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The Latest News from CDHBC | Spring 2013

In This Issue

We’re Taking our Show on the Road!

Getting to the Root of the Matter is coming to a community near you.

You’re invited to attend Getting to the Root of the Matter – a new education and communications outreach program designed to help dental hygienists in B.C. stay current with recent changes in regulations and expectations, and help dispel some of the common and confusing myths circulating in our profession.

Eight Events plus Webinar

Getting to the Root of the Matter will travel around the province this fall with events in eight communities as well as a webinar for those who can’t attend in person.

The program, presented by the College’s friendly and knowledgeable practice advisors, will be interactive - giving participants the opportunity to test their knowledge in a series of practice scenarios. You’ll use “clicker” technology to respond anonymously and then see the tally of audience responses in real time. Plus it’s a great opportunity to meet with your dental hygiene colleagues in the local and regional community.

CE Credits

Dental Hygienists who attend the program will earn 2 CE credits.

Details coming soon!

Watch your email in for locations, dates and times, and register early to secure your spot.

See you there!

Message from the Registrar

In February, I returned to College after my maternity leave and was excited to see all the work and changes that had taken place while I was gone! Many thanks to Heather Biggar who was the Acting Registrar for the past year, as well as all the College staff for all their hard work on big projects like the 365-exempt category, the QAP, and some complex inquiry cases.

You will see that this work continues by the size of this edition of Access - x pages of important information!

2013 marked our first cohort of registrants being enrolled in the new Quality Assurance Program (QAP). 471 registrants took the QAP Assessment Tool in January and February. Details on their results as well as the results of the exit survey that those registrants completed are found on page X. I’m pleased to see that the program is running as it should and registrants are finding it a helpful learning experience.

The other big change for the College in the past year was the implementation of the 365-exempt category of registration. While not the ultimate solution, it was an important step forward to provide greater access to dental hygiene care as registrants in the category are exempt from the 365 day rule in every practice setting. The College Board and Staff are working hard to establish multiple pathways for registrants to satisfy the educational requirement for admission to this category. Details on the pre-approved substantial equivalency streams can be found on page X. We are also working with Thompson Rivers University to develop a Prior Learning Assessment Recognition (PLAR) process. This will allow registrants who don’t have a degree, but who believe they have gained the knowledge and skill of the four competencies in the bylaws to a degree level through experience and other alternative learning, to apply to the category. This process will be available in the Fall of 2013. Following this, we will be developing a rubric by which to access and/or develop other educational opportunities (i.e. modules, courses, etc) to satisfy the educational requirement of the 365-exempt category. We hope to have the rubric in place by early 2014.

Moving forward there is still much work to do. We will continue to further assess the QAP against the guiding principles as well as develop the indirect care assessor process. As outlined above, we will continue to develop the other pathways for registrants to access the 365-exempt category. We will be moving forward with the regulation and bylaw renewal project to update our regulations and bylaws to reflect current standards from the Ministry of Health as well as to more accurately reflect current dental hygiene practice. Please watch the website and your email for more details on these and other items.

We know that there has been a significant amount of information disseminated about changes that have taken place recently. While we have made a concerted effort to communicate with registrants in a variety of ways, it has been challenging for dental hygienists to keep up to date. As a result, we’re very excited to announce the launch of Getting to the Root of the Matter! This is a new education outreach program that will help dental hygienists feel comfortable that they are current in their understanding of the regulations as they apply in their day-to-day practice.

Getting to the Root of the Matter will include events in 8 communities and a webinar for those who are unable to attend in person. The program will be interactive, providing attendees with ‘clickers’ so they can respond anonymously to a series of dental hygiene practice scenarios and see the tally of audience responses in real time. After the scenarios, there is generous time for questions and answers on topics of interest to attendees.

Attendees will have the opportunity to learn about their College and meet the practice advisors, and meet and interact with their colleagues in the local and regional dental hygiene community.

Dental Hygienists who attend the program or webinar will earn 2 CE credits.

We hope that you will take the time to reserve your seat in a session near you!

Lastly I hope that you will take the time to ensure that the portable USB drive which was distributed to all registrants last year is up to date. Please download this edition of Access as well as recent bulletins to your drive, which can be found on the CDHBC website, and an updated version of the handbook will also be available shortly. We feel that the USB drive is an important tool enabling all registrants to have important resources and information at their finger tips.

