n pediatric and cmmunity ral health. He als hlds a Masters f Public Health degree frm Harvard University Schl f Public Health. Fr his full bi visit: http://www.uclachatpd.rg/faculty--staff.html Ratinale and Gals: Substantial disparities in children s ral health and access t a full range f ral health/dental services exist thrughut Califrnia and the US. The need fr interprfessinal cllabratin is critical t ensure different health care prvider types are engaged and prepared t address the ral health needs f children in the cmmunity. The verall purpse f Strategic Partnership fr Interprfessinal Educatin in Pediatric Dentistry (SPICE- PD) is t augment and advance the training prvided thrugh the UCLA Cmmunity Health and Advcacy Training in Pediatric Dentistry (CHAT-PD) residency prgram t mre effectively prepare dentists t meet the grwing ral health needs f children with special needs, and thse frm underserved, high-need vulnerable ppulatins in the Ls Angeles area. Frm successful implementatin f the CHAT-PD prgram (funded by HRSA grant # D88HP20129) we have strategically develped a prpsal t addresses areas f high need, with gals that align with the directin in which health care is mving, keeping in mind the cmmunity and trainees we aim t impact. The prject has three main gals: A) Establish an Integrated Oral and Primary Healthcare Clinical Training Prgram fr UCLA Cmmunity Health and Advcacy Training in Pediatric Dentistry (CHAT-PD), Advanced Educatin General Dentistry (AEGD), Pediatric Medicine, and Nursing Prgrams. B) Update and enhance existing CHAT-PD residency curriculum t prepare pstdctral pediatric dentists t prvide care fr underserved and special needs grups and cmmunities in the evlving field f dentistry. C) Enhance training in dental public health and ppulatin health management fr UCLA CHAT-PD and AEGD residents thrugh a partnership with the UCLA Schl f Public Health. The prject aims t meet these gals with the design f a didactic curriculum, and clinical experiences integrated in a cmmunity-based interprfessinal setting. The cmplete implementatin f this prpsal will prduce highly trained pediatric dentists wh are equipped t better serve the cmmunity and children with special health care needs. AEGD, Pediatric Medicine Residents, and Family Nurse Practitiner (FNP) residents will als receive bth didactic and clinical training in wrking with children ages 0-5 years. The prject will, in cllabratin with pediatric medicine, integrate pediatric dental services. The prject will demnstrate significant cst savings and an effective strategy f cllabratin fr delivery f services. Funding pririty: The prject meets the funding pririty areas in the fllwing categries: (1) Cllabrative Prject; (2) Frmal Relatinship; (3) Cultural Cmpetency & Health Literacy; (4) Special Ppulatin; (5) Vulnerable Ppulatin Fcus; (6) Discipline Retentin; (7) Placement in Practice Settings; and (8) Student Training. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 2

Curse curriculum subject t change at any time at the discretin f the prject directr. Prgram Year One Prgram Year 1 Summer Quarter July & Aug Cre classes: Dentistry fr Dental Residents, Physical Diagnsis, Medical Emergencies, Intr t Pediatric Dentistry, Intr t Orth, Behavir Guidance, *Caries Disease Management/Risk Assessment (*SPICE Mdule) Cultural Cmpetency (as part f Intrductin t SPICE) Cmmunity Partners (as part f Intrductin t SPICE) Prgram Year 1 Fall Quarter Sept - Dec Caries Disease Management/Risk Assessment (Hybrid) Mtivatinal Interviewing & nline learning Interprfessinal Educatin: Pediatric Medicine Plicy & Advcacy Applied Statistics & Research Design Cmmunity Partners -Intr t Practicums Level I & II Special Needs Curse "Medically Cmprmised Patients - (*tw-year lng curse, fr all residents) Prgram Year 1 Winter Quarter Jan-Mar Ethics (Hybrid) Interprfessinal Educatin: Pediatric Medicine Cmmunity Partners: Practicum level I & II wrap-up Autism Spectrum Disrder Applied Statistics & Research Design cntinued- selectin f research hypthesis and research design Prgram Year 1 Spring Quarter Apr- Jul Plicy & Advcacy- AAPD advcacy days (April )(Advcacy days pre-wrk and pst-reflectin sessin) (nt supprted by SPICE funds) Cmmunity Partners: Prvided by Schl f Nursing faculty fr IPE educatin & NOHC cnference April (pre-wrk & pst reflectin sessin)- selected Peds & AEGD residents attend Autism Spectrum Disrder clinical rtatin Applied Statistics & Research Design cntinued (data cllectin) This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 3

Prgram Year Tw Prgram Year 2 Summer Quarter July & Aug Applied Statistics & Research Design cntinued (data cllectin) Caries Disease Management & Risk Assessment- selected guest lecturers & nline learning (Hybrid) Prgram Year 2 Fall Quarter Sept - Dec Caries Disease Management/Risk Assessment (Hybrid) Quality Imprvement & Practicum Plicy & Advcacy Applied Statistics & Research Design cntinued Cmmunity Partners Prgram Year 2 Winter Quarter Jan-Mar Selected guest lecturers & nline learning Plicy & Advcacy -Lcal & State f CA legislatin (TBA) Applied Statistics & Research Design: CSPD Annual Meeting pster presentatins (March) (pre-wrk & pst-reflectin sessin) Prgram Year 2 Spring Quarter Apr- Jul Practice Management (nt a SPICE mdule) Applied Statistics & Research Design cn t: AAPD annual meeting (May) pster presentatin (pre-wrk & pst reflectin sessin) Autism Spectrum Disrder clinical rtatin (TBA) Prgram Year 3 Summer Quarter Applied Statistics & Research Design cntinued-final research paper write-ups: Alumni Day and UCLA Research day pster presentatins This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 4

Strategic Partnership fr Interprfessinal Cllabrative Educatin in Pediatric Dentistry COMMUNITY PARTNERS MODULE Curse Syllabus Curse Title: Cmmunity Partners Curse Enrllment: Pediatric Dental Residents & Advanced Clinical Trainees (ACTs) This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 5

Curse Chair/C-Chair Jim Crall, DDS, MS, ScD James J. Crall, D.D.S., M.S., Sc.D. is a Prfessr and Chair f the Divisin f Public Health and Cmmunity Dentistry at the UCLA Schl f Dentistry. Dr. Jim Crall directs the HRSA/MCHB Leadership Training in Pediatric Dentistry Prgram. He served as Directr f the HRSA/MCHB Natinal Oral Health Plicy Center frm 2000-2008, was Prject Directr fr the AAPD Head Start Dental Hme Initiative frm 2007-2010, and has been Child Advcate fr the American Academy f Pediatric Dentistry since 1995. He has authred r cauthred ver 60 peer-reviewed manuscripts and nearly 40 chapters, technical briefs, and cmmissined wrks (including the CMS Guide t Children s Dental Care in Medicaid). Email: jcrall@dentistry.ucla.edu Inese Verzemnieks, PhD, RN, CNL Dr. Verzemnieks is the prject directr f the Center fr Vulnerable Ppulatins Research (CVPR). She received her PhD in Nursing with a cgnate in develpmental psychlgy in 1998. Dr. Verzemnieks is currently a lecturer at University f Califrnia, Ls Angeles, and faculty research and clinical expertise. Email: iverzemn@snnet.ucla.edu Francisc Rams-Gmez, DDS, MS, MPH Francisc Rams-Gmez, D.D.S., M.S., M.P.H. is a prfessr in the Divisin f Pediatric Dentistry and the Directr fr the Pediatric Dentistry Preceptrship Prgram at the UCLA Schl f Dentistry. Dr. Rams-Gmez jined the schl as a faculty member in 2008. Dr. Rams-Gmez has been a pediatric dentist fr mre than twenty years with specific fcus and research in the areas f early childhd caries (ECC) preventin, ral disease risk assessment, and cmmunity health with an emphasis n underserved ppulatins. Varius cmmunity partners and experts are invited fr guest presentatins. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 6

Curse descriptin This curse will intrduce students/ residents t scial and health care systems and determinants f health and the impact n the ral health f the individual and ppulatin. Students/ residents will demnstrate the ability t access and describe the use f ppulatin-based health data fr health prmtin, patient care and quality imprvement. Tpics that will be cvered include: Cmmunity health and scial welfare including scial prgrams Financing and wrkfrce issues Pediatric ral health systems f care Health equity/ health disparities Health educatin and health prmtin Ppulatin health management Health acrss the life span Curse cmpetencies Describe scial and health care systems lcally and natinally and determinants f health and their impact n the ral health f the individual and ppulatin. Describe the ral health status and needs f the US ppulatin, including the underserved, and minrity grups. Curse Objectives On successful cmpletin f this curse, residents will be prepared t: Identify the causes f scial and behaviral factrs that affect health f individuals and ppulatins Identify individual, rganizatinal, and cmmunity cncerns, assets, resurces, and deficits fr scial and behaviral science interventins Identify critical stakehlders fr the planning, implementatin, and evaluatin f public ral health prgrams plicies, and interventins Describe the rle f scial and cmmunity factrs in bth the nset and slutin f public ral health prgrams, plicies, and interventins. Describe the different US scial welfare systems, healthcare systems and health insurance systems and their implicatins fr ppulatin ral health status. Define ral health literacy fr the health care prvider and dental public health prfessinal Identify aspects f an ral health literate rganizatin and be able t suggest ways t implement ral health literate best practices Describe the individual, cmmunity and public health implicatins f lw ral health literacy and the rle f hme visiting prgrams Explain strategies t cmmunicate mre clearly with patients, the public, r cmmunity This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 7

Lecture Seminar Literature Review Resident Presentatin Instructinal methd(s) used in this curse (Check all that apply) Prjects Grand Runds Other: GME Cmpetencies addressed by the curse: (check all that apply) Patient Care Medical Knwledge Practice-Based Learning & Imprvement Interpersnal & Cmmunicatin Skills Prfessinalism Systems-Based Practice Bimedical Sciences Behavir Guidance Grwth & Develpment Oral Facial Injury & Emergency Care Oral Diagnsis, Oral Pathlgy, & Oral Medicine Preventin & Health Prmtin Cmprehensive Dental Care CODA Standards addressed by this curse: (check all that apply) Management f a Cntemprary Dental Practice Patients with Special Health Care Needs Hspital Dentistry Pulp Therapy Pediatric Medicine Advcacy Teaching Evaluatin Criteria/Methds Students /Residents attainment f curse bjectives will be assessed by cmpletin f tw cmmunity level practicums. Applied learning experiences Practicum level I: Residents participate in an activity r event led r rganized by a cmmunity rganizatin Practicum level II: Residents initiate cntact with a cmmunity rganizatins, and wrk cllabratively t imprve systems f care fr the ral health f children. Written reprts f the practicums must be cmpleted and practicum level II summaries presented in class. Fr mre details n the practicums refer t SPICE website at: http://www.uclachatpd.rg/practicum.html Remediatin Plicies A custmized remediatin prgram will be designed t address areas f deficiency This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 8

