Competencies for the Baccalaureate Degree in Dental Hygiene Program Graduate School of Dental Hygiene
Introduction
Competence is an acceptable, measurable defined level of special skill and knowledge derived from education, experience, role modeling and overall socialization. To be competent, an entry level dental hygienist must perform at or above the acceptable defined standard.
Competencies for the Baccalaureate Degree in Dental Hygiene Program Graduate identifies and organizes the knowledge, skill, behaviors and attitudes that graduates must attain to assume entry-level roles as practitioners, oral health educators, administrators/managers, consumer advocates, change agents, and researchers in a variety of environments. The Competencies in this document serve as the foundation for the selection of course content, sequencing of courses, intra and extra mural learning activities, faculty communication and decision-making, and outcomes assessment. As such, the Competencies serve as a framework for curriculum development, implementation and evaluation. The document is viewed as a method of communicating and operationalizing the standards that the faculty and society have deemed important for an entry-level dental hygienist to possess in order to care for and promote the health of individuals, families, groups and communities.
Domains
The organization of the document flows from the general categories that comprise the central domains of the curriculum, to the specific behaviors that reflect the foundational abilities expected of students at the course level( See Figure 1). The domains should be viewed as themes or broad categories of professional focus that transcend numerous courses and learning activities. The concept of domains is intended to encourage threads of consistency, emphasis and focus that develop and advance throughout the curriculum. In this document, domains are labeled.
I. Professionalism and Ethics
II. Dental Hygiene Process of Care
III. Health Promotion and Community Involvement
IV. Professional Commitment and Advancement
Organization
Figure 1. Organization of Competencies for the Baccalaureate Degree in Dental Hygiene Program Graduate.
Major Competencies
Within each domain, major competencies expected of the program graduate are identified. A major competency is the ability to perform or provide a particular complex professional activity which is intellectual, affective and/or psychomotor in nature. For example, "the dental hygienist must be able to systematically collect, analyze and record data on the general, oral and psycho-social health status of clients using methods consistent with medico-ethico-legal principles." The complexity of this professional service suggests that multiple and more specific supportive and foundational abilities are required to enable the performance of any major competency. In this document, major competencies are numbered 1-11. An overview of the domains and the major competencies is displayed in Figure 2.
Supporting Competencies
Specific abilities, called supporting competencies, must be mastered in order to carry out major
competencies. Examples of supporting competencies include the ability to "recognize medical conditions that will impact overall client care," "obtain consultations as appropriate," or "formulate goals and establish expected outcomes related to the dental hygiene diagnosis." Mastery of all supporting competencies related to a service or task is a necessary condition for the acquisition and demonstration of a major competency. While less complex than a major competency, a supporting competency also requires more specific abilities termed foundational knowledge, skills and attitudes. In this document, supporting competencies are numbered 1.1 to 11.9.
Foundational Knowledge, Skills and Attitudes
Foundational knowledge, skills and attitudes (foundational abilities) are acquired through didactic, laboratory and clinical instruction that provide the information, mentoring and experience needed for satisfactory mastery of supporting competencies. Foundational knowledge is the ability to use information and correctly answer specific questions when asked, such as on a written examination or during a practical examination. Foundational skill is the ability to follow specific guidelines or a prescribed process that yields an acceptable result in standardized situations, for example, performing a professional fluoride treatment during a practical examination on a lab partner or periodontal probing on a model. Foundational attitudes are positive intellectual and behavioral actions, such as addressing a client's need for freedom from anxiety prior to proceeding with the planned care.
Course objectives, which are found in the course syllabi, are designed to delineate Foundational Knowledge, Skills and Attitudes. The basic medical, dental and dental hygiene sciences, the psychosocial sciences, clinical sciences and management sciences provide the instruction at the foundational level. Didactic, small group, library, seminar, laboratory, case-based and clinical instruction provide information, psychomotor, and problem solving experiences that enable students to acquire and demonstrate competence in a variety of employment settings. The inclusion of any specific foundational ability in the curriculum is based on its direct support of one or more of the Supporting and Major Competencies. Foundational Abilities are listed as course objectives and found in the course outlines. Therefore, foundational abilities are not listed in this document.
Summary
This document is designed to direct the educational process for students as one step to assuring employers and the public of educated, competent dental hygienists who are capable of providing preventive, educational and therapeutic oral health services in a variety of environments. These competencies define a standard of performance for a new graduate, rather than predict the higher level of performance that will be attained by baccalaureate level dental hygienists over their career lifetime. Implementation and evaluation of Competencies for the Baccalaureate Degree in Dental Hygiene Program Graduate rests with the faculty responsible for the educational programs within the School of Dental Hygiene at Old Dominion University. Ultimately, the true measure of the value of a competency-based education will be the quality of the graduates, the satisfaction of the employers, and the oral health status of the populations served.