Message from the Chair

Hello everyone, my name is Tamera Servizi and I have the privilege of serving as the new Chair of the Board of CDHBC. I have served as an elected board member for the past 3 years, and am starting my second term of office. I am very excited about this opportunity, and look forward to the next two years. I would like to thank the outgoing Chair, Marilynne Fine, whose wisdom and mentorship has been invaluable to myself and to the entire Board and whose perspective and sense of humour will be sorely missed around the table.

Since graduating from VCC in 1999, I have mainly spent my 14 years in dental hygiene in clinical practice, first in the Greater Vancouver area and currently in Courtenay on beautiful Vancouver Island. These days I am balancing a busy clinical practice with a husband and 2 small boys, and most days I struggle to complete my treatment notes in time to rush off to get the boys to soccer practice. I’m sure many of you can relate to the challenge of juggling our professional lives with our personal ones!

In these hectic days, it can be difficult to stay abreast of the many recent changes in our profession. The recently implemented Quality Assurance Program is the culmination of many years of hard work on the part of the Board, the Quality Assurance Committee, and College staff. Having been involved at the Board level for the past 3 years, I firmly believe that the QAP is a program that BC registrants can be proud of and can count on to move our profession into the future.

The recently implemented practice category, the 365-exempt category, is an important step toward increasing access to care. The Board is working on minimizing barriers to accessing it by establishing multiple avenues for registrants to satisfy the requirements of the category. Keep on the lookout for information on this exciting new opportunity.

In closing, I know that often change can be unwelcome, but consider the following; without change women would not be allowed to vote, BC dental hygienists would not be self-regulating, and acid-wash jeans and spiral perms would still be in style. So don’t fear change, embrace it!

Full Registration (365-Day Rule Exempt) Substantial Equivalency Streams

In March of 2012, the Minister of Health announced that they would be implementing the 365 exempt category to allow for registrants in this category to be completely exempt from the 365 day rule in every practice setting. As of July 3, 2012 the Full Registration Category (365-Day Rule Exempt) came into effect. At that time, those registrants who held a Residential Care Registration were grandfathered into this category. The College also developed a plan to develop four main pathways for registrants to satisfy the educational requirement of the category. The first pathway was for those registrants who graduated with a degree in dental hygiene from an approved Canadian dental hygiene program, as this is the primary requirement in the bylaws. Registrants in this pathway were able to apply to the category beginning in January 2013. The second pathway to satisfy the educational requirement is the substantial equivalency streams. There are 7 streams that recognize registrants who have degrees in areas other than dental hygiene combined with experience in being a primary care provider (both in dental hygiene or other health professions). Starting May 13, 2013, registrants with the required qualifications and submission of evidence of an applicable Substantial Equivalency Stream will be eligible to apply to the Full Registration (365-Day Rule Exempt) category. The application form for this pathway can be accessed on the Registration and Renewal page on the College website.

The College is currently working on developing a Prior Learning Assessment Recognition (PLAR) process as the third pathway. The PLAR will be available in the Fall of 2013. Lastly we will be developing a rubric to assess other educational opportunities (i.e. modules, courses, etc) as a fourth pathway and will have that in place in early 2014.

For the substantial equivalency pathway, registrants with the following qualifications may apply under the Full Registration (365-Day Rule Exempt) Category:

Current CDHBC registration in the Full Practicing or Conditional category;
Health Care Providers (HCP) Level CPR certification;
Submission of Evidence of an Applicable Substantial Equivalency Stream; and
A minimum of 3500 hours of Clinical Dental Hygiene Practice experience in the past 5 years.

Substantial Equivalency Streams

A.) Educator Category:
Applicable to those who are/were employed as an educator in an accredited oral health program for more than 12 months and have obtained a minimum of a bachelor degree level of education.

B.) Public Health Category:
Applicable to those who are/were employed as a registered dental hygienist in a public health setting for more than 12 months and have obtained a minimum of a bachelor degree level of education.

C.) Hospital/Health Agency/Health Facility Category:
Applicable to those who are/were employed as a registered dental hygienist in a hospital, health agency or health facility for more than 12 months and have obtained a minimum of a bachelor degree level of education.

D.) Self-Employed Category:
Applicable to those who are/were employed as a registered dental hygienist operating a free standing practice for more than 12 months and have obtained a minimum of a bachelor degree level of education.

