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Meeting ReportExhibits

ADEA Statement on Professionalism in Dental Education

(As approved by the 2009 ADEA House of Delegates)

Journal of Dental Education July 2012, 76 (7) 932-937;

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The American Dental Education Association (ADEA) is committed to developing and sustaining institutional environments within the allied, predoctoral, and postdoctoral dental education community that foster academic integrity and professionalism. The ADEA Task Force on Professionalism in Dental Education was charged by the ADEA Board of Directors with the development of an ADEA Statement on Professionalism in Dental Education for the dental education community. All seven ADEA Councils endorsed this effort and were represented on the Task Force. Through its work, the Task Force sought to identify and clarify those personal and institutional values and behaviors that support academic integrity and professionalism in dental education and that are aligned with the existing values and codes of the dental, allied dental, and higher education professions.

The Task Force acknowledges and respects that each academic dental education institution has its own unique culture, institutional values, principles, processes, and, in some cases, codes of conduct for institutional members. The ADEA Statement on Professionalism in Dental Education is not intended to replace or supersede these codes.

The Task Force hopes that this statement stimulates broad discussions about professional behavior in dental education, provides guidance for individual and institutional behavior within dental education, and, in so doing, supports professionalism across the continuum of dental education and practice.

Values Defining Professionalism in Dental Education

The Task Force identified and developed the following six values-based statements defining professionalism in dental education:

Competence: Acquiring and maintaining the high level of special knowledge, technical ability, and professional behavior necessary for the provision of clinical care to patients and for effective functioning in the dental education environment.

Fairness: Demonstrating consistency and even-handedness in dealings with others.

Integrity: Being honest and demonstrating congruence among one’s values, words, and actions.

Responsibility: Being accountable for one’s actions and recognizing and acting upon the special obligations to others that one assumes in joining a profession.

Respect: Honoring the worth of others.

Service-Mindedness: Acting for the benefit of the patients and the public we serve and approaching those served with compassion.

A discussion of each of these values follows and includes a fuller definition of each value and a description of the behaviors that enactment of the value requires and to which all members of the dental education community can aspire.

In developing the ADEA Statement on Professionalism in Dental Education, the Task Force sought to align the statement with existing codes of ethics and conduct within the allied, predoctoral, and postdoctoral dental communities. To illustrate the continuity of these values between the dental education community and the practicing community, the discussion of each value includes a reference to the ethical principles espoused by the American Dental Association (ADA Principles of Ethics and Code of Professional Conduct) and the American Student Dental Association (ASDA Student Code of Ethics) and the values expressed in the American Dental Hygienists’ Association (ADHA) Code of Ethics for Dental Hygienists.

Finally, examples of how the value applies to different constituencies within the dental education community are provided.

Detailed Definitions of the Six Values

Competence

Acquiring and maintaining the high level of special knowledge, technical ability, and professional behavior necessary for the provision of clinical care to patients and for effective functioning in the dental education environment

Expanded definition: Encompasses knowledge of oral health care (having acquired the unique knowledge, skills, and abilities required for effective provision of clinical care to patients); knowledge about how people learn and skills for effective pedagogy (including developing curriculum and assessments); knowledge of ethical principles and professional values1; lifelong commitment to maintain skills and knowledge; modeling appropriate values as both an educator and a dental professional; developing ability to communicate effectively with patients, peers, colleagues, and other professionals; recognizing the limits of one’s own knowledge and skills (knowing when to refer); and recognizing and acting upon the need for collaboration with peers, colleagues, allied professionals, and other health professionals. Includes recognizing the need for new knowledge (supporting biomedical, behavioral, clinical, and educational research) and engaging in evidence-based practice.

Alignment with:

ADA Principles of Ethics: beneficence, nonmaleficence

ADHA Code of Ethics: beneficence, non-maleficence

ASDA Student Code of Ethics: nonmaleficence and beneficence

Examples:

  1. For students: Learning oral health care is a top priority. Develop the habits and practices of lifelong learning, including self-assessment skills. Accept and respond to fair negative feedback about your performance (recognize when you need to learn). Learn and practice effective communication skills. Know the limits of your knowledge and skills, and practice within them; learn when and how to refer.

  2. For faculty: Engage in lifelong learning, and evaluate and enhance your abilities in this area; model continuous professional development in oral health care and pedagogy. Ensure curricular materials are current and relevant. Model effective interactions with patients, colleagues, and students; accept and respond to constructive criticism about your performance (recognize when you need to learn). Know the limits of your skills and practice within them; model how and when to refer; acknowledge and act on the need for collaboration.

