EPA 2B: Develop Comprehensive Treatment Plan
SCOPE OF WORK: This activity includes demonstrating informed decision- making about diagnoses and oral health management based on patient information and preferences, biomedical science, up- to-date scientific evidence, and clinical judgement for patients with simple, moderate, and complex needs.
Domains of Competence
- Professionalism and Ethics
- Person-Centered Care
- Health Promotion
- Critical Thinking and Decision Making
- Biomedical Science Application
Knowledge
- Foundational knowledge of techniques, materials, and indications for specialty procedures
- Ethical and evidence-based decision making
- Professional* and patient** factors in determining options
- Overarching importance of prevention in oral health and health maintenance
- Prognosis determination
- Sequencing of the treatment plan
- Consultation and referral (integrate EPA 3)
- Required documentation of the treatment plan in electronic patient record (EPIC Wisdom)
Skills
- Develop evidence-based plan using ethical principles and person- centered care
- Develop a collaborative plan that incorporates professional and patient factors
- Develop plan that includes all the patient’s diagnoses
- Phase plan to best meet the needs of the patient and includes health promotion and disease prevention
- Sequence plan by patient’s priority and need, and to facilitate efficient treatment delivery
- Identify need for referral and/or consultation (integrate with EPA 3)
- Properly document treatment plan in electronic patient record (Epic Wisdom)
*PROFESSIONAL FACTORS: e.g., discerning reasonable treatment options; indications and contraindications for treatment procedures; training, experience, and expertise of the dentist
**PATIENT FACTORS: e.g., patient concerns, preferences, values & expectations; motivation for and commitment to treatment; available time & resources; barriers to care
| Treatment Plan |
Meets Expectations of the Graduate
|
Progressing
|
Below Expectations
|
Critical Error
|
|---|---|---|---|---|
| Proposed Treatment | Treatment plan is comprehensive, evidence-based, and accurately identifies appropriate treatment recommendations for all diagnosed conditions, integrates biomedical science, and reflects comprehensive person-centered care by incorporating the patient's systemic health, oral health needs, values, concerns, and goals; treatment scope is neither under- nor over-treatment | Treatment plan requires minimal modifications to fully address all diagnosed conditions and/or deliver person-centered care; may include minor instances of under- or over-treatment, or struggles to support proposed treatment with biomedical or scientific evidence | Treatment plan fails to identify appropriate treatment recommendations — including incomplete treatment of diagnosed conditions, or an overly aggressive or unnecessarily extensive treatment plan that does not reflect the patient's actual oral health needs; does not reflect person-centered care and/or does not demonstrate use of scientific evidence to support treatment decisions | Treatment plan is contraindicated, poses risk of harm, or reflects a significant failure to identify appropriate treatment – including gross under-treatment of active disease or an aggressively over-treatment plan – in a manner that disregards the patient’s health and well-being and could result in significant deterioration of oral or systemic health |
| Phasing | Creates an optimally phased treatment plan based on contemporary evidence that incorporates biomedical science and meets the patient’s medical and oral health needs, while addressing patient concerns, priorities, and preferences | Creates a phased treatment plan that needs minimal modifications to meet the patient’s medical and oral health needs or fully address patient’s preferences; or struggles with providing biomedical or scientific evidence to support plan | Creates a treatment plan that does not meet patient’s oral health condition and/or patient’s priorities, does not demonstrate knowledge of scientific evidence to support plan | Treatment plan has indirect restorations in absence of disease control or definitive restorative treatment in the presence of active periodontal disease and or infection |
| Sequencing | Treatment plan is optimally sequenced to meet the patient’s oral health needs and priorities, and maximizes efficiency in patient management | Treatment plan sequencing needs minimal modifications to meet the patient’s oral health needs and/or priorities or to maximize efficiency in patient management | Treatment plan sequence does not meet the patient’s oral health needs or patient’s priorities | Treatment plan is sequenced improperly, putting the patient at undue risk for oral infection or medical emergency |
| Accommodation Plan for Special Needs | Creates a treatment plan that is optimally assessed for accommodations and concessions from routine care (e.g. evaluating triggers, motor abilities, oral/facial limitations, sensory impairments, medical complications, communication, cognitive ability, biomedical impact, oral health maintenance capabilities, BADL/ADL, assistance needs) | Creates a treatment plan that needs minimal modifications for accommodations and concessions from routine care (e.g. evaluating triggers, motor abilities, oral/facial limitations, sensory impairments, medical complications, communication, cognitive ability, biomedical impact, oral health maintenance capabilities, BADL/ADL, assistance needs) | Creates a treatment plan that does not meet the patients need for accommodations and concessions from routine care, does not demonstrate knowledge or assessment of the patient’s special need, overestimates or underestimates the ability to provide treatment. | Treatment plan does not include the patient's need for accommodations and concessions from routine care for the special need that could lead to severe outcomes or potentially life- threatening problems. Overestimate ability to provide treatment that places the patient at undue risk for harm or poor outcomes. |
Rating on "Documentation" for this encounter will be included for the assessment of this task.
Phasing refers to the segments of a treatment plan. Sequencing refers to the ordering of specific procedures within the treatment plan.