E.) International Health Professional Category:
Applicable to those with international credentials in a health care profession at a bachelor degree level, with practice experience as a health care provider as a registrant in good standing with the appropriate regulatory body in Canada for more than 12 months prior to dental hygiene practice.

F.) Canadian Health Care Professional Category:
Applicable to those with a bachelor degree and practice experience as a healthcare professional as a registrant in good standing with the appropriate regulatory body in Canada for more than 12 months prior to dental hygiene practice.

G.) Dental Hygiene Practitioner Category:
Registrant with a health sciences related degree and at least 12 months experience in dental hygiene practice.

The application form for this pathway can be accessed on the Registration and Renewal page on the College website.

Recognition of specialized knowledge as an outcome of practice experience has been an accepted method to validate specialty certification in other health professions (e.g. nursing, social work). Nursing certification organizations establish eligibility requirements for their certification based on standards of practice within the specialty, validation of the critical tasks and responsibilities through benchmarking research among nurse specialists, and professional judgment of subject matter by experts.1 The National Association of Social Workers offers voluntary credentials. Social workers with a master's degree in social work may be eligible for the Academy of Certified Social Workers (ACSW), the Qualified Clinical Social Worker (QCSW), or the Diplomat in Clinical Social Work (DCSW) credential, based on their professional experience.2

Recognition of the value of professional experience has also been demonstrated within dental hygiene. Donnelly (2008) conducted a survey of BC registrants in the Full Registration (Residential Care) category with a response rate of 62%. Half of the respondents held a bachelor degree; however, when they were asked how they gained their knowledge, skills and abilities for the practice setting, 79% indicated that it was a result of formal didactic training, and field experience.3

Essentially, the 365 Day Rule Exempt category of registration requires the registrant to assume the responsibilities of a primary care provider. It acknowledges dental hygiene bachelor education as providing the educational experiences and outcomes to support this. It also provides an opportunity for those who do not have this credential to demonstrate their abilities based on their professional experience and education.

It can be argued that registrants who identify with one of several of the substantial equivalency
categories have already demonstrated the responsibilities of a primary care provider. Other categories recognize the value of a health science baccalaureate degree with a diploma dental hygiene education as equivalent. Program content and outcomes of health science degrees must include core health professional competencies found in peer-reviewed literature4 and meet the 6 dimensions of transferable learning abilities and knowledge base as per the BC Ministry of Advanced Education program review criteria.5

All registrants applying for the 365-day rule exempt category will also be required to
demonstrate 3500 hours of clinical practice and current health professional level CPR.

A glossary of terms is provided in Full Registration (365-Day Rule Exempt) Information Guide [c1] found[j2] on the College website. Please contact the College directly for more information on this and the other pathways to access this registration category.

Examination Interpretation Guideline

The following questions from registrants are often received by the Dental Hygiene Practice Advisors at the College of Dental Hygienists of BC:

“Exactly what type of exam is required to satisfy the 365 day rule? Is a specific exam sufficient?”

“If a new client is coming into the office, can they see the dental hygienist first before having their new client exam if they saw another dentist within the past 365 days?”

“Does the exam have to be performed by a BC dentist?”

The Dental Hygienists Regulation indicates that the examination must be performed by a dentist who is a registrant of the College of Dental Surgeons of BC. The following Interpretation Guideline outlines precisely what the term “examined” means. An examination can be a specific, recall or comprehensive exam as deemed appropriate by the dentist in accordance with the College of Dental Surgeons of BC (CDSBC) Practice Guidelines. It is important to note that restorative or other dental work recorded on the chart does not constitute an examination.

CDSBC describes the components of a dental examination in Dental RecordKeeping Guidelines (2010) as the written and/or electronic descriptions of the conditions that are present related to the following:

Extra-Oral Evaluation;
Soft Tissue Evaluation;
Dentition Evaluation;
Vital Signs (as appropriate);
Periodontal Evaluation (PSR or full periodontal exam where appropriate);
Arch Relationship and Growth/Development Evaluation – where appropriate; and
Chief complaint.

It is important that the client’s record reflects that each of the categories have been assessed during the examination. For clients with a relatively healthy mouth, a notation such as “within normal limits” may be sufficient. The client’s reasons for seeking care should also be documented. Registrants who document for the dentist are also encouraged to review Tab 5 in the CDHBC Registrant’s Handbook in order to ensure adherence to Practice Standard #8 regarding documentation.