  3. For researchers: Generate new knowledge. Engage in lifelong learning and evaluate and enhance your abilities in this area; model continuous professional development. Model effective interactions with patients, colleagues, and students; accept and respond to fair negative feedback about your performance (recognize when you need to learn).

  4. For administrators and institutions: Set high standards. Learn and practice effective self-assessment skills; accept and respond to fair negative feedback (recognize the need for institutional learning and address it); acknowledge and act on the need for collaboration. Support the learning needs of all members of the institution and encourage them to pursue lifelong learning.

Fairness

Demonstrating consistency and even-handedness in dealings with others

Expanded definition: Encompasses consideration of how to best distribute benefits and burdens (to each an equal share, to each according to need, to each according to effort, to each according to contribution, to each according to merit2 are some of the possible considerations); encompasses even-handedness and consistency; includes setting process standards, striving for just consideration for all parties, ensuring consistency in application of process (following the rules) while recognizing that different outcomes are possible, transparency of process, and calibration; consistent, reliable, and unbiased evaluation systems; commitment to work for access to oral health care services for underserved populations.

Alignment with:

ADA Principles of Ethics: justice, beneficence, nonmaleficence

ADHA Code of Ethics: justice and fairness, beneficence, nonmaleficence

ASDA Student Code of Ethics: justice, non-maleficence and beneficence

Examples:

  1. For students: Follow institutional rules and regulations. Promote equal access to learning materials for all students and equal access to care for the public.

  2. For faculty: Use appropriate assessment and evaluation methods for students; view situations from multiple perspectives, especially those that require evaluation; provide balanced feedback to students, colleagues, and the institution. Use evidence-based practices. Promote equal access to oral health care.

  3. For researchers: Set high standards for the conduct of research, and use unbiased processes to assess research outcomes. Generate data to support evidence-based practice and education.

  4. For administrators and institutions: Set high standards, and ensure fair, unbiased assessment and evaluation processes for all members of the institution, including applicants to educational programs. Ensure that institutional policies and procedures are unbiased and applied consistently; ensure transparency of process. Provide leadership in promoting equal access to care for the public.

Integrity

Being honest and demonstrating congruence among one’s values, words, and actions

Expanded definition: Encompasses concept of wholeness and unity3; congruence between word and deed; representing one’s knowledge, skills, abilities, and accomplishments honestly and truthfully; devotion to honesty and truthfulness, keeping one’s word, meeting commitments; dedication to finding truth, including honesty with oneself; willingness to lead an examined life; willingness to engage in self-assessment and self-reflection; willingness to acknowledge mistakes; commitment to developing moral insight3 and moral reasoning skills; recognizing when words, actions, or intentions are in conflict with one’s values and conscience4 and the willingness to take corrective action; dedication and commitment to excellence (requires more than just meeting minimum standards), making a continual conscientious effort to exceed ordinary expectations.1 Encompasses fortitude, the willingness to suffer personal discomfort, inconvenience, or harm for the sake of a moral good.3

Alignment with:

ADA Principles of Ethics: beneficence, nonmaleficence, veracity

ADHA Code of Ethics: beneficence, non-maleficence, veracity

ASDA Student Code of Ethics: nonmaleficence and beneficence, dental student conduct

Examples:

  1. For students: Strive for personal and professional excellence. Take examinations honestly; make entries in patients’ records honestly.

  2. For faculty: Strive for personal and professional excellence in teaching, practice, research, or all of these. Represent your knowledge honestly.

  3. For researchers: Strive for personal and professional excellence. Report research outcomes honestly.

  4. For administrators and institutions: Strive for personal, professional, and institutional excellence. Use appropriate outcomes measures, and acknowledge openly when improvements need to be made. Ensure institutional systems and structures are honest, open, and respectful, and do not create undue conflicts.

Responsibility

Being accountable for one’s actions and recognizing and acting upon the special obligations to others that one assumes in joining a profession

Expanded definition: Encompasses the concepts of obligation, duty, and accountability; requires an appreciation of the fiduciary relationship (a special relationship of trust) between oral health professionals and patients and between the profession and society. Accountability requires fulfilling the implied contract governing the patient-provider relationship as well as the profession’s relationship to society1; includes standard setting and management of conflicts of interest or commitment,1 as well as meeting one’s commitments and being dependable. It requires striking a morally defensible balance between self-interest3 and the interest of those who place their trust in us, our patients and society; keeping one’s skills and knowledge current and a commitment to lifelong learning; and embracing and engaging in self-regulation of the profession, including peer review and protecting from harm those who place their trust in us.

