ADEA CCI Liaison Ledger

Perspective on Person-centered Care: Advanced Dental Education

(Guest Perspective) Permanent link   All Posts

Todd ThiererThe ADEA CCI Liaison Ledger talks with Todd Thierer, D.D.S., M.P.H., Associate Dean for Clinical Affairs and Associate Professor, Department
of Primary Dental Care, School of Dentistry, University of Minnesota
School of Dentistry

Liaison Ledger: What would need to change in advanced dental education programs (such as curriculum, accreditation, licensure, admissions standards) to produce graduates that are person-centered care providers?
Todd Thierer: Continuity of care is an issue, especially in shorter general dentistry programs, because of resident rotations and other things that take folks away from the comprehensive care of patients. In advanced dental education, we assign patients to individual residents, and I think we need to move toward a team approach where residents are part of a team that’s headed by a faculty member who’s responsible for the patient’s care. That would create a person-centered approach where that person feels like they’re not being shifted around at the discretion of the program for educational purposes, but it’s actually they and their treatment that’s at the center of things.  

The curriculum also needs to change so the residents’ prime focus is not on getting experience doing procedures but on being able to address the needs of the particular patients they’re seeing that day. That needs to be one of the outcomes residents are evaluated on.  

Especially in the specialty programs, we tend to be very procedure-focused, and we tend to focus on making sure residents attain technical competence. We spend less time making sure they provide a patient experience so people feel that they’re treated well. We don’t collect that data, and that’s not going to change unless there’s an accreditation requirement to do that.

Liaison Ledger: Where does a health professions education association begin in trying to transform the faculty perspective from patient-centered to person-centered?
Todd Thierer: The previous iteration of CCI put humanistic values in the CODA standards, but it was more on the school culture side of things. ADEA has a history of working with CODA, and I think we can do that again to add very specific standards about the patient experience to the standards for predoctoral and advanced dental education programs, and detail how those standards need to be used to evaluate students and residents. I would be fairly specific about the skills they need to demonstrate in order to graduate.

Liaison Ledger: What does the advanced dental education program of the future look like to you if the predominant model of practice is person-centered?
Todd Thierer: Right now, we do patient-satisfaction surveys, but it’s not so much about the patient experience. We need to find ways to collect better data on the patient experience, to have staff members for whom that’s their prime focus.

Hospitals now have a person who is totally devoted to patient experience, so hospital-based education programs are getting a taste of that already, but it’s not reflected in the accreditation requirements. I keep going back to that, because unless person-centered care is required there, there’s going to be a resistance that won’t be overcome.

Responses from our authors
Nadeem Karimbux: Who is going to be the champion of the patient or the person in terms of advocating for them and helping them navigate through what are very complex organizations? To have that humanistic or personal touch, to look at that information and provide holistic, comprehensive care—even within the medical field—is something that I think doesn’t exist.

Regarding continuity of care, a lot of teaching clinics have moved to what we call a comprehensive care model, but the advanced education programs still are really almost islands of their own. The extreme of procedure-driven, discipline-driven treatment plans takes us even further away from what we are trying to get at with person-centered care.

Andrew Spielman: Dr. Thierer’s comments also speak to the major deficiency that we currently face in patient care delivered in a dental school setting, or even a residency setting. If I were a patient, I would hate to move from one practitioner to another. I believe that we will become truly person-centered when a dental student completes patients and one of the outcome assessments is, “I completed the following patients, and they were happy with my care.”

Competencies could really move into a patient-satisfaction-based outcome. If you had to achieve 4.5 stars on a Yelp-type survey of patient satisfaction, it would certainly make the student pay attention.

Nadeem Karimbux: There’s really nothing in the advanced dental education program standards right now that talks about person-centered or even patient-centered care. Appropriate standards would go a very long way to establishing that person-centered care should happen in some form across all graduate programs.

Muhammad Walji: Let’s be careful with the standards as well, because some aspects of person-centered care are harder to measure than technical procedures. It may be challenging.


Leave a comment
Name *
Email *

Duggan ad 2013