Sessin Length f Sessin Summer 1 Hr Intrductin t Cmmunity Health & Advcacy (CHAT-PD) COURSE SCHEDULE Title f Sessin Tpics Cvered Instructr Intrductin t HRSA funding, gals, & bjectives f CHAT-PD. Overview f website, resurces, and requirements Summer 1 Hr Intrductin t Cmmunity Partners Varius scial services agencies and their rle in cmmunity ral health preventin and prmtin Summer 2 Hrs Scial Determinants f Health Rle f scial determinants f health (such as health care services, scial & cmmunity cntext, educatin, ecnmic stability, etc.) n ral health Summer 1 Hr Cmmunity Partners Site Visit: Venice Family Clinic / Simms Mann & Lu Clen Tur f IOCP clinics Summer 1 Hr Intrductin t WIC Wmen Infant & Children natinal prgram. Summer 1 Hr Intrductin t Early Head Start / Head Start with an emphasis n dental Head Start care and Natinal and State Prgram Summer 1 Hr. LA Children s Dental Insurance Plans- Healthcare (30 mins) Fall 1 Hr Cmmunity Clinic and Prgrams in Ls Angeles Infrmatin Reprts (PIR) Dental and Health Insurance with emphasis n Medi-Cal First 5 LA s investment in Dental Hme prject. Cmmunity Clinics & Prgrams Fall 2 Hrs Healthcare financing I and II Overview f the structure, rganizatin, and financing f dental services fr children in the United States. Fall 2 Hrs Defining the Access Prblem Features f the current dental care delivery system and relatin t access issues. Access and utilizatin trends f dental services in the US 2 Hrs Appraches t Imprving Perfrmance Medi-aid structure & reimbursing Fall f Oral Health Care Systems rates, alternative appraches Fall 2 Hrs Health Literacy Health Literacy and Readability f Patient Educatin Materials Imprving Patient Outcmes Fall r 2 hrs Hme Visiting Hme visiting and its rle in Winter cmmunity ral health Francisc Rams Gmez Francisc Rams Gmez Francisc Rams Gmez Francisc Rams Gmez Karen DelaCruz Stacey Scarbrugh Linda Lpez Jim Crall Jim Crall Jim Crall Jim Crall Inese Verzemnieks Inese Verzemnieks This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 9

Learning Resurces & Readings All available nline at UCLA MedHub. Here are a few: Natinal Security and U.S. Child Health Plicy: The Origins and Cntinuing Rle f Medicaid and EPSDT Sara Rsenbaum D. Richard Mauery Peter Shinc Julia Hidalgd. Department f Health Plicy Brief, Gerge Washingtn University. Available at: http://publichealth.gwu.edu/departments/healthplicy/chpr/dwnlads/mil_prep042605.pdf Medi-Care prgram. General Infrmatin Centers fr Medicare & Medicaid Services 2014; Available at: https://www.cms.gv/medicare/medicare-general-infrmatin/medicaregeninf/index.html HOW MEDICARE WAS MADE By Julian E. Zelizer, The New Yrker, FEBRUARY 15, 2015 available at: http://www.newyrker.cm/news/news-desk/medicare-made The Children's Health Insurance Prgram (CHIP). Centers fr Medicare & Medicaid. Available at: https://www.medicaid.gv/chip/benefits/chip-benefits.html US Department f Health and Human Services, Administratin fr Children and Families. Head Start general verview. Available at: https://eclkc.hs.acf.hhs.gv/hslc/hs/abut Medicare vs. Medicaid. United Health Care. Available at: https://www.medicaremadeclear.cm/basics/medicare-vsmedicaid US Department f Health and Human Services. HRSA. Maternal and Child Health. Early and Peridic Screening, Diagnsis, and Treatment (EPSDT) prgram. Available at: http://learning.mchb.hrsa.gv/epsdt/verview.html Califrnia Department f Health Care Services, Systems f Care Divisin, Children's Medical Services CHDP PERIODICITY SCHEDULE FOR HEALTH ASSESSMENT REQUIREMENTS BY AGE GROUPS. Available at: https://files.medical.ca.gv/pubsdc/publicatins/masters-other/chdp/frms/peridhealth_c01.pdf Vujicic M, Nasseh, K. Gap in dental care utilizatin between Medicaid and privately insured children narrws, remains large fr adults. Health Plicy Institute Research Brief. American Dental Assciatin. December 2015 (Revised). Available frm: http://www.ada.rg/~/media/ada/science%20and%20research/hpi/files/hpibrief_0915_1.ashx Brickhuse, T.H., R.R. Haldiman, and B. Evani, The impact f a hme visiting prgram n children's utilizatin f dental services. Pediatrics, 2013. 132 Suppl 2: p. S147-52. Kniak-Griffin, D., Verzemnieks, I. L., Andersn, N. L., Brecht, M. L., Lesser, J., Kim, S., & Turner-Pluta, C. (2003). Nurse visitatin fr adlescent mthers: tw-year infant health and maternal utcmes. Nurs Res, 52(2), 127-136. Review by Mathematica f the varius DHHS-ACF designated evidence based mdels f hme visiting fr mthers and yung children http://hmvee.acf.hhs.gv/hmvee-executive-summary-2016_cmpliant.pdf Verhef, W. A., Livas, C., Delli, K., & Ren, Y. (2015). Assessing the standards f nline ral hygiene instructins fr patients with fixed rthdntic appliances. J Am Dent Assc, 146(5), 310-317. di: 10.1016/j.adaj.2015.01.004 Miller, E., Lee, J. Y., DeWalt, D. A., & Vann, W. F., Jr. (2010). Impact f caregiver literacy n children's ral health utcmes. Pediatrics, 126(1), 107-114. di: 10.1542/peds.2009-2887 This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 10

Strategic Partnership fr Interprfessinal Cllabrative Educatin in Pediatric Dentistry STATISTICS & RESEARCH METHODS MODULE Curse Syllabus Curse Title: Research Design & Applied Statistics Curse Enrllment: Pediatric Dental Residents & Advanced Clinical Trainees (ACTs) This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 11

Curse Chair/C-Chair Dnna Kritz-Silverstein, Ph.D. Dr. Kritz-Silverstein has a dctrate in scial psychlgy with a minr in statistics frm New Yrk University and is an Adjunct Prfessr in the Department f Family and Preventive Medicine at UCSD. Her areas f research include wmen s health, heart disease risk factrs, bne health, and cgnitive functin. Fr the past 23 years, she has been C-Investigatr and Principal Investigatr n NIH funded Ranch Bernard Study grants in additin t serving as Fllw-up Crdinatr fr the study. Email: dsilverstein@ucsd.edu Chi-Hng Tseng, Ph.D. Dr. Tseng received his Ph.D in Bistatistics frm UCLA in 2004. His research interest includes design f clinical trials, survival analysis, multiple cmparisns prblem, and statistical genetics. He has extensive cllabrative experience in cardilgy, infectius disease, pulmnary, nephrlgy, cancer, and health services studies. Dr. Tseng will be prviding the pediatric dental residents cntinuus ne-n-ne feedback n their research prjects. He is the SPICE Infrmatin Systems Expert and data crdinatr. Email: CTseng@mednet.ucla.edu Francisc Rams-Gmez, DDS, MS, MPH Francisc Rams-Gmez, D.D.S., M.S., M.P.H. is a prfessr in the Divisin f Pediatric Dentistry and the Directr fr the Pediatric Dentistry Preceptrship Prgram at the UCLA Schl f Dentistry. Dr. Rams-Gmez jined the schl as a faculty member in 2008. Dr. Rams-Gmez has been a pediatric dentist fr mre than twenty years with specific fcus and research in the areas f early childhd caries (ECC) preventin, ral disease risk assessment, and cmmunity health with an emphasis n underserved ppulatins. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 12

Curse Descriptin Residents will be prvided with the necessary scientific fundatin f knwledge and skills required t practice effective Evidence- based dentistry. Residents will gain knwledge t frm critical questins, lcate infrmatin, judge the quality f available infrmatin, and apply evidence t clinical decisin making and nging evaluatin n bth patient care at the individual level and cmmunity level. Knwledge f basic research design and statistics is imprtant in rder t understand the scientific literature that will be read thrughut ne s prfessinal career as well as t give ne the ability t cnduct their wn research prject. This curse surveys basic research design and research methds alng with basic descriptive and inferential statistics. Curse Cmpetencies Residents are expected t becme knwledgeable in research design, basic statistics and t gain the skills necessary t interpret the results f statistical analyses. Curse Objectives On successful cmpletin f this curse, residents will be prepared t: Critique, synthesize, and apply infrmatin frm scientific and lay surces t imprve ral health. Understand basic statistical and research design terms and prcedures including IRB prcesses. Frmulate apprpriate research questin and cnduct an apprved research prject Cmplete a research paper/pster write-up and present t audience. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 13

COURSE SCHEDULE Sessin # 1 (1 st yr residents nly) Fall PGY 1 2 Fall PGY 1 Length f Sessin Title f Sessin Tpics Cvered Instructr 1.5 Hrs Develping a Schlarly Research Surces f ideas, steps fr ding Dnna Kritz- Prject research prject, bias, and writing a Silverstein research prpsal 1.5 hrs Intr t Study Design Imprtance f research; Scientific methds; Hypthesis testing; sampling strategies; research designs and advantages/disadvantages f each Dnna Kritz- Silverstein 3 Fall PGY 1 1.5 Hrs Research Design & Descriptive Statistics Variables; types f variables, cnfunding, Scales f measurements descriptive statistics; measures f central tendency; data distributins & data display Dnna Kritz- Silverstein 4 Fall PGY 1 1.5 Hrs Intrductin t parametric statistics Independent and paired t-tests; Analysis f variance; Dnna Kritz- Silverstein 5 Fall PGY 1 1.5 Hrs Parametric (cntinued) & Nnparametric Inferential Statistics Crrelatin analysis; Regressin analysis; Chi- square tests, Odds rati; Hw t knw what statistics t use. Dnna Kritz- Silverstein 6 Fall PGY 1 2 Hrs Submitting an IRB: Prcess & Prtcls IRB review prcess & Web IRB submissin prcess IRB staff 7 Winter PGY 1 8 Spring PGY2 2-3 Hrs Research prject updates and faculty feedback 2-4 Hrs (varies) Presentatin f research prjects at selected prfessinal cnferences such as the annual AAPD & CSPD meetings (and at UCLA research day and Alumni Day). Dr. Rams, Dr. Kritz- Silverstein, Dr. Tseng, ther invited faculty Dr. Rams, Dr. Kritz- Silverstein, Dr. Tseng, ther invited faculty This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 15

Strategic Partnership fr Interprfessinal Cllabrative Educatin in Pediatric Dentistry POLICY & ADVOCACY MODULE Curse Syllabus Curse Title: Plicy & Advcacy Curse Enrllment: Pediatric Dental Residents & Advanced Clinical Trainees (ACTs) This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 16

Curse Chair/C-Chair Francisc Rams-Gmez, DDS, MS, MPH Francisc Rams-Gmez, D.D.S., M.S., M.P.H. is a prfessr in the Divisin f Pediatric Dentistry and the Directr fr the Pediatric Dentistry Preceptrship Prgram at the UCLA Schl f Dentistry. Dr. Rams-Gmez jined the schl as a faculty member in 2008. Dr. Rams-Gmez has been a pediatric dentist fr mre than twenty years with specific fcus and research in the areas f early childhd caries (ECC) preventin, ral disease risk assessment, and cmmunity health with an emphasis n underserved ppulatins. Sarah Blenner, JD, MPH Sarah Blenner is the prject Manager at Public Health Training Prgram n Ppulatin Health Advcacy fr the Office f the Assciate Dean f Public Health Practice at UCLA Fielding Schl f Public Health. She has extensive experience in Plicy and Advcacy Develpment. Email: sblenner@ph.ucla.edu James Crall, DDS, MS, Sc.D James J. Crall, D.D.S., M.S., Sc.D. is a Prfessr and Chair f the Divisin f Public Health and Cmmunity Dentistry at the UCLA Schl f Dentistry. Dr. Jim Crall directs the HRSA/MCHB Leadership Training in Pediatric Dentistry Prgram. He served as Directr f the HRSA/MCHB Natinal Oral Health Plicy Center frm 2000-2008, was Prject Directr fr the AAPD Head Start Dental Hme Initiative frm 2007-2010, and has been Child Advcate fr the American Academy f Pediatric Dentistry since 1995. He has authred r cauthred ver 60 peer-reviewed manuscripts and nearly 40 chapters, technical briefs, and cmmissined wrks (including the CMS Guide t Children s Dental Care in Medicaid). Email: jcrall@dentistry.ucla.edu Varius cmmunity partners and experts are invited fr guest presentatins. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 17