Alignment with:

ADA Principles of Ethics: beneficence, nonmaleficence

ADHA Code of Ethics: beneficence, non-maleficence

ASDA Student Code of Ethics: nonmaleficence and beneficence

Examples:

  1. For students: Meet commitments; complete assignments on time; make your learning a top priority. Acknowledge and correct errors; report misconduct and participate in peer review.

  2. For faculty: Continuously improve as a teacher; stay current; set high standards. Respect time commitments to others; be available to students when assigned to teach; meet commitments. Acknowledge and correct errors; report and manage conflicts of interest or commitment. Ensure that all patient care provided is in the best interest of the patient; ensure that patient care provided is appropriate and complete; protect students, patients, and society from harm. Report misconduct and participate in peer review.

  3. For researchers: Know and practice the rules and regulations for the responsible conduct of research; stay current. Meet commitments; report and manage conflicts of interest or commitment; report scientific misconduct and participate in peer review.

  4. For administrators and institutions: Continuously improve as administrators. Use appropriate institutional outcomes assessments, and continuously improve institutional systems and processes; acknowledge and correct errors. Report misconduct and support institutional peer review systems.

Respect

Honoring the worth of others

Expanded definition: Encompasses acknowledgment of the autonomy and worth of the individual human being and his or her belief and value system1; sensitivity and responsiveness to diversity in patients’ culture, age, gender, race, religion, disabilities, and sexual orientation5; personal commitment to honor the rights and choices of patients regarding themselves and their oral health care, including obtaining informed consent for care and maintaining patient confidentiality and privacy1 (derives from our fiduciary relationship with patients); and according the same to colleagues in oral health care and other health professions, students and other learners, institutions, systems, and processes.1 Includes valuing the contributions of others, interprofessional respect (other health care providers), and intraprofessional respect (allied health care providers); acknowledging the different ways students learn and appreciating developmental levels and differences among learners; includes temperance (maintaining vigilance about protecting persons from inappropriate over- or undertreatment, abandonment, or both3) and tolerance.

Alignment with:

ADA Principles of Ethics: autonomy, beneficence, nonmaleficence

ADHA Code of Ethics: individual autonomy and respect for human beings, beneficence, nonmaleficence

ASDA Student Code of Ethics: patient autonomy, nonmaleficence and beneficence

Examples:

  1. For students: Develop a nuanced understanding of the rights and values of patients; protect patients from harm; support patient autonomy; be mindful of patients’ time and ensure timeliness in the continuity of patient care. Keep confidences; accept and embrace cultural diversity; learn cross-cultural communication skills; accept and embrace differences. Acknowledge and support the contributions of peers and faculty.

  2. For faculty: Model valuing others and their rights, particularly those of patients; protect patients from harm; support patient autonomy. Accept and embrace diversity and difference; model effective cross-cultural communication skills. Acknowledge and support the work and contribution of colleagues; accept, understand, and address the developmental needs of learners. Maintain confidentiality of student records; maintain confidentiality of feedback to students, especially in the presence of patients and peers.

  3. For researchers: Protect human research subjects from harm; protect patient autonomy. Accept, understand, and address the developmental needs of learners. Acknowledge and support the work and contributions of colleagues.

  4. For administrators and institutions: Recognize and support the rights and values of all members of the institution; acknowledge the value of all members of the institution; accept and embrace cultural diversity and individual difference; model effective cross-cultural communication skills. Support patient autonomy, protect patients from harm, and safeguard privacy; protect vulnerable populations. Create and sustain healthy learning environments; ensure fair institutional processes.

Service-Mindedness

Acting for the benefit of the patients and the public we serve, and approaching those served with compassion

Expanded definition: Encompasses beneficence (the obligation to benefit others or to seek their good4 as well as the primacy of the needs of the patient or the public, those who place their trust in us); the patient’s welfare, not self-interest, should guide the actions of oral health care providers. Also includes compassion and empathy; providing compassionate care requires a sincere concern for and interest in humanity and a strong desire to relieve the suffering of others3; empathic care requires the ability to understand and appreciate another person’s perspectives without losing sight of one’s professional role and responsibilities3; extends to one’s peers and coworkers. The expectation that oral health care providers serve patients and society is based on the autonomy granted to the profession by society. The orientation to service also extends to one’s peers and to the profession. Commitment of oral health care providers to serve the profession is required in order for the profession to maintain its autonomy. The orientation to service also extends to encouraging and helping others learn, including patients, peers, and students. Dental education institutions are also expected to serve the oral health needs of society not only by educating oral health care providers, but also by being collaborators in solutions to problems of access to care.