Often times a new client coming into a new dental practice is booked with the dental hygienist for dental hygiene care prior to being examined by the new dentist. The dentist’s exam can take place prior to the hygienist seeing a new client, or it can take place at some point during the new client’s initial appointment with the hygienist.

Dental hygienists working without a dentist on site are able to initiate dental hygiene assessments and/or provide regular care as long as the client has had a dental exam from a dentist within the past 365 days. It would be advisable for documentation standards that the dental hygienist documents the date of the client’s last exam as provided by the client (or their previous dental office) and the examining dentist's name in the chart. Some dental hygienists go beyond this by also asking the client to sign or initial an area in the chart to verify that they have received a dentist’s exam within the past 365 days and the information documented is accurate.

References:

CDSBC Dental Recordkeeping Guidelines (2010)

CDHBC Registrants Handbook, Tab 3, Dental Hygienists Regulation section 6(1)

CDHBC Registrants Handbook, Tab 5

CDHBC Registrants Handbook, Tab 7

Enclosed is the Interpretation Guideline on “Examination” found in the Registrants’ Handbook Tab 7, which provides further explanation.

EXAMINATION

ISSUE

Registrants have requested an interpretation of the definition of the term “examined” contained in section 6(1) of the Dental Hygienists Regulation.

REFERENCE

Dental Hygienists Regulation (see Tab 3):

6(1) No registrant may practise dental hygiene unless

(a) prior to or during the initial appointment, the client is examined by a dentist,

(b) at the time of any subsequent appointment, the client has been examined by a dentist within the previous 365 days or within such shorter time as is necessary or appropriate in accordance with good dental hygiene practice or good dental practice.

POLICY

Background

It is considered important to ensure that clients have the benefit of an overall dental examination to assess general oral health. Focusing only on dental hygiene requirements may not be in the client’s best interests.

Policy Statement

The term “examined” as used in section 6(1) of the Dental Hygienists Regulation means that the dentist has performed an examination in keeping with the College of Dental Surgeons of British Columbia Practice Guidelines.

Assumptions and Rationale

The issue of whether or not the client is billed for the examination is not relevant to this definition.
Restorative or other dental work recorded on the chart does not constitute an examination.
An examination may be a specific, recall or comprehensive exam as deemed appropriate by the dentist in accordance with CDSBC Practice Guidelines.

2013 QAP Cohort Results

The first Quality Assurance Program (QAP) Cohort of registrants completed the QAP Assessment Tool in January and February of 2013.

The first Cohort group consisted of 471 registrants. Of those, 435 successfully completed their first attempt at the QAP Assessment Tool. An additional 11 registrant’s scores fell within the 3% cut-off score and were given a successful result.

Only 25 registrants in the first Cohort were unsuccessful at their first QAP Assessment Tool attempt. To date, 18 registrants have now successfully completed the assessment, 5 registrants have yet to complete their second attempt, and 2 registrants were unsuccessful at their second attempt and are now participating in the Assessor Process.

In the event of a second unsuccessful result, a registrant is paired with a calibrated Assessor who will work with the registrant to conduct an alternative assessment. The Assessor and the Quality Assurance Committee (QAC), along with the registrant, will determine a guided learning plan and remedial activities specific to enhancing the quality of practice of the registrant.

The 2013 QAP Cohort group was given the opportunity to provide feedback on the QAP Tool Preparation process, and the Process Assessment, through an online survey. Feedback from the Cohort group indicated that the average time spent preparing for the QAP Assessment tool was 41 hours and 71% of registrants felt that the QAP Assessment Tool Preparation Guide was useful in their preparation.

The initial Pilot group felt that two hours to complete the QAP Assessment Tool was insufficient, therefore the allowed time was extended by 30 minutes. Survey results of the 2013 QAP Cohort group indicated that 70% of the registrants felt that the two and a half hour time allotment was adequate to complete the Tool. Only 21% of the surveyed participants did not feel that the content in the QAP Assessment Tool was a fair representation of the dental hygiene practice.

The full survey results can be viewed on the CDHBC website’s Quality Assurance Program: QAP Assessment Tool page.