Curse Descriptin This curse cvers the plicy and advcacy cmpnents f the prgram with presentatins as well as pprtunities fr expsure t health plicies at natinal, state, and lcal levels as well as prfessinal and rganizatinal plicies. Dental prfessinal s rle in advcating fr ptimal ral health will be discussed. Curse Cmpetencies 1. Demnstrate the ability t describe the US plicy and advcacy legislative prcesses. 2. Demnstrate the ability t cmmunicate and cllabrate with relevant stakehlders t advcate fr plicies that impact ral and general health fr individuals and ppulatins. 3. Demnstrate the ability t participate in inter-prfessinal care acrss the lifespan f peple frm diverse cmmunities and cultures. Curse Objectives On successful cmpletin f this curse, residents will be prepared t: Residents are expected t becme knwledgeable in the verall federal and State health plicy making prcess, current plicies in place, and strategies applied in advcacy. Describe hw laws and plicies and develped and implemented in the US. Identify the rle f the dental prfessin in advcating fr ptimal health fr the US ppulatin, including underserved and vulnerable ppulatins. Describe the rles f dental public health rganizatins in ral health advcacy. Educate and prmte awareness abut the imprtance f ral health t plicy makers and regulatry agencies and fficials. Discuss the US plicies that regulate r affect the prvisins f ral healthcare, including cverage f dental care and state practice acts. Describe the rle f inter prfessinal cllabratins in advcating fr plicies that prevent and treat dental diseases. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 18

Instructinal methd(s) used in this curse (Check all that apply) Lecture Seminar Literature Review Resident Presentatin GME Cmpetencies addressed by the curse: (check all that apply) Patient Care Medical Knwledge Practice-Based Learning & Imprvement Interpersnal & Cmmunicatin Skills Prfessinalism Systems-Based Practice Bimedical Sciences Behavir Guidance Grwth & Develpment Oral Facial Injury & Emergency Care Oral Diagnsis, Oral Pathlgy, & Oral Medicine Preventin & Health Prmtin Cmprehensive Dental Care Prjects Grand Runds Other: Applied Learning Experience CODA Standards addressed by this curse: (check all that apply) Management f a Cntemprary Dental Practice Patients with Special Health Care Needs Hspital Dentistry Pulp Therapy Pediatric Medicine Advcacy Teaching Evaluatin Criteria/Methds MedHub curse evaluatins and active class participatin Remediatin Plicies A custmized remediatin prgram will be designed t address areas f deficiency This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 19

COURSE SCHEDULE Sessin # & Quarter 1 Fall PGY 1 &2 Length f Sessin 2 Hrs Federal, State, and cmmunity prgrams Title f Sessin Tpics Cvered Instructr - Intrductin t scial health services prgrams and relatinship t legislatin - Issues f these prgrams and relatin t pediatric ral health Jim Crall 2 Fall PGY 1 &2 2 Hrs Advcacy & Plicy making prcess - Structure f US legislature - Hw Bills becme Law in the US - Health plicy develpment and the decisin prcess - Defining prblems, statistics and prblems, & pssible plicy changes - Review f AAPD plicy pririties Sarah Blenner 3 Fall PGY 1 & 2 2 Hrs Advcacy & Plicy: Beynd legislatin Influencing Health Care plicies and prgrams - Federal, versus /and State respnsibilities fr ral health/dental care - Review f selected current ral health and ral health related health Bills - Prfessinal advcacy effrts Sarah Blenner 4 Fall PGY 1 & 2 1 Hr Advcacy Webinar: Dental insurance and the essential pediatric ral health benefits in the Affrdable Care Act - Infrmatin n the types (embedded r stand-alne) f dental plans in yur state - Participatin in the new exchange plans - cverage in the individual and small grup market Online AAPD 5 Fall PGY 1 & 2 2 Hrs The Health Care System befre and after the ACA, plicy enactment and implementatin - Assessment f different prvider mdels and the rle f health prfessinal rganizatins in prmting r ppsing each mdel - U.S. Health Care System Affrdable Care Act with special emphasis n the ral health prvisins Francisc Rams Gmez/ Jim Crall This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 20

6 Fall r Winter 7 Winter r Spring PGY 1 8 Winter r Spring 2 Hrs Hld a mck legislatin advcacy sessin 2 Days Applied Learning Experience: AAPD Advcacy Day 2 hrs Applied Learning Experience: AAPD Advcacy Day - Debriefing - Residents chse and research the ral health issue they wish t advcate fr and assemble all the necessary evidence and present in class fr discussin Natinal Advcacy days participatin, pre-wrk assignments Applied learning debriefing sessin: - Residents respnsible fr prviding feedback and questins - Residents reflecting n their wn views n the infrmatin, and explring ptential alternatives t questins/issues encuntered Francisc Rams Gmez Francisc Rams Gmez Francisc Rams Gmez 9 TBA PGY 1 & 2 2 Days Applied Learning Experience: State and/r lcal level advcacy State Advcacy days participatin pre-wrk assignments Francisc Rams Gmez 10 Winter PGY 1 & 2 11 Spring PGY 1 12 Spring 2 hrs Applied Learning Experience: State level and/r lcal advcacy - Debriefing 2 Days Natinal Oral Health cnference (selected pediatric and AEGD residents participate) 2 Hrs Natinal Oral Health cnference- Debriefing Applied learning debriefing sessin: - Residents respnsible fr prviding feedback and questins - Residents reflecting n their wn views n the infrmatin, and explring ptential alternatives t questins/issues encuntered Applied learning experience Applied learning debriefing sessin: - Residents respnsible fr prviding feedback and questins - Residents reflecting n their wn views n the infrmatin, and explring ptential alternatives t questins/issues encuntered Francisc Rams Gmez Francisc Rams Gmez This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 21

Strategic Partnership fr Interprfessinal Cllabrative Educatin in Pediatric Dentistry DISEASE MANAGEMENT & RISK ASSESSMENT MODULE Curse Syllabus Curse Title: Disease Management/Risk Assessment Curse Enrllment: Pediatric Dental Residents & Advanced Clinical Trainees (ACTs) This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 22

Curse Chair/C-Chair Francisc Rams-Gmez, DDS, MS, MPH Francisc Rams-Gmez, D.D.S., M.S., M.P.H. is a prfessr in the Divisin f Pediatric Dentistry and the Directr fr the Pediatric Dentistry Preceptrship Prgram at the UCLA Schl f Dentistry. Dr. Rams-Gmez jined the schl as a faculty member in 2008. Dr. Rams-Gmez has been a pediatric dentist fr mre than twenty years with specific fcus and research in the areas f early childhd caries (ECC) preventin, ral disease risk assessment, and cmmunity health with an emphasis n underserved ppulatins. Leah Fitzgerald, PhD, RN Leah FitzGerald, RN, FNP-C, PhD, is an Assistant Prfessr f Nursing at the UCLA Schl f Nursing. Dr. FitzGerald is bard certified by the American Nurses Credentialing Center as a Family Nurse Practitiner (FNP). Dr. FitzGerald has 23 years f clinical research experience. She cmpleted pst-dctral training at the UCLA Nrman Cusins Center in psychneurimmunlgy, prviding a strng fundatin fr Bi behaviral Nursing research, recgnizing the benefits and risks f preventive health behavirs and the cmplexity underlying behaviral change. Email: lfitzgerald@msmu.edu Varius cmmunity partners and experts are invited fr guest presentatins. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 23

Curse Descriptin In this curse residents learn the fundamental cncepts f health prmtin and disease preventin. Emphasis is n assessment, health prmtin, and risk reductin/ preventin related t ral health. The American Academy f Pediatric Dentistry and the American Assciatin f Pediatrics currently recmmend that children receive their first dental evaluatin within the first year f life. In general, there is an increasing trend tward prviding dental care t children befre the age f three. The reasns fr early dental interventin with pregnant wmen, infants and parents are t determine the risk status based n the infrmatin frm the parents and t perfrm a screening risk assessment and examinatin f infants muths. This early care prvides an pprtunity t educate and infrm parents abut their children s ral health. Anticipatry guidance/cunseling fr children s dental health is an imprtant part f preventive care, and may be the mst effective way t prevent prblems (such as early childhd caries (ECC)) that traditinal infectius-disease mdels have failed t address. Curse Cmpetencies Describe caries develpment, prgressin and pathphysilgy Learn the fundamental cncepts f ral health prmtin and disease preventin at the individual and at the cmmunity level. Describe access t care issues and develp strategies fr ral disease preventin at the individual and at the cmmunity level. Apply risk based diagnsis and treatment planning Curse Objectives On successful cmpletin f this curse, residents will be prepared t: Understand why pregnancy prvides a unique pprtunity t prvide ral health interventins fr wmen and their infants. Realize the impact f maternal ral health n the lnger-term ral disease status in families. Knw the backgrund and clinical evidence in supprt f perinatal and infant ral care. Be able t perfrm a caries risk assessment thrugh the use f the CAMBRA tl fr 0-5 and clinical exam results in a private practice r in a cmmunity based clinical envirnment. Identify the dental prducts available fr patient interventins and develp a treatment care path t manage dental caries fr any patient based upn CAMBRA risk assessment prtcls. Understand the benefits and challenges in creating buy-in frm dental team members, and the influence f third party payers n patient acceptance. Learn t examine, diagnse, and treat very yung children using an Infant Oral Care mdel. Effectively utilize Mtivatinal Interviewing skills t elicit psitive behavir change. Cmprehend the barriers t access in care fr lwer incme families, Deliver perinatal and infant/tddler ral health preventin and educatin, and Be able t ffer dental practitiners infrmatin n a dental practice mdel in wrking with the yungest ppulatin f pediatric patients and t gain mre in depth pediatric dental experience. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 24

Instructinal methd(s) used in this curse (Check all that apply) Lecture Seminar Literature Review Resident Presentatin GME Cmpetencies addressed by the curse: (check all that apply) Patient Care Medical Knwledge Practice-Based Learning & Imprvement Interpersnal & Cmmunicatin Skills Prfessinalism Systems-Based Practice Bimedical Sciences Behavir Guidance Grwth & Develpment Oral Facial Injury & Emergency Care Oral Diagnsis, Oral Pathlgy, & Oral Medicine Preventin & Health Prmtin Cmprehensive Dental Care Prjects Grand Runds Other: CODA Standards addressed by this curse: (check all that apply) Management f a Cntemprary Dental Practice Patients with Special Health Care Needs Hspital Dentistry Pulp Therapy Pediatric Medicine Advcacy Teaching Evaluatin Criteria/Methds Written examinatin (final exam at end f Summer Quarter) Cmpletin f Infant Oral Care Prgram (IOCP) rtatin. Fr details: http://www.uclaicp.rg/ Active participatin in class Reflectin papers Curse evaluatin Remediatin Plicies A custmized remediatin prgram will be designed t address areas f deficiency This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 25

