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Professionalism as a Core Competency in the Academic Program of the UCSF School of Dentistry

Revised and Approved by Faculty Council
July 1, 2006

I. Introduction

The UCSF School of Dentistry has a strong curriculum for educating its students in the scientific principles and technical skills required to be successful dentists and dental educators. Graduates of this School should also exhibit a high degree of professionalism, which derives from a capacity for self-evaluation and moral reflection. Professionalism is one critical cornerstone of a successful academic program, just as it is a cornerstone of a responsible, collegial and compassionate career in the practice of dentistry and related disciplines.

Whereas academic criteria for demonstrating competency in didactic and technical skills have been well documented in the UCSF curriculum, academic criteria for demonstrating an appropriate level of professionalism have not. In addition, developing clear competency standards and outcomes measures for students in the area of professionalism has become a high priority for faculty, students, staff and administrators alike.

This document lays out the principles of professionalism for predoctoral and postgraduate professional students. It also defines a new competency standard and outcomes measures for evaluating professionalism, within the academic program, for predoctoral and postgraduate professional students in the UCSF School of Dentistry.

II. Statement of Educational Philosophy, UCSF School of Dentistry

We, the faculty, students, and staff of the UCSF School of Dentistry, are committed to fostering an environment of mutual trust and respect. We believe this goal requires clear communication, compassion for others, and enthusiasm for the dental profession. To this end, we accept personal responsibility for our interactions with patients and colleagues and we encourage one another through constructive guidance. This team philosophy will be the foundation of all our endeavors, even in challenging times. In this way we will continue to achieve academic and clinical excellence, create lifelong professional partnerships and provide lasting contributions to the greater community.

III. Definition of Professionalism

Professionalism: A level of ethical, legal and moral conduct in one's field that an individual must adhere to in order to gain and maintain the trust of others.

IV. Principles of Professionalism for Predoctoral Dental Students and Postgraduate professional students at UCSF, and for the Profession of Dentistry

Professionalism Standard: Attitudes and Behaviors of the Student Dentist
The Student consistently demonstrates the following attitudes and behaviors (examples follow, but are not all inclusive):

1. Shows a dedicated desire to learn: for example, by:

  • thorough preparation for all class, laboratory, and clinic sessions
  • completing all course requirements & clinical obligations on time
  • a willingness to ask for and receive academic performance feedback
  • seeking out clarification, tutoring, or other assistance when necessary
  • staying informed by regularly checking email, voicemail, mailboxes and CLE communications
  • keeping planned absence requests to a minimum
  • maintaining an open-mind with regard to exposure to new ideas
  • a willingness to give constructive feedback to peers
  • maintaining a commitment to life-long learning to maintain the knowledge and clinical skills necessary to provide quality patient care

2. Shows respect toward others as demonstrated by:

  • cordial and respectful interactions with individuals inside and outside UCSF
  • respecting diversity, including but not limited to, race, gender, religion and cultural background, sexual orientation, age, disability or socioeconomic status
  • following faculty or staff directives in classes or patient care settings
  • appropriate behavior in class, lab, or clinic such that there is no interference with others' ability to learn or the faculty's ability to teach
  • appropriate dress, consistent with that of a professional, in all school settings
  • responsible notification when ill and prior approval for planned absences

3. Consistently places the patient's needs first as demonstrated by:

  • providing timely assessment and treatment of the oral health care needs of all patients on a student's assigned list in a manner consistent with the patient's treatment needs and desires, without preference to some over others, and without neglecting needs of those who do not meet the student's current course requirements
  • Providing effective, timely patient care appropriate to course expectations. This includes obtaining appropriate consultations, performing a comprehensive medical history, being alert to medication allergies and changes in systemic health status, entering patient data and treatment notes into the electronic record in a timely way, and following the established clinic protocol in providing care
  • maintaining the confidentiality of all patient health information
  • not creating phantom patients or otherwise manipulating efficient patient scheduling or chair availability
  • recognizing one's limitations and seeking help when one's level of training is insufficient to provide appropriate patient care
  • returning all messages and telephone calls from patients promptly

4. Consistently displays honesty and integrity as demonstrated by

  • presenting only one's own work as one's own
  • refusing to participate with those who invite you to behave unethically
  • reporting inappropriate, dishonest, or unethical behavior to course or clinic directors
  • complying with campus and University policies and guidelines regarding student conduct, treatment of other members of the UCSF community and ethics

5. Displays emotional maturity and adequate physical health to provide oral health treatment to patients in a responsible manner, as demonstrated by:

