SDM PH521 Behavioral-transcript (2).pdf

SPEAKER 0 So. All right. Good morning. I know many of you are trying to find your partners. I'm hopeful that as many of you are with your partner as possible, but. I love to see it. Thank you. So if we could take a seat as best as we can, we'll. We'll give some room to move around if necessary. But...

SPEAKER 0 So. All right. Good morning. I know many of you are trying to find your partners. I'm hopeful that as many of you are with your partner as possible, but. I love to see it. Thank you. So if we could take a seat as best as we can, we'll. We'll give some room to move around if necessary. But we have a lot that we want to do today, so we'll go ahead and get started. Today, there's going to be a lot of time for you to work with your partner. And actually, for the next couple course classes, we'll have some time for you to make some important steps in progress and what we'll be doing as we move forward. But today, I'm really excited to be here with Miss Sarkis, and we have a really interesting class for you today that's linking something you might be really familiar with, with something we're learning. So as we start out with any lecture in this course, we'll give you some objectives. So today we'll be thinking about how this relates to ethics and professionalism. So what how does behavioral science fit into the puzzle. That will be my first clinical visit. And we'll start with an example. So you're sitting in your office and you get a knock on the door. It's your hygienist. You've worked with her for some time and she says, hey, uh, so I have Brian in my chair, and Brian promised me last time, and he promised you two that he was going to take X-rays at this visit. He said he was going to do it and now he's refusing. And we really haven't taken X-rays on him in about three years. And she asks you very seriously, what do you want me to do? So let's ask you. How do you respond? I'm kind of. Yeah, that's what I do, so I can. And if not, if you're not with your partner right at this minute, we'll give you some time to move. So if you could just take a seat and then we'll give you a second. Thank you for those who are trying to find them. We've got about 31 people logged in. I'd love to know what we think. So she. And what is your action? Closer to 54. 57. 68. All right. We're a little over 100. Let's take a peek. Have a conversation with the patient itself. So we're going to continue with this scenario. But as we do, we'll talk a little bit about how this situation and others can link to the concept of ethics and professionalism. SPEAKER 1 Can you hear me now? Yeah. It's good to to see you. I've been seeing a lot of the DMD two class in IPM two, which I've really enjoyed. Um, and we're going to. But for the as one class, I haven't seen you since the fall. So just to kind of link to what we have done, um, in your first year. Um, we're going to talk about professionalism as kind of the overarching umbrella, the importance of communication for the dentist as being part of being a professional. Uh, ethical issues versus ethical dilemmas. And we're going to look at those Ada principles of ethics again, briefly. Yeah. So here are just a couple of definitions. Simple definitions of professionalism. Just to kind of re-awakening your thinking again about professionalism and what it means. So the skill, good judgment and polite behavior that is expected from a person who is trained to do a job well, another definition is professionalism is commonly understood as an individual's adherence to a set of standards, code of conduct, or collection of qualities that characterize accepted practice within a particular area of activity. So it's a very broad umbrella. It encompasses ethics as well as actually doing your professional, um, obligations. So it involves a knowledge base. And in this class you're certainly getting a knowledge base in terms of behavioral sciences skills, which we're going to try to workshop a little bit this morning. And you continue to do in this class. And then your behavior and that all encompasses professionalism. I just wanted to put this slide up quickly. It's from a D.A. and it's looking at, um, value based statements defining professionalism in dental education, what you want to try to achieve as you graduate. So competence. Fairness, integrity, responsibility, respect and service mindedness. So again, the professionalism umbrella is a broad one that covers a lot of skills, knowledge, skills and behavior. In terms of the importance of communication. Effective communication is extremely important in dentistry, which I think is being well illustrated in this class. And there are many different variables that affect communication, including your values, your personal values, your training, your personal experiences, culture, language. Um, you want to focus on effective, clear, um, concise, complete and timely communications as a professional. And there are many potential barriers to communication, many of which you might have already experienced yourself in your own life. They can include language, varying communication styles, and conflict. And here's just an image of professionalism being that umbrella over accountability. Altruism, which is really thinking about the best interests of the patient doing something, um, generous minded, um, excellence, humanism and the the base