Sessin # & & Quarter Length f Sessin COURSE SCHEDULE Title f Sessin Tpics Cvered Instructr 1 Summer 2 hrs Cntemprary Caries Management in Pediatric Dentistry I (Perinatal and Infant Oral Health) Intrductin, CAMBRA Intr t Disease Management Francisc Rams-Gmez 2 Summer 2 hrs Cntemprary Caries Management in Pediatric Dentistry II Fundamentals f caries disease management Francisc Rams-Gmez 3 Summer 4 hrs Medical Apprach And Micrbilgy f Dental Caries Pathphysilgy f dental caries Francisc Rams-Gmez 4 Summer 5 Summer 6 Summer 7 Fall 8 Fall 2 ½ hrs Clinical Cases & Clinical Implementatin f Minimally Invasive Dentistry I 4 hrs Fluride & Sealants; Evidence Based Usage Fr Preventin And Treatment, Plitical Aspects Of Cmmunity Fluridatin 3 hrs Reflectin sessin Resurces & nline learning review 2 hrs Intrductin t Mtivatinal Interviewing and in clinic bservatin f MI skills 2 hrs Mtivatinal Interviewing: Patient engagement and activatin and clinic bservatin f MI skills. Case discussins n caries disease mgmt. cases Sealants articles AAPD manual Dr. Featherstne Vide (nline learning and reflectin paper) DentaQuest Website and resurces AAPD Manual Includes recrding f resident patient MI sessin and in-class grup feedback t analyze dental residents current flw ad structure f prviding dental services t determine where and when MI will be inserted mst effectively during the clinic wrkflw. Includes recrding f resident patient MI sessin and in-class grup feedback Francisc Rams-Gmez Ed Hewlett, DDS Francisc Rams-Gmez Leah Fitzgerald Leah Fitzgerald This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 26

Required readings All required reading materials are upladed int UCLA MedHub and available n the UCLA SPICE PD website at: http://www.uclachatpd.rg/disease-management--risk-assessment.html Sme are listed belw: Wright, J. T., Tampi, M. P., Graham, L., Estrich, C., Crall, J. J., Fntana, M., Carrasc-Labra, A. (2016). Sealants fr preventing and arresting pit-and-fissure cclusal caries in primary and permanent mlars: A systematic review f randmized cntrlled trials-a reprt f the American Dental Assciatin and the American Academy f Pediatric Dentistry. J Am Dent Assc, 147(8), 631-645 e618. di: 10.1016/j.adaj.2016.06.003. Available at: http://jada.ada.rg/article/s0002-8177(16)30475-5/pdf Wright, J. T., Crall, J. J., Fntana, M., Gillette, E. J., Nvy, B. B., Dhar, V., Carrasc-Labra, A. (2016). Evidence-based clinical practice guideline fr the use f pit-and-fissure sealants: A reprt f the American Dental Assciatin and the American Academy f Pediatric Dentistry. J Am Dent Assc, 147(8), 672-682 e612. di: 10.1016/j.adaj.2016.06.001. Available at: http://jada.ada.rg/article/s0002-8177(16)30473-1/pdf Albin, J., & Tiwari, T. (2016). Preventing Childhd Caries: A Review f Recent Behaviral Research. J Dent Res, 95(1), 35-42. di: 10.1177/0022034515609034. Available at: http://jdr.sagepub.cm/cntent/early/2015/09/30/0022034515609034.full.pdf+html This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 27

Strategic Partnership fr Interprfessinal Cllabrative Educatin in Pediatric Dentistry ETHICS & PROFESSIONALISM MODULE Curse Syllabus Curse Title: Ethics & Prfessinalism Curse Enrllment: Pediatric Dental Residents & Advanced Clinical Trainees (ACTs) This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 28

Curse Chair/C-Chair Francisc Rams-Gmez, DDS, MS, MPH Francisc Rams-Gmez, D.D.S., M.S., M.P.H. is a prfessr in the Divisin f Pediatric Dentistry and the Directr fr the Pediatric Dentistry Preceptrship Prgram at the UCLA Schl f Dentistry. Dr. Rams-Gmez jined the schl as a faculty member in 2008. Dr. Rams-Gmez has been a pediatric dentist fr mre than twenty years with specific fcus and research in the areas f early childhd caries (ECC) preventin, ral disease risk assessment, and cmmunity health with an emphasis n underserved ppulatins. Ian Culter, PhD Dr. Culter has mre than 20 years f experience cnducting bth qualitative and quantitative research n chirpractic. He is the principal investigatr f the Evidenced-Based Practice Center fr Cmplementary and Alternative Medicine at RAND and is the principal investigatr n a case study f integrative medicine funded by NCCAM. Culter is a frmer directr f the UCLA/Drew University Center fr Minrity Oral Health; was a member f the Natinal Institutes f Health's Cancer Advisry Panel fr Cmplementary and Alternative Medicine; and serves n the advisry cmmittee fr the NCCAM Center fr Chirpractic Research. Email: culter@rand.rg This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 29

Curse Descriptin Thrugh a cmbinatin f classrm discussin and activities, this curse intrduces residents t cultural and ethical issues relevant t dental schl clinics and private practice. In a small grup envirnment, residents have the pprtunity t discuss schl culture and intercultural relatinships, preparing them fr experiences with a diverse schl culture and patient pl. Ethics, alng with state and federal regulatins, are intrduced as they apply t dentistry practiced in dental schl clinics and private practice. Curse Cmpetencies Demnstrate the ability t incrprate ethical reasning and actins that prmte culturally cmpetent ral health care t individuals and ppulatins. Curse Objectives On successful cmpletin f this curse, residents will be able t: Describe cmmn ethical and bimedical principles based n the Cde f Ethics Utilize cmmn ethical principles t respnd t cmmn ethical issues as it relates t practicing pediatric dentistry. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 30

Instructinal methd(s) used in this curse (Check all that apply) Lecture Seminar Literature Review Resident Presentatin GME Cmpetencies addressed by the curse: (check all that apply) Patient Care Medical Knwledge Practice-Based Learning & Imprvement Interpersnal & Cmmunicatin Skills Prfessinalism Systems-Based Practice Bimedical Sciences Behavir Guidance Grwth & Develpment Oral Facial Injury & Emergency Care Oral Diagnsis, Oral Pathlgy, & Oral Medicine Preventin & Health Prmtin Cmprehensive Dental Care Prjects Grand Runds Other: CODA Standards addressed by this curse: (check all that apply) Management f a Cntemprary Dental Practice Patients with Special Health Care Needs Hspital Dentistry Pulp Therapy Pediatric Medicine Advcacy Teaching Evaluatin Criteria/Methds Active participatin in class Ethics case review and discussin Online curse evaluatin Remediatin Plicies A custmized remediatin prgram will be designed t address areas f deficiency This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 31

COURSE SCHEDULE Sessin # & Quarter 1 Winter 2 Winter 3 Winter Length f Sessin Title f Sessin Tpics Cvered Instructr 2 Hrs Overview f ethical principles fr dentistry 2 Hrs The prfessinal rle f the dentist T examine the cncept f ethics, its underlying philsphical principles, and the prblems f defining ethical behavir in health sciences. Ethical cdes fr apprpriate behavir twards patients general public clleagues 2 Hrs Research Ethics Analysis f ethical issues; Prtectin f human subjects; Respnsibilities f researchers; Authrship; Scientific miscnduct Ian Culter (nline) Ian Culter (nline) Ian Culter (nline) 4 Winter 2 Hrs Ethics Case Studies Resident-led grup ethics case discussins with fcus n prenatal and pediatric cases Ram- Gmez Grup case discussins Additinal Learning Resurces & Readings: Culter, I., Yamamt, J. M., Marcus, M., Freed, J., Der-Martirsian, C., Guzman-Becerra, N., Guay, A. (2004). Self-reprted ral health f enrllees in capitated and fee-fr-service dental benefit plans. J Am Dent Assc, 135(11), 1606-1615. Culter, I. D., Freed, J. R., Marcus, M., Der-Martirsian, C., Guzman-Becerra, N., Guay, A. H., & Brwn, L. J. (2004). Self-reprted satisfactin f enrllees in capitated and fee-fr-service dental benefit plans. J Am Dent Assc, 135(10), 1458-1466; quiz 1469. Hernandez, J. B., Culter, I., Gldman, D., Freed, J., & Marcus, M. (1999). Managed care in dental markets: is the experience f medicine relevant? J Public Health Dent, 59(1), 24-32. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 32

Strategic Partnership fr Interprfessinal Cllabrative Educatin in Pediatric Dentistry CULTURAL COMPETENCY MODULE Curse Syllabus Curse Title: Cultural Cmpetency Curse Enrllment: Pediatric Dental Residents & Advanced Clinical Trainees (ACTs) This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 33

Curse Descriptin Master the specific knwledge and skills that enhances pediatric dental resident s ability t prvide culturally cmpetent care in diverse settings t individuals and cmmunities. Curse Cmpetencies Describe cultural cmpetency is a set f cngruent behavirs, attitudes, and plicies that cme tgether in a system, agency r amng prfessinals and enable that system, agency r thse prfessins t wrk effectively in crsscultural situatins. Learn the fundamental cncepts and skills f being a culturally cmpetent health prvider. Curse Objectives On successful cmpletin f this curse, residents will be prepared t: Articulate the meanings f culture and cultural and linguistic cmpetency, and hw they can affect ral health care delivery. Describe disparities in ral health and recgnize the barriers t accessing ral health care and services. Explain the imprtance and benefits f prviding culturally and linguistically apprpriate ral health care. Explain the meaning f cmmunicatin and the characteristics f effective cmmunicatin with yur patients. Describe sme preparatin steps t take t prvide culturally and linguistically apprpriate services in ral health practice. List the essential cmpnents f culturally and linguistically apprpriate ral health care and services. Identify and describe culturally and linguistically apprpriate practice management strategies that can enhance yur patient care and services. Identify barriers t effective cmmunicatin. Describe culturally and linguistically apprpriate techniques that enhance yur ability t prvide effective, culturally and linguistically apprpriate services. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 35

Instructinal methd(s) used in this curse (Check all that apply) Lecture Seminar Literature Review Resident Presentatin GME Cmpetencies addressed by the curse: (check all that apply) Patient Care Medical Knwledge Practice-Based Learning & Imprvement Interpersnal & Cmmunicatin Skills Prfessinalism Systems-Based Practice Bimedical Sciences Behavir Guidance Grwth & Develpment Oral Facial Injury & Emergency Care Oral Diagnsis, Oral Pathlgy, & Oral Medicine Preventin & Health Prmtin Cmprehensive Dental Care Prjects Grand Runds Other: CODA Standards addressed by this curse: (check all that apply) Management f a Cntemprary Dental Practice Patients with Special Health Care Needs Hspital Dentistry Pulp Therapy Pediatric Medicine Advcacy Teaching Evaluatin Criteria/Methds Cmplete pre and pst-test nline n Think Cultural Health website and email nline cmpletin certificate t Dr. Rams-Gmez Cmplete annual resident curse evaluatins Remediatin Plicies A custmized remediatin prgram will be designed t address areas f deficiency This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 36