Figure 2. Competencies
I. Professionalism and Ethics
The contemporary dental hygienist provides clinical care using evidenced-based knowledge, professional judgment and skills. The dental hygienist is a licensed professional who must be capable of discerning and effectively managing ethical issues and problems in the workplace. As dental hygiene creates a unique identity for the profession and increases the knowledge base of the profession, the dental hygienist must be able to understand and apply rapidly changing, evidence based information to a variety of roles in the employment environment. Therefore, critical thinking, problem solving, and decision-making skills are critical to possess.
1. Professional Behavior
Professional behavior encompasses many components including a team approach, positive verbal and nonverbal communication, interpersonal skills, attention to feedback, protocol adherence, thorough and complete documentation, and time management. The dental hygiene graduate must be able to practice using a team concept in a professional manner.
Specifically, the dental hygiene graduate must be able to:
1.1 Assume responsibility and accountability for dental hygiene actions and services, according to protocol.
1.2 Provide accurate, consistent, and complete documentation when serving in professional roles.
1.3 Communicate effectively using verbal, nonverbal written and electronic communication skills.
2. Ethical Behavior
The dental hygiene graduate must be able to discern and manage the ethical issues faced in dental hygiene.
Specifically, the dental hygiene graduate must be able to:
2.1 Integrate the ADHA code of ethics in all professional endeavors.
2.2 Adhere to local, state and federal laws, recommendations, and regulations for dental hygiene actions and services.
2.3 Serve all clients without discrimination, appreciating the diversity of the population.
2.4 Apply principles of risk management to manage professional risks and prevent liability.
3. Problem-Solving & Decision Making
The dental hygiene graduate must be able to acquire, synthesize, and analyze information in a scientific and effective manner.
Specifically, the dental hygiene graduate must be able to:
3.1 Critically analyze published reports of oral health research and apply this information to the practice of dental hygiene.
3.2 Evaluate the safety and efficacy of oral health products, interventions, and treatments.
II. Dental Hygiene Process of Care
The dental hygiene graduate is a licensed preventive oral health professional who provides educational, preventive, and therapeutic services in the support of optimal oral health. The dental hygiene process of care applies principles from the biomedical, clinical, and psychosocial sciences to diverse populations that may include the medically compromised, mentally or physically challenged or socially or culturally disadvantaged.
4. Assessment
The dental hygiene graduate must be able to systematically collect, analyze and record data on the
general, oral, and psycho-social health status of clients using methods consistent with medico-legal-ethical principles.
Specifically, the dental hygiene graduate must be able to:
4.1 Assess client concerns, goals, values, and preferences to guide client care.
4.2 Obtain, review, update, and interpret an accurate medical/dental history and vital signs, recognizing conditions that require special precautions or consideration prior to or during dental hygiene care.
4.3 Perform an extraoral and intraoral examination.
4.4 Perform an examination of the teeth and accurately record the results.
4.5 Evaluate the periodontium, and identify conditions that compromise periodontal health and function.
4.6 Identify the need for radiographs and radiographically distinguish normal from abnormal anatomical findings.
4.7 Recognize predisposing and etiological risk factors that require intervention to prevent and control disease.
4.8 Perform appropriate examinations to obtain, validate and interpret diagnostic information, recognizing advantages and limitations
4.9 Identify clients at risk for a medical emergency and take appropriate precautions to minimize those risks.
5. Diagnosis
The dental hygiene graduate must be able to use critical decision making skills to reach conclusions about the client's human needs related to oral health and disease, based on all available assessment data.
Specifically, the dental hygiene graduate must be able to:
5.1 Analyze and interpret the data to formulate a dental hygiene diagnosis related to and congruent with the diagnosis of the dentist and other health professionals.
5.2 Obtain consultations as appropriate
6. Planning
The dental hygiene graduate must be able, through collaboration with the client and/or other health professionals, to formulate a comprehensive dental hygiene care plan. The care plan will delineate dental hygiene interventions to be provided that are evidenced-based, client-centered and related to the identified human need deficits.
6.1 Establish a planned sequence of educational, preventive, and therapeutic services, collaboratively with the client, based on the dental hygiene diagnosis.
6.2 Formulate goals and establish expected outcomes related to the needs and desires of the client and the dental hygiene diagnosis.
6.3 Make referrals to professional colleagues as indicated by the care plan.
7. Implementation
The dental hygiene graduate must be able to provide specialized care that includes educational, preventive, and therapeutic services designed to assist the client in achieving and maintaining oral health goals.