of the whole structure are your clinical competence, your good communication skills, and your sound understanding of ethics. Just to remind you quickly, from our first year, there are different types of ethical issues we face in practice. I would say around 90% of the ethical issues doctors face in practice are, um, right versus wrong ethical issues. And they're called compliance based issues where they're not really any true ethical dilemma. You are simply being tempted to do what you know or you intuit or you think might not be right. Then we have true ethical dilemmas which are right versus right where which is values based. And there is no really clear right answer when you're trying to decide which is an ethical issue or an ethical dilemma. Um, you can use these types of tests if you know it's against the law, you know, it's an ethical issue and not a true dilemma. Um, if if you look at your the Ada code and you see the code makes it clear what your behavior should be, you know, it's an ethical issue and not a dilemma. If in your gut you feel that you're being tempted to do the wrong thing, it's an ethical issue and not a dilemma. If you knew your decision was going to be posted on the front page of or all over social media, I should say I was going to say the front page of a newspaper, which is kind of an old concept now, or if your role model or your mother was being told about your choice and you felt uncomfortable and you wouldn't want it to be widely known, then that's a good indication. It's probably an ethical issue where you're it's a compliance based issue where you're tempted to do something that you know you really shouldn't. So to determine that if it's right versus wrong, you or a true ethical dilemma, you really need to look at sources of professional standards and also legal requirements, which can vary sometimes from state to state. And these sources are prohibitive. And they they basically describe what you should do and how you should comply as a professional. Um, and here are some quick sources for professional standards. The American college and the Ada, um, and for legal requirements. There are state laws and federal laws, certainly, um, dental regulations based on the State Dental Practices Act. And your state in which you're licensed are a good source of information. So and generally in professional ethics for you all as dental students is you must put the best interests of the patient before your own interests and making a decision quickly just to remind you of what the principles are. So we have beneficence. Non Maleficent's. Justice, veracity and patient autonomy. Respecting the patient's right to self-determination and confidentiality for autonomy do no harm for non malfeasance. Promote the patient's welfare. Do good. For beneficence. Justice is fairness and a duty to treat people fairly. And finally veracity to communicate truthfully, which is very, very important. And we'll talk about that. Um, so onward to Doctor Mara for what would you say and how would you say it? SPEAKER 0 So 73% of you said that you would have a conversation with Brian yourself. So I want you to give me a sentence, a few words. How would you start that conversation? I'll put the number up for those who can't see it. And in about a minute we'll be doing attendance. So just so you know, if you're going the restroom, you might want to hold off. So the scenario that. Is thinking about Brian, who was your patient who's refusing dental X-rays? So for those who are coming in late, 73% of your classmates suggested that they would have a conversation with Brian themselves. I want to know, what would you say to a patient who isn't getting their x rays and needs them? The standard of care suggests they should get their x rays. You can type that. As I pull this up, I just want to make sure we don't have the same issue as last week. SPEAKER 2 Uh. SPEAKER 0 Yeah. I didn't get rid of the attendance link. I'm just trying to do both things at once. So if you have signed in, great. Thank you. If you haven't, keep trying. I do want you to answer the question. Okay. So only seven of you have. Back. Is that better? You got it. Okay, cool. I still see way less than, like, a third of the class responding to the question. So we're going to pull up some of those answers to what you'd say to Brian. The QR code. For just another minute it looks like almost everyone was successful. SPEAKER 2 Mhm. Mhm. Yeah. SPEAKER 0 Not sure. All right. So. SPEAKER 3 Doctor Maxine Storm has been Cindy's regular dentist for the past eight years. SPEAKER 4 So, Cindy, how have you been? SPEAKER 5 Pretty good. SPEAKER 4 You've grown up a lot since I last saw you. SPEAKER 5 Yeah. SPEAKER 4 So your chart says that you are due for some x rays, and your mom said that that would be fine. So I'll have my assistant come in and get you for those in a minute. Your mom said you've been brushing and flossing and that you haven't had any new problems with your teeth. Would you say that's right, Cindy? Is something wrong? What is it? SPEAKER 5 What's that sign for? SPEAKER 4 Oh, that's just there. Because certain care or medications we provide could be harmful at various stages of pregnancy. So I'll just have you wait here for a few minutes. SPEAKER 5 I think I'm pregnant. SPEAKER 4 Have you seen the doctor? SPEAKER 5 No. I got one of those home tests and it said I was. Cindy. You