{"id":63567,"date":"2026-01-21T14:20:13","date_gmt":"2026-01-21T19:20:13","guid":{"rendered":"https:\/\/www.bu.edu\/dental\/?page_id=63567"},"modified":"2026-06-30T10:03:59","modified_gmt":"2026-06-30T14:03:59","slug":"defining-entrustable-professional-activities-for-geriatric-dentists","status":"publish","type":"page","link":"https:\/\/www.bu.edu\/dental\/defining-entrustable-professional-activities-for-geriatric-dentists\/","title":{"rendered":"Defining Entrustable Professional Activities for Geriatric Dentists"},"content":{"rendered":"

Progress Update<\/strong><\/span><\/h2>\n
\n

We are using Entrustable Professional Activities (EPAs)<\/b><\/h3>
\n

We are using Entrustable Professional Activities (EPAs) because they describe real, observable tasks that a dentist must be trusted to perform independently. EPAs make the work visible, support accreditation, guide curriculum design, and help demonstrate why geriatric dentistry requires training beyond general dentistry.<\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

\n

We began with a national scoping review<\/b><\/h3>
\n

We began with a national scoping review to understand what geriatric dentists actually do in real practice. This helped us identify the full range of clinical, ethical, and system\u2011navigation tasks that are not captured in current competency lists.<\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

\n

Delphi Round 1 tested the clarity and relevance of the four EPA domains<\/b><\/h3>
\n

Delphi Round 1 tested the clarity and relevance of the four EPA domains. The panel strongly agreed that the domains were appropriate for specialty\u2011level practice. All existing activities met consensus for inclusion, though public\u2011health\u2013related tasks were viewed as slightly less central to daily clinical care.<\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

\n

Round 1 comments highlighted important gaps<\/b><\/h3>
\n

Round 1 comments highlighted important gaps in the current framework, including caregiver\u2011dependent care, cross\u2011setting care coordination, complex behavioral management, medical co\u2011management, legal\/ethical responsibilities, and preventive\/maintenance\u2011focused workflows.<\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

\n

Delphi Round 2 evaluated nine new proposed activities<\/b><\/h3>
\n

Delphi Round 2 evaluated nine new proposed activities to determine whether each one was distinct, important, and should be included in the final EPA set. All items were rated highly important, but distinctiveness varied \u2014 showing that panelists differentiate between \u201cimportant to do\u201d and \u201cimportant enough to stand alone.\u201d<\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

\n

Five activities reached full consensus<\/b><\/h3>
\n

Five activities reached full consensus, including polypharmacy risk coordination, capacity assessment, elder abuse reporting, and communication of treatment modifications. Others were important but not clearly distinct enough to stand alone, such as medical clearances, integrated care planning, nutrition counseling, and public\u2011health surveillance.<\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

\n

Psychometric testing showed that the original four\u2011domain model did not hold statistically<\/b><\/h3>
\n

Psychometric testing showed that the original four\u2011domain model did not hold statistically, with some domains merging and others lacking a clear identity. This raised important questions about how to structure the specialty in a way that is teachable, assessable, and defensible to accrediting bodies.<\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

\n

Our expert panel is now working to finalize a clear, defensible EPA framework<\/b><\/h3>
\n

Our expert panel is now working to finalize a clear, defensible EPA framework that demonstrates the unique scope of geriatric dentistry, supports accreditation and training standards, and strengthens the case that this work cannot be fully performed by a general dentist without additional specialty preparation.<\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