Specifically, the dental hygiene graduate must be able to:
7.1 Educate clients to prevent and control risk factors that contribute to caries, periodontal disease, and other oral conditions.
7.2 Utilize accepted infection control procedures.
7.3 Obtain radiographs of diagnostic quality.
7.4 Apply basic and advanced principles of dental hygiene instrumentation to remove deposits without trauma to hard or soft tissue.
7.5 Control pain and anxiety during treatment through use of accepted pharmacological and behavioral techniques.
7.6 Select and administer the appropriate chemotherapeutic agent and provide pre- and post-treatment instructions.
7.7 Provide adjunct dental hygiene services that can be legally performed in the Commonwealth of Virginia.
7.8 Manage medical emergencies in the client care environment.
8. Evaluation & Maintenance
The dental hygiene graduate must be able to evaluate the effectiveness of implemented educational, preventive, and therapeutic services and modify as needed.
Specifically, the dental hygiene graduate must be able to:
8.1 Determine the outcomes of dental hygiene interventions using indices, instruments, examination techniques, and client self-report as specified in the client goals.
8.2 Compare actual outcomes to expected outcomes, reevaluating goals, diagnoses and services when expected outcomes are not achieved.
8.3 Develop and maintain a periodontal maintenance program.
8.4 Determine the client's satisfaction with the oral health care received and the oral health status achieved.
III. Health Promotion & Community Involvement
Trends toward consumerism, self-care, disease prevention, health promotion and healthy lifestyles means that clients, wherever they might be, want and need information on oral health and disease. Teaching and health promotion strategies are involved in the full range of dental hygiene actions directed toward helping diverse populations achieve oral wellness.
9. Education & Communication
The dental hygiene graduate must be able to promote the values of oral and general health to the public and organizations within and outside the profession.
Specifically, the dental hygiene graduate must be able to:
9.1 Identify factors that can be used to motivate the client for health promotion, disease prevention and/or health maintenance.
9.2 Educate other individuals and/or organizations about the assessment, access and delivery of services in the provision of oral health care.
9.3 Present educational information to diverse client populations, in a variety of settings using appropriate teaching strategies.
10. Community Involvement
The dental hygiene graduate must be able to initiate and assume responsibility for health promotion and disease prevention activities for diverse populations in a variety of settings.
Specifically, the dental hygiene graduate must be able to:
10.1 Assess community oral health needs, risk and available resources and evaluate outcomes for health improvement and access to the healthcare system.
10.2 Plan, implement, and evaluate community oral health education and services in a variety of settings.
10.3 Use screening, education and referral to introduce consumers to the healthcare system.
10.4 Provide dental hygiene services as an interdisciplinary healthcare member in a variety of settings.
IV. Professional Commitment and Advancement
For professional advancement and lifelong learning, the dental hygienist must be able to derive the relevance from rapidly changing information. An understanding of administrative leadership allows the dental hygienist to advance the goals of the profession both as an individual and via groups. Knowledge of the scientific method ensures that actions taken by the dental hygienist are based on scientific evidence, and not merely on ritual, tradition, intuition or personal preference.
11. Professional Commitment
The dental hygiene graduate must be concerned with improving the knowledge, skills and values of the profession.
Specifically, the dental hygiene graduate must be able to:
11.1 Advance the values of the profession through leadership, service activities and affiliations with professional and public organizations.
11.2 Assume the roles of the professional dental hygienist (clinician, educator, researcher, change agent, consumer advocate, administrator) as defined by the ADHA.
12. Professional Advancement
The dental hygiene graduate must pursue new knowledge on a continual basis due to the changing health care environment.
Specifically, the dental hygiene graduate must be able to:
12.1 Assume responsibility for professional growth through lifelong learning.
12.2 Evaluate professional issues and scientific literature in order to make evidence-based decisions that advance the profession of dental hygiene.
References:
American Association of Dental Schools, Section on Dental Hygiene Education Competency Development Committee. (1999). Competencies for Entry Into the Profession of Dental Hygiene. Washington, D.C.
Baylor College of Dentistry, Caruth School of Dental Hygiene. (1994). Competencies for the Dental Hygienist. June 1. Caruth School of Dental Hygiene: Dallas, TX.
The University of Texas Health Science Center at San Antonio, Department of Dental Hygiene. (19xx). Competencies for the Certificate Dental Hygiene Graduate. Department of Dental Hygiene: San Antonio, TX.
University of Maryland at Baltimore, Department of Dental Hygiene, (1995). Competencies for Dental Hygiene Graduates. August. Department of Dental Hygiene: Baltimore, MD
