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The innovative course guide

Being quicker and more comfortable for the patient, intraoral scanning enables use of full-color 3D models for diagnosis, treatment planning, and patient education.

Educational innovation is a high priority at ATSU. The University’s mission places an emphasis on innovative academic programs, and faculty members are continuously finding new, effective ways to educate students. From course design to novel technology, creative and unique ideas are shaping curricula University-wide.

After scouring the course catalog and speaking with dozens of faculty members around ATSU’s circuit, the University has no shortage of cool classes. Hundreds of amazing courses, featuring best practices and evidence-based research, are available to students every year. On the following pages, Still Magazine presents a condensed guide to 12 of ATSU’s most innovative courses preparing the next generation of healthcare professionals.

Digital Dentistry

Dr. Akshay Vij and student sit by a computer and discuss 3D implant planning.

Dr. Akshay Vij discusses 3D implant planning with a student.

Digital technology is revolutionizing the field of dentistry. It is dramatically improving patient experiences and quality of care received. It is also improving the dentist’s experience in providing services while decreasing treatment time and costs.

As technology continues to advance at a rapid pace, many dental procedures that were done manually or conventionally are now done digitally. To keep its students at the forefront, ATSU-MOSDOH created a new Digital Dentistry elective for students completing their final year of clinical training.

“Digital dentistry is no longer the future; it’s the present,” says Akshay Vij, BDS, ACT, specialty care director of esthetic and digital dentistry at the St. Louis Dental Education and Oral Health Center. “In the last year, we have incorporated digital dentistry in a meaningful way.”

The curriculum features intraoral scanning for crowns, bridges, dentures, diagnostics, and more. After completing a patient’s scan, the case may be sent to partner dental laboratories for their advanced capabilities or to in-house milling units and 3D printers that allow same-day restorations. The curriculum also gives students an opportunity to learn about guided implant planning and surgery, as well as interdisciplinary treatment planning, which improves predictability and patient outcomes.

Dr. Vij takes digital dentistry education a step further and offers a three-day training session for a small group of students. First, students learn about intraoral scanning, design and milling restorations, and improving esthetics with customized staining to better match patients’ teeth. Then, students apply these skills and techniques on live patients.

“The course gives students an advantage and preparedness, regardless of where they choose to practice,” Dr. Vij says. “We want our students to be ready to perform digital dentistry on day one.”

Shock Block

Three students gather around simulation doll in the HPS lab.

ATSU-KCOM students work together to save a patient in the Drabing Human Patient Simulation Center.

Every spring, first-year medical students at ATSU-KCOM learn about types of shock a physician may encounter in a clinical setting: hypovolemic, obstructive, cardiogenic, and distributive shock. Patient shock is complex because it involves many fields of knowledge, including internal medicine, physiology, microbiology, pharmacology, and surgery. The sooner a physician identifies the type of shock and begins appropriate treatment, the better a patient’s chances of survival.

In past years, shock was taught in discipline-based silos, which created overlapping course content and left students with a fragmented view of the topic. In spring 2018, faculty members upended the traditional, aligned shock curriculum to improve students’ learning experience.

Matthew Hardee, DO, led a faculty initiative to integrate shock lectures into a two-day section called Shock Block. With the help of Robert Theobald, PhD; William Sexton, PhD; Sarah Brewer, DO; Roy Danks, DO; and Neal Chamberlain, PhD, he collected shock lectures from each discipline and combined the material into one PowerPoint presentation. Within a few meetings, the faculty members cut repetitive content and whittled 406 slides into 164 slides.

“We were surprised by the amount of material that was repeated in each of our courses,” Dr. Chamberlain says. “The typical seven-hour lecture was cut down to four hours.”

The newly integrated lecture allowed each faculty member to speak about his or her area of expertise as it related to shock. This format also allowed the faculty members to learn from each other.

In addition to streamlining lecture content, they also revamped learning exercises to reinforce course material and put knowledge into practice. The day following the integrated lecture, students worked in small groups to complete shock cases on paper. Then, they moved to the Drabing Human Patient Simulation Center for hands-on practice.

As for the results of Shock Block, students performed as well or better on paper cases than in previous years. Lecture attendance, which is optional because of online recordings, increased from 25 percent to 62 percent. Additionally, feedback from students was positive. They seemed to enjoy the integrated approach, including the flow and consistency of content.

“The only major complaint from students was they wanted more simulated shock cases,” Dr. Chamberlain says. “We’re keeping that in mind for next year.”

Doctor of Athletic Training program: Winter Institute

Student does work on her laptop

DAT students participate in the 2018 Winter Institute.

For one week, students in ATSU-ASHS’ online Doctor of Athletic Training (DAT) program gather in Arizona for a Winter Institute. Students come face to face with nationally recognized faculty for an in-depth, interactive educational experience on innovations to advance athletic healthcare.

