American Dental Education Association

1. American Dental Education Association Special Interest Group on Clinical Simulation

2. Special Interest Groupon Clinical Simulation 1984-2002 17 Sessions in 18 Years

3. Lest We Forget:Humans Practice Dentistry Michael M. Belenky, DDS, MPH Associate Professor Dental School, University of Maryland, Baltimore

4. We Live in Remarkable Times • 20 th Century was an Era of Great Human Tragedy and Extraordinary Human Achievement. • Wright Brothers, in 1903, Proved that Man Could Free Himself from the Bond of Earth and Fly; 66 Years Later, Man Walked on the Moon • Identification of the Human Genome • We Live in an Age of Extraordinary Opportunity for Change and Progress; We Require Only an Open Mind and a Willingness to Consider Change.

5. A Remarkable Change in Dental Education Realistic Clinical Simulation

6. Humans Do DentistryNot Equipment Priority: Human Factors and the Way We Work

7. Ergonomics • Relationship between humans, the tasks they perform, and the environment in which tasks are performed. • Equipment-centered Ergonomics: Human Adaptation to Requirements of Equipment. • Human-centered Ergonomics: Equipment is adapted to Requirements of Humans.

8. Reason for Change • Dentistry’s Occupational Profile of Contortion and Distortion of Body Form • High Incidence of Repetitive Stress Injuries (RSIs),Cumulative Trauma Disorders (CTDs), and Musculo-Skeletal Disorders (MSDs) • Cost of these Problems (absence from work, therapy, long-term care, hospitalization, rehabilitation, income loss, etc.)

9. We Work as We Learned • Unrealistic Bench-Top Exercises in Non-Patient Care Settings. • Focus on Outcome Product. • Self–Discovery of Performance Process, Absent Attention to Human-Centered Ergonomics. • Mirror Utilization often a Default Option. • Relearning Required when Patient “Breathes, Talks, and Salivates.”

10. Strategy for Change in Dental Schools • Identify Need for Change • Identify Cost of Change • Identify Benefits of Change • Develop a Proposal for Change Test Phase Implementation Phase

11. Strategy for Change in Dental Schools • Inform Faculty of Proposal • Obtain Faculty Consensus • Obtain Administrative Support • Establish Faculty Task Force • Test Proposed Change • Conduct Related Research • Evaluate Outcome • Implement Change and Monitor Change

12. Strategy for Selection of Ergonomic Concept • Define Requirement/Task • Examine the Ergonomic Literature • Examine Precedent Initiatives • Review and Consider Options for Selection • Consider Personnel and Financial Costs of Possible Options • Select and Recommend Option of Choice

13. Faculty Benefits • Advanced/Improved Teaching Methods and Technology • Future-Oriented Image for School/Faculty • “Best and Brightest” Attracted to School • Increased Efficiency and Effectiveness in Psychomotor Learning and Patient Care • Reduced Time and Effort in Teaching • Increased Personal Satisfaction

14. Limits to Change • Reluctance to Change • Absence of Imagination and Creativity • Tiered Decision Process without End • Limited Funds for Change Requirements • Lack of Administrative Support

15. #1 Obstacle Reluctance to Change

16. #1 Requirement TFI Total Faculty Involvement Key to Success

17. TFI Commitment Participation Reward

18. Thank You