Training in Primary Care Medicine and Dentistry

The Appalachian counties of Eastern Kentucky epitomize national oral health and general health disparities, having very low socioeconomic status (SES) including very high disease rates for children living below federal poverty levels. Findings from the 2000 Children's Oral Health Survey found 7.7% of children in the Eastern Region had a need for urgent care (compared to a state rate of3.9%). This indicates many rural children have active ongoing, pain and infection from this chronic infectious disease process. Objectives I. Add one residency position to the existing GPR program so that all residents can be rotated to clinical experiences in rural and urban fixed and mobile clinics for underserved children. 2. Expand and evaluate the training of GPR residents to a higher level of competence in the management of pediatric patients from underserved areas. 3. Develop and evaluate the effectiveness of urban and rural teams of health professionals to identify, diagnose, treat and refer pediatric patients from underserved areas. 4. Use and evaluate distance learning methods, such as two-way television and hand held personal organizers, to provide on site instruction and data collection assistance. Methodology - Family practice medical and GPR dental residents will be trained together to work with pediatric dental patients. Pendragon Software imparts the ability to create survey forms that can be downloaded onto PDA (Personal Digital Assistants) via the Internet and controlled from one location, making it is easy to update information collected. Evaluation - A report will be made on designated forms concerning the number of residents each year, their completion rate, and the performance on BHPr performance goals and objectives. Data will be collected about the number and type of pediatric procedures performed by each resident at all sites. Success of the teams will be determined by PDA records of patient exams, faculty and resident questionnaires, and following some cases through the health system. At the end of each year both medical and dental residents will be assessed regarding the effectiveness of distance learning and telemedicine.