Partnering with Academic Institutions and Residency Programs to Develop Service Learning Programs

Strengthening the Oral Health Safety Net (SOHSN) Initiative June 29, 2015

Irene V. Hilton, DDS, MPH

NNOHA Dental Consultant

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Objectives

Describe at least two benefits for Health Centers of engaging in service learning partnerships

Describe at least two benefits for learners of engaging in service learning partnerships

Describe at least two benefits for academic institutions of engaging in service learning partnerships

List at least three planning considerations for Health Center dental programs considering service learning partnerships

Background

Health Center mission of providing training and employment for local community

1980’s random partnerships

2008 official ADEA policy statement

2001-2010

http://www.dentalpipeline.org

Results

Health Centers are the largest percentage (29%) type of community site where students perform pipeline program service learning (http://www.adea.org/policy_advocacy/federal_legislative_regulatory_resources/Documents/ IOMStatement01062011.pdf)

Poll

How many of you are currently hosting dental student rotations or dental residency programs in your Health Center?

1. Yes

2. No

3. N/A

Health Center Benefits

Recruit future oral health professionals to Health Centers

Allows Health Center to become familiar with strength & weaknesses

Creates professional development opportunities for oral health professionals employed at Health Centers

• More fulfilling professional life, increased job satisfaction

Recruitment tool to attract new oral health professionals to Health Center jobs, retention strategy

Health Center Teaching Faculty

Credentialed as faculty of the academic institution or residency program- same process as at home institution

Faculty development- teaching and mentoring techniques, evaluating and assessing student or resident performance.

Additional continuing education opportunities

• Latest knowledge, techniques

• On site CE

• Discounted CE

Increase Access to Care

Increase encounters/revenues if capacity

Access broad spectrum of dental specialists and specialty services

Expedited referral to the academic institution or residency program

Tele-dentistry consults

Poll

How many of you are currently hosting dental hygiene student rotations in your Health Center?

1. Yes

2. No

3. N/A

Benefits to Students and Residents

Exposed to individuals from culturally, linguistically, and economically diverse populations, including those with special health care needs, complex medical issues

Enhance cultural competence

Gain appreciation for social determinants of health

Interdisciplinary Environment

Co-location with primary care, behavioral health, pharmacy, optometry, podiatry, social workers, patient navigators

Students/residents observe the practical aspects of interprofessional collaboration

Improve Clinical Skills

Gain competence & speed at performing a wide range of clinical procedures

Obtain experience working with populations that access oral health care at lower rates than the general population, such as infants and children 0-5 and pregnant women

Practice Management

Learn day-to-day operations

Observe clinical, health-information-technology, and administrative systems

• Infection control

• Peer review

• Quality Assurance

Poll

How many of you are currently hosting dental assisting student rotations in your Health Center?

1. Yes

2. No

3. N/A

Benefits for Academic Institutions

Required by CODA

“Dental education programs must make available opportunities and encourage students to engage in service learning experiences and/or community-based learning experiences. Service learning experiences and/or community-based learning experiences are essential to the development of a culturally competent oral health care workforce.” (Commission on Dental Accreditation,

Accreditation Standards for Dental Education Programs)

More Benefits

Opportunity to offer students and residents a diverse clinical experience

Pilot models and approaches for developing community-based dental education curricula, clinical programs

Pilot methodologies for testing and evaluating programs and student competencies

Cost Savings

Dental schools choose not to construct direct patient care clinics or plan small clinics that will accommodate only a small number of students

Savings in facilities, faculty, and infrastructure associated with providing direct patient care in traditional academic institution clinics

Greater flexibility in allocating resources to other educational areas

Research

Offer academic institutions opportunities to conduct community-based research

Health center patients are typically from populations that have higher rates of oral disease than the general population and that are under-represented in research

Models

Pre-doctoral rotations

Post-doctoral residencies

Dental hygiene rotations

Dental assisting rotations

HC- academic institution clinic collaborations

Poll

How many of you have gone on to permanently hire someone who did a service learning rotation at your Health Center?

1. Yes, we have hired

2. No, we have not hired

3. We don’t host any service learning in our Health Center

4. N/A

Planning Considerations

Is service learning right for my dental program?

Assessing Organizational Readiness

Has the Health Center identified what it hopes to gain from a service learning partnership?

Is leadership willing to devote the required resources to the partnership?

Are oral health professionals who work at the Health Center willing to go through the faculty development and credentialing process and serve as engaged and enthusiastic teachers and mentors?

Ask/Learn

Academic Partner

Mission Alignment

Track record of successful partnering

Communication

Thorough orientation & understanding of division of responsibilities

Level of administrative and technical support

Space

Procedures/Requirements

Sufficient patients

Adequate procedure mix

Residency requirements

• At site or by arrangement

Systems to assess competence, identify deficient areas, and arrange remediation experience

Support Team Ratio

Engaged Health Center Staff

WIN-WIN NEGOCIATIONS

Hosting Students

Faculty Supervision

Academic institution or residency program faculty placed at the Health Center

Develop and credential Health Center oral health professionals as adjunct faculty of the academic institution or residency program

Faculty Development

Training in teaching and mentoring techniques

How to evaluate and assess performance in a standardized manner

Understanding of credentialing, faculty appointment, training, evaluation and supervisory requirements

Financial Considerations

Many different types of financial arrangements between Health Centers and academic institutions and residency programs

Health Centers need to negotiate a mutually agreeable arrangement

Must know current revenue & productivity data

Health Center Perspective

At minimum, revenue neutral

Current levels of productivity, anticipated student and supervising faculty productivity levels, number of chairs, availability of support staff, and additional costs

Expect productivity of supervising faculty will decrease owing to loss of operatory space and time spent in supervisory duties. Maybe offset by revenues and productivity by student/resident.

Examples of Arrangements

Health Center trained faculty, keeps revenues

Academic institution or residency program covers the salary and fringe benefits of post-doctoral residents, Health Center retains revenues

Academic partner places own faculty in Health Center. Health Center purchases faculty time and retains revenues

Health Center negotiates to pay the academic institution or residency program percentage of revenues

Successful Partnerships

Flexibility

Communications- each partner clearly understands their role & expectations

Champions

What have been the benefits of service learning rotations? (Discussion)

Challenges

Meeting CODA Requirements

Revenue Sharing

Productivity Changes

Lack of Communication

What have been the challenges?

(Discussion)

Conclusion

Service learning partnerships can provide benefits to Health Centers and patients served

Challenges inherent in developing and maintaining such programs can be addressed

Success when WIN-WIN

http://www.nnoha.org/nnoha-content/uploads/2014/06/Academic-Partnerships-Paper-final_2014-06-03.pdf

www.nnoha.org

Irene V. Hilton, DDS, MPH NNOHA Dental Consultant irene@nnoha.org San Francisco Department of Public Health 1525 Silver Avenue San Francisco, CA 94134 (415) 657-1708