Inquiry Committee Focus

Under the Health Professions Act (HPA) the main objective of the College is to serve and protect the public. Along with this mandate, under the HPA, is the obligation “to establish, monitor and enforce standards of practice to enhance the quality of practice and reduce incompetent, impaired or unethical practice amongst registrants” and “to establish, monitor and enforce standards of professional ethics amongst registrants”. HPA 16 (2) (d & g)

It is the responsibility of the CDHBC Inquiry Committee to investigate inquires brought to the attention of the College that breach these standards. To date, the Inquiry Committee has reviewed 102 complaints filed against registrants.

A dental hygienist who believes the behavior of another is not in the best interest of the client or public has a professional and ethical obligation to report the observed incident(s), including but not limited to unsafe or substandard procedures, or performing services outside the Scope of Practice, to the appropriate agency, as outlined by the Health Professions Act (HPA).

The College wants registrants to understand how the complaint process works, and the types of complaints that are most often reviewed, by the Inquiry Committee. To illustrate this, a Record of Decision, from a matter recently investigated by the Inquiry Committee, will be published in this and future issues of Access.

This new segment is intended to enhance a registrant’s understanding of the College bylaws, Practice Standards, Scope of Practice and Code of Ethics by allowing them to exam the elements of a complaint, the process used by the Inquiry Committee to investigate the complaint, and how the final disposition was reached.

This exercise is not meant to intimidate registrants, but rather to empower them with the opportunity, through improved understanding, knowledge and skills, to align their dental hygiene practice in accordance with the College bylaws, Practice Standards, Code of Ethics and Scope of Practice as set out in the Registrant’s Handbook.

The following Record of Decision is the result of a complaint received by a dentist on May 23, 2012.

Inquiry Committee Record of Decision

File Reference: DH1295
ELEMENTS OF COMPLAINT

On May 23, 2012, the Registrar received a written complaint from a dentist alleging that the Registrant had engaged in unethical behaviour after being terminated from his/her employment. The Complainant alleged the Registrant returned to the clinic operated by the Complainant on May 12, 2012 after (s)he was terminated and intentionally deleted 96 appointments from the clinic’s Dentrix software.

The Inquiry Committee resolved to investigate the matter.

On June 5, 2012, the Registrant provided a response denying that (s)he was responsible for deleting the appointments and pointing out that anyone in the clinic could log into the software and have the ability to move, delete or alter appointments. Before exiting the clinic, the Registrant left his/her key and acknowledged leaving a handwritten note on the Complainant’s desk in which (s)he made some disparaging remarks concerning the Complainant.

On June 11, 2012, the Inquiry Committee appointed an inspector to assist with its investigation. The inspector interviewed the Complainant and the Registrant, as well as all of the employees who were present in the clinic on May 12, 2012. The Inspector also obtained an independent Dentrix audit trail report (ATR) from a Dentrix IT technician confirming the deletion of the 91 appointments between 11:20-11:29 am on May 12th.

On December 18, 2012, the College office received a copy of the inspector’s report, a copy of which was provided to both the Complainant and the Registrant for comment. The report and respective responses to the report were submitted to the Inquiry Committee for review in consideration of their decision in this matter.

COMMITTEE DECISION
After reviewing the information gathered for this investigation, the Inquiry Committee passed a motion under s. 33(6)(b) of the Health Professions Act, R.S.B.C. 1996, c. 183 (the “Act”) to issue a letter of warning to the Registrant containing a number of recommendations which are set out below:

The Registrant should provide a letter to the Complainant expressing regret for the tone and content of the handwritten note and acknowledging that it was not professional or warranted. Any such letter should be delivered to the College office, rather than to the Complainant directly, and the College will arrange for delivery of the letter;
The Registrant should enroll in and complete a workplace anger management course such as the one offered at the Justice Institute of British Columbia to address the issue of his/her behaviour in the workplace;
If the Registrant is unable to find an appropriate course on workplace anger management, (s)he should consider counseling with a qualified professional to address workplace anger issues.

Although these are recommendations rather than directions, the failure to follow these recommendations will be taken into account by the Inquiry Committee or Discipline Committee in the event that there is a future complaint concerning the Registrant’s conduct as a decision under s. 33(6)(b) constitutes “past action” within the meaning of s. 39.2(1)(b) of the Act.

