The REAL Curriculum ACEs
Within the CWRU School of Dental Medicine's REAL (Relevant, Experiential, Active Learning) Curriculum are curriculum components called ACEs (A Cornerstone Experience). ACEs employ a "just-in-time" approach to learning, such that integrated content is taught in the didactic or pre-clinical setting just prior to a clinical experience that provides students with the opportunity to immediately apply what they have learned.
The Department of Community Dentistry has spearheaded the ACE program, creating experiential learning opportunities in years one, two and four with a focus on access to care issues. These are described below:
- Healthy Smiles Sealant Program (First Year)
- Family First Program (Second Year)
- Geriatric Dentistry Lifelong Smiles Program (Third and Fourth Years)
- Community Health Rotations Capstone (Fourth Year)
Epidemiology for Public Health and Clinical Practice
This three-week intensive sequence provides dental students with their first experience with the problem-based learning format. The course focuses on content foundation in epidemiology and skills for evidence-based practice in dentistry. Problem-based cases use oral health topics to present the skills for critical appraisal of the health literature. Small-group settings permit students to gain experience in applying these skills to relevant dental literature.
The mission of the Healthy Smiles Sealant Program is to reduce disparities in oral health care for underserved school children in the Cleveland Metropolitan School District, the second largest school district in Ohio. In order to accomplish this mission, a 72-hour academic course entitled "Outreach Preventive Dentistry" was created during the first semester of the first-year curriculum. After completion of the course, which entails 40 hours of lecture, 12 hours of laboratory sealant placement and 20 hours of in-clinic sealant placement, the school-based sealant component commences in early December for three-weeks.
The school-based clinical experience carries through the first, second and third years of dental school. During the 2010-2011 school year, all 76 CMSD kindergarten through 8th grade schools were visited; over 5,300 school children were examined and treated; approximately 3,000 children were referred for more extensive treatment; and over 16,000 sealants were placed. Also, all 76 schools were visited by our health educators with over 19,000students receiving oral health education. All services received by the children were free of charge due to the generosity of foundations and in-kind donations and no tuition dollars are utilized to fund the program.
The Healthy Smiles Sealant Program was initiated through a pilot grant in 1999 funded by the Saint Luke's Foundation of Cleveland. The partnership between CWRU School of Dental Medicine, the Cleveland Metropolitan School District (CMSD) and Saint Luke's Foundation led to a District-wide program in 2001 when the Foundation elevated the Sealant Program to Strategic Initiative Status. As one of three Strategic initiatives within the Foundation, the Sealant Program was designated as an evergreen (continuous) funding program. In 2002, the Sealant Program was awarded a four-year grant from the Robert Wood Johnson Foundation to educate all 2nd and 6th grade school children, their parents, teachers, school nurses, and principals. In 2004, the Sealant Program was able to initiate the education of pre-kindergartners through first graders from a grant awarded by the Cleveland Foundation. In addition to the annual funding for the Sealant Program totaling three-quarters of a million dollars, Proctor and Gamble donates free tooth brushes, toothpaste and instruction booklets to every child examined in the program; Ultradent Products Incorporated donates free sealant material for every one purchased; and KaVo America Corporation donated two Diagnadent instruments. In addition, the University provides storage space for the dental equipment, supplies and vehicles.
The objectives of the Healthy Smiles Sealant Program are to (1) Treat all 2nd, 3rd and 6th grade children in the Cleveland Municipal School District with a signed consent form; (2) Perform on-site dental exams on 2nd, 3rd, and 6th graders and place sealants on all permanent molar teeth at risk for dental decay; (3) Provide classroom education by dental health educators to all pre-kindergarten, kindergarten, 1st, 2nd, 3rd and 6th graders and their teachers, school nurses and principals; (4) Expose all dental students to the needs of underserved children and the communities in which they live; and (5) Refer all participating school children with dental disease for dental care. In order to accomplish the objectives, the Healthy Smiles Sealant Program maintains a staff of 13 personnel: a dental director, two half-time dentists, half-time dental coordinator, full-time and part-time dental assistants, part-time and half-time dental hygienists, two full-time health educators, a half-time expanded function dental auxiliary, a half-time referral coordinator, and a full-time equipment technician/driver. It is through the dedication of the Sealant staff, the volunteer dentists and all 280 dental students that we have been so successful.
One of the objectives of Healthy People 2010 is to "increase the proportion of health professions training schools whose basic curriculum for health care providers includes the core competencies in health promotion and disease prevention." Recently, concepts such as interprofessional training among health professions students and evidence-based dental care have been gaining momentum in dental education. Last year, the CWRU School of Dental Medicine developed and implemented the Family First Program to address these areas. The purpose of such a cornerstone experience (ACE) is to incorporate the care of families, inter-professional interactions, risk assessment, and small group learning grounded in students' clinical experiences with the family they are caring for.
The goals of this program for second year dental students are to train dental students to integrate risk assessment in their everyday practice, consider individual patients in the context of the family, delineate genetic and environmental components of risk for oral diseases, promote interdisciplinary interactions, and foster experiential learning. Major aspects of the program are family recruitment, patient admission, risk assessment, and small group discussion.
With the use of a 38-foot-long mobile van and mobile dental operatories, the Geriatric Dentistry Program - Lifelong Smiles' mission is to deliver comprehensive dental care to the elderly population in adult day care centers, assisted living facilities, and nursing home facilities.
Director Dr. Suparna A. Mahalaha engages students in didactic instruction in geriatric dentistry, with guest lecturers from various disciplines, during the third year of dental school. As part of students' fourth year curriculum, they have a clinical geriatric rotation in which they provide dental care, assess patients through interdisciplinary training, and discuss overall treatment plans with students of medicine, nursing, pharmacy, and social work.
Lifelong Smiles support staff include a dental assistant, driver Gary Sislak, and administrative assistance from Amber Burris. The program is supported by the McGregor Foundation and several other foundations, along with the CWRU School of Dental Medicine.