  • obtaining required documentation for any learning difference or physical handicap that requires accommodation on the part of the School or its faculty
  • notifying the Dean of Students and the Dean of Academic Affairs of any special needs for accommodations (physical, cognitive, or emotional), prior to the academic year if possible, and, where needed, notifying course directors, in advance, when accommodations are desired
  • notifying appropriate personnel if ill, emotionally compromised, or otherwise unable to perform clinical or academic duties; it is the expectation that the responsible student will self-assess physical and emotional fitness for patient care

6. Represents oneself in a professional manner outside the university

  • Awareness of one's responsibilities as a health care professional at all times in terms of the needs of the community

V. Professionalism Competency and Learning Outcomes for the DDS Program

A. Professionalism Competency Statement

The School of Dentistry has adopted a statement regarding professionalism as one of its competency statements (descriptions of behaviors that must be demonstrated during the educational process and are measured throughout the curriculum). Professionalism is an intangible quality that is difficult to measure. However, it can be approached by evaluating behavior. The statement, defined as competency statement #1 follows:

Demonstrate ethical and professional behavior in interactions with the UCSF community including students, staff, faculty, and patients.

B. Professionalism as a Core Component of all Courses and Programs: Course Expectations for Students and Faculty

Student Expectations of Faculty:
The course director and faculty will provide:

  • Clear set of ground rules and guidelines delivered at the start of the course, consistently and fairly applied throughout the entire course
  • Classes that start on time and stay within the prescribed time limit
  • Lecture series, lab exercises, and/or clinic experiences, supported with web-based materials appropriate for the course, and integrated with the appropriate resource materials
  • Web-based interactive learning modules that reinforce and complement the course materials whenever possible
  • Examinations that reflect the indicated content of the course
  • Grades and answers to examinations disseminated confidentially as soon as possible after examinations
  • Opportunity to ask questions during course times, and the expectations that faculty will respond to student emailed questions in a timely manner
  • Opportunity to interact with the instructor through office hours and/or CLE
  • No disturbances by cell phones and/or pagers
  • An atmosphere that is conducive to learning

Faculty Expectations of Students:
Students are expected to:

  • Attend all the lectures, discussions, clinics, laboratory sessions in the course
  • Arrive on time and leave when the class, laboratory, or clinic has ended
  • Pay attention and be courteous to fellow students and course faculty
  • No disturbances by classmates entering or exiting at untimely moments, or engaged in casual conversation
  • Silence cell phones and pagers
  • Read, understand and follow the guidelines laid out in the course syllabus
  • Prepare for class in advance by reading the relevant assigned materials, reviewing syllabi, CLE materials, or other assigned activities
  • Complete any web-based modules and other activities in parallel with the classroom or lecture materials in a timely manner
  • Stay informed of course updates or faculty requests by regularly checking email, voicemail, mailboxes and CLE communications
  • Complete all examinations, laboratory and clinic exercises, and patient care associated with the course in an honest and professional manner
  • Ask for clarification and receive feedback from faculty when you are unsure or unclear about any element of the course
  • Provide constructive feedback about all elements of the course at the end of the quarter through the anonymous E*Value system

C. The Role of Faculty in Measuring and Implementing Professionalism Standards, and Suggested Outcomes Measures for Professionalism.

In order to implement a professionalism standard throughout the curriculum and for each course, stream leaders and course directors will be asked to add the professionalism competency statement (competency statement #1: in A above), and the statement of student and faculty expectations (in B above) to their courses.

The professionalism competency statement (A) and the list of expectations for professional behavior (B) can be measured by employing a variety of strategies.  Although some expectations are consistent over all courses, measurable behaviors in laboratory and clinic courses may be somewhat different than those used in lecture or seminar type courses.

Course directors have the right and responsibility, through the doctrine of academic freedom, to select and implement measurement strategies that they feel are most appropriate for their particular course.  Each individual course director, assisted by the stream leader and the course faculty, will, therefore, define the professionalism measures to be used in their lecture, lab or clinic course, and state these in writing at the start of the course.  Course Directors, in consultation with the course faculty, will also need to determine a threshold for behavior, beyond which sanctions occur.

Suggested Outcomes Measures for Professionalism. In order to assist the faculty in incorporating measures of professionalism into their courses, the following suggested activities are presented for measuring professionalism. This list is not all-inclusive: course directors may choose other measures not listed below.  Course Directors should choose the measures appropriate for their course(s), and post them in all course syllabi, and on CLE, along with the new Competency Statement on professionalism (see A, above).

