ADEA CCI Liaison Ledger

Perspective on Person-centered Care: Allied Dental Education

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Donna HomenkoThe ADEA CCI Liaison Ledger talks with Donna Homenko, RDH, Ph.D., adjunct faculty at Cuyahoga Community College and
Case Western Reserve University School of Dental Medicine

Liaison Ledger: What would need to change in allied dental education (such as curriculum, accreditation, licensure, admissions standards) to produce graduates who can provide person-centered care?
Donna Homenko: There should be more focus on the intraprofessional along with the interprofessional. We’ve always talked about the dental team, but it’s important that everyone’s role be clearly understood. The allied dental professional is often the first one to meet and assess that new patient. We can focus on their health literacy, their health needs. Then the allied dental student needs to be brought into the interprofessional fold. Many dental hygiene and dental assisting programs are taking place outside a university setting, where most interprofessional education (IPE) is taking place. There are many ways to connect allied students to IPE, whether that’s through a two-week intensive course or through distance education. 

Liaison Ledger: Where does a health professions education association begin in trying to transform the faculty perspective from patient-centered to person-centered?
Donna Homenko: The ADEA regional workshops are very helpful. ADEA could also develop a template for an online course that talks about how we start to shift to person-centered care and what’s being done in places that have begun this shift. I can see almost a whiteboard or a blog within this educational template where educators can contribute their comments or ideas for objectives, clinical experiences and resources related to person-centered care. 

Liaison Ledger: What would the allied dental program of the future look like to you if the predominant model of practice were person-centered?
Donna Homenko: Some sort of immersion experience—clinically, collaboratively—would be important for beginning to develop a person-centered curriculum. On a mission trip, the lines between the health professions are dissolved. Everyone goes in to help that person at that point in time.

Allied dental programs must have greater clinical collaboration, and very early on, perhaps around community experiences, to see how all the disciplines interact with individuals. When dental hygienists and assistants learn across the clinical aisle from dentists, I think there’s a greater appreciation for what each one does and how they relate to the patient and then to that whole person. 

Responses from our authors
Nadeem Karimbux: I think Dr. Homenko’s point about immersion is very well taken. But the models and the way we assess this are still to be developed. You’ve really got to have students immersed in these kinds of experiences and have faculty assess them, which can actually take a lot of time.

Muhammad Walji: Dr. Homenko’s comments reminded me of this siloing of health care, which isn’t very person-centered. We’re learning more and more that there is a great relationship between the different diseases and conditions throughout the body. A patient probably does not care who’s treating them that much, as long as they get treated fully. So while the distinction is important for the professional organizations, hopefully it can become a little bit less apparent for the patient.

Nadeem Karimbux: In order to change the behavior of practitioners, you really have to also look at the ways that they get reimbursed. That drives a lot of behavior, and until the system changes and people are rewarded for health outcomes, I don’t think things are going to change too much. Now, I do think that information technology is going to change the way that people can access their information, and that would allow them to question some of the treatments they have. The switch also has to come from the health providers recognizing that care becomes much more of a dialogue, rather than something that is totally prescriptive.

Andrew Spielman: I think that the team is important, and I believe that it needs to remain the nucleus of delivering the care, whether the care setting stays the same or is going to be modified. One of the key drivers in the next five years is going to be the use of artificial intelligence in medical and oral health decision-making, as patients will have access to their own personal data. So the person-centered aspect is not just that the professionals have to worry about being more friendly. It’s going to also mean that the person is going to become the center of collecting, monitoring, curating and helping make decisions about their own health.


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