Dental Anesthesiology - Competency & Proficiency Requirements

Upon completion of training the student/resident will be:

a) Able to demonstrate in-depth knowledge of the anatomy and physiology of the human body and its response to the various pharmacologic agents used in anxiety and pain control;

     1. The experience in this area is intended to enable the resident to have a thorough understanding of the airway, cardiovascular and head and neck anatomy and how the patient will respond to various pharmacologic and physiologic states.

     2. This will be reviewed during lectures and reviewed clinically during general anesthesia where profound physiologic changes are noted

     3. Examinations will be given periodically both in writing and proactively in a clinical environment. This will be documented by test results and evaluations for both written and clinical exams.

b) Able to demonstrate in-depth knowledge of the pathophysiology and clinical medicine related to disease of the human body and effects of various pharmacological agents used in anxiety and pain control when these conditions are present;

     1. The experience in this area is intended to enable the resident to understand clinical medicine related to disease states, including an understanding of oral pathology, syndromology, and anxiety and pain control.

     2. Intended experiences include lectures and conferences in oral pathology, anxiety and pain control, and syndromology. Review of clinical medicine related to disease states will occur during the medicine and pediatrics rotations.

     3. Tests and evaluations will be given periodically in writing and proactively in the clinical environment. This will be documented by test results and written evaluations.

c) Proficient in evaluation patientsí physiological and psychological need for various forms of anxiety and pain control and their potential response to anxiety and pain control procedures;

     1. The experience in this area is intended to enable the resident to have an understanding of the entire spectrum of pain and anxiety control. The resident will understand the control of the perception of pain as well as the effects of pharmacologic agents and potential reactions affecting both physical and mental well being.

     2. Intended experiences include lectures and conferences on physiological and psychological reactions and affects of various anxiety and pain control methods. There will be reading assignments in the above subjects. Review of clinical medicine related disease states will occur during the medicine and pediatric rotations.

     3. Tests and evaluations will be given after the lecture and reading assignments. This will be documents by test results and written evaluations.

d) Proficient in evaluating patientsí physiological and psychological risks associated with the use of various modalities of pain and anxiety control;

     1. The experience in this area is intended to enable the resident to evaluate riskd related to disease states and ASA status.

     2. Intended experiences include reading assignments and lectures covering the above areas, as well as clinical experience.

     3. Knowledge will be tested by written exams and written clinical evaluations. This will be documented by test results, evaluations, and case reports.

e) Proficient in selecting as appropriate anxiety and pain control modality to use in relation to the specific physical and psychological status of the patient.

     1. The experience in this area is intended to enable the resident to use different modalities to ensure continuation of therapies, based upon the level of the patients compliance and being able to shift one modality to another.

     2. Proficiency is ensured by clinical reviews with the resident at case completion. This will be documented via case report.

f) Proficient in patient preparation for sedation/anesthesia, including pre-operative and post operative instructions and informed consent/assent;

     1. The experience in this area is intended to enable the resident to assure proper work up through discharge and beyond including interpretation of laws affecting ability for patient consent

     2. The resident will experience preparation and completion of the facility consent procedure, as well as operative, anesthesia , and discharge documentation.

     3. The documents are reviewed for completeness as part of the resident evaluation process.

g) Proficient in the use of anesthesia related equipment for the delivery of anesthesia, patient monitoring, and emergency management;

     1. The experience in this area is intended to enable the resident to review and evaluate equipment, set up, monitor and manage patient status. The resident will also be taught emergency planning.

     2. The resident will have instruction and demonstration of the set up and monitoring of anesthesia related equipment, as well as emergency drills and case scenarios to cover possible emergency situations.

     3. There will be lectures, demonstrations, exams, and individual instruction on this topic. Each resident will be ACLS/PALS certified. This will be documented by test results, completion of certifications, and evaluation of case scenarios.

h) Proficient in the administration of local anesthesia, sedation, and general anesthesia as well as psychological management and behavior modification as they relate to paion and anxiety control in dentistry;

     1. The experience in this area is intended to enable the resident to understand various dental procedures and the various pain and anxiety control modalities used for each. The residents will learn how to comfortably administer local anesthesia, sedation, and general anesthesia as well as the use of non pharmacologic modalities in a dental setting.

     2. The residents will experience lectures, exams, patient treatment settings, and discuss relevant articles and books in journal clubs.

     3. Competency will be determined by exam results, evaluations, and case reviews.

i) Proficient in managing perioperative emergencies and complications related to anxiety and pain control procedures, including the immediate establishment of an airway and mainteneance of ventilation and circulation;

     1. The experience in this area is intended to enable the resident to monitor and control the airway throughout a procedure. The resident will have the ability to react and manage perioperative complications.

     2. The resident will experience mock case scenarios, clinical evaluations, and assignments

     3. Competency will be established by case reviews and written clinical evaluations

j) Competent in the diagnosis and non-surgical treatment of acute pain related to the head and neck region;

     1. The experience in this area is intended to enable the resident to diagnose and manage acute head and neck pain non invasively

     2. The students will experience these techniques clinically

     3. Competency will be determined by written clinical evaluation and case reports.

k) Familiar with the diagnosis and treatment of chronic pain related to the head and neck region:

     1. The experience in this area is intended to enable the resident to manage chronic oro-facial pain utilizing diagnostic nerve blocks, referred pain trigger points, etc.

     2. The resident will treat patients with atypical chronic head and neck pain. Case studies and current literature will be reviewed with the residents.

     3. Competency will be determined by written clinical evaluations and case reports

l) Able to demonstrate in-depth knowledge of current literature pertaining to dental anesthesiology;

     1. The experience in this area is intended to enable the resident to be aware of current research and studies in the area of dental anesthesiology. The students will be expected to produce a paper suitable for publication

     2. The residents will experience literature reviews, journal clubs, and lectures on research methodology and analysis.

     3. Competency will be determined by production of a paper suitable for publication by the completion of the program. In addition, residents will prepare a poster suitable for presentation at a professional conference or meeting.
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