  • Didactic courses

    • Expected behaviors

      • Full Attendance
      • Punctuality: i.e. arriving on time, for all classes and lectures
      • Adequate preparation for class by completing all homework, independent projects, and/or group working assignments
    • Unacceptable behaviors

      • Talking and other behaviors in class that are rude or disruptive to professors and students
      • Cheating such as copying the work of others on tests and other assignments
  • Laboratory courses

    • Expected Behaviors

      • Full Attendance
      • Punctuality: i.e. arriving on time, to all laboratory courses
      • Wearing appropriate personal protective equipment (PPE) while working on laboratory projects
      • Being prepared with course materials and equipment at the beginning of the laboratory session.
      • 100% attention during lectures given in the laboratory and other classrooms
    • Unacceptable behaviors

      • Cheating on exams or test cases
      • Not doing ones own work
      • Performing laboratory work from other courses during specified laboratory time.
      • Behavior that is disruptive to other students in the laboratory.
  • Clinical courses

    • Expected behaviors

      • Full Attendance
      • Punctuality: i.e. arriving on time to all clinic courses, clinic sessions and patient appointments
      • Functioning constructively as a member of the dental student team
      • Wearing appropriate clinical attire
      • Wearing appropriate personal protective equipment (PPE)
      • Consistently observing infection control procedures
    • Unacceptable behaviors

      • Creating phantom patients to reserve chairs, canceling patients inappropriately, refusing to treat assigned patients, and any patient management behavior that hinders the customer service and academic goals of the clinic
      • Cheating on competency examinations
      • Inappropriate patient management
      • Disrespectful or disruptive behavior towards staff, students or patients in clinic.
D.  Procedures for handling Breaches of Professionalism

Breaches of Professionalism standards that occur in courses or clinics will be handled as follows.

Any egregious unprofessional behavior (such as cheating on exams or lab work, patient endangerment or unacceptable patient management), will be reported to the Dean, and could result in the student being suspended or dismissed from Dental School, depending on the severity of the incident. 

For other types of unprofessional behavior, a faculty member and/or a Course Director concerned about a student’s behavior will initially give feedback to the student and make suggestions for improvement, making reference to faculty expectations for professionalism (section V-B), and specific course outcomes related to professionalism (section V-C). 

If the behavior continues, or is initially serious enough, the Course Director will complete a Professionalism Evaluation Report (PER), review it with the student and forward it to the Dean. The relevant Student Status committee will also be notified at its regular quarterly meeting. The student will have the opportunity to respond in writing on the Professionalism Evaluation Report form, and will sign the form.  The student will meet with the Dean and Course Director regarding the professionalism concerns raised, and the required remediation. At this time the student will have the opportunity to discuss his/her viewpoint in the event the report resulted from a misunderstanding or appeared to the student to be arbitrary.  

If there are multiple Professionalism Evaluation Reports for a student within one single-quarter or multi-quarter course, the student could receive an NP for that course due to this pattern of unprofessional behavior, at the recommendation of the Course Director, even if the student has passed all academic or technical components of the course. 

Institutional Professionalism refers to one’s conduct outside the classroom or clinic. A student may receive a Professionalism Evaluation Report for unprofessional behavior that occurs outside the classroom or clinic, due to, for example, inappropriate behavior with administrative staff or members of the Dean’s office.  Such Institutional personnel may submit a Professionalism Evaluation Report to the Dean, reporting a student for unprofessional behavior.

If a student receives one or two Professionalism Evaluation Reports in his/her first two years, and none subsequently, these Reports will not become part of the student’s record.  However, if additional forms are submitted in the 3rd and 4th years, this will be considered evidence of a pattern of unprofessional conduct.  In addition, if 3rd and 4th year students with no Professionalism Evaluation Reports in their first two years, acquire two or more such reports in their 3rd and 4th years, this will also be considered a pattern of unprofessional conduct. At that point, all such incidents will be on the student’s record, with any or all of the following consequences: 

    • The student will be placed on Academic Probation for this pattern of unprofessional behavior. Such Academic Probation status will be handled by Student Status committees as described in the Regulations of the School of Dentistry :

      http://dentistry.ucsf.edu/students-faculty-staff/students/regulations-of-the-school-of-dentistry
       
    • The Professionalism Evaluation Reports and pattern of unprofessional behavior for such    students will affect the Dean’s letters of recommendation for post-graduate    programs/residencies, or other professional opportunities following graduation.
    • Patient care is a privilege. Students with a pattern of unprofessional behavior may be subject to sanctions, including restrictions in clinic or deferred externship experiences. 
    • Students will be ineligible for awards, such as those given at the annual Recognition Banquet.