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TLC Hot Take September 2022

As the Horizon Report points out, educators are welcoming opportunities to learn how to better incorporate technology tools and instructional activities into their pedagogical approaches. If you cannot participate in the Introduction to Educational Technology for Educators (IET) course, consider checking out related resources highlighting the possibilities of adopting technology into your professional practice. 

The TLC hosted Dr. Mai-Ly Duong (ATSU-ASDOH) in a special three-part series on using Google products that provided practical application ideas for these tools. You can find these sessions, as well as our other archived presentations, on The Learning Channel.

This month, The Center for the Future of the Health Professions will post another monthly op-ed column for 2022. Our columns represent strong, informed, and focused opinions on issues affecting the health professions’ future. As mentioned previously, the center was developed to provide state, local, and national policymakers and health system stakeholders with accurate, reliable, and comprehensive data and research about the healthcare workforce to effectively plan for a sustainable future and make the best use of available resources.

This month features a discussion of requirements for dental residency training for licensure in the U.S. In the U.S., each state has requirements regarding the criteria a dentist needs to meet to get a license to practice. For some states, it is lumped into the initial licensure category, and for some states, it is a different process called a specialty licensure application.

This brief article is authored by Leonard Goldstein, DDS, PhD, assistant vice president for clinical education development in the office of academic affairs at A.T. Still University (ATSU). Dr. Goldstein came to ATSU from the New York Institute of Technology College of Osteopathic Medicine. As director of clerkship education, he was responsible for developing and monitoring the rotations for 600 medical students annually. His previous administrative positions include serving as an assistant dean for graduate program development, medical director of a hospital-based temporalmandibular joint (TMJ)/facial pain center, and program director for a master of science program in forensic examination.

Dr. Goldstein has presented multiple papers on clinical education at national conferences and is the author/co-author of more than 60 publications in pain management, forensic dentistry, and TMJ dysfunction.

We look forward to your comments.

Randy Danielsen, PhD, PA-C Emeritus, DFAAPA

Professor & Director

The Center for the Future of the Health Professions

A.T. Still University

A requirement for dental residency training for licensure in the U.S.

Licensure by residency in the dental profession was limited to two states, Connecticut and New York. In 2003, New York state enacted legislation that allowed graduating dentists to participate in a one-year post-graduate residency in place of the clinical portion of the licensing exam. In 2007, it became mandated throughout the state. This was a dramatic paradigm shift for the dental community, and overall opinions vary widely on the topic. Since New York state enacted the PGY-1 residency as a pathway to licensure, the following states have also made it a pathway to licensure, but not a requirement for licensure:

  • California
  • Colorado
  • Minnesota
  • Ohio
  • Washington

Before discussing the pros and cons of licensure by residency, I would like to share how this became law in New York state. During the early 2000s, I was a member of the Council on Dental Practice and Hospital Dentistry for the New York State Dental Society. The Council felt that it was necessary to require a PGY-1 for licensure. Our recommendation had nothing to do with the North East Regional Dental Board Exam (NERB). However, the executive director of the New York State Dental Society was angry that a substantial number of New York students failed the clinical portion of the NERB each year. So, he lobbied the New York State Legislature and had a law passed and signed by the governor that a PGY-1 would be utilized instead of the clinical portion of the NERB. Then, he had the law passed that said the PGY-1 would be a requirement in New York state for licensure in dentistry. Unfortunately, on a national level, states look at New York’s law and always see it as doing away with the exam, which was not our council’s idea or intention.

Arguments against licensure by residency

Historically, the one-time board exam is seen as the ultimate competency determination. Since it has been the “gold standard” for so long, talks of eliminating this path to licensure have met with considerable opposition. There are no procedures to qualify attending dentists and no way to get an accurate assessment due to a possible bias of the close relationships between residents and residency directors. Another argument against licensure by residency is that there is no specific curriculum for all residency programs. Each program may have its strengths and weaknesses, but there are no specific criteria that residents must consistently pass in order to graduate from the program. Also, there are no procedures in place to qualify attending dentists. Remember, faculty members and supervisors become evaluators of the same individuals whose development they have been fostering.

Arguments for licensure by residency

A novice dentist may be able to expand his/her skills and experiences to become competent and even an expert in a year of supervised practice. It takes out the variable that comes with a one-moment-in-time examination of a live person, where nothing is standardized. The one-time exam on a live patient presents many variables that may result in an untoward occurrence with little or nothing to do with the student’s clinical abilities. There are many factors outside the student’s control; often, these are reasons for failure. Also, there is no test for critical thinking or other characteristics needed to be a competent dentist. These things can be assessed and improved through coaching in a year-long program. The one-time clinical exam relates to essential learning of technical procedures, not more significant levels of learning.

Downfalls in the current system of dental education are widely known and tolerated. Instructors are at a premium, and students complain that the instructors in the clinic are not always there, so opportunities for advancement are often missed. In addition, since many schools require specific procedures and competencies to graduate, patient care is often modified to fit the need of the requirements. It may not always be in the best interest of the patients. Similarly, treatment may often be delayed or postponed while waiting for the exam date. We can debate whether this is ethically acceptable in the practice of dentistry.

With these arguments noted, we can see how a residency education can overcome them. Comprehensive care is the norm in hospitals and health centers, where most dental residencies are located. The one-time clinical exam is not a barometer of the dentist as a whole and has no bearing on how the dentist will practice. There is no way through the snapshot test to assure the student’s chairside manner or how the student may work in a team setting. In a residency, however, this is paramount!

Conclusion

Licensure by residency is a very acceptable way to determine competency. It provides for a more thorough observation and assessment over a long time. However, residencies need a uniform, standard set of guidelines that each program must utilize to determine readiness for licensure. The time has come again for the American Dental Association (ADA) to re-evaluate a nationwide movement towards licensure by residency.