\n

What\u2019s involved?<\/strong><\/h3>\n
    \n
  • Participants will complete up to three rounds of surveys to help the panel reach consensus on which activities should be included as Entrustable Professional Activities (EPAs) for geriatric dental practice. Each round is expected to take approximately 10\u201315 minutes.<\/li>\n
  • Participants are not required to share personal information in order to take part. Those who choose to provide contact information will be invited to complete follow\u2011up rounds.<\/li>\n
  • Panel responses will be collected through REDCap, a secure, BU\u2011approved research platform. Only the study team will have access to the data. Responses will not be linked to participant names unless contact information is voluntarily provided. Any identifying information will be stored separately from survey responses, and all data will be maintained on secure servers and deleted at the end of the study in accordance with BU privacy guidelines.<\/li>\n
  • Participants may enter an optional gift card drawing after each round. Email addresses for the drawing will be stored separately from anonymous survey responses. Across all three rounds, six prizes will be awarded. Based on expected participation, the estimated odds are approximately 1 in 67 for a $100 gift card in Round 1, about 1 in 70 for a $300 gift card in Round 2, and about 1 in 100 for the $500 gift card in Round 3. Entry in the drawing is voluntary.<\/li>\n<\/ul>\n

     <\/p>\n

    Process of the Study <\/strong><\/h2>\n

    \"\"<\/p>\n

    About the Research Team<\/strong><\/h2>\n

    This Delphi study, led by Dr. Bethy Turton, is one component of a larger international initiative to define the specialized practice of geriatric dentistry. Across this broader program of work, our colleagues serve in leadership and advisory capacities, guiding the development of Entrustable Professional Activities (EPAs) for the field. For this specific Delphi process, they contribute expert advisory input to strengthen the rigor and relevance of the work, while all IRB\u2011regulated activities are conducted solely by Dr. Turton.<\/p>\n\n\n\n
    \"\"<\/td>\nDr Bethy Turton
    \n<\/strong>Principal Investigator for the Delphi Process<\/strong><\/strong>Dr. Bathsheba (Bethy) Turton, BDS, MComDent, PhD, is an Assistant Professor at the Henry M. Goldman School of Dental Medicine, Boston University. Trained in dental public health in New Zealand and Australia, she has led international research and clinical trials on caries prevention, silver fluoride therapies, and innovations in oral health systems. Dr. Turton\u2019s work spans academic, governmental, and NGO collaborations, with a focus on building sustainable oral health programs in resource-limited settings. Her recent research applies systems thinking to oral disease prevention in long-term care, integrating clinical, policy, and community perspectives to design interventions that improve outcomes for older adults.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Collaborating Advisors<\/strong><\/p>\n\n\n\n\n\n\n\n
    \"\"<\/td>\nDr. Lyubov Slashcheva, <\/strong>DDS, MPH
    \n<\/em>Project Lead, Geriatric Dentistry EPA initiative<\/strong>
    \nApple Tree Dental (USA)<\/em>Dr Slashcheva is the project lead for the boarder EPA project. She is a public health dentist with deep experience in community-based geriatric care and interprofessional practice, advising on EPAs that reflect real-world care delivery and equity considerations.<\/td>\n<\/tr>\n
    \"\"<\/td>\nRoberto Carlos Castrej\u00f3n<\/strong>\u2011<\/strong>P<\/strong>\u00e9<\/strong>rez, <\/strong>DDS, MSc, PhD
    \nProject Manager, Geriatric Dentistry EPA Initiative<\/strong>
    \nUniversidad Aut\u00f3noma Metropolitana (UAM), Mexico
    \n<\/em>
    \nDr. Roberto Carlos Castrej\u00f3n\u2011P\u00e9rez is a public health dentist and researcher with extensive experience in aging, oral health epidemiology, and the coordination of large, multi\u2011institutional research initiatives. He has contributed to international efforts focused on improving oral health outcomes for older adults, with scholarly work spanning frailty, geriatric syndromes, health services research, and community-based care models.In his advisory role for this broader EPA development program, Dr. Castrej\u00f3n\u2011P\u00e9rez supports project management, methodological planning, and cross-team coordination.<\/td>\n<\/tr>\n
    \"\"<\/td>\nDr. David Chvartszaid, <\/strong> DDS, MSc, MSc, FRCDC
    \nUniversity of Toronto; Department of Dentistry, Alpha Omega Dental Center, Baycrest Hospital \u00a0<\/span>
    \n<\/em>
    \nA prosthodontist and geriatric dentistry expert<\/span> with extensive experience in competency development and postgraduate training. His expertise supports the alignment of EPAs with advanced clinical practice.<\/td>\n<\/tr>\n
    \"\"<\/td>\nDr. Nicholas Tong, <\/strong>BDS, MFDS RCSEd, PhD
    \nUniversity of British Columbia
    \n<\/em>
    \nA clinician\u2011scientist with expertise in aging, oral health policy, and competency-based education, contributing guidance on the structure and evaluation of EPAs.<\/td>\n<\/tr>\n
    \"\"<\/td>\nDr. Gabriel Lee<\/span>, <\/strong>BDS, Grad Dip Geriatric Dentistry, MPH
    \nFaculty of Dentistry, National University of Singapore<\/span>
    \n<\/em>
    \nA academic-clinician trained in geriatric dentistry and public health, with active educational leadership in both undergraduate and postgraduate geriatric dentistry education. His expertise in professional competency development further supports the development of EPAs in geriatric dentistry.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
      <\/ul>\n

