Appendix A - Domains of Competence and Rubrics for Assessment
Professionalism and Ethics
Learners are expected to model personal agency and apply principles of ethical decision-making and professional responsibility in all contexts. The learner should demonstrate integrity, characterized by benevolence, truthfulness, and person-centeredness. Leading with empathy and practicing with compassion, the learner will prioritize care consistent with and respectful of the patient’s values, preferences, and expressed needs. Learners will also demonstrate reliability and humility across clinical and interpersonal domains. The learner should identify, evaluate, and address unethical or unprofessional behavior. Knowledge of and adherence to the laws and standards of the profession must be demonstrated.
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| PROFESSIONALISM AND ETHICS: Describes level to which the learner applies the principles of ethical decision-making and professional responsibility in all contexts. | Models personal agency, acts with integrity and humility, and demonstrates ethical decision-making and professional responsibility to act in the best interest of the patient | N/A | Does not model personal agency, act with integrity and humility, and/or demonstrate ethical decision-making and professional responsibility to act in the best interest of the patient | Consistently fails to act in the best interest of the patient by lacking integrity and humility or ethical decision-making, thereby negatively impacting patient care (Advocate) Exhibits inappropriate conduct with patients, caregivers, faculty/staff, the care team, and/or peers (Advocate) |
| Identifies, evaluates, and addresses unethical or unprofessional behavior in practice | N/A | Does not identify, evaluate, and address unethical or unprofessional behavior in practice | Practices under the influence of drugs/alcohol (Advocate) Reports or documents false or intentional inaccurate information (Advocate) | |
| Demonstrates compliance with HIPAA rules | N/A | Demonstrates non-compliance with HIPAA rules | Requires prompting to provide a reasonable rationale for the procedure(s) being performed | |
Person-Centered Care - Communication, Patient Awareness and Sensitivity
Learners are expected to deliver person-centered care in all phases, including assessment, treatment planning, collaborative care, and the provision of care. This means providing care that is respectful of and responsive to patient preferences, needs, and values, and sensitive to the patient’s social, economic, emotional, physical, and cognitive circumstances. Person-centered care also ensures that patient’s values guide all clinical decisions, providing the patient and/or caregiver with information and education appropriate for their literacy level on clinical conditions, prognosis, prevention, and processes of care, with the patient and/or caregiver actively engaged as partners in decision-making. This capacity includes demonstrating cultural competence and humility, valuing inclusion, and managing a multidimensionally diverse patient population. Learners who demonstrate appropriate person- centered care are focused on relationally driven communication with patients. Interpersonal and communication skills encompassed in person-centered care include, and are not limited to, exploring patient concerns, active listening, demonstrating non-judgmental attitude, attending to the patient’s physical comfort, addressing fear and anxiety.
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| PERSON-CENTERED CARE: Describes level to which the learner provides care that is respectful of, and responsive to, individual patient preferences, needs, and values, while being sensitive to the patient’s social, economic, emotional, physical, and cognitive circumstances. | Demonstrates respect, and prioritizes care consistent with patients’ values, preferences, and expressed needs | Demonstrates respect most of the time and/or inconsistently obtains or prioritizes patients’ values, preferences, and expressed needs | Consistently demonstrates disrespect; fails to obtain or prioritize patients’ values, preferences, and expressed needs most of the time | Fails to obtain and prioritize patients’ values, preferences, and expressed needs. Fails to act for the benefit of the patient (Advocate) |
| Effectively employs the principles of behavioral sciences, such as communication skills, empathy, motivational interviewing, that demonstrate attention to individual differences, such as diversity, culture, psychosocial history/background, literacy, life course, etc. | Most of the time effectively employs the principles of behavioral sciences, such as communication skills, empathy, motivational interviewing, that demonstrate attention to individual differences, such as diversity, culture, psychosocial history/background, literacy, life course, etc. | Inconsistently employs the principles of behavioral sciences, such as communication skills, empathy, motivational interviewing, that demonstrate attention to individual differences, such as diversity, culture, psychosocial history/background, literacy, life course, etc. | Fails to employ the principles of behavioral sciences that lead to lack of responding to individual differences, adversely affecting patient trust, compliance, and care Exhibits inappropriate conduct with patients, caregivers, faculty/staff, the care team, and/or peers (Advocate) Does not accurately and effectively communicate rationale, progress, or processes of care for the procedure(s) (Advocate) | |
| Effectively employs the principles of behavioral sciences to relieve fear and anxiety. | Most of the time effectively employs the principles of behavioral sciences to relieve fear and anxiety. | Inconsistently employs the principles of behavioral sciences to relieve fear and anxiety. | ||
| Actively engages patient/caregiver as a partner in decision-making | Most of the time actively engages patient/caregiver as a partner in decision-making | Inconsistently engages patient/ caregiver as a partner in decision- making | Does not engage patient/caregiver as a partner in decision-making (Advocate) | |
| Provides effective accommodations for necessary modifications and adjustments to routine care in managing the treatments of patients with special needs, ensuring the use of respectful and appropriate language | Minor adjustments required to accommodate necessary modifications to routine care for managing treatment of patients with special needs, while using respectful and appropriate language | Does not adequately accommodate necessary modifications and adjustments to routine care when managing treatment of patients with special needs, despite using respectful and appropriate language | Faills to adequately accommodate necessary modifications and adjustments to routine care when managing treatment of patients with special needs, and/or uses disrespectful and inappropriate language (Advocate) | |
