EPA 4B: Deliver Preventive Care – Counseling
SCOPE OF WORK: This activity includes emphasizing prevention to reduce the development of disease and to minimize the progression of disease. In addition, this activity conducts appropriate follow-up to build a long-term relationship with patients and their caregivers.
Domains of Competence
- Professionalism and Ethics
- Person-Centered Care
- Health Promotion
- Critical Thinking and Decision Making
- Biomedical Science Application
Knowledge
- Epidemiology and etiopathology of diseases and conditions affecting the oral maxillofacial complex
- Behavioral and social determinants of health
- Risk assessment, health promotion, and disease prevention models and strategies for individuals and populations
- Goal setting (appropriateness and timing), planning, sequencing, evaluating progress to include stages of readiness to change (precontemplation, contemplation, preparation, action, maintenance)
- Strategies for effective communication and behavioral change in diverse populations (e.g., understanding of patient awareness and health literacy, motivational interviewing, use of aids for patient education)
- Required documentation of patient counseling in electronic patient record (EPIC Wisdom)
Skills
- Develop patient rapport and engender trust
- Apply knowledge of disease processes and conditions to discern patient’s oral health status
- Application of critical thinking skills to distinguish relevant information and identify when to explore further
- Apply evidence-based strategies and techniques for health promotion and disease prevention in person-centered manner
- Develop goals collaboratively for, and assess progress of, patient’s prevention plan that incorporates patient needs, preferences, and values
- Properly document counseling goals, content, patient responses and adjustments to intervention in electronic patient record (Epic Wisdom)
| Deliver Preventive Care - Counseling |
Meets Expectations of the Graduate
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Progressing
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Below Expectations
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Critical Error
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| INFORMATION DELIVERY | Utilize evidence-based techniques to ensure patient understanding, such as adapting language to patient’s level of literacy; using visuals, models, demonstrations, teaching aids, external resources, and utilizing Teach Back Method | May not successfully use or adapt language to patient’s literacy level (i.e., use of a few technical terms); may not utilize resources or evidence-based techniques to improve communication optimally or effectively; or may not ensure patient understanding (Teach Back Method) | Language not effectively adapted to patient’s level of literacy (frequent use of technical terms) and/or not using evidence-based techniques or resources used to improve communication or ensure patient understanding | Fails to adapt language to patient’s level of literacy (extensive use of technical terms) or use evidence-based techniques or provide resources to ensure patient understanding which can be detrimental to patient’s health |
| GOAL SETTING | Provider engages patient in setting SMART* goals based on their specific needs, interests, biopsychosocial factors, and aligns with patient’s abilities and readiness to change | Provider engages patient in setting goals based on their specific needs and interests but those goals may not necessarily align with SMART goals or with patient’s abilities or readiness for change | Goals are set with little patient input and SMART goals do not align with patient’s abilities and/ or readiness for change | Fails to engage patient in setting goals or using SMART* framework |
| FOLLOW UP AND EVALUATION PLAN | Personalized instructions are provided based on patient’s level of literacy that includes the patient’s specific and measurable goal(s) | Instructions are provided but may not be adjusted for patient’s level of literacy; evaluation plan specified is based on patient’s goal(s) but is not specific and/or measurable | Instructions provided are generic with a generic evaluation plan that is not based on patient’s goal(s) | Fails to provide follow-up instructions when necessary and no evaluation plan developed which minimizes the likelihood of oral health improvement |
*SMART GOALS: S – Specific. When setting a goal, be specific about what you want to accomplish; M –Measurable. What metrics are you going to use to determine if you meet the goal?; A–Achievable; R–Relevant; T–Time-Bound