The Inquiry Committee warned the Registrant that his/her future behaviour in the workplace must be above reproach, and that (s)he must ensure that (s)he conducts him/herself in a professional, respectful, and ethical manner. The Registrant’s handwritten note to the Complainant and his/her behaviour in the workplace reflected poorly on him/her as a professional, and reflected poorly on the profession as a whole.

RELEVANT PROVISION OF ACT, REGULATION OR BYLAWS

Act, section 32(1); 32 (2); 33(1); 33(5); 33(6)(a)
STATUS
Closed.

The key issues in this particular matter are:

Professional Behaviour: The Registrant in this matter exhibited unprofessional behavior through the tone of the handwritten note left on the employer’s desk.
Code of Ethics: While the Inquiry Committee was able to link direct evidence to the Registrant, there was highly suspicious circumstantial evidence that drew question to whether or not this Registrant had violated the College’s Code of Ethics.

Electronic Documentation: the importance of unique user ids and passwords for all parties that have access to the company’s Dentrix software system. If this clinic had individual user ids and passwords already in place, this matter may have had a significantly different outcome.

Root of the Matter: Orofacial Myofunctional Therapies

Orofacial Myofunctional Therapies

Jacqueline Guyader Senior Dental Hygiene Advisor

In the past several years there have been a number of educational offerings for training allied health professionals in the field of Orofacial Myofunctional Therapy. With courses now being offered in BC, there has been an increased interest demonstrated by dental hygienists to incorporate orofacial myology therapies into their dental hygiene practice setting. As a result, the College has received a number of questions from registrants who are thinking of taking the course, as well as questions from those who have successfully completed the course and are seeking clarification of CDHBC’s stance regarding how Orofacial Myfunctional Therapies (OMT) fall within the Dental Hygiene Scope of Practice.

In response to these inquires, the College has developed an interpretation guideline for Orofacial Myfunctional Therapies. The OMT interpretation guideline is meant to clarify how a dental hygienist, with the appropriate training in OMT, may incorporate orofacial myology therapies into the practice setting as they relate to the Dental Hygienists Scope of Practice. It is critical to remember that OMT completed by a dental hygienist must follow the full Dental Hygiene Process of Care. It is not within the Dental Hygiene Scope of Practice to diagnose an orofacial myofunctional disorder (OMD). A dental hygienist is allowed to provide orofacial myofunctional therapy interventions that remain within the Scope of Practice to alleviate OMD disorders, only as they relate to the soft tissues of the oral cavity proper. As with all client care, OMT is to be provided in collaboration with appropriate allied health professionals, such as dentists, orthodontists, and speech and language pathologists.

The following OMT Interpretation Guideline was approved by the College Board in March of 2013 and will apply to those registrants who meet and maintain the criteria for this adjunctive therapy.

POLICY

Background

As stated in the Scope of Practice in the CDHBC Registrant’s Handbook (Tab 6) “dental hygienists may assess the status of teeth and adjacent tissues and provide preventative and therapeutic dental hygiene care for teeth and adjacent tissues.”

Appropriate Education is defined in Tab/Section 6 of the CDHBC Registrant’s Handbook and applies to the acquisition of knowledge and skills required to incorporate Orofacial Myfunctional Therapies (OMT) within the dental hygiene care. The ethical obligation to maintain competence in a skill in order to continue to incorporate it within dental hygiene care would also apply to OMT.

Providing a dental hygienist follows the full Assessment, Diagnosis, Planning, Implementation, and Evaluation (ADPIE) process of care, OMT may be incorporated as an adjunctive to dental hygiene care. The focus of ADPIE must remain on the muscles of the lips and tongue along with how they interact with those muscles associated with the face. Interventions provided must focus on the exercises related to soft tissues in the oral cavity proper relating to resting position and functional patterns of these muscles and those related in the face. No therapies may be provided past the oral cavity proper in the oropharyngeal region. Interventions in this region are restricted activities that do not fall within the Dental Hygiene Scope of Practice.

The Dental Hygienists Regulation does not require supervision for the provision of OMT. However, the dental hygiene scope of practice does not include a diagnostic-level decision making component for Orofacial Myofunctional Disorders; therefore a diagnosis would be required by a health care professional such as an orthodontist, dentist or physician.

POLICY STATEMENT

Dental hygiene professionals who have received the appropriate education and certification in OMT and maintain currency may incorporate OMT into their dental hygiene practice.