Team Communication and Collaboration
Learners are expected to develop the skills necessary to work as a collaborative team member and manage a practice effectively. Learners will demonstrate their knowledge of health care systems, models of care delivery, financing of health services, effective management styles, the principles of hiring practices, and marketing strategies, and the application of legal and regulatory concepts in the provision of health care services. Learners will demonstrate an ability to function as a leader of an oral health care team and be able to navigate the oral health care profession as a team-based venture, valuing and leveraging the expertise of intra- and interprofessional partners and engaging in collaborative decision-making in the coordination of patient care. In all contexts, learners are expected to understand the roles and responsibilities for collaborative practice, demonstrate teamwork and effective communication to facilitate collaboration, and apply values and ethics to team-based care to ensure that the provision of care is safe, timely, efficient, effective, and equitable. Learners must demonstrate their ability to function successfully in a multidimensionally diverse work environment, embracing cultural diversity and individual differences that characterize patients, populations, and the health care team.
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| TEAM COMMUNICATION AND COLLABORATION: Describes level to which the learner applies values and ethics to team-based care by leveraging the expertise of intra- and inter-professional partners. Learners engage in respectful and collaborative decision-making and demonstrate an ability to function as an effective manager of a practice and as a leader of an oral health care team. | Engages in collaborative partnership by asking relevant questions, actively listens, considers multiple perspectives. | Engages in collaborative partnership but requires prompting to ask relevant questions; actively listens and considers multiple perspectives. | Does not engage in collaborative partnership by asking relevant questions, and/or actively listens, or considers multiple perspectives; | Does not engage in collaborative partnership, increasing potential for patient harm Disregards faculty instruction or fails to get faculty consent (Thinker) |
| Leads by building consensus around practical solutions to issues within the office/practice | Leads by building consensus around practical solutions to issues but leaves some concerns unaddressed | Builds incomplete consensus around practical solutions with significant probability of negative outcome | Fails to build consensus around practical solutions to issues within the office/practice | |
| Interacts respectfully by demonstrating humility (recognizes limits, asks for help, is receptive to feedback) and agency (proactive toward work, team, safety, personal development) through verbal and nonverbal communication | Generally, interacts respectfully by demonstrating humility and agency but may inadvertently struggle to operationalize in action or conversation | Generally, interacts respectfully by demonstrating humility and agency but may significantly inadvertently struggle to operationalize in action or conversation | Interacts disrespectfully and/or lacks humility and agency in verbal responses and/or nonverbal actions. Exhibits inappropriate conduct with patients, caregivers, faculty/staff, the care team, and/or peers (Advocate) | |
Health Promotion
Learners are expected to apply principles of behavioral sciences in the context of person-centered care to promote, improve, and maintain patient health and wellness. This will be demonstrated by the learner’s ability to recognize and effectively respond to situations of limited patient engagement and/or non-adherence, as well as common presentations of behavioral health conditions in the oral health setting. Throughout both the assessment and treatment phases, learners will integrate a range of skills, including but not limited to mental health and substance use screening, behavior guidance, motivational interviewing, prevention of oral and systemic conditions, and patient education.
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| HEALTH PROMOTION: Describes level to which the learner can promote, improve, and maintain patient health and wellness throughout the assessment and treatment phases of care. Learners consider and attend to the multiple psychosocial factors that may influence patient overall experience, from intake, to treatment, and recovery. | Recognizes opportunities to discuss and implement strategies that support health and disease prevention | Recognizes most opportunities to discuss and implement strategies that support disease prevention | Inconsistently recognizes opportunities to discuss and implement strategies that support health and disease prevention | Fails to act for the benefit of the patient (Advocate) Unprepared to the extent that can cause harm (Thinker) |
| Recognizes and effectively responds to situations of limited patient engagement, non-adherence, and common presentations of behavioral health conditions in the oral health setting | Mostly recognizes and responds to situations of limited patient engagement, non-adherence, and common presentations of behavioral health conditions in the oral health setting | Inconsistently recognizes and responds to situations of limited patient engagement, non-adherence, and common presentations of behavioral health conditions in the oral health setting | ||
Critical Thinking and Decision Making
Learners are expected to apply a critical thinking approach in their decision-making as a vital component of the provision of health care. Learners demonstrate one very important component of this capacity through a process of scientific inquiry: articulating important clinical questions, searching the latest relevant research, and critically appraising available evidence. Learners will demonstrate their provision of person-centered care by integrating the highest quality research evidence, clinical expertise, and patient’s personal preferences and unique concerns, expectations, and values into the decision-making process. Learners will also demonstrate the ability to consider patients’ social, economic, emotional, physical, and cognitive circumstances and priorities when providing care.