COURSE SCHEDULE Sessin # & Quarter 1 Summer 2 Summer 3 Summer 4 Summer 5 Summer Length f Sessin Title f Sessin Tpics Cvered Instructr 1 hr Crss-Cultural Cmmunicatin Terminlgy, Effective strategies/cmmunicatin skills acrss varius cultures 1 hr Cultural Cmpetency Prvide culturally cmpetent ral health care Selfpaced (est. 1hr) Selfpaced Selfpaced Fundamentals f Culturally and Linguistically Apprpriate Oral Health Care and Services Culturally and Linguistically Apprpriate Oral Health Practice Management Cmmunicatin and Messaging in the Dental Chair Fundamentals f culturally and linguistically apprpriate ral health care and services Culturally and linguistically apprpriate practice management strategies that can address barriers t ral health care Basic infrmatin abut effective ral health cmmunicatin and an verview f barriers and challenges t cmmunicatin that may arise when cmmunicating with yur patients. Elena Ruiz / Francisc Rams Gmez Elena Ruiz / Francisc Rams Gmez Online Think Cultural Health* Online Think Cultural Health* Online Think Cultural Health* Learning Resurces & Readings: https://ralhealth-thinkculturalhealth-qc.astutetech.cm/cntent/intrductin/intrductin.asp This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 37

Strategic Partnership fr Interprfessinal Cllabrative Educatin in Pediatric Dentistry QUALITY IMPROVEMENT MODULE Curse Syllabus Curse Title: Quality Imprvement Curse Enrllment: Pediatric Dental Residents & Advanced Clinical Trainees (ACTs) This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 38

Curse Chair/C-Chair Francisc Rams-Gmez, DDS, MS, MPH Francisc Rams-Gmez, D.D.S., M.S., M.P.H. is a prfessr in the Divisin f Pediatric Dentistry and the Directr fr the Pediatric Dentistry Preceptrship Prgram at the UCLA Schl f Dentistry. Dr. Rams-Gmez jined the schl as a faculty member in 2008. Dr. Rams-Gmez has been a pediatric dentist fr mre than twenty years with specific fcus and research in the areas f early childhd caries (ECC) preventin, ral disease risk assessment, and cmmunity health with an emphasis n underserved ppulatins. Mira Inkelas, PhD, MPH Dr. Inkelas directs quality imprvement initiatives t redesign primary care t achieve preventin and develpment gals fr children and their families. She has wrked with netwrks f physicians, early care and educatin prgrams, and cmmunity rganizatins t imprve care thrugh the Early Develpmental Systems Initiative (EDSI). Recent cllabratins fcus n creating crss-sectr learning systems that use prcess imprvement and transfrmative care design strategies t prduce better utcmes fr ppulatins f children. Email: minkelas@ucla.edu Rbin Flint, DrPH (c), MPH Rbin Flint is a Prject Directr at the Center fr Healthier Children, Families & Cmmunities is a multidisciplinary, cmmunity-fcused research, plicy, and training center at UCLA. Established in 1996, we are a jint effrt f the David Geffen Schl f Medicine Department f Pediatrics and the UCLA Fielding Schl f Public Health. The Center als includes faculty frm the UCLA Luskin Schl f Public Plicy & Scial Research, Schl f Law, and the Cllege f Letters and Sciences. Email: rflint@ucla.edu This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 39

Curse Descriptin Students/residents will be able t describe and apply selected quality imprvement methds and tls, including use data fr quality imprvement in patient care. Curse Cmpetencies Demnstrate ability t use quality imprvement strategies t slve prblems, imprve efficiency, reduce cst, increase quality, imprve patient safety, r imprve patient experience. Curse Objectives On successful cmpletin f this 3 part curse, residents will be able t: Understand the principles and practice f quality measurement, quality imprvement, and prcess redesign in healthcare and dentistry Discuss quality care in dentistry Understand and list the elements f the Mdel fr Imprvement Demnstrate use f the cmpnents f a PDSA Cycle Identify and evaluate selected cre prcesses f health/ral health care rganizatins Apply rganizatinal prblem-slving tls, including rt cause analysis, PDSA Use techniques fr wrkflw redesign [t assess quality f care delivery] Apply reliability cncepts t care prcesses Frmulate plans fr quality imprvement Recgnize dental quality measures This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 40

Instructinal methd(s) used in this curse (Check all that apply) Lecture Seminar Literature Review Resident Presentatin GME Cmpetencies addressed by the curse: (check all that apply) Patient Care Medical Knwledge Practice-Based Learning & Imprvement Interpersnal & Cmmunicatin Skills Prfessinalism Systems-Based Practice Bimedical Sciences Behavir Guidance Grwth & Develpment Oral Facial Injury & Emergency Care Oral Diagnsis, Oral Pathlgy, & Oral Medicine Preventin & Health Prmtin Cmprehensive Dental Care Prjects Grand Runds Other: CODA Standards addressed by this curse: (check all that apply) Management f a Cntemprary Dental Practice Patients with Special Health Care Needs Hspital Dentistry Pulp Therapy Pediatric Medicine Advcacy Teaching Evaluatin Criteria/Methds Active participatin in class Practicum cmpletin, written reflectin, QI prject presentatin Curse evaluatin Remediatin Plicies A custmized remediatin prgram will be designed t address areas f deficiency This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 41

Part A: Required resident pre-readings COURSE SCHEDULE Institute fr Healthcare Imprvement (IHI) Open Schl has nline, free mdules n prcess imprvement tpics, which are available at ihi.rg. The mdules are free when yu register fr Open Schl as a student r resident at: http://www.ihi.rg/educatin/ihipenschl/ Cmplete befre Sessin 2: IHI Open Schl Web Mdule QI 103: Testing and Measuring Changes with PDSA Cycles IHI Open Schl Web Mdule QI 104: Interpreting Data: Run Charts, Cntrl Charts, and Other Measurement Tls Berwick DM. 2008. The science f imprvement. JAMA, 299(10), 1182-1184. di: 10.1001/jama.299.10.1182 Cmplete befre Sessin 3: IHI Open Schl Web Mdule PS 103: Human Factrs and Safety IHI Open Schl Web Mdule PS 104: Rt Cause and Systems Analysis Hw t reinvent the schl lunch and get kids t eat better. Wired. 2014. Available at: https://www.wired.cm/2014/04/hw-t-reinvent-the-schl-lunch-and-get-kids-t-eat-better/ Recmmended: Spear SJ. 2005. Fixing health care frm the inside, tday. Harv Bus Rev. 83(9):78-91. Available at: https://hbr.rg/2005/09/fixing-health-care-frm-the-inside-tday This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 42

Part B: Didactics Sessin # Date Sessins Tpics Cvered Instructr 1 9/9/16 PGY1 & 2 Fall 2016 Quality in the Prfessin f Dentistry - Mdel fr Imprvement and PDSAs Measures, Aims, Changes, Small- Scale learning cycles (PDSAs), use f run charts fr learning Dr. Inkelas/ Rbin F. MacBride 2 9/30/16 PGY1 & 2 Fall 2016 Prcess Mapping & Reliability Applicatin f reliability cncepts t care prcesses Prcess mapping Dr. Inkelas/ Rbin F. MacBride 3 10/21/16 PGY1 & 2 Fall 2016 Rt Cause Analysis (RCA) Driver Diagrams Cnducting rt cause analysis Creating driver diagrams Dr. Inkelas/ Rbin F. MacBride 4 12/2/16 PGY1 & 2 Fall 2016 Prject Presentatins & Discussins Resident- led QI prject presentatins Rbin F. MacBride Dr. Rams- Gmez Part C: Practicum Due Date Steps fr the Practicum Instructr 9/9/16 Identify pssible practicum tpics, and craft initial practicum aim Dr. Inkelas/ Rbin F. MacBride 9/30/16 Frm practicum teams; select and finalize practicum aim (submit t instructrs) Dr. Inkelas/ Rbin F. MacBride 10/21/16 Cmplete prcess map f clinic wrkflw related t aim (submit t instructrs) Dr. Inkelas/ Rbin F. MacBride 10/28/16 Cmplete rt cause analysis diagram related t aim (submit t instructrs) Dr. Inkelas/ Rbin F. MacBride 11/4/16 Cmplete driver diagram related t aim (submit t instructrs) Cmplete the Plan sectin f ne PDSA (submit t instructrs) Cmplete at least ne PDSA (submit t instructrs) 12/2/16 Team presentatins (Prblem statement, aim, RCA, prcess map, driver diagram, measures, PDSA example, what was learned) Written reflectins (submit t instructrs) Dr. Inkelas/ Rbin F. MacBride Dr. Inkelas/ Rbin F. MacBride This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 43

Quality Imprvement Series fr Pediatric Dentistry Residents (practicum idea change very year) The educatinal bjective is t intrduce residents t prcess imprvement methds that they can use in future clinical practice. These methds are nw cre cmpetencies in ACGME, and are a cre part f practice-based learning, prfessinalism, and system based practice, amng ther cmpetencies in dentistry. They are essential t the learning health system as described by the Institute f Medicine (IOM). T be respnsive t current and future prfessinal needs f dentistry residents, we crafted a series f sessins with the residents t intrduce them t these prcess imprvement skills. The mst effective way f learning these skills is t apply them. While it is pssible fr residents t becme familiar with the methds with hypthetical care delivery challenges, they learn much mre quickly and effectively by analyzing and then cnsidering hw they might g abut imprving a real care delivery challenge that they are familiar with. Residents learn best when the care delivery challenge is ne that they are currently invlved in, and care abut. The prblem shuld be a felt need f the team; it shuld nt run cunter t any institutinal pririties, but the prblem that the team wrks n may nt be a tp sectin r institutinal pririty. In additin t fur in-persn sessins in Fall 2016, the residents will participate in a team practicum t analyze and ideally imprve a wrkflw that they are currently invlved in. The length f the practicum will range frm several weeks t 2-3 mnths depending n what tpic the residents select. This invlves a small number f hurs f actual wrk. Fr the practicum, residents will meet as a team, apply sme f the imprvement skills that they learn in the in-persn sessins, including analytic skills (such as prcess flw mapping, rt cause analysis) and planning and imprvement skills (such as creating aims, designing small learning cycles (plan-d-study-act cycles), planning any changes they will test at a small scale and the data they will cllect and reprt). The curse faculty (Mira Inkelas, Rbin Flint MacBride) will be available fr cnsultatin. Sharing the learning will be an imprtant aspect f the practicum. Part f the in-persn sessin time will be dedicated t residents sharing what they have learned frm their testing and hw they are applying the new knwledge f the system r wrkflw they are trying t imprve. We have identified sme pssible tpics that the residents culd select fr their practicum. These are tpics that have been identified as in need f imprvement, and they are tpics that residents wuld be able t analyze and then design changes fr. The residents wuld nly test sme changes at a very small scale s it is unlikely that they wuld significantly change any prcess that they wrked n. Caries Risk Assessment: Hw t increase the reliability f cnducting and dcumenting caries risk assessment (CAMBRA) (currently estimated at 46%). Areas t explre include a wrkflw that wuld increase reliability, understanding the cycle time fr cmpleting the CRA and hw t ptentially shrten it, using CDT cdes. Risk-based scheduling: What might it lk like fr the clinic t have capacity t see higher risk patients at a mre frequent disease management peridicity? Is there a way t bill fr these visits? Scheduling and phne cverage: Might phne access imprve if residents scheduled their wn patients befre they leave (exceptin f sedatin visits)? Hw might this wrk? Verificatin f eligibility: This takes time, hw can this be dne mre efficiently? Billing: hw can we reliably prvide the dcumentatin (x-ray r phtgraph) necessary fr reimbursement f sedative fillings (reduce write-ffs)? Tracking incipient lesins and remineralizatin: Increasing use f cdes fr incipient lesins; adding dntgram t AxiUm t mark teeth with lesins; using dntgram t track lesins and remineralizatin Self management gal setting and tracking: Creating dummy cdes fr SMGs t track individual changes; what wrkflw might allw fllw up n previusly set gals; what wrkflw might allw fllw up n IV sedatin patients. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 44

