|

|
At the completion of the program, I felt
competent in the following areas...
Assessment (The systematic collection and
analysis of the following data to identify patient needs and oral health
problems.):
|
SA -
Strongly Agree
A - Agree
NB - No Bias
D - Disagree
SD - Strongly Disagree
NA - Not Applicable
|
| 1. |
Obtain, review, and update a
complete medical and dental history, including vital signs. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 2. |
Perform an extraoral and intraoral
examination and identify patient needs. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 3. |
Perform a periodontal and dental
examination. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 4. |
Obtain diagnostic quality
radiographs and identify abnormal findings. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 5. |
Obtain intraoral photographs. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 6. |
Take impressions and fabricate
study models |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 7. |
Obtain indices and utilize them in
patient communications. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 8. |
Perform risk assessments (i.e.,
tobacco, systemic, caries) . |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 9. |
Assess psychosocial and
environmental factors and their influence on patient health. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
|

|
|
Diagnosis and Planning:
Determination of dental hygiene treatment needs and the establishment of
realistic goals and treatment strategies to facilitate optimal oral health .
|
SA -
Strongly Agree
A - Agree
NB - No Bias
D - Disagree
SD - Strongly Disagree
NA - Not Applicable
|
| 10. |
Ability to determine dental hygiene
treatment needs. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 11. |
Ability to develop an integrative
plan for Dental Hygiene treatment and Health promotion-education. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 12. |
Ability to obtain informed consent
for treatment. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 13. |
Ability to prepare and present a
dental hygiene case presentation. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
|

|
|
Implementation: Provision of
treatment as identified in the assessment and planning phase.
|
SA - Strongly Agree
A - Agree
NB - No Bias
D - Disagree
SD - Strongly Disagree
NA - Not Applicable
|
| 14. |
Ability to properly implement
infection control procedures. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 15. |
Ability to perform periodontal
debridement and scaling on patients with light to moderate periodontal
disease. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
|
16. |
Ability to perform periodontal
debridement and scaling on patients with severe periodontal disease. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 17. |
Ability to utilize pain management
techniques. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 18. |
Ability to utilize chemotherapeutic
agents . |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 19. |
Ability to implement appropriate
fluoride therapy. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 20. |
Ability to apply of pit and fissure
sealants and evaluate their success. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 21. |
Ability to perform coronal
polishing for stain removal. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 22. |
Ability to care for oral
prostheses. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 23. |
Ability to participate in the care
and maintenance of restorations. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 24. |
Ability to provide integrative
health promotion, nutritional counseling, and preventive counseling. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 25. |
Ability to provide dental hygiene
care for the child, adolescent, adult, geriatric and medically compromised
patient. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
|

|
|
Evaluation: Measurement of the
extent to which goals identified in the treatment plan were achieved.
|
SA -
Strongly Agree
A - Agree
NB - No Bias
D - Disagree
SD - Strongly Disagree
NA - Not Applicable
|
| 26. |
Ability to utilize indices for
evaluation of patient self-care. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 27. |
Ability to reevaluate oral and
periodontal health status. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 28. |
Ability to determine follow-up
treatment needs. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 29. |
Ability to determine appropriate
continuing care (recall) needs. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 30. |
Ability to determine appropriate
referral needs. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 31. |
Ability to determine patient
satisfaction with treatment. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
|

|
|
Additional Competencies.
|
SA -
Strongly Agree
A - Agree
NB - No Bias
D - Disagree
SD - Strongly Disagree
NA - Not Applicable
|
| 32. |
Possesses the interpersonal and
communication skills to effectively interact with diverse population groups. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 33. |
Ability to assess, plan, implement
and evaluate community-based oral health programs including, health
promotion and disease prevention activities. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 34. |
Ability to provide appropriate life
support measures for medical emergencies that may be encountered in dental
hygiene practice. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 35. |
Ability to apply ethical, legal and
regulatory concepts to the provision and/or support of oral health care
services. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 36. |
Ability to evaluate of current
scientific literature. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
| 37. |
Ability to utilize critical
thinking and problem solving strategies related to comprehensive patient
care and management of patients. |
SA
|
A
|
NB
|
D
|
SD
|
NA
|
|

|
|
Additional Program Experiences - as related to
effectiveness in helping you learn.
Please use the new scale indicated.
|
VH
- Very Helpful
H - Helpful
NB - No Bias
SH - Not Very Helpful
NH - Not at all Helpful
NA - Not Applicable
|
| 38. |
Critical Thinking in Medical-Surgical Settings - Case Study Text. |
VH
|
H
|
NB
|
SH
|
NH
|
NA
|
|
Please add any comments you
might have concerning the Community Service Site(s)
that you attended,
indicating the name(s) of the site(s):
|
| 39. |
Critical Thinking in Medical-Surgical Settings - Case Study Text. |
VH
|
H
|
NB
|
SH
|
NH
|
NA
|
|
Please add any comments you
might have concerning the Elder Site(s)
that you attended, indicating the name(s) of the site(s):
|
| 40. |
Critical Thinking in Medical-Surgical Settings - Case Study Text. |
VH
|
H
|
NB
|
SH
|
NH
|
NA
|
|
Please add any comments you
might have concerning the Youth Site(s)
that you attended, indicating the name(s) of the site(s):
|
|
Comments regarding things you would like to change about the program:
|
|
Comments regarding things you think should stay
the same in the program:
|
|
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Survey.
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