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WellSpan Medical Education

General Practice Residency Goals and Objectives

Introduction to the goals and objectives

The upcoming year will be rigorous and is designed to give you an opportunity to gain clinical experience and proficiency in a wide variety of medical and dental areas. The subsequent sections outline the goals and objectives for the residency program. It is expected at the completion of the year that you will have had exposure or gained proficiency as noted in each of the areas listed. It is important that you become familiar with these goals and objectives. During the year through evaluations, meetings with your mentor, and daily interaction with faculty these areas will be assessed to ensure you are receiving the necessary experience and training to meet the stated goals.

Patient Assessment and Diagnosis

  1. Medical Risk Assessment
    1. Medical history (ROS, social history, family history, hospitalizations, medications/allergies)
    2. Assignment of ASA classification
    3. Medical management
      1. Systemic disease and dental treatment implications
      2. Development of interdisciplinary skills
  2. Dental Assessment
    1. Dental history
    2. Intraoral and extraoral examination
    3. Appropriate charting and radiographs
    4. Diagnosis

Planning and providing comprehensive multidisciplinary oral health care

  1. Treatment planning
    1. Development of a comprehensive treatment plan based on sound diagnoses
    2. Appropriate sequence of treatment
    3. Effective revision of treatment as indicated by changing of patient's needs
    4. Modification of treatment secondary to patient's medical conditions
    5. Informed consent and treatment options
  2. Delivery of comprehensive care with appropriate multidisciplinary treatment
    1. Providing comprehensive care at a level beyond a recent dental graduate
    2. Developing a team approach in the management of complex cases and utilizing appropriate referral
    3. Pre and post treatment communication

Hospital Dentistry

  1. Admissions/Discharge of Same day surgeries
    1. Pre-admission preparation
      1. Review of history & physical
      2. appropriate labs
      3. medications
      4. diagnostic studies
    2. Pre-operative orders
    3. O.R. protocol and consent
    4. Operative reports
    5. Post-operative orders and notes
    6. Discharge instructions and follow-up
  2. Inpatient Consults
    1. Requesting medical consults
    2. Conducting consults from other services and providing appropriate treatment
  3. Call Responsibilities (Emergency Department coverage)
  4. Hospital Governance
    1. Hospital organization/structure
    2. Credentialing Process
    3. Application for privileges
    4. Hospital record protocol

Outpatient

  1. Practice Management
    1. Financial considerations (dental insurance contracts, payment options, preauthorizations, financial contracts)
    2. Insurances (malpractice, disability, etc)
    3. Associateships/partnerships
    4. Employee management
    5. Informational technology
    6. Quality management
  2. Ethics
    1. Ethical theories
    2. Ethical decision making
    3. Professional responsibility
  3. Multidisciplinary Skills
    1. Team approach
    2. Appropriate referral
    3. Communication
    4. Follow-up
    5. Community service

Off-Service Rotations

  1. Anesthesia Rotation
    1. Perform a preoperative evaluation
    2. Assessment of the effects of behavioral and pharmacologic techniques
    3. Venipuncture technique
    4. Patient monitoring
    5. Airway management
    6. Understanding of the use of pharmacologic agents
    7. Recognition and treatment of anesthetic emergencies
    8. Assessment of patient recovery from anesthesia
  2. Medicine Rotation
    1. Obtaining and interpreting the patient's chief complaint, medical, and social history, and review of systems
    2. Obtaining and interpreting clinical and other diagnostic data from other health care providers
    3. Using the services of clinical, medical, and pathology laboratories
    4. Performing a history and physical evaluation and collect other data to establish a medical assessment.
  3. Mobile Dentistry & FQHC's
    1. Mobile Dentistry – Transporting the portable dental operatory equipment to local facilities. Providing dental services to rural, vulnerable, and/or underserved populations within the WellSpan Health service area. Exposure on the treatment of patients with developmental disabilities and skilled nursing homes.
    2. FQHC – Residents have the opportunity for exposure in various facilities over the course of their 12 months. Rotating through regional Federally Qualified Healthcare Centers in underserved areas and rural populations. Additionally, residents attain exposure in building interdisciplinary relationships to improve patient care outcomes.

