HEED: NYU’s Mentor–Protégé Model of Dental Education
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Charles N. Bertolami, DDS, DMedSc; Elyse Bloom, MA; and John D. McIntosh, MPA
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“Under the mentor–protégé model, a professor practitioner mentors a very small group of student protégés or associates. The professor is identified as the patient’s dentist, remaining so from year to year and engendering the patient’s loyalty to the faculty member-dentist and to the system. Insofar as practical, faculty and students would treat patients side-by-side. The efficiency and productivity of a private practice would not be attained nor expected, but efficiency would be much greater than it is now in most dental school clinics. Sometimes procedures would be performed by the faculty member, sometimes by the student associate, but the relationship and identity of the faculty member as the patient’s dentist (in the mind of the patient) would continue through the years. Discussion and assignments could occur using a morning rounds format or a daily case-conference between mentor and protégés.”1
In the summer of 2019, a 4-month phase I pilot project based on the HEED concept was conducted at NYU Dentistry’s main campus in Manhattan. Ten rising D4 students and five supervising faculty members were involved in the project and due to the assignment of students to required rotations, at any given time six of the 10 students and two of the faculty members were assigned to HEED. Those students assigned to HEED had eight 1-hour appointments scheduled daily. The HEED pilot was conducted in this manner 5 days a week with six students and two faculty members participating each day.
A key element was that the faculty would serve as hands-on, active teachers, performing clinical care along with students. If a student was running late, the faculty member would take over the case to make sure the patient was not delayed beyond the scheduled appointment time. In such a situation, the student’s role shifted to that of a clinical assistant learning how to complete the appointed procedure within the designated time.
The competency requirements and method of assessment of those competencies were the same as those for students in all classes. In essence, the pilot was the same as an “elective,” and competencies were not evaluated. However, what we learned from tracking the data and from both student and faculty feedback was that the need to track minimum requirements to qualify for competency assessment was obviated by the close student/faculty interaction experienced in the HEED pilot.
During the phase I pilot, the average number of monthly patient visits per student increased by more than 3.3 times those recorded during the same period by students in our general clinics. On a per-student basis, pilot program students produced monthly billings that were 3.4 times that of our general clinics.
In October 2020, the school launched a phase II pilot, with the opening of a new facility located in downtown Brooklyn’s highly diverse and populous City Point development. NYU Dentistry Brooklyn Patient Care is designed specifically for the HEED approach. It consists of six dental office suites, each with six operatories.
At the time of this writing no students are currently assigned to the Brooklyn site. Student rotations will be added in consultation with the Commission on Dental Accreditation and at such time as the practice has acquired a patient roster sufficient to provide the rich educational experiences that align with the goals of the HEED model.
Central components of this new dental education model are faculty compensation and student selection. Faculty compensation will be incentivized beyond the base salary in proportion to the clinical revenue of the practice. Fourth-year students will be selected from among those who are planning to enter general practice; interviews between the proposed mentor and student protégé will be relied on heavily to assure synergy and commitment. Further, dental assistants and dental hygienists will be incorporated into the model to perform the tasks that these professionals would normally do as part of a general dental practice.
With this environment replicating that of a true private practice, efficiency and patient happiness become central aims for encouraging the patient’s return for continuing care. At the same time, it is likely that this new model of dental education will lead to greater professional satisfaction among faculty and students.
Charles N. Bertolami, DDS, DMedSc
Herman Robert Fox Dean, New York University College of Dentistry, New York, New York
Elyse Bloom, MA
Associate Dean for Communications and Public Affairs, New York University College of Dentistry, New York, New York
John D. McIntosh, MPA
Associate Dean for Clinical Administration and Clinical Revenue Management, New York University College of Dentistry, New York, New York