Please read the the documentation below and sign with your initials on the next page to agree.

Confidentiality Statement

The Dental profession holds a special position of trust within society. As a consequence, society affords the profession certain privileges that are not available to members of the public-at-large. In return, the profession makes a commitment to society that its members will adhere to high ethical standards of conduct.

Included in these standards is the responsibility of the dental professional to ensure and maintain the confidentiality of information pertaining to the personal, treatment, and health status of each individual patient.

As such, the Office of Clinical Affairs at Temple University School of Dentistry requires that all individuals involved with direct patient care or with access to patient information acknowledge, by signature, an understanding of the importance of confidentiality and compliance with school policy ensuring protection of patient information.

I certify that I fully understand that the patient information to which I am privileged is highly confidential and may be discussed only with individuals directly involved with patient's care or maintenance of that patient's record; with written consent of that patient; or pursuant to a valid subpoena/order of the court (must go through the Office of Clinical Affairs). I agree to abide by this standard.

Temple University Kornberg School of Dentistry Technical Standards

Purpose

Temple University Kornberg School of Dentistry (TUKSoD) provides this description of Technical Standards to inform prospective and enrolled students of the skills required in the provision of oral health care services. These technical standards reflect performance abilities and characteristics that are necessary to successfully complete the requirements of the dental school curriculum, including the clinical component which involves treating the school's patients ' Applicants should review the technical standards to develop an understanding of what is necessary to succeed in dental school.

The following technical standards describe the essential functions that students must demonstrate in order to fulfill the requirements of the dental education program and thus, are required for advancement through and graduation from the program. The technical skills areas include cognitive, motor, sensory, communication, and behavioral. Reasonable accommodations for persons with disabilities can be made, so long as such accommodations do not require a change in fundamental program requirements of the curriculum, create a direct threat to the health or safety of others, or create an undue burden on the university.

1. Cognitive

GENERAL: A student must be able to measure, calculate, reason, analyze, integrate, and synthesize information within a specified amount of time, including settings where time available for observation is brief, such as emergencies.

SPECIFIC: A student must be able to comprehend and mentally visualize three-dimensional relationships and to understand the spatial relationships of structures, and use imaging technology in treatment planning and diagnosis. Problem solving and clinical decision making, and critical thinking skills are demanded of a dentist in a health care setting. A student must be able to perform these skills in a timely fashion for effective patient treatment.

2. Motor Skills

GENERAL: A student must have a sufficient level of manual dexterity to execute fine movements required to provide general dental care and treatment to patients within a specified amount of time, including settings where time available is brief, such as emergencies.

SPECIFIC: It is required that a student possess the manual motor skills necessary to directly perform diagnostic and treatment procedures associated with the practice of general dentistry. Such procedures require coordination of both gross and fine muscular movements, equilibrium, and functional uses of the senses of touch, hearing, and vision.

SPECIFIC: A student must be able to perform basic life support (including CPR), transfer and position disabled patients, and position and reposition self around patients in various treatment settings. The student must be able to operate dental equipment controls utilizing fine hand movements, position and move dental instruments and move in all directions. Students must be able to work in the proper ergonomic positions appropriate to the delivery of dental treatment for extended times.

3. Sensory/Observation

BASIC SCIENCES

GENERAL: A student must be able to acquire a defined level of required information as presented through demonstrations and experiences in the basic and dental sciences.

SPECIFIC: This includes, but is not limited to, information conveyed through physiologic and/or pharmacological demonstrations, and in microscopic images of microorganisms and human or animal tissues in normal and pathologic states. A student must be able to acquire information from written documents and to visualize information presented in images from paper, films, slides, video and computer. A student must be able to interpret radiographs and other graphic images, with or without the use of assistive devices. A student must have functional use of visual, auditory, and somatic sensation when using educational and treatment instruments (e.g., microscopes, stethoscopes).

CLINICAL SERVICES

GENERAL: A student must be able to observe a patient accurately, and observe and appreciate non-verbal communications when performing general dental treatment or administering medications.

SPECIFIC: A student must be able to perform visual and tactile dental examinations and treatment to discern slight differences and variations in color, shape, and general appearance between normal and abnormal soft and hard tissues.
Use of tactile senses may be either direct through palpation or indirect through instrumentation. A student must also possess the visual acuity to read charts, records, small print and handwritten notation, and distinguish small variations in colors.

4. Communication

GENERAL: A student must be able to communicate with patients clearly and effectively; establish good rapport; convey or exchange information at a level allowing development of a health history; identify problems presented; explain alternative solutions; and give directions during treatment and post-treatment.

SPECIFIC: A student must have the ability to retrieve information from literature, computerized data bases and lectures, and to communicate concepts on written exams and patient charts. Patients, faculty, students, and staff must be able to easily understand the student's communication in order to effectively evaluate performance and to work collaboratively in the care of patients. Patients must be able to understand the student to help establish patient rapport; understand what information is requested and needed; and understand the explanation of treatment procedures, treatment options, informed consent, and follow-up or home care.

5.  Behavioral

GENERAL: A student must possess the emotional health and maturity required for full utilization of intellectual abilities; the exercise of good judgement; maintenance of patient confidentiality; the prompt completion of all responsibility’s attendant to the diagnosis and care of patients; and the development of mature, sensitive, and effective relationships with patients, faculty, staff and students.

SPECIFIC: The student must be able to tolerate physically and emotionally demanding workloads; function effectively under stress; adapt to changing environments; display flexibility; and learn to function in the face of uncertainties inherent in the clinical problems of patients. A student must be able to manage apprehensive patients with a range of moods and behaviors in a tactful, culturally sensitive, congenial, personal matter so as not to alienate or antagonize them. A student must reasonably be expected to accept criticism and respond by appropriate modification of behavior.

Temple University Disability Resource Services is available to students to support their needs. Please visit http://www.temple.edu/studentaffairs/disability/ for more information.

Process for Assessing the Applicant's Ability to Meet the Technical Standards

1. In reviewing an applicant who may not meet the technical standards, the Dean for Admissions and Student Affairs will meet with the Academic Dean and Clinical Dean to discuss the issue. The applicant may be requested to meet with the deans and/or provide supporting documentation from an appropriate specialist. Persons involved will be asked to identify how the candidate will meet the technical standards with or without accommodations. If accommodations are considered, the Assistant Dean for Admissions and Student Affairs will communicate with Disability Services to determine the reasonableness of the accommodation.
2. After assessing the applicant and relevant information, if the deans determine that the applicant cannot meet the technical standards with or without reasonable accommodations, the application will be rejected.
3. If the Deans determine that the applicant can meet the technical standards, the subsequent admissions review process will proceed.

I certify that I fully understand the technical standards needed to succeed in Dental School.

Photographic Consent Release

I hereby give my consent to have the Kornberg School of Dentistry of Temple University store my image in still or video format, audio or written transcripts from my admissions interview on the Kornberg School of Dentistry secured internal server for the sole purpose of providing access to this material to authorized staff, faculty and other individuals in considering my candidacy for admission.

I grant permission to the Temple University Kornberg School  of Dentistry to use any electronic media images/video for candidate consideration.