The week is intensive, and the days are structured on themes: leadership, higher education, patient care, and research. Students must come to the institute with an innovation project to lead back at their own organization. They work in groups throughout the week to develop those projects. They also work in groups to discuss contemporary literature and to reflect on what they learned each day.

“My drive to come home and help advance both our local practice and the profession is incredibly high,” says one DAT student. “I have already started putting my project into action.”

“I have thought for too long I could not change things at my institution,” says another student. “I have come back with a renewed sense of urgency and willingness to advocate for myself and my patients.”

Eric Sauers, PhD, ATC, FNATA, ’97, professor and chair, interdisciplinary health sciences, is the institute facilitator. He modeled the Winter Institute after attending the Harvard Macy Institute for Leading Innovations in Health Care and Education. He considered the Harvard Macy Institute to be transformational and wanted DAT students to have a similar experience.

“This course, more than any other I have taught in my 18 years here at ATSU, changes the way students view themselves as healthcare providers and how they interact with their patients and their environment,” Dr. Sauers says. “That is powerful.”

Leadership and Practice

In today’s volatile healthcare environment, leaders need to be knowledgeable and adaptable to guide their organizations effectively and ethically. The pressure is on for these leaders to solve dilemmas successfully while keeping an eye on the bottom line. For students in the online Doctor of Health Administration program at ATSU-CGHS, the Leadership and Practice course introduces leadership theories and styles and how they are applied in the real world.

The course emphasizes professional development and lifelong learning. Students are encouraged to identify websites, journals, leadership books, and other resources to begin building their own personal library. In addition to discussions and assignments, students complete a series of self-assessments to help identify their leadership strengths and opportunities for growth.

“Self-assessments allow students to gain insight into who they are personally and professionally as leaders,” says John Fick, EdD, FACHE. “We want our students to continue growing as leaders, even after they have a terminal degree in hand.”

Students have the opportunity to develop their own leadership philosophy as well as the opportunity to apply theoretical knowledge in an online hospital simulation. The simulation provides a unique, safe setting for team building, decision-making, and implementing change management.

In the Lakeview Hospital simulation, students assume the role of vice president of patient services and are asked to improve wait times in the emergency department. They review the case in detail, interview stakeholders, evaluate and implement tactics, and receive feedback. With limited time and resources, their goal is to get at least 60 percent buy-in from stakeholders.

“Students receive immediate feedback based on their decisions while learning the complexities of an organization,” Dr. Fick says. “As scholar-practitioners, we want them to become accustomed to being change agents.”

Health and Healing

ATSU-SOMA’s mission emphasizes preparing students to serve the underserved. To fulfill its mission, the School selects students who desire to work in medically underserved communities, particularly in community health centers. Because these students often come from diverse, underserved backgrounds, the School introduced three pre-matriculation modules to level differences among incoming students.

The modules, created and produced by Harvard Medical School, include topics on genetics, immunology, and physiology. According to Deborah Heath, DO, associate dean of curricular integration, these three disciplines are ubiquitous to students’ medical education and are essential building blocks for more complex coursework.

Prior to and during their first year, students are granted access to the online modules for a total of 10 weeks. While on campus, students study the topics in small, student-led interactive groups as part of their first course titled Health and Healing.

“The modules provide all students with a common language and foundational support for our highly integrated clinical curriculum,” says Dr. Heath.

The Harvard modules feature best practices in education, including pre- and post-exams, frequent self-assessments, and interactive videos. Some lessons take students inside the hospital of Massachusetts General with world-renowned researchers and clinicians. Students participate in bedside encounters with these researchers and clinicians who collaborate in patient management and discuss clinical relevance of basic sciences.

“Harvard faculty members are teaching our students through these modules,” Dr. Heath says. “Currently, we are collaborating with Harvard to assess the impact of these modules on our students.”

Doctor of Occupational Therapy program: Certificate in Public Health

Student helps a woman in a wheelchair to put a casserole dish in the oven.

Students in the Doctor of
Occupational Therapy
program will now earn a
certificate in public health.

Occupational therapists work with individuals across the life span to facilitate full participation in all aspects of everyday living, regardless of abilities. These therapists address physical, emotional, cognitive, and behavioral issues and usually interact with people who have developed impairments compromising their ability to function.

ATSU-ASHS’ Doctor of Occupational Therapy (OTD) program added four courses to its curriculum to better prepare students to care for varied patient populations. The courses, which emphasize prevention and primary care, comprise a certificate in public health. They include Introduction to Behavioral Sciences and Health Education, Public Health Concepts, Identifying Community Health Needs, and Development of Community-Based Programs.