Strategic Partnership fr Interprfessinal Cllabrative Educatin in Pediatric Dentistry INTERPROFESSIONAL EDUCATION (IPE)/TRAINING MODULE Curse Syllabus Curse Title: UCLA Schl f Medicine and UCLA Schl f Dentistry Interprfessinal Partnership Curse Enrllment: Pediatric Medical Residents & Pediatric Dental Residents in interprfessinal educatinal setting This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 45

Curse Descriptin This three part curse aligns with SPICE PD Gal A (Fcus Area I) which is t establish an integrated ral and primary healthcare clinical training prgram fr UCLA Cmmunity Health and Advcacy training in Pediatric Dentistry (CHAT-PD), Advanced Educatin General Dentistry (AEGD), pediatric medicine, and nursing prgrams. Curse Cmpetency Describe and apply basic ral health strategies and risk-based diagnsis and treatment t prevent dental disease. Curse Objectives On successful cmpletin f this curse, residents will be able t: Understand and be able t identify basic nrmal and abnrmal pediatric ral and dental anatmy/health Understand ral-systemic link and health prblems assciated with pr ral health Understand the ral health and pregnancy cnnectin Demnstrate the inclusin f the ral cavity in the HEENT (head, ears, eyes, nse, and thrat) cmpnent f the review f systems and demnstrate inclusin f the ral cavity exam in the HEENOT (head, ears, eyes, nse, ral cavity, and thrat) cmpnent f the physical exam Articulate and perfrm a six step caries risk assessment including applying fluride varnish Describe the rle f interprfessinal cllabratins in imprving ral health fr children This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 47

Instructinal methd(s) used in this curse (Check all that apply) Lecture Seminar Literature Review Resident Presentatin Clinical rtatins Prjects Grand Runds Other: GME Cmpetencies addressed by this curse (check all that apply) Patient Care Medical Knwledge Practice based learning and imprvement Interpersnal and cmmunicatin skills Prfessinalism Systems-based practice CODA Standards addressed by this curse (check all that apply) Bimedical sciences Behavir guidance Grwth and develpment Oral facial injury and emergency care Oral diagnsis, ral pathlgy, & ral medicine Preventin and health prmtin Cmprehensive dental care Management f a cntemprary dental practice Patients with special health care needs Hspital dentistry Pulp therapy Pediatric medicine Advcacy Teaching This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 48

PART A: Prerequisites The residents are required t review a list f required curse material prir t the start f the curse. 1) Cmplete the nline curse http://www.smilesfrliferalhealth.rg/ Cmplete nline Curses 2, 4 & 6 http://smilesfrliferalhealth.rg/ Nte: yu will need t create an nline prfile, this shuld take ~1 hur 2) Watch the shrt IOCP six-step vides at: http://www.uclaicp.rg/six-step-prtcl.html. 3) View Clgate Webinar n : The Art f Perinatal and Infant Oral Health By Dr. Rams- Gmez http://www.clgateralhealthnetwrk.cm/webinar/the-art-f-perinatal-and-infant-ral-health/ Nte: yu will need t create an nline prfile, this shuld take ~1 hur Additinal Resurces, Readings & IOCP Clinic Dcuments: http://www.uclaicp.rg/relatedarticles.html Fr mre specific evidence-based infrmatin and guidelines, please see: Oral Health During Pregnancy and Early Childhd: Evidence-Based Guidelines fr Health Prfessinals http://www.cdafundatin.rg/prtals/0/pdfs/ph_guidelines.pdf PART B: Didactics Thrugh a cmbinatin f classrm lecture and discussin, this curse intrduces residents t evidence related t ralsystemic health and knwledge f the nature, prevalence, and cnsequences ral manifestatins f chrnic diseases acrss the lifespan. Skills t btain an apprpriate health histry, including baseline ral health, risk factrs, chrnic disease implicatins and acute/episdic prblems will be presented. Residents will learn their rle in preventing ral disease, addressing frequently encuntered ral prblems, and prmting ral health amng their patients. PART C: Hands-n clinical training and experience Thrugh a hands-n clinical training residents will learn t assess a patient s ral health, be able t identify basic healthy vs. abnrmal ral cnditins, apply the cncepts f caries risk assessment and perfrm the clinical prtins f a caries management by risk assessment (CAMBRA- 6 step prtcl). Part C f this curse will be accmplished in clse cllabratin between the residents and the pediatric dental residents fr interprfessinal cllabratin and peer learning. Residents will gain the cnfidence in perfrming a six step caries risk assessment and an ral exam n infants and tddlers. Evaluatin Criteria/Methds Residents will be evaluated based n attendance and active participatin in discussins, lectures and treatment/case study sessin. Annual pst curse nline survey will be cllected Newly acquired clinical skills will be tested via peer t peer and faculty bservatinal assessments and resident selfassessments fr cnfidence. Remediatin Plicies This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 49

A custmized remediatin prgram will be designed t address areas f deficiency COURSE SCHEDULE PART B- Didactic Prtin Overarching Gal 1. Understand and be able t identify basic nrmal and abnrmal pediatric ral and dental anatmy/health Sessin Title, number & Length f Sessin Basics f ral health and dental anatmy 1 2 Hurs Desired Learning Outcmes By the end f this curse, the resident will have acquired the fllwing knwledge & skills: -Understand and name the basic ral anatmy and characteristics f the pediatric dentitin and sft tissues -Identify differences between nrmal and abnrmal findings -discuss cmmn dental develpment issues in children and adlescents -ffer apprpriate anticipatry guidance regarding ral develpmental issues Teaching methds -lectures - reading assignments and respnses Instructr Faculty Assessments Annual pst curse nline survey 2. Understand ral-systemic link and health prblems Oral systemic link 2 1 Hur - Understand the prevalence and sequelae f ral disease - Understand the interrelatinship between ral and systemic disease - Develp a patient centered management plan that includes ral health interventins related t verall health - Make apprpriate inter prfessinal referrals - Discuss the rle f the pediatrician in prmting ral health including lifestyle cunseling -lectures - reading assignments and respnses Faculty Annual pst curse nline survey This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 50

Overarching Gal Sessin number & Length f Sessin Desired Learning Outcmes By the end f this curse, the medical residents will have acquired the fllwing knwledge & skills: Teaching methds Instructr Assessments 3. Understand ral health and pregnancy cnnectin 4. Demnstrate the inclusin f the ral cavity in the HEENT (head, ears, eyes, nse, thrat) cmpnents f the cmprehensive histry and physical examinatin t the HEENOT (head, ears, eyes, nse, ral cavity, thrat) Prenatal Oral Health 3 1 Hur HEENT t HEENOT 4 2 Hurs -Understand the ral health link t pregnancy -understand the evidence fr peridntitis affecting pregnancy utcmes -cunsel abut ral health cnditins in pregnancy -understand the evidence fr caries risk transmissin frm mther t child -articulate the safety f cmmn dental interventins in pregnancy -prmte ral health in pregnant wmen and newbrn child in culturally apprpriate manner -make apprpriate inter prfessinal referrals - Understand the prevalence, etilgy, and cnsequences f dental caries, in particular Early Childhd Caries (ECC) - Understand the rle f culture and ral health - review use f prper psitining and equipment t perfrm ral exams n children - Develp awareness f particular challenges invlved in the examinatin f special needs patients - Cnsistently perfrm thrugh and nnthreatening ral exams f infants and children -lectures - reading assignments and respnses -lectures - reading assignments and respnses -case studies grup discussin Online reading and webinars Dr. Francisc Rams- Gmez Faculty Annual pst curse nline survey Annual pst curse nline survey 5. Understand and perfrm apprpriate ral exams f children This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 51

COURSE SCHEDULE PART C (Hands-n Clinical Experience) Overarching Gal Sessin number Length f Sessin Desired Learning Outcmes By the end f this curse, the physician will have acquired the fllwing skills: Teaching methds Instructr Assessments 5. Perfrm apprpriate ral exams. 6.Articulate and perfrm a six step caries risk assessment 1 2 hurs 2 1 hur 2 1 hur - recgnize the varius stages f ECC n ral examinatin - describe and implement preventin f ECC thugh the use f fluride, prper hygiene, diet, and apprpriate dental referrals -describe and practice a fluride applicatin - cmplete a variety f case-based clinical histry and physical examinatin simulatin gaining cnfidence in placing hands in muth f patients and linking verall health t ral health (ral-systemic risk assessment prfile) - make apprpriate inter prfessinal referrals - Assess a child s risk fr develping ECC - Perfrm caries risk assessment, prper ral exam and FL varnish n patients: 1. Caries risk assessment 2. Knee-t-knee psitining 3. Tthbrush prphy 4. Clinical ral screening f the patient 5. Fluride varnish applicatin - Peer t peer learning: Pediatric dental residents will train the residents in prper ral health clinical examinatin, ral hygiene instructins (OHI- tthbrushing, flssing, auxiliary aids) and applicatin f fluride varnish. Supervised hands-n clinical rtatin at IOCP sites At Simms Mann and Lu Clen Supervised hands-n clinical rtatin at IOCP sites At Simms Mann and Lu Clen Dr. FRG Pediatric dental residents/ preceptr s Dr. FRG Pediatric dental residents/ preceptr s Dr. FRG Pediatric dental residents/ preceptr s - Peer t peer bservatinal assessment - Peer t peer and faculty bservatinal assessment - Peer t peer and faculty bservatinal assessment This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 52

Overarching Gal Sessin number Length f Sessin 6. Self-management gals Desired Learning Outcmes By the end f this curse, the physician will have acquired the fllwing skills: Teaching methds Instructr Assessments Reflectin sessin 3 1 hur Reflectin sessin - discuss and evaluate didactic lessns n ral health and practical experience - grup team discussin Faculty Additinal resident required reading (all available nline at www.uclachatpd.rg) Keeping Healthy Teeth Caries Free: Pediatric CAMBRA Prtcls. Rams-Gmez & Ng 2011. CDA Jurnal 39(10): 723-733. Six Step Prtcl fr a Successful Infant Oral Care Visit. Rams-Gmez & Ng 2009. Cmmittee n Adlescents, PDT. Selected case studies fr review with IPE resident participants Dental faculty and respective faculty t prvide and residents can bring their wn cases fr grup review This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 53

Strategic Partnership fr Interprfessinal Cllabrative Educatin in Pediatric Dentistry INTERPROFESSIONAL EDUCATION (IPE)/TRAINING MODULE Curse Syllabus Curse Title: UCLA Schl f Nursing and UCLA Schl f Dentistry Interprfessinal Partnership Curse Enrllment: Secnd year Advanced Pediatric Nurses (APNs) & Pediatric Dental Residents in interprfessinal educatinal setting This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 54