OMT may be used as an adjunct therapy supported through the Dental Hygiene ADPIE Process of Care.

Any diagnosis of an orofacial disease and/or disorders must be made by a dentist or appropriate health professional and not by the dental hygienist. Appropriate referrals are required when care is required not relating to soft tissues of the oral cavity or when deemed appropriate. OMT therapies should be completed in collaboration with other health care professionals involved in the client care when appropriate.

No treatment may be provided outside of the dental hygienists scope of practice which includes treatment beyond the oral cavity proper into the pharyngeal region as this is a restricted activity outside the dental hygienists scope of practice.

In conjunction with upholding Continuing Competency expectations required by the CDHBC, a registrant practicing OMT must maintain competence by upholding appropriate continuing education specific to OMT practice.

REFERENCE

College of Dental Hygienists of British Columbia. Registrant’s Handbook. 3rd ed. Victoria: CDHBC; 2009.
The International Association of Orofacial Myology
Mason, R. A retrospective and prospective view of orofacial myology. International Journal of Orofacial Myology. 2005 November:31
American Speech-Language-Hearing Association 2012
Andresen T, et al. Efficacy of osteopathy and other manual treatment approaches for malocclusion e A systematic review of evidence, International Journal of Osteopathic Medicine (2012)

Notice of Annual General Meeting

Thursday, June 6, 2013
7:00 p.m. to 9:00 p.m.

Holiday Inn Express Burnaby/Metrotown,
4405 Central Blvd, Burnaby, BC

Annual General Meeting

Business considered will be the Reports of the College's Committees, the Annual Report, Audited Financial Statements for 2012/2013 and 2011/2012 Annual General Meeting Minutes.

Current Issues Session

Jennifer Lawrence, Registrar, will present an update on current issues
affecting dental hygiene practice and regulation.

The AGM is open to all registrants and the public, but to ensure sufficient seating, those who plan to attend are asked to RSVP by May 24, 2013 by phone on 1‑800‑778‑8277, or email cdhbc@cdhbc.com.

SkyTrain station and major bus exchange are immediately adjacent to the hotel.
Complimentary underground parking.
Registrants who attend the AGM may claim continuing competency credit.

Revitalized Continuing Competency Educational Principles

In early 2005 the Health Professions Act (HPA) was amended requiring the College to develop a new Quality Assurance Program (QAP). The QAP was implemented in January 2013. The QAP has an assessment process in the format of a quality assurance program assessment tool (QAP Assessement Tool). The results generated by the QAP assessment tool will guide a registrant’s focus for continued professional development through the creation of an individualized online learning plan. Within the next five years all registrants will be enrolled in this program.

As a result of the development of the QAP there was a need to update what was accepted for continuing education (CE) credits. The College has updated the continuing competency (CC) principles to ensure they reflect the values and beliefs relating to the QAP. The principles also serve to provide guidance for registrants as they seek out CE opportunities in order to improve their dental hygiene knowledge and practice.

In March of 2013 the College Board approved the newly revised CC Principles. These six CC Principles were then implemented on April 1, 2013 and will apply to all registrants regardless of their CC or QAP Cycle.

Continuing Competency Principles

Continuing competency activities must be evidence based and contribute to scientific, practical, professional or ethical aspects of the registrant’s dental hygiene practice.
Registrants have the professional responsibility to maintain safe, competent, evidence-based dental hygiene practice through on-going professional development, reflective practice and integration of learning into practice.
Registrants have a responsibility to demonstrate professional development through self-reflection on their current practice, knowledge, skills, and abilities.
Every Registrant in a practicing registration category will participate in the QAP, complete the assessment tool and develop an individualized learning plan with articulated learning goals. The learning plan should be of substantial depth, applicable to his/her area of practice and identified needs
It is the Registrant’s responsibility to retain records that support all continuing competency credit submissions such as certificates of completion, self-reflection papers, evaluations and other supporting documentation for each current cycle and for at least 5 years thereafter.
The College Supports quality improvement efforts at a personal or organization level as an important and a critical way to incorporate acquired knowledge into the dental hygiene practice setting.