can't tell my mom, okay? SPEAKER 3 Well, how should doctor Tom handle this situation? What are the ethical and professional issues raised by this scenario? You may pause the video to consider this question. SPEAKER 0 So let's as we practice and as I promised, we will have one test like question at every lecture. And this is yours for today. Once you've answered this question, I want you to go on to blackboard. And there are two things I'd like you to do. The first is that there's a document in the content subfolder that I want you to download on your device. Once you've answered this question and we're getting close to everybody there. So let's see. Oh, interesting. Can someone who said she's in the pre contemplation phase tell me why. It's a lot of you. I can't tell exactly the number because I put this 46, okay, 46 and 47. So who's in that 46? Who wants to tell me why she's in the the pre contemplation phase. Almost half of your peers in the room agree with you? Yeah. Tell me. She's not decided. She wants to tell her mom now. Thinking back. To the definitions from last week. I want you to think about what you just said. She hasn't decided if she wants to tell her mom. SPEAKER 2 She said something. SPEAKER 0 Oh, so she's aware, so she knows she has a problem, or she has something that she needs to make a decision about, right? If you're aware that you need to make a decision about it. Are you in pre contemplation phase? No. You're in what phase? Right. So thinking that, you know, you have an option. And now what we're going to do is I'd like everyone to go to blackboards content folder, as I was saying, and download a case study. And in that case study document, I want you to open it on your computer, as Miss Sarkis presents a couple of different options to think about. What would you do? SPEAKER 2 Just drag that. Yeah. Perfect. Great. SPEAKER 1 All right. Well, it was interesting seeing your reaction to watching the video. It's, um, watching the practitioner's face was interesting, right? Um, but it's also nervous making. Right. What if you or that practitioner and you have a young patient like that? Um, so what could possibly be the choices? One is to do nothing, leaving Cindy alone with the matter. And remember, when we are faced with any kind of ethical issue or dilemma, we really need to generate all possible courses of action, good and bad. So that's the goal here. The second would be try to convince Cindy to discuss the possible pregnancy with her mother, because we know in the case that Cindy thinks she's pregnant, it's not necessarily something that's been confirmed. Um, you could inform Cindy that you must tell the mother. If Cindy doesn't tell her herself. You could offer to tell the mother so Cindy will not have to disclose the pregnancy herself, giving her support. You could arrange for Cindy to see a physician to make sure of her condition, which is a challenging option in and of itself. Um. Or you can inform Cindy's mother in spite of Cindy's objections. And ultimately you could do a possibly. Oops. Sorry. SPEAKER 0 It's okay. SPEAKER 1 Really screwed that up. Um, you can tell the differences in our ages, right? SPEAKER 0 I think it's the rain today. We're not. SPEAKER 1 There we go. So. And and one possibility, too, is to do a combination, um, trying to maybe combine a couple of these options together, and I'm not going to touch the slides again. Should I advance or. Okay. We're good. SPEAKER 2 Um. SPEAKER 0 So now that we we should all be sitting in a minute, what we'll be doing is looking through some of these different options and working with our partners from our written assignment in the download that you just downloaded from blackboard, everyone was able to see it. Yep. It goes into further analysis or more information about your different options. And towards the end of the document, it asks you to then submit something via a web link. That link may or may not be working perfectly, but a link is available within the content folder. We're going to spend 20 minutes now working with our partners, reading through that document and selecting which option or options, as Miss Sarkis mentioned, would be what you and your partner would agree is best to move forward once you've selected an option and came to an agreement, we're assuming that might take a little bit of time. You're then going to follow the instructions on the bottom to start describing what would you actually say? What would you actually do? Any questions about what we'll be working on for the next 20 minutes? If you are not with your partner, you will be able to move to them. Now if your partner is absent, I think there are a few of you who have sick partners or different reasons. Maybe if you came to this general area you'd be able to find someone to work with. For today, I want you to practice collaborating as part of what you will be doing over the next week. As you prepare for the first submission of that first paper next week. Sound good? I'll turn the lights back on. All right, let's go. SPEAKER 1 Just to clarify for everybody, the patient is a minor. UNKNOWN For. Yeah. Okay. SPEAKER 0 So I think we're just about ready to come back together as a group. I know I didn't we didn't give too many instructions on who should type in the Excel document or how many people what we're going to do a quick overview and then we're going to practice. So