Alignment with:

ADA Principles of Ethics: beneficence, justice

ADHA Code of Ethics: beneficence, justice and fairness

ASDA Student Code of Ethics: nonmaleficence and beneficence, justice

Examples:

  1. For students: Contribute to and support the learning needs of peers and the dental profession. Recognize and act on the primacy of the well-being and the oral health needs of patients and society in all actions; provide compassionate care; support the values of the profession. Volunteer to work for the benefit of patients, society, colleagues, and the profession to improve the oral health of the public.

  2. For faculty: Model a sincere concern for students, patients, peers, and humanity in your interactions with all; volunteer to work for the benefit of patients, society, colleagues, and the profession to improve the oral health of the public. Model recognition of the primacy of the needs of the patients and society in the oral health care setting and, at the same time, support the learning needs of students. Contribute to and support the knowledge base of the profession to improve the oral health of the public.

  3. For researchers: Generate new knowledge to improve the oral health of the public; contribute to and support the learning needs of students, colleagues, and the dental profession. Model the values of and service to the dental profession and to relevant scientific and research associations; volunteer to serve the public and the profession; engage in peer review.

  4. For administrators and institutions: Recognize and act on opportunities to provide oral health care for underserved populations. Encourage and support all members of the institution in their service activities; provide leadership in modeling service to the profession and the public.

REFERENCES
  1. ↵
    1. Stern DT
    . Measuring medical professionalism. New York: Oxford University Press, 2006:15–32.
  2. ↵
    1. Beauchamp TL,
    2. Childress JF
    . Principles of biomedical ethics, 3rd ed. New York: Oxford University Press, 1989.
  3. ↵
    1. Rule JT,
    2. Bebeau MJ
    . Dentists who care: inspiring stories of professional commitment. Chicago: Quintessence Publishing Co., Inc., 2005:171–2.
  4. ↵
    American College of Dentists. Ethics: core values & aspirational code of ethics. At: www.acd.org/acdethics1.htm. Accessed: December 8, 2008.
  5. ↵
    Accreditation Council for Graduate Medical Education. Common program requirements: general competencies. At: www.acgme.org/outcome/comp/GeneralCompetenciesStandards21307.pdf. Accessed: December 8, 2008.

ADEA Task Force on Professionalism in Dental Education

Task Force Chair

Dr. Richard N. Buchanan, Dean, University at Buffalo School of Dental Medicine

Representing the Council of Allied Dental Program Directors

Dr. Susan I. Duley, Associate Professor of Dental Hygiene, Clayton State University

Representing the Corporate Council

Mr. Daniel W. Perkins, President, AEGIS Communications

Representing the Council of Deans

Dr. Cecile A. Feldman, Dean, University of Medicine and Dentistry of New Jersey

Representing the Council of Faculties

Dr. Kenneth R. Etzel, Associate Dean, University of Pittsburgh School of Dental Medicine

Representing the Council of Hospitals and Advanced Education Programs

Dr. Todd E. Thierer, University of Rochester, Eastman Department of Dentistry

Representing the Council of Sections

Dr. Judith Skelton, Associate Professor, University of Kentucky, Division of Dental Public Health

Representing the Council of Students

Mr. Matthew MacGinnis, Dental Student, University of Southern California

Representing the ADA’s Council on Dental Education and Licensure

Dr. Frank A. Maggio, American Dental Association

Representing the ADA’s Council on Ethics, Bylaws, and Judicial Affairs

Dr. David Boden, American Dental Association

Representing the Commission on Dental Accreditation

Dr. James R. Cole II

Representing the American Student Dental Association

Mr. Michael C. Meru, Dental Student, University of Southern California

At-Large Representatives

Dr. Marilyn S. Lantz, Associate Dean, University of Michigan School of Dentistry

Dr. Kathleen Roth, ADA Immediate Past President

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Journal of Dental Education: 76 (7)
Journal of Dental Education
Vol. 76, Issue 7
1 Jul 2012
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