Curse Descriptin this three part curse aligns with SPICE PD Gal A (Fcus Area I) which is t establish an integrated ral and primary healthcare clinical training prgram fr UCLA Cmmunity Health and Advcacy training in Pediatric Dentistry (CHAT-PD), Advanced Educatin General Dentistry (AEGD), pediatric medicine, and nursing prgrams. Curse Cmpetency Describe and apply basic ral health strategies and risk-based diagnsis and treatment t prevent dental disease. Curse Objectives On successful cmpletin f this curse, residents will be able t: Understand and be able t identify basic nrmal and abnrmal adult and pediatric ral and dental anatmy/health Understand ral-systemic link and health prblems Understand ral health and pregnancy cnnectin Demnstrate the inclusin f the ral cavity in the HEENT (head, ears, eyes, nse, and thrat) cmpnents f the cmprehensive histry and physical examinatin t the HEENOT (head, ears, eyes, nse, ral cavity, and thrat) Understand and perfrm apprpriate ral exams f adults, children and special ppulatins Articulate and perfrm a six step caries risk assessment Describe the rle f interprfessinal cllabratins in imprving ral health fr children This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 56

Instructinal methd(s) used in this curse (Check all that apply) Lecture Seminar Literature Review Resident Presentatin Simulatin lab Labratry Prjects Grand Runds Prblem based learning/case studies Clinical rtatins Other: GME Cmpetencies addressed by this curse (check all that apply) Patient Care Medical Knwledge Practice based learning and imprvement Interpersnal and cmmunicatin skills Prfessinalism Systems-based practice CODA Standards addressed by this curse (check all that apply) Bimedical sciences Behavir guidance Grwth and develpment Oral facial injury and emergency care Oral diagnsis, ral pathlgy, & ral medicine Preventin and health prmtin Cmprehensive dental care Management f a cntemprary dental practice Patients with special health care needs Hspital dentistry Pulp therapy Pediatric medicine Advcacy Teaching This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 57

PART A: Prerequisites The nursing students are required t review a list f required curse material prir t the start f the curse: 1) Read and review the Oral Health During Pregnancy and Early Childhd: Evidence-Based Guidelines fr Health Prfessinals http://www.uclaicp.rg/uplads/1/5/7/0/15703160/ral_health_during_pregnancy_and_early_childhd_evidencebased_guidelines_fr_health_prfessinals.pdf 2) Cmplete the nline curse Smiles fr Life curriculum, selected mdules: available at http://www.smilesfrliferalhealth.rg/buildcntent.aspx?tut=555&pagekey=62948&cbreceipt=0 3) Link t Imprtant Readings & IOCP Clinic Dcuments: http://www.uclaicp.rg/related-articles.html 4) View Clgate Webinar n : The Art f Perinatal and Infant Oral Health By Dr. Rams-Gmez http://www.clgateralhealthnetwrk.cm/webinar/the-art-f-perinatal-and-infant-ral-health/ PART B: Didactics This is the didactic prtin f the curse: thrugh a cmbinatin f classrm lecture and discussin, this curse intrduces APN students t evidence related t ral-systemic health and knwledge f the nature, prevalence, and cnsequences ral manifestatins f chrnic diseases acrss the lifespan. Skills t btain an apprpriate health histry, including baseline ral health, risk factrs, chrnic disease implicatins and acute/episdic prblems will be presented. Students will learn their rle in preventing ral disease, addressing frequently encuntered ral prblems, and prmting ral health amng their patients. PART C: Hands-n clinical training and experience Thrugh a hands-n clinical training APN nursing students will learn t assess a patient s ral health, be able t identify basic healthy vs. abnrmal ral cnditins, apply the cncepts f caries risk assessment and perfrm the clinical prtins f a caries management by risk assessment (CAMBRA- 6 step prtcl). Part B f this curse will be accmplished in clse cllabratin between the APN nursing students and the pediatric dental residents fr inter prfessinal cllabratin and student t student peer learning. APN nursing will gain the cnfidence in perfrming a six step caries risk assessment and an ral exam n patients. Evaluatin Criteria/Methds Nursing students will be evaluated based n attendance and active participatin in discussins, lectures and treatment/case study sessin and rtatins. Annual pst curse nline survey will be cllected Newly acquired clinical skills will be tested via peer t peer and faculty bservatinal assessments and student selfassessments fr cnfidence Remediatin Plicies A custmized remediatin prgram will be designed t address areas f deficiency This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 58

COURSE SCHEDULE PART B- Didactic prtin Overarching Gal Sessin number & Length f Sessin Desired Learning Outcmes By the end f this curse, the student will have acquired the fllwing knwledge & skills: Teaching methds Instructr Assessments 1. Understand and be able t identify basic nrmal and abnrmal adult and pediatric ral and dental anatmy/health 1 2 Hurs -Understand and name the basic ral anatmy and characteristics f the healthy adult and pediatric dentitin and sft tissues -Identify differences between nrmal and abnrmal findings -discuss cmmn dental develpment issues in children and adlescents -ffer apprpriate anticipatry guidance regarding ral develpmental issues -lectures - reading assignments and respnses Nursing faculty Annual pst curse nline survey 2. Understand ral-systemic link and health prblems 2 1 Hur - Understand the prevalence and sequelae f ral disease - Understand the interrelatinship between ral and systemic disease - Develp a patient centered management plan that includes ral health interventins related t verall health - Make apprpriate inter prfessinal referrals - Discuss the rle f the nurse in prmting ral health including lifestyle cunseling -lectures - reading assignments and respnses Nursing faculty Annual pst curse nline survey 3. Understand ral health and pregnancy cnnectin 4. Demnstrate the inclusin f the ral cavity in 3 1 Hur 4 2 Hurs -Understand the ral health link t pregnancy -understand the evidence fr peridntitis affecting pregnancy utcmes -cunsel abut ral health cnditins in pregnancy -understand the evidence fr caries risk transmissin frm mther t child -articulate the safety f cmmn dental interventins in pregnancy -prmte ral health in pregnant wmen and newbrn child in culturally apprpriate manner -make apprpriate inter prfessinal referrals - Understand the prevalence, etilgy, and cnsequences f dental caries, in particular Early Childhd Caries (ECC) -lectures - reading assignments and respnses -lectures Online reading and webinars Dr. Francisc Rams- Gmez Dr. Francisc Annual pst curse nline survey Annual pst curse This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 59

the HEENT (head, ears, eyes, nse, thrat) cmpnents f the cmprehensive histry and physical examinatin t the HEENOT (head, ears, eyes, nse, ral cavity, thrat) - Understand the rle f culture and ral health - review use f prper psitining and equipment t perfrm ral exams n adults and children - Develp awareness f particular challenges invlved in the examinatin f special needs patients - Cnsistently perfrm thrugh and nnthreatening ral exams f infants and children - Cnsistently perfrm thrugh ral, face, and neck examinatins (HEENOT) n adults. - reading assignments and respnses -case studies grup discussin Rams- Gmez nline survey 5. Understand and perfrm apprpriate ral exams f adults, children and special ppulatins COURSE SCHEDULE PART C (Hands-n Clinical Experience) Overarching Gal Sessin number Length f Sessin Desired Learning Outcmes By the end f this curse, the student will have acquired the fllwing skills: Teaching methds Instructr Assessments 5. Perfrm apprpriate ral exams. 1 1 hur 2 2 hurs - recgnize the varius stages f ECC n ral examinatin - describe and implement preventin f ECC thugh the use f fluride, prper hygiene, diet, and apprpriate dental referrals -describe and practice a fluride applicatin - Observe dental clinic by nursing students - Peer t peer learning: Pediatric dental students will train the nursing students in prper ral health clinical examinatin, ral hygiene instructins (OHItthbrushing, flssing, auxiliary aids) and applicatin f fluride varnish. -bservatin Dr. FRG Pediatric dental residents/p receptrs Dr. FRG Pediatric dental - Peer t peer bservatinal assessment Nne This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 60

6.Articulate and perfrm a six step caries risk assessment 3 1 hur 4 1 hur - participate in simulatin experiences that include HEENOT cmplaints such as muth pain, bleeding gums, mucsal ulceratins, and sre thrat. - cmplete a variety f case-based clinical histry and physical examinatin simulatin gaining cnfidence in placing hands in muth f patients and linking verall health t ral health (ralsystemic risk assessment prfile) - make apprpriate inter prfessinal referrals - Assess a child s risk fr develping ECC - Perfrm caries risk assessment, prper ral exam and FL varnish n patients: 7. Caries risk assessment 8. Knee-t-knee psitining 9. Tthbrush prphy 10. Clinical ral screening f the patient 11. Fluride varnish applicatin 12. Self-management gals -simulatin lab practice -case studies -hands-n supervised clinical training residents/p receptrs Dr. FRG Pediatric dental residents/p receptrs Dr. FRG Pediatric dental residents/p receptrs - Peer t peer and faculty bservatinal assessment -student selfassessment - Peer t peer and faculty bservatinal assessment - student selfassessment Additinal Learning Resurces & Readings (all available nline at www.uclachatpd.rg) Int the Future: Keeping Healthy Teeth Caries Free: Pediatric CAMBRA Prtcls. Rams-Gmez & Ng 2011. CDA Jurnal 39(10): 723-733. Six Step Prtcl fr a Successful Infant Oral Care Visit. Rams-Gmez & Ng 2009. Cmmittee n Adlescents, PDT. Selected case studies fr review with IPE student participants Dental faculty and nursing faculty t prvide and students can bring their wn cases fr grup review This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 61

Strategic Partnership fr Interprfessinal Cllabrative Educatin in Pediatric Dentistry SPECIAL NEEDS CHILDREN MODULE Curse Syllabus Curse Title: Autism Spectrum Disrder Curse Curse Enrllment: Pediatric Dental Residents & Advanced Clinical Trainees (ACTs) This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 62

Curse Chair/C-Chair: Tanya Paparella, Ph.D. Dr. Tanya Paparella is a specialist in the field f autism with mre than 20 years f interventin and research with children n the autism spectrum. She is currently an Assciate Clinical Prfessr in the Divisin f Child Psychiatry at the University f Califrnia Ls Angeles (UCLA), a licensed clinical psychlgist, and since 2001 Directr f UCLA s Early Childhd Partial Hspitalizatin Prgram (ECPHP) which is an internatinally recgnized treatment prgram fr yung children with autism. Email: TPaparella@mednet.ucla.edu Stephanny Freeman, Ph.D. Dr. Stephanny F.N. Freeman is an Assciate Clinical Prfessr in the Department f Child Psychiatry at UCLA and a licensed clinical psychlgist. She C-Directs the Early Childhd Partial Hspitalizatin (ECPHP) Prgram at UCLA. Research interests included the scial (peers and friendship) and emtinal (recgnitin, empathy, and prblem slving) develpment f children with develpmental disabilities. Dr. Freeman als investigates and has published research-based interventin prcedures n cre deficits fr preschl and yung children with autism, best practice interdisciplinary interventins fr children with autism, and play/scial skills develpment in autism. Email: SFreeman@mednet.ucla.edu Kristen Hayashida, M.Ed., BCBA Kristen Hayashida is a Bard Certified Behaviral Analyst at the Early Childhd Partial Hspitalizatin Prgram (ECPHP) which is an internatinally recgnized mdel treatment prgram fr children frm tw-t-six years f age with autism, related develpmental disabilities, and behaviral disrders. The ECPHP prvides fully integrated, interdisciplinary, state-f-the-art treatment fr children as well as supprt, educatin, and transitin planning fr families ver a shrt-term, intensive perid. Fr many children, ECPHP transfrms the curse f their develpment and lng-term utcmes. Kristen has ver 10 years f experience wrking with special needs children. E-mail: KHayashida@mednet.ucla.edu. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 63