some of you are asking, why am I sitting next to my partner for the written assignment next week? And the reason is, is because you're going to be working on something totally different. It does not relate to today's course, except for the transferable skills you working with your partner, you coming up with a solution and you scripting what you're going to say. Because when I think about the assignments that you're working on in this class, I want it to be things you would actually feel comfortable with coming out of your mouth. Right? Because this is practice. Because as we started this course, you'll be seeing patients very soon in the treatment center. So when I think about the different options and I look at the option tab, very few of you chose option one. An option one was to. Do nothing, right. There's one group, I think, that says that they want to do nothing, right? They want to call their lawyer. But as as Miss Sarkeesian, I mentioned the goal of today's class. And please feel free to turn. SPEAKER 1 I was going to say you. You can't call me on speed dial at this particular point. SPEAKER 0 There's a there's a hefty fee for that, I think, too. Right. But in all seriousness, today is not the day to talk about. It's to be mine, grounded in ethics and professionalism. And you'll get to practice a lot more of health care law concepts with Mr. Case next semester in the fall semester. Yeah, I. SPEAKER 1 Just wanted to say that we don't know the age of Cindy. And it can vary by jurisdiction. So in Massachusetts it's typically like 16 years old. Um, but there is this situation. There is no confirmation that she's actually pregnant. It's something that she thinks that she is. And this is what the dentist has to deal with in this circumstance. So of course there are legal circumstances that you worry about. But as Doctor Mara was saying, the point is, is what would you say to open up the conversation and how will you engage in an active way, Cindy, and having this conversation? SPEAKER 0 And I don't know how you feel about this, Mr. Keyes, but I think when you're faced with the situation in the chair or you're in the treatment center and maybe Doctor Shake kind of to chime in, too, from a health perspective as well. We if you don't know the answer to something, are you expected to have the perfect well thought out answer right away? We're not robots, right? I think that one thing that we talked about last week is the difference between compassion and empathy, right? And we talked about how empathy is actually what research suggests is the most effective way to communicate with our patients, to motivate them to a behavior change. Right. But we know compassion takes empathy one step further, where we're no longer just feeling someone's suffering, but we're trying to solve it for them, right? And I think I had some interesting conversations. I don't know if you all did too, or who you were talking with with your partner, is that this concept does play into how we formulate questions. Right? So from my understanding of what Misaki said, we really don't know if Cindy's pregnant, right? We need more information or she needs we need confirmatory tests, right? To know that she's actually pregnant. But there's a ways that we're going to approach conversations and think about conversations with an empathetic lens, right, where we're thinking about how we can and what we can say. To target and to move our conversation to whatever our goal is. And that's why this exercise had these different options of thinking about where we want to go. And for some of you, and I don't think it's totally unreasonable, is when you're in a situation where you need a minute, that you take a minute. The worst outcome. If you felt like, you know you're totally overwhelmed by this situation, or you don't know where to move forward, or you're worried you're going to say something that you're going to regret, right? Taking a step away isn't bad. And that's why maybe this answer isn't as kind of laughable as I think someone said as we read it on the screen. I mentioned this in the first and second class. I can't make you be robots of what you're going to say in every situation. That's not the intent of this course. The intent is to think about how we're going to say something, to progress towards a goal, and to try to produce as few roadblocks along that path as possible. So for you, if a roadblock is going to be saying something that you're not comfortable saying, I think it's reasonable to step aside. Maybe not call your lawyer, but maybe talk to somebody else. Especially when you're in an institution of learning, you have tons of people you can go and talk to, and you can gain the support you need to feel more comfortable moving the needle forward. SPEAKER 1 I just want to fully agree with that. And you definitely can call me on speed dial for an ethical issue to really, you know, step back and to take it in and be reflective. And there's nothing wrong with that. Um. It's. The point is, is what you're practically going to be saying to the patient at this time. I think it's it's, you know, just to reassure them or to connect with them. You don't want to take a minute and not say anything to them, like run out of the room. SPEAKER 6 I would say, right. SPEAKER 0 So we'll put up a couple of different answers that you all wrote in generated in this document. And