Visit the CDHBC Website for further elaboration and examples for the Continuing Competency Principles

Expanded Continuing Competency Credits Framework

Registered Dental Hygienists in BC have the privilege of being self regulated professionals under the Health Professions Act (HPA). With this privilege, the College has a duty as a regulatory body “to establish and maintain a continuing competency program to promote high practice standards amongst registrants”, as outlined in the HPA section 16(2)(e). The Quality Assurance Program (QAP) was developed in order to comply with the HPA with the intent of providing public protection by ensuring a continued quality of dental hygiene practice by registrants.

It is considered a professional and ethical obligation for a dental hygienist to comply with the continuing competency program as outlined by the College and mandated under the HPA. However, dental hygienists as health care professionals should look beyond the HPA as being the sole reason for engaging in continuing competency educational activities. Innovations in technologies, a growing body of dental and dental hygiene related research, and an increase in the aging demographics of the population in BC are just a few examples of valid reasons for a dental hygienist to remain current with dental hygiene issues in order to enhance their practice.

Continuing Competence (CC) is a lifelong process that enables registrants at all stages in their careers to be involved in a process that allows them to use their professional judgment to seek out learning opportunities to improve their integration of knowledge and skills into the dental hygiene practice setting. In early 2013 the College Board approved an update to the Continuing Competency Principles as well as an expanded continuing compentency credit framework. These updates came into effect April 1, 2013. The CC Principles and the expanded CC credit opportunities apply for those in both the three-year CC cycle and those registrants in the five-year QAP cycle.

The expanded CC credit framework promotes group learning, self learning, and reflective learning. These three content categories will house all learning activities.

Group learning is defined as large or small group activities or courses. Examples may include but are not limited to: courses, study clubs, symposiums, membership on dental hygiene committees.
Self learning is defined as independent learning that is self paced, working towards a learning outcome. Professional writing for a dental hygiene publication, reading a dental hygiene journal article, or completing a dental hygiene module would be some examples considered for the self learning category.
Reflective learning is the active pursuit of learning from an experience (be it a course, a journal reading or an experience in practice) by reflecting on the experience in order to understand and guide future actions when placed in a similar situation. This may be demonstrated through, but is not limited to, reflective journaling, developing a learning plan, reflecting on how a previously taken course impacts the dental hygiene practice of the registrant, and peer assessment.

This expansion will provide flexibility and increased diversity for professional development activities as registrants seek out appropriate means to enhance their dental hygiene practice. This CC credit framework will also complement varied learning styles as a wider variety of educational modalities and opportunities are now available. Due to geographic constraints throughout this large province, the enhancement of activities will assist the registrant in seeking out meaningful courses for identified learning needs rather than merely attending courses of convenience.

The framework for the expanded CC credit Program is outlined in a quick reference format in Table #1. All CC credit activities are based on activity type or hours spent on the given activity.

The following is an example of how the competency categories and credit activities would work together based on the expanded Continuing Competency Credit Framework.

A registrant identified areas they felt required updated information to inform their current dental hygiene practice. To address these identified learning needs, the registrant attended the Pacific Dental Conference (PDC) in March 2013 for 2 ½ days and completed the following:

Thursday: attended a 5 hour lecture “Fighting Dental Disease: Drugs, Bugs and Dental Products”, presented by Dr. Jacobsen.
Friday: attended a 5 hour hands-on course, “Simplified Digital Photography Hands-On”, presented by Dr. Young.
During lunch on both Thursday and Friday the registrant attended the Exhibit Hall, asking questions of exhibitors and gathering information on products for a total of 2 hours.
A week after the PDC the registrant completed a substantial self reflection for the “Simplified Digital Photography” course. The registrant completed the self-reflection form template to complete the following information: experience, including knowledge they gained from the course, a reflection on how the information gained will impact their practice, followed by a plan to implement the knowledge into their practice setting, and finally an evaluation on how the incorporation of this new knowledge has impacted their practice.

The following table provides a graphic of how these activities would look under the CC credit Framework.

Competency Category	Activity #, Description and Name of Completed Activity	Credits Being Claimed
1. Group-Learning	#1, Course - Fighting Dental Disease: Drugs, Bugs and Dental Products	5
2. Group-Learning	#1, Course - Simplified Digital Photography Hands-On	5
3. Self-Learning	#2, Attending Dental Conference - PDC	2
4. Reflective-Learning	#12, Reflective Learning – reflection on “Simplified Digital Photography Hands-On” course	1

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