Curse Descriptin This three-part curse aligns with SPICE PD Gal B (Fcus Area I) which is t enhance existing CHAT PD residency curriculum t prepare pst-dctral pediatric dentists t prvide care fr underserved and special needs grups and cmmunities in the evlving field f dentistry. Curse Cmpetencies Demnstrate the ability t describe ASD disrders and their health and dental implicatins Demnstrate the ability t cmmunicate and adapt patient care t special needs/asd children Demnstrate the ability t participate in interprfessinal care acrss different health/behaviral disciplines. Curse Objectives On successful cmpletin f this curse, residents will be prepared t: Identify and understand the behaviral characteristics that describe autism spectrum disrder (ASD) in children. Identify the red flag behavir characteristics assciated with at risk pre-identified yung children. Identify the characteristics f cmrbid disrders and neurlgical factrs. Articulate the factrs (e.g., envirnmental, cultural, access t care, etc.) cntributing t pr ral health in ASD ppulatins. Understand the prcess f identificatin f ASD in yung children and assessments used t give a diagnsis. Understand the rle f parents as resurces t health prfessinals abut their child s develpment and behavir. Learn abut the treatment ptins fr ASD/special needs children. Learn functinal analysis f behavir. Learn simple, apprpriate and effective techniques fr child behavir management in the dental ffice. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 64

Lecture Seminar Literature review Resident presentatin Simulatin lab Labratry Teaching methd(s) used in this curse (check all that apply) Prjects Grand runds Prblem based learning/case studies Clinical rtatins Other: GME Cmpetencies addressed by this curse (check all that apply) Patient Care Medical Knwledge Practice based learning and imprvement Interpersnal and cmmunicatin skills Prfessinalism Systems-based practice CODA Standards addressed by this curse (check all that apply) Bimedical sciences Behavir guidance Grwth and develpment Oral facial injury and emergency care Oral diagnsis, ral pathlgy, & ral medicine Preventin and health prmtin Cmprehensive dental care Management f a cntemprary dental practice Patients with special health care needs Hspital dentistry Pulp therapy Pediatric medicine Advcacy Teaching This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 65

PART A: Pre-requisites Dental residents will review basic infrmatin abut ASD as it relates t the practice f ral health. See required reading materials belw. PART B: Didactics Thrugh a cmbinatin f classrm lecture and discussin, this curse intrduces dental resident students t ASD/specials needs children and their unique health and ral health issues. Dental residents will learn behavir prtcls fr managing nt typical child behavir at dental ffice settings by certified behavir analyst (BCBA). PART C: Practical experience Dental residents will be given an pprtunity t bserve children diagnsed with autism spectrum disrders in a treatment prgram. Dental residents will be assigned a child enrlled in the treatment prgram thrugh the adpt a family prcess. During the practical experience prtin, the dental resident will be expected t identify and analyze the behavir f their adpted child using ABA methdlgy. The resident will then cmplete a CAMBRA six step prcess using behaviral management techniques n their adpted child under the supervisin f Semel Faculty. Finally, resident will schedule and cmplete a full dental exam in clinic n their adpted child (if pssible depending n insurance issues). Evaluatin Criteria/Methds Students will be evaluated based n attendance and active participatin in discussins, lectures, treatment/case study sessin and rtatin Pre and pst tests will be used t assess basic knwledge (if applicable) Faculty bservatinal assessments will be used t prvide students with perfrmance feedback and additinal strategies fr future use. Annual pst curse nline survey will be cllected Remediatin Plicies A custmized remediatin prgram will be designed t address areas f deficiency This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 66

COURSE SCHEDULE PART B - Didactic prtin Overarching Gal 1. Identify and understand the behaviral characteristics that describe ASD in children. 2. Identify the red flag behavir characteristics assciated with at risk pre-identified yung children. 3. Identify the characteristics f cmrbid disrders and neurlgical factrs. 4. Articulate the factrs (e.g., envirnmental, cultural, access t care, etc.) cntributing t pr ral health in ASD ppulatins. Sessin Title, Sessin Number & Length f Sessin Intrductin t Autism Spectrum Disrder (ASD) 1 2 hurs Curse Objectives By the end f this curse, the student will have acquired the fllwing knwledge & skills: - understand the characteristics f Autism Spectrum Disrder (ASD) in preschlers - understand the red flag characteristics assciated with ASD in pre-identified at risk children -understand the curse f ASD in early childhd -identify the clinical and behaviral manifestatins f ASD - identify and understand the cmrbid disrders in ASD - identify cntributing neurlgical factrs in ASD - identify the clinical and behaviral manifestatins f ASD as related t ral health (PICA, unusual ral habits, snacking frequency, disability cnditins, sensry issues, sleep issues, etc.) Teaching methds -lectures - reading assignment s and respnses Instructr Semel Institute Faculty : Tanya Paparella, Ph.D. Assessments Pre-test 5. Understand the prcess f identificatin f ASD in yung children and assessments used t give a diagnsis. 6. Understand the rle f parents as resurces t health prfessinals abut their child s develpment and behavir. 7. Learn abut the treatment ptins fr ASD/special needs children. Treatment Optins fr ASD 2 2 hurs - distinguish typical child behavir frm nt typical child behavir - identify methds f gathering infrmatin frm parents regarding their child s behavir -learn abut different mdalities f psychlgical and behaviral treatment fr ASD - learn abut pharmaclgical treatments fr ASD - intrduce applied behaviral analysis (ABA) as an evidencebased mdel f behavir change -lectures - reading assignment s and respnses Semel Institute Faculty : Stephanny Freeman, Ph.D. This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 67

Overarching Gal 8. Learn functinal analysis f behavir. 9. Learn simple, apprpriate and effective techniques fr child behavir management in the dental ffice. Sessin Title, Sessin Number & Length f Sessin ABA fr Dental Prfessinals 3 2 hurs Curse Objectives By the end f this curse, the student will have acquired the fllwing knwledge & skills: - identify maladaptive behavirs and define the behavir based n tpgraphy and functin - identify the envirnmental setting events, antecedents, and cnsequences t maladaptive behavir - determine what envirnmental and evidence based behavir mdificatins techniques can be used fr treating patients with ASD in the dental ffice (mdelling, Tell-D-Shw, use f encuragement and descriptive praise, planned ignring and redirectin, ffering alternatives, lighting issues, nise issues, etc.) - evaluate and apply ral hygiene mdificatins (take it slw, separate tth brushing int steps, using scial stries, using a timer, etc.) Teaching methds - reading assignment s and respnses - lectures - case studies Instructr Semel Institute Faculty : Ms. Kristen Hayashida, Ed.M., B.C.B.A. Assessme nts Pst-test This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 68

COURSE SCHEDULE PART C - Practical experience Overarching Gal Sessin number & Length f Sessin Desired Learning Outcmes By the end f this curse, the student will have acquired the fllwing skills: Teaching methds Instructr Assessments 8. Learn functinal analysis f behavir. 9. Learn simple, apprpriate and effective techniques fr child behavir management in the dental ffice. 1 3 hurs 2 1-2 hurs 3 1 hur -guided bservatin f ECPHP prgram by dental resident students using the ne-way windws - participate in simulatin experience: cmplete a variety f case-based clinical decisins based n histry including parental infrmatin btained thrugh a dental behavir questinnaire. - children will get (prtable) chair experience using learned behavir mdificatin techniques - perfrm CAMBRA six step prcess - select a specific family t wrk with later at the dental clinic ( adpt a family ) - make apprpriate inter prfessinal referrals -articulate and utilize the behavir prtcl/behavir mdificatin techniques n actual ASD patients ( adpted family ) at dental clinic - discuss and evaluate lectures n ASD and practical experience -bservatin -grup team discussin -simulatin practice using (prtable) dental chair - hands-n clinical utilizatin f behavir prtcls - grup team discussin Semel Institute Faculty Semel Institute Faculty Semel Institute Faculty (ptinal) under supervisin f dental faculty Semel Institute Faculty and dental faculty Faculty bservatinal assessment Faculty bservatinal assessment This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 69

Additinal Learning Resurces & Readings Fr Part A University f Washingtn DECOD Prgram (2010). Children with autism spectrum disrder. In Oral health fact sheets fr patients with special needs. Retrieved frm http://dental.washingtn.edu/wp-cntent/media/sp_need_pdfs/autism- Dental.pdf Fr Part B Sessin 1: Schreibman, L. (1988). Behaviral characteristics f autism In Autism, (pp. 14-27). Newbury Park, CA: Sage Publicatins Sessin 2: Delli, K., Reichart, P.A., Brnstein, M.M., Livas, C. (2013). Management f children with autism spectrum disrder in the dental setting: Cncerns, behaviral appraches and recmmendatins. Med Oral Patl Oral Cir Bucal, 18(6), 862-8. Sessin 3: Glasberg, B.A. (2008). Stp That Seemingly Senseless Behavir!. Bethesda, MD: Wdbine Huse, Inc. (Chapters 1 and 6) This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 70

Strategic Partnership fr Interprfessinal Cllabrative Educatin in Pediatric Dentistry SPECIAL NEEDS CHILDREN MODULE Curse Syllabus Curse Title: The Cmplex Special Needs Patient Multidisciplinary Apprach Curse Enrllment: Pediatric Dental Residents, General Practice Residency Residents (GPRs), AEGD Residents & Preceptrs/ACTs This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 71

Curse Chair/C-Chair: Daniela Silva, DDS, MS Dr. Daniela Silva is the Dr. Thmas K. Barber Endwed Chair, the Directr f the Pediatric Residency Prgram, an Assciate Clinical Prfessr in Pediatric Dentistry and the Chair f the Sectin f Pediatric Dentistry. Dr. Silva jined the University Of Flrida Cllege Of Dentistry in August 2004 and was the Residency Prgram Directr f the Gainesville and the Naples prgrams until July 2011, when she jined the UCLA Schl f Dentistry. Dr. Silva is a Diplmate f the American Bard f Pediatric Dentistry. Email: drsilva@dentistry.ucla.edu Setareh Ghafuri, DDS Setareh Ghafuri went t University f Suthern Califrnia, Ls Angeles, t cmplete predctral curses befre ging n t University f the Pacific fr a dental degree, fllwed by Bstn University t cmplete a tw year specialty training in pediatric dentistry. Dr. Ghafuri is a Bard Certified Diplmat f the American Bard f Pediatric Dentistry and a Fellw f the American Academy f Pediatric Dentistry. She is a part time clinical faculty at the University f Califrnia, Ls Angeles, and Sectin f Pediatric Dentistry. Email: sghafuri@dentistry.ucla.edu Eric Sung, DDS Dr. Eric Sung is a Prfessr f Clinical Dentistry and Chair f the Sectin f Special Patient Care; and is the Vice Chair f the Divisin f Advanced Prsthdntics. Dr. Sung is als the Prgram Directr f the General Practice Residency prgram. His backgrund is in training and prviding cmprehensive treatment fr the medically, physically, and psychlgically cmplex individuals. Email: esung@dentistry.ucla.edu This prject is supprted by the Health Resurces and Services Administratin (HRSA) f the U.S. Department f Health 72