I want you to read kind of within option two. So what's option two again? Try to convince her. Which of these options sticks out to you? Because not only do we hope to practice this today, but we want to find some good and bad examples and maybe create a resource for you to think about how you might approach different conversations, even with the first couple of words. So one that stood out to me and said, I think. One of them said something about being anxious, right? This conversation, this topic made you feel. Oh, yeah, I noticed this topic of conversation made you anxious. Someone said that to you, how would you feel? Are you going to double down and feel more anxious than you probably already were? Do you think that that's the most effective way? What is that person trying to do? Who wrote that? If you want to out yourself, you can. If not, we can talk about you anonymously. If. What are they trying to do? Which is actually correct? Be what? Being empathetic, right? They notice someone's anxious. But if you're about to take like a really hard exam and someone tells you, like, you look really nervous, how's that going to go over? It's probably not going to go over super well. Right? So I think we have to think about how we can capitalize on being empathetic, but not necessarily with doing that. But I like the approach, right. Because we're thinking about how we're going to motivate right off the bat with a way that we're connecting with our patient. Is there something else in this column? And you guys can all look on the on the link as well. Is there is there another starter that feels a little bit more. Something that you would feel comfortable saying that you don't think would create an adverse reaction. What do you think? I mean, 2726. I appreciated that you confided in me today. How would that make you feel? Make it better. Yeah. I mean, okay, we can do it too. So I think that that right away is going to make you feel settled, right? Heard listened to. But I think the harder part is what's actually coming after you say that, right. That could definitely go in your toolkit of things that you should say. I appreciate you telling me that. I realize that might have been difficult, but that doesn't quite move us to numbered option number two, does it? It's what I wanted to see, right? It's what we wanted to see. We want to see how you can connect and be empathetic with your patient. But is that moving us to try to persuade her to tell her mother? So what do they write after? Have you considered disclosing this information to your mom? How does that make you feel? SPEAKER 7 Which is already saying that he cannot tell. SPEAKER 0 She's already told you so. When you go to a store or when you do something and you're like, oh, I already I think for some of you maybe that are parents in the room, right. Which I can really relate to that if you go somewhere and you tell your story and someone's supposed to already know your story because you're going to the same place again, how does that make you feel when you're, like, repeating certain things you've already said? Like they're no one's listening to you. And if someone's not listening to you or you being empathetic. Absolutely not. Right. That's the examples we talked about when you're not actually zoning in on the patient that you're talking to, when you're not actually listening to what they're saying and demonstrating that you're listening. So the second part of that sentence, even though it started really well, probably isn't as strong. Is there anything else on this list that you see maybe that I can scroll to that has a second part that once you establish some initial empathy, that then moves you towards the direction that you're trying to go. 31. It's important to tell your mom about it so you can have the proper support. SPEAKER 8 Yeah. SPEAKER 0 She knows that. Okay. So Miss Serkis presented these options, right? And we presented these options together. Where? I had some interesting conversations and I don't know if you all did too. Where sometimes when we try to go directly to what we want to fast, what happens? We get lost, right? We get a roadblock. We might not actually accomplish what we want to because we're being overly direct in what we're saying. I like elements of that sentence. Does anyone have an idea how you might change it? To be a little less direct. Yeah, I want to. Hmm. Did everyone hear that? She said. Can you tell me why you don't want to tell your mom about this? And that's interesting for a lot of reasons. Does anyone have an idea why? She's scared. Why would she be scared? I mean, apart from actually being pregnant is probably very scary. I don't I can't relate to that. She. What? She might have a bad relationship with her mom, right? She's a minor. And there's a chance that we don't know because we don't have all of the information here. That there might be potential abuse, right? So I think sometimes before we even start taking a question and thinking about where we're going to categorize this, right, where does it fall on my Excel spreadsheet? We have to still think of what other information we need to collect. To make the best informed decision based on what you know. And to help move patients to that outcome that we're trying, that we established after we think about what the potential outcomes are, that's going to be best for you, for the