ATSU-ASHS teamed up with ATSU-CGHS to provide this certificate to students, making the OTD program the first program in the country to have a public health certificate embedded in its curriculum. Students who graduate with the certificate will have an advantage, as they will be able to understand and assess community needs and possess skills and strategies to develop and implement programs in underserved areas. According to Jyothi Gupta, PhD, OTR/L, chair, occupational therapy, the program emphasizes contextual influences on health and well-being with social determinants of health and public policy threaded throughout the curriculum.

“The new accreditation standards include population-based care,” Dr. Gupta says. “Since this is the expertise of public health, it made sense to prepare our students to work with other professions and disciplines.”

Collaborative Dental Rounds

Beginning in fall 2014, ATSU-ASDOH took a new approach to integrating didactic and preclinical material with clinical experiences to improve student learning. Faculty introduced Collaborative Dental Rounds, where students from each year of the four-year dental medicine program team up to treat simulated patients.

Modeled after a course presented at the American Dental Education Association Annual Session & Exhibition by Marquette University School of Dentistry, Collaborative Dental Rounds develops simulated patients to offer the groups of multiyear students an opportunity to apply basic, preclinical, and clinical sciences within a real-time digital platform. Students have the opportunity to get medical consults and use axiUm software, a dental practice management system. Students also respond to clinical “interventions” when the treatment plan is suddenly modified.

“Some first-year students feel lost at the beginning,” says Klud Razoky, BDS, who oversees the course. “After the first session, they see the value of the experience and feel it is beneficial.”

Within this course, students have the opportunity to learn and the opportunity to teach. Students periodically meet with faculty mentors to produce high-quality digital presentations.

“The course allows faculty to connect with students and guide their learning to a subject matter that may be of particular interest to them,” says Amy Jensby, DMD, CPH, ’11, course instructor. “I enjoy watching students move into a leadership role by their fourth year.”

Environmental Health Sciences

In ATSU-CGHS’ Environmental Health Sciences course, students learn about community health and variables that negatively affect health. The 10-week class, offered through the online Master of Public Health program, is jam-packed with concepts ranging from epidemiology and toxicology to chemistry and biology.

As students work through each module, they delve into topics such as food-borne illness, vector-borne illness, air pollution, waste disposal hazards, and issues associated with climate change. They discuss health implications of each topic, as well as advantages and disadvantages of management alternatives. The evidence-based course encourages students to substantiate their ideas and opinions on established research.

“Students learn how interconnected our environment is to our health and well-being,” says Rochelle Mascarenhas, BDS, MPH. “A multitude of factors influence lifestyles and health outcomes.”

Sharing public health information is essential, and according to Dr. Mascarenhas, messages need to be tailored to each audience accordingly. Instead of submitting traditional papers, students complete assignments by conveying information to a population through a specific medium. Depending on the population’s traditions and culture, mediums may include audio and video public service announcements, trifold brochures, research briefs, or social media campaigns.

Many course assignments and discussions focus on counties in northeast Missouri, where ATSU-CGHS is based. These assignments allow students the option to participate in outreach opportunities to educate diverse communities while increasing their awareness of environmental health principles.

“Students need to base their opinions and advice on credible evidence,” Dr. Mascarenhas says. “As experts in public health and as providers, the public will look to them for advice.”

Clinical Ultrasound

Ultrasound technology is used

ATSU-KCOM students learn to use ultrasound during the first two years of the DO program.

Ultrasound imaging has become increasingly popular in medical practice to assess and diagnose various conditions. To ensure students are practice-ready, ATSU-KCOM implemented ultrasound education into its medical school curriculum. In 2011, the College was one of the first osteopathic medical schools in the country to use the technology, and since then, it has integrated a Clinical Ultrasound course into the first two years of the four-year curriculum.

Students master ultrasound techniques for all body regions and systems in hands-on labs. In the first semester, ultrasound labs align with gross anatomy labs. In the following semesters, labs correlate with systems blocks. Students learn clinical applications of ultrasound and its use to diagnose pathological conditions. Students also learn “living anatomy” with the technology through cadaveric dissection.

“Our efforts resulted in a successful hybrid of a dissection-based Gross Anatomy course with embedded ultrasound imaging,” says Tatyana Kondrashova, MD, PhD. “Such integration resulted in better retention of anatomical knowledge and significantly enhanced student learning.”

The course continued its innovative approach to education by adding ultrasound phantoms to the labs, including simulators with pathological conditions. Many labs added clinical cases where students are presented with a case, followed by a demonstration and practice on fellow students. Additionally, the cardiology block added a workshop combining electrocardiography and echocardiography to help students better understand cardiac physiology.

“My goal is to make basic medical education more interesting and engaging for students through ultrasound,” Dr. Kondrashova says. “The course not only covers all body systems and organs but also teaches them clinical reasoning and procedural skills.”