Restorative

  1. Understanding the parameters of restorability ofa single tooth
  2. Restoration of single tooth using acceptable dental materials and techniques
  3. Restoration of endodontically treated teeth

Periodontal Therapy

  1. To properly diagnose and classify gingivitis and periodontal disease with clinical and radiographic findings
  2. To effectively treat periodontal disease with appropriate treatment, patient education, maintenance, and referrals
  3. To assist or perform periodontal surgery including: gingivectomy, crown lengthening, implant placement and gingival grafts
  4. To understand the esthetic aspect of periodontal tissues when performing surgical procedures in the anterior portions of the oral cavity and in the placement of anterior implants

Occlusion

  1. Occlusion overview
  2. TMJ disorders and orofacial pain
  3. Occlusal disorders

Oral Surgery

  1. Hard and Soft Tissue Surgery
    1. Resident will be able to perform routine extractions
    2. Resident will be able to surgically extract fully erupted teeth
    3. Resident will have exposure and some experience in third molar extractions
    4. Resident will be able to manage oral mucosal diseases
    5. Resident will have exposure in pre-prosthetic surgery
    6. Resident will have insight to clinical limitations and the need for appropriate referral
  2. Treatment of Medical and Dental Emergencies
    1. Treatment of head and neck infections
      1. Medical/dental assessment (ROS, medications, allergies, HPI)
      2. Appropriate dx using clinical examination, radiographs, and laboratory studies
      3. Antibiotic therapy and its limitations
      4. Indications for culturing and technique
      5. Appropriate treatment and referral
    2. Dental alveolar trauma and oral maxillofacial trauma
      1. Medical/dental assessment (ROS, medications, allergies, HPI)
      2. Proper diagnosis through the use of clinical examination, radiographs, and laboratory studies
      3. Providing appropriate treatment for dental alveolar trauma and follow-up care
      4. Exposure to oral maxillofacial trauma with experience in diagnosing and developing communication skills with the oral maxillofacial surgeon
    3. Post-operative complications
      1. post-operative bleeding
      2. alveolar osteitis
      3. pain management
      4. post-operative infections
    4. Management of Medical Emergencies
      1. recognition of medical emergencies and identifying the type and source of the medical problem
      2. appropriate management of medical emergencies and identifying the need for EMS activation
      3. documentation with medical/legal ramifications and appropriate follow-up

Endodontics

  1. To properly diagnose pulpal pathology using clinical exams, tests, and radiographs
  2. To diagnose and provide appropriate pulpal therapy for traumatized teeth, including crown fractures, root fractures, luxations, and avulsions
  3. To diagnose and treat cracked tooth syndrome
  4. Experience in the use of rotary endodontics and wan-n vertical condensation
  5. Understand clinical limitations and when referral is indicated
  6. Appropriate treatment of post-endodontic complications

Pain and Anxiety Control

  1. Perform a thorough patient evaluation
  2. Control pain and anxiety in a conscious patient with the use of behavior management, local anesthesia, nitrous oxide
  3. Understand the risks, benefits, indications for dental treatment with nitrous oxide

Pediatrics

  1. Diagnosis and treatment planning
  2. Pediatric restorative procedures
  3. Pulpal therapy for pediatric patients including primary teeth and premature secondary teeth (open apices)
  4. Behavioral and pharmacokinetic modalities with the pediatric population
    1. Nitrous oxide
    2. Chairside behavioral skills
  5. Space maintenance
  6. Developing skills to effectively treat special needs patients with developmental and physical disabilities

Preventive Dentistry

  1. Patient education and motivation
  2. Microbiology of caries formation and patient behavioral modification to control caries rates
  3. Fluorides in a preventive program topical/systemic
  4. Nutritional assessment of dental patients

Implant Dentistry

  1. Appropriate diagnosis and treatment planning
  2. Surgical considerations in placement of implants
  3. Surgical placement and restoration of implants
  4. Esthetic considerations for anterior implant placement and restoration
  5. Follow-up and maintenance of implant dentistry

Restoration of the edentulous space

  1. To diagnose a patient's, need for replacement of missing teeth and to treatment plan appropriately taking into consideration the indications and contraindications for fixed, removable and implant prosthesis
  2. To gain experience in fabricating complete and partial removable dentures, fixed dentures, immediate dentures, overdentures, and restoring implants
  3. To select the appropriate prosthetic materials and develop an appropriate occlusal scheme

Research (Optional)

  1. Identify and utilize the different roles of the Emig Research Center
  2. Know where to obtain research information
  3. Define the term research in human subject
  4. Review IRB/HITAA regulations
  5. Identify resources for implementing research projects

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