The ADEA CCI Liaison Ledger talks with Donna Homenko,
RDH, Ph.D., adjunct faculty at Cuyahoga Community College and
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
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
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
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.
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.