James Pashayan, DDS MA Ed. Assistant Dean for Clinical Education jpasha@midwestern

1. Midwestern UniversityCollege of Dental Medicine“The Dean as the Chief Clinical Officer: Maximizing the Use of the Clinic” James Pashayan, DDS MA Ed. Assistant Dean for Clinical Education jpasha@midwestern.edu

2. The General Practice ModelClinic Administration

3. Vertical Integration of Student/Patient Care • 110 D4 Students 110 D4/D3 Teams • 111 D3 Students Continuation of care Peer mentoring External rotations

4. Vertical Integration of Student/Patient Care • 10 FTE CCC • 10 FTE CCF • 4 0.5 FTE 110 D4/D3 Teams 1 Faculty per 4.5 operatories

5. Infrastructure Support Services-Business “Work Station on Wheels” Charge reader Keyboard Receipt drawer Printer Maximizes the use of patient clinic treatment time : no student/patient lines at front office desk

6. Procedure paid prior to treatment Appointment made before patient leaves operatory

7. Material/Equipment and Patient Flow • No student lines for • material/equipment • Faster start for patient interaction • Keeps students engaged in patient • care longer • Accountable chain of custody • within the clinic • Staff-supported assistance • to student • Chain of custody • Appointment scheduling • assistance for student • 53 Full time dental staff

8. Infrastructure Support Services-Dental Suites Delivery of supplies/small equipment to Suites = no student lines at the dispensary = increased educational experience and clinical productivity

9. Business support staff (PARS) Role of the Clinical Care Coordinator and Support Facultyin the General Practice Model

10. Statistics 1st Class graduates in May 2012 Competency based clinical curriculum 35,000 patient visits since June, 2010

11. Statistics for First Class Experiences = 44,135 ($4,731,900 ) MWU income expectation 2010-2011 = $1.5 M CDM income production 2010-2011 = $3.4 M

12. Statistics for Second Class D-3 experiences = 8,635 ($668,500) Since June 6, 2011

13. Keeping Students EngagedA Positive Plan Negative Positive Personal Days Policy Competencies Continuity of instruction/calibration General practice model Working in pairs/mentoring other students Student production earning addition time off from the clinic • Requirements • Competencies • >0.5 FTE faculty • Departmental treatment planning • Working solo • No short term incentives • Changing protocol Where we are and where we want to go………

14. Projected ten percent increase in student productivity = $283,220/4 quarters

15. Student Comments “I think that the best part of our clinical education model is NOT having departments.” “Not having departments keeps our school able to adapt to changes in philosophy with the faculty, administration, and the profession at large.” “I believe that the D3/D4 pairing is crucial. First, having an assistant is crucial to time efficiency.” “… having a D-3 partner is great for continuity of care. My patients already have a working and trusting relationship with my D-3, and both my patients and myself will be comfortable with the transition to a new D-3 when I graduate.”

16. Student Comments “I feel my clinical experience has benefitted from being able to treatment plan and oversee care of my patients without having them shuffled off to other departments, and being able to rely on specialties where appropriate.” “It allows the D-4 to teach the D-3 and allows the D-3 to break into clinic easier without the fear of jumping into the deep end of the pool.”

17. Program Challenges and Solutions • Starting the model without departments unknown territory administrative budgeting increased management • Hiring the right people for clinical positions skill sets determination faculty developmentin specialty care • Adapting from private practice to educationClinical Faculty Director • Small faculty numbers: burn-outadministrative time via external rotations • Troubled student partnerships • Scheduling within the clinical setting general practice model

18. Thank You