The A.T. Still Memorial Library in Mesa, Arizona, recently held a naming contest for its newest members: two spiney friends were in search of names and we sent out a call to help.

Many submissions were given by students and faculty members. Some honorable mention submissions included:

  • Boney Wan Kenobi
  • Jon Bone Jovi
  • Humerus Jones
  • Skelly Clarkson

In the end, a vote was cast and the winning names came from Ariel Showalter, PT, ’24, and Stephanie Cacal, ATSU-SOMA OMS II.

I am pleased to announce our newest library members as Bone A. Lisa and Albert Einspine!

Congratulations to our winners and thank you to everyone who submitted ideas. Come in and say hi to our very “hip” members!

Library training modules have been developed to improve the participants’ understanding of the evidence-based practice (EBP) research process and to help them excel in an evidence-based healthcare environment.

All ATSU students, faculty and staff are welcome to use these modules to further their education in EBP. Each module is designed to build upon the skills developed in the previous module. Participants are not required to attend the modules in any particular order, however it is recommended. Module topics include:

  • Plagiarism & citation
  • Research question development & advanced search
  • PubMed & MeSH
  • Levels of evidence & critical appraisal
  • Literature reviews & citation managers
  • Research gaps & how to find supporting evidence

The modules are held every Wednesday at 5:00 p.m. CT via Zoom. Registration is required for all modules. All registrants will be sent a recording of the module for future reference.

Take a study break with the library! On Tuesday, Aug. 9, 2022, the A.T. Still Memorial Library Missouri branch will be hosting a Zine Night from 5:30-7:30 p.m.

Zine night is an opportunity to take a study break, engage in a fun, creative activity, and socialize with others from around campus.

The theme of the inaugural Zine Night will be “Why I chose the medical or dental profession.” The library will provide a variety of supplies to create your zine, but you are welcome to bring personal ephemera for yours! You are welcome to keep your creations or donate them to the Library Zine collection.

All ATSU students, staff, and faculty are welcome to attend. Spouses and children over the age of 10 are also welcome.

In January 2023, the National Institute of Health (NIH) will institute the new data management and sharing policy. This policy will be applicable to all NIH funded proposals that “produce scientific data.”

To assist researchers in understanding this new policy, how to develop a plan and tools to assist with data management and preservation, the A.T. Still Memorial Library has developed a LibGuide detailing the changes. The data services guide will also provide additional information about the data services provided by the library.

If you are interested in learning more about this new policy, Laura Lipke, A.T. Still University’s Kirksville College of Osteopathic Medicine liaison librarian, will be holding a presentation on Friday, August 26, 2022 at noon CT on the Kirksville, Missouri, campus.

To the incoming classes of 2024, 2025, and 2026, and all the new faculty and staff behind their successful academic pursuits, welcome to the best health sciences university, A.T. Still University. The library also welcomes back our awesome continuing students, staff, and faculty as well!

The library is excited to be your partner in your learning experience and your research journey. In support of these, at the library you’ll find wonderful spaces to study, your textbooks in print or electronic format, deep, supporting journal and eBook collections, 3D printing, and amazingly helpful library staff.

Each program has a liaison librarian that can serve you in many ways. We can consult on library resources to place in your curriculum. Liaisons can provide evidence-based practice instruction to help students develop their critical thinking skills and navigate library resources. We can perform literature searches or collaborate on more formal reviews. And, of course, we have the fastest interlibrary loan document delivery service west of the Mississippi River.

Save the date Sept. 22, 2022 at noon at the library to attend our 100th birthday party in Kirksville, Missouri, or Mesa, Arizona. Stay tuned for details for the celebration in Santa Maria, California, planned for October.

Please explore our other stories to see what other innovative things have happened in the library and meet some new staff members!

Cordially Yours,

Hal Bright

University Library Director

Pre-assessment week can get pretty stressful at A.T. Still University’s College for Healthy Communities campus, so the library brought in the coffee machine and stocked the snack table with coffee and tea, with both caffeinated and decaffeinated options. A variety of snacks were provided, including apples and the popular “Cutie” oranges. Breaks have been shown to help reduce stress and improve performance, memory, and functioning (Kim 2017.) Tea, coffee, and snacks help fuel the body and brain, improve performance, and boost well-being.

The Kirksville library traditionally hosts coffee and tea for finals weeks. Assessment weeks are the PA program version of finals, so the Library Director Hal Bright, MLIS, and Assistant Librarian Dot Winslow, MFA, decided to try it out on the California campus. The students enjoyed the perk-up snack station and fueled their studies for a successful assessment week.

Are you in need of a heart, brain, or sacrum? Check out the 3D Printing LibGuide, or contact Debra Loguda-Summers, 3D printing services manager.

The A.T. Still Memorial Library has hundreds of files for you to choose from and are continually updating our gallery with images of STL files we can print for you. Also, if you find an STL or OBJ file you would like printed, email the file or link to Deb.

The library also has a designated computer with 3D software, including Osirix, which converts CAT scans and MRI files to 3D files for printing, a 3D scanner, and several training manuals that you can check out if you have a 3D printer at home.

Whether you are new or a seasoned veteran of 3D printing and what to learn more, we invite you to consider joining the MD3D Printing Club.

The A.T. Still Memorial Library on the Kirksville, Missouri, campus has been awarded a $10,951.00 grant from the Northeast Missouri Osteopathic Charitable Trust.

Funding from this grant will purchase additional anatomical models for our patrons, including a spondylolisthesis Dynamic Model, Human Calvarium with hyperostosis frontalis interna, 3D printed lower left leg with pelvis and dental disease model of the lower jaw.

ATSU RESEARCH NEWSLETTERS