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| CRITICAL THINKING AND DECISION-MAKING: Describes level to which the learner critically appraises literature and assesses oral health care cases in terms of supporting science and evidence. | Systematically gathers, appraises, and integrates data to provide evidence-based care | Can make systematic decisions that are appropriate based on current level of understanding (D2/D3) or gives a general rationale that may not be supported by data | Does not follow a systematic process when making decisions or is unable to provide a rationale or evidence from literature to support a treatment decision | Unable to solve a problem, resulting in increased potential for patient harm (Thinker) Disregards faculty instruction or fails to obtain faculty consent (Thinker) |
| Analyzes and evaluates information and explains the considerations on which a judgement or clinical decision is made | Inconsistently analyzes and/or evaluates information to explain the considerations on which a judgement or clinical decision is made | Does not analyze and/or evaluate information to explain the considerations on which a judgement or clinical decision is made | ||
Biomedical Science Application
Learners are expected to demonstrate a high level of biomedical sciences foundational knowledge and its application necessary for understanding of etiology, epidemiology, differential diagnosis, pathogenesis, prevention, treatment, and prognosis for oral and oral-related conditions. Learners must be able to interpret and apply contemporary and evidence-based contemporary knowledge of biomedical sciences in their provision of oral health care. They will demonstrate the desire for continuous learning about biomedical sciences and how this knowledge is being applied to advance health care. As capacities of well-prepared dentists, biomedical sciences reflect knowledge bases learners must access, interpret, and apply in an agile and analytical manner.
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| BIOMEDICAL SCIENCE APPLICATION: Describes level to which the learner engages in continuous study of biomedical and clinical sciences and demonstrates the desire to adapt and change by applying this knowledge to advance health care. | Explains the dental implications that could arise based on patient’s medical history | Fails to address one non- harmful medical issue that is pertinent to dental care | Fails to a address more than one non-harmful medical issue that is pertinent to dental care | Fails to address a medical issue pertinent to dental care, increasing potential for patient harm |
| Accurately applies evidence-based biomedical science knowledge to patient care, including etiology, prevention, diagnosis, treatment, and prognosis | Applies most biomedical science concepts relevant to patient care | Inconsistently applies biomedical science concepts into clinical care | Cannot properly apply biomedical science knowledge to patient care, increasing potential for patient harm (Clinician) | |
Self-Assessment
Learners are expected to self-assess their performance and progress on a regular basis throughout the curriculum, identifying strengths and areas for improvement through personal learning plans. In addition, learners receive feedback of their self- assessment after each clinical encounter, assisting identification of their own learning needs. Learners must also demonstrate the desire and capacity to adapt to change and find, integrate, and apply new knowledge to improve their overall performance and advance health care. Learners assume responsibility for their own learning and reflect on their experiences, demonstrating professional competency and values for self-directed lifelong learning.
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| SELF-ASSESSMENT: Describes level to which the learner can identify strengths and areas for improvement, receive feedback, assume responsibility for their own learning, and reflect on their experiences (i.e., using the “Stop, Start, Continue” framework in the comments section of the ACE form, end of block self-assessments, etc.) | Consistently demonstrates ability to identify overall strengths and areas for improvement when completing self-assessment forms | Mostly demonstrates ability to identify overall strengths and areas for improvement when completing self-assessment forms | Demonstrates an incomplete ability to identify overall strengths and areas for improvement when completing self-assessment forms | Exhibits inappropriate conduct with patients, caregivers, faculty/staff, the care team, and/or peers (Advocate) Disregards faculty or no faculty consent (Thinker) |
| Consistently demonstrates humility when receiving feedback. (i.e., acknowledges areas for improvement, asks follow-up questions for future encounters, uses professional and respectful communication skills in discussion with faculty) | Mostly demonstrates humility when receiving feedback. (i.e., acknowledges areas for improvement, asks follow-up questions for future encounters, uses professional and respectful communication skills in discussion with faculty) | Inconsistently demonstrates humility when receiving feedback. (i.e., sometimes acknowledges areas for improvement, occasionally asks follow-up questions for future encounters, does not use professional and respectful communication skills in discussion with faculty) | ||
Clinical Skills
Learners are expected to demonstrate the ability to provide oral health care by performing clinical procedures using evidence-based techniques and technologies on patients across the stages of life and with various needs and circumstances. Clinical skills encompass all the skills outlined in the patient care process as represented by the Entrustable Professional Activities (i.e., assessment, plan of care, collaborative care, and provision of care), and include demonstrating competence in encounter management. Learners are expected to demonstrate the application of advanced techniques and technologies in various provisions of care.