Interprofessional Education: The Oral Physical Examination for Medical Students [by Doctors of Dental Medicine]
|9300||January 7, 2013||1|
Medical students are sophisticated learners within a complex medical teaching and health care delivery environment. In our experience they hunger for pragmatic, practical learning situations, to demonstrate real-world inferences from medical knowledge, to practice delivering health care and providing treatment.
We are experienced faculty at the University of Pittsburgh School of Dental Medicine. We advocate preventive dental care and treatment as front-line intervention in the biological relationships between dental problems and general systemic health. In our academic experience we see medical students barely instructed in the adequate performance of the dental clinical examination, possessing only the most minimal knowledge of the role of oral health in preventing systemic illness.
We believe in systemic medicine and dentistry that emphasizes 'skill in doctoring' and that extends beyond diagnosis to carrying forward with the patient plans for coping with the diagnosis. That is treatment.
Our goal is shared responsibility for oral health among primary providers. We believe ‘interprofessional’ medical education across conventional professional boundaries will improve medical students’ oral and systemic health knowledge and ultimately clinical practice, their ability to diagnose potential health problems early, making adequate referrals for treatment or prevention.
Our emphasis is inflammation, chronic or acute, as an etiologic factor. Instruction is nine self-motivated, independent yet aggregating modules. Lessons are designed similarly, to convey simultaneously the intuitive subtlety of clinical observation, important requisite facts of oral and systemic health knowledge, and synthesis of observation and knowledge into clinical medical practice.
This course addresses relationship(s) between oral and systemic health so that medical students are effective in diagnosing and treating oral clinical indications of poor health. Compromised oral health may be related and contributing to poor systemic health.
Concepts instructed include oral clinical indications, symptoms and signs of gingival health (and disease); the same regarding periodontal health (and disease); and the same regarding manifestation of systemic disease on the gingiva.
Students completing this instruction will be able to clinically recognize and differentiate between gingival abscess and periodontal abscess, including familiarity with radiographic evidence.
Students will recognize dental implants, clinically and on radiograph. Students will learn and recognize the etiology of periodontal disease. Students will learn clinical interventions that prevent and treat periodontal disease.
Students completing this instruction will recognize that prevention or intervention in the clinical progress of periodontal disease may improve individual systemic pre-disposition or health status in conditions relatable to oral or periodontal health, such as cardiovascular disease, diabetes, rheumatoid arthritis, pregnancy.
Students will learn appropriate clinical interventions to interrupt the progression of associated systemic disease. Students will learn when to make referrals to specialized dentists or physicians.
Significance: Medical students, with this instruction, will be able to perform a clinically-acceptable oral examination. Students will recognize oral health as a viable component of overall systemic health.
Limitations: Instructional resource is self-directed self-paced tutorial. One obvious limitation is the absence of a live clinical instructor. Level of instruction is to the adequately-prepared medical student with average laymen’s clinical aptitude, to provide working journeyman clinical proficiency in very basic dental medicine.
Famili P, Seyedain A. Interprofessional Education: The Oral Physical Examination for Medical Students [by Doctors of Dental Medicine]. MedEdPORTAL Publications; 2013. Available from: https://www.mededportal.org/adea/publication/9300 http://dx.doi.org/10.15766/mep_2374-8265.9300
Contains Information Suitable for Patient Education
- To review the presentation and assessment of gingival health.
- To review the identification of plaque and calculus and to instruct the etiology of periodontal disease.
- To recognize and perform physical examination confirming periodontal pocketing, as a component of periodontal disease.
- To evaluate (examine) for, recognize on physical examination, and differentiate between periodontal abscess and gingival abscess.
- To understand the physical and etiologic relationships between periodontal disease and the systemic disease diabetes.
- To examine, evaluate, and assess various radiographic evidence related to the periodontium and periodontal disease
- Physical Examination, Periodontal Pocketing, Gingival Abscess, Plaque, Calculus, Oral-Systemic Disease, Building Oral Health Capacity (BOHC) Collection
Endocrinology, Diabetes & Metabolism
- Endocrinology, Diabetes & Metabolism
- Internal Medicine
Assessment, Diagnosis & Treatment
Establishment & Maintenance of Oral Health
Skills & Doctoring
- Assessment, Diagnosis & Treatment
Knowledge for Practice
- Clinical Exam
- Medical Student
Professional School Post-Graduate Training
Authors & Co-Authors
Pouran Famili, DMD
University of Pittsburgh
Ali Seyedain, DMD
University of Pittsburgh
Sponsorship or Funding Source
This project is also sponsored in part by funding from the Health Resources and Services Administration/Maternal Child Health Bureau grant #U44MC20223.
Effectiveness and Significance
This submission is crafted as independent self-directed study (tutorial) material for medical students, communicating elements of the oral/periodontal health-systemic health connection by instructing the oral examination from the subtlety of the experienced dentist's viewpoint, including using the dentist's radiographic evidentiary tools and the dentist's diagnostic parameters of health and disease.
Special Implementation Guidelines or Requirements
None, especially. The self-directed study materials and the knowledge conveyed would be most useful at the beginning of medical education. The full idea of the curriculum conveys instruction in how to conduct a hands-on clinical oral examination, these slides document/reinforce the second, more didactic level of knowledge gained from the clinical oral examination (not so much 'how to look' but 'what you have seen').
When we taught the pilot mini-elective to medical students that inspired this idea, we learned some interesting things about the medical student mind. Highly pragmatic, highly practical, really interested only in material useful to them as medical students: one comment from the elective was to suggest that the course be made required material for the Advanced Physical Examination test in January. Doing so would guarantee that attention was paid. Another student commented that the presentation on pathophysiology and clinical practice from the dentists' perspective was especially helpful. That student remarked that he had already begun using the techniques demonstrated in the physical exams he was conducting in the hospital.
This information is made available under the Creative Commons license.