Integrated Ultrasound Education

Drs. Deborah Heath and Inder Makin perform abdominal ultrasound on a student.

Drs. Deborah Heath and Inder Makin perform abdominal ultrasound on a student.

Innovation is woven throughout the first two years of ATSU-SOMA’s program, from the clinical presentation curriculum to early contextual clinical training where second-year students are distributed among community health centers to work with underserved populations. While students are provided integrated basic and clinical sciences didactic material, a variety of methodologies incorporate active learning strategies, including flipped classroom, small-group cases, and hands-on physiologic and imaging methods.

As part of the hands-on imaging approaches, ultrasound technology is an essential component of this active learning model. Rather than learning to use ultrasound independently, it is embedded in the learning of a skill. For instance, in an Osteopathic Principles and Practice lab focused on the evaluation and treatment of the shoulder, ultrasound imaging allows students to visualize normal anatomy while practicing osteopathic manipulative treatment procedures.

Professor Inder Makin, MD, PhD, has more than 25 years’ experience in ultrasound applications and instrumentation. He initiated the use of ultrasound in ATSU-SOMA’s research projects with Deborah Heath, DO, associate dean of curricular integration, and then joined forces with Kellie Bliven, PhD, ATC, director, interdisciplinary health sciences, to incorporate ultrasound into the curriculum.

In addition to using ultrasound in teaching and research, the School has integrated ultrasound education in the community. ATSU-SOMA collaborated with faculty members at Midwestern University to improve ultrasound imaging expertise. The cross-town partnership, led by Dr. Makin, enables faculty to gain knowledge from experts at each institution.

“With the additional competency of knowledge and skill in point-of-care ultrasound imaging, DO graduates will be highly competitive as they move toward the single-accreditation residency programs in 2020,” Dr. Makin says. “Collaboration with Midwestern University represents substantive progress in enhancing osteopathic medical professional training.”

The partner institutions received a $350,000 grant to continue these collaborations. In addition, Dr. Makin and his colleagues are creating a lecture series for faculty development. While many medical schools still do not teach ultrasound, ATSU-SOMA’s ultrasound initiatives demonstrate the importance of this technology in medical education and ensure it is part of students’ educational fabric.

Removable Prosthodontics: Partial Dental Prostheses

Prosthodontics is usually the most daunting area of dentistry for students. The specialty, which involves the restoration and replacement of teeth, is challenging because it requires knowledge of all dental specialties and how they are related. Creating partial dental prostheses, or partial dentures, means prosthodontists first have to consider many factors such as occlusion, periodontal health, restorative options, and extractions.

“As a student, I did not want to be a prosthodontist,” says Ammar Musawi, MDS, BDS, whose specialty is prosthodontics. “Then, I realized I didn’t like it because of the way it was taught.”

In ATSU-MOSDOH’s Partial Dental Prostheses course, faculty members took a new approach to educating students. Dr. Musawi and Robert Collinge, DDS, primary faculty members for the course, implemented student-centered learning in the form of small group case discussions.

The three-week course breaks students into small groups with a faculty member assigned to each group. Then, students in each group work together to complete 10 patient cases – more cases than in previous years. Rather than teaching or dictating, the faculty member observes and guides the group as needed through the partial denture design process.

Since faculty implemented the change in course format, student course evaluation scores have improved. Feedback from students indicates they enjoy working together in small groups, as well as the increased number of cases.

“I tell students they may not like the course, but once they understand it, they understand how all disciplines of dentistry should be considered when treating a patient,” Dr. Musawi says. “The way we are teaching it now is how I wish I could have learned it.”

Fixed Prosthodontics

Critical thinking, hand skills, and the latest technology converge in ATSU-ASDOH’s Fixed Prosthodontics course. The course, which comprises a significant portion of the second-year curriculum, teaches students to make crowns and bridges and ultimately provide esthetic restorations best suited to their patients’ needs.

In 2015, ATSU-ASDOH faculty implemented prepCheck analytical software into the course as a way for students to receive objective feedback of their preparations. It offers precise measurements and a “report card” in which students evaluate the percentage of their preparation meeting clinical requirements. Additionally, it gives students another opportunity to gain competence in digital dentistry.

“This software enables students to look at their preparation and reflect on the good and bad aspects of their work,” says Tamer El-Gendy, DMD, BDS, MS, ’10. “It helps them improve their hand skills by giving them instant feedback.”

ATSU-ASDOH was among the first schools in the country to implement prepCheck software into its curriculum. The software proved to have great potential, and today, faculty members are conducting research to implement the technology into grading.

“This course is one of the toughest courses students will take during their dental education,” Dr. El-Gendy says. “It is very rewarding to see a huge improvement in students’ hand skills and critical thinking.”


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