      Together, these advisors bring diverse clinical, educational, and international perspectives that help ensure the EPA development process reflects the complexity of geriatric dentistry across settings and systems. Their role is consultative; all study design, data collection, and IRB\u2011regulated activities are led solely by Dr. Turton.<\/p>\n

      Study Overview<\/strong><\/h2>\n
      \n

      What is a Delphi study?<\/h3>
      \n

      A Delphi study is a way to gather expert opinions and reach agreement on a topic through a series of surveys. Instead of meeting in person, experts answer questions online in multiple rounds. After each round, the responses are summarized and shared back with the group, so participants can see what others think and adjust their answers if they want. This process continues until the group reaches a clear level of agreement, or \u201cconsensus,\u201d on the key issues. It\u2019s useful for complex topics where there isn\u2019t one right answer, like setting standards or defining best practices.<\/p>\n

      <\/div>\n<\/div>\n<\/span><\/p>\n

      Why are EPAs important for geriatric dentistry?<\/h3>
      \n

      Entrustable Professional Activities (EPAs) are important because they turn broad skills into clear, real-world tasks that dentists must be trusted to perform safely and independently. Caring for older adults often involves complex medical conditions, multiple medications, and challenges like frailty or cognitive decline. EPAs help ensure that dentists are prepared for these situations by setting clear expectations for what they can do without supervision. This makes training more practical, improves patient safety, and supports consistent, high-quality care for older adults.<\/p>\n

      <\/div>\n<\/div>\n<\/span><\/p>\n

      Who should participate (clinicians, caregivers, educators, advocates)?<\/h3>
      \n

      The surveys will include people with experience or interest in caring for older adults. This means dentists who treat older patients, dental educators and researchers, and other health professionals like nurses and physicians who work with aging populations. It will also include caregivers, older adults themselves, and advocates who support oral health or elder care. These three groups of participants (Dental professionals, medical professionals, and older adults or caregivers) bring different perspectives so the group can agree on what skills and tasks are most important for dentists working with older adults.<\/p>\n

      <\/div>\n<\/div>\n<\/span><\/p>\n

      What\u2019s the impact of their contribution?<\/h3>
      \n

      By taking part in this study, you will help shape what skills and tasks are most important for dentists who care for older adults. We are not looking for everyone to agree right away\u2014your unique perspective matters. Differences in opinion help us understand where there is uncertainty and where more discussion is needed. Sharing your honest views will make the final recommendations stronger and more inclusive, so they reflect the real-world needs of patients, caregivers, and professionals.<\/p>\n

      <\/div>\n<\/div>\n<\/span><\/p>\n

      \n

       <\/p>\n

      ASGD Webinar: Strengthening the Geriatric Oral Health Workforce by Defining Specialized Practice<\/yt-formatted-string><\/h2>\n