patient, primarily, right, and for you to navigate them to. Anything to add to that. So I'm interested to see and this is part of like this experiment too, is that there's a final tab. We made our own option. Oh there's a lot of you that made your own option. Any numbers stand out to anyone here. Okay. I wonder if there's like a rap text. Can I do that? What do you like about 13, Mr. Keys? SPEAKER 2 From the beginning. Yeah. SPEAKER 1 I like that. Um, identifying that you've actively listened and to make the patient more comfortable. I think it's tough on this tab, because there isn't a lot of actual conversation that people have added, but they just want to combine two options, which makes a lot of sense. And for those of you who are feeling kind of anxious around, like actually having this with a patient, the good thing is that, you know, in talking about these types of things in school, you're really building your awareness and your toolkit. Right? So this is a this is might be stressful a bit, but it's an empowering exercise that Doctor Myra is providing and has through this course. So. SPEAKER 0 And I think I totally agree with some of the answers. And that is probably because it's tricky, right? How do you start a conversation when you're pulling together lots of different options? But I don't know about you, but when I was walking around, a lot of people also felt very strongly about four. Is that true? Yeah. So let's look at number four, because I see some things that maybe are that we could combine and consider as we move towards the we made our own option. Anything jump out and it could be something that's not on the screen. It could be on your screens too. Say 14. Someone said that? I want you to not only think about this, is looking at what option you think is best, but what options you could speak out of your mouth, right? I understand this might be uncomfortable, but it's important to be supported by your family through a pregnancy. What do you think? So as a dentist, one of our at least as a general dentist, right? One of the most rewarding parts for me is that and for those of you who have practiced before, and probably those of you who are seeking to go into this profession, as we get to see the same people over and over again. Right. So there's a lot of context to this scenario that we didn't talk about that could influence the way that you provide information. And as you move towards your written assignments in this course, there's no I leave them open ended. Right? Because I'm not saying, you know this or you don't. I don't know if these patients have been patients of record for you for one minute or for 20 years, right? That's something you can come up with and agree to as you create your scenario of how you're probing into these questions. Right. These are situational pieces of situational context that could influence how you say something, right? Because we all know if we know someone and we go up and talk to them, we might feel we might approach them in a different way than we would approach them when we never knew before. We don't know before or we've never had a conversation with. Right. So I think this answer, whatever one I just read out loud kind of to me as I read it, makes me feel like I know this family a little bit, right? And sometimes we have to be careful when we do that too, right? I don't know. I was saying something in the back. You guys have all watched, like, 20, 20 or like Dateline, right? Or some kind of a show where there's someone that does something horrific that you never really thought that they would be the person that did it. And sometimes we don't get a total glimpse into everyone's lives as we formulate these conversations, but I think we can include some situational context that we might know and how we emote and build that empathy. And I think that's what that person is trying to do, right? Do you agree? Are there any that do that in a little softer way on that list? Do you know what I mean when I say that? A little less direct, maybe a little more general. Because support is important, right? It might not be familial support because if there is some some subjective abuse or anything going on with this, this with Cindy. You know, saying something like family could actually make it worse, right? So as we think about words, we want to craft our word choice in a way that doesn't isn't influenced or biased with our own thoughts and perceptions about the relationships that we're building, but are as general as possible and encouraging as possible to think about empathy. Right. And for those of you who we've worked with in the first year, of course, we think back to kind of the way that we positively frame situations. And this is a situation that's kind of harder to frame positively, but we want to focus on an outcome that we're moving to in a generalizable way that's encouraging, and that makes the person feel like they're supported regardless of their own individual situations. And that's why we talked about factors like social determinants of health in the first couple of weeks of this course. Right. Other things that are outside factors that could influence our own behavior. So by saying something more generic about having support necessary, I want to make sure that, you know, my goal is that you feel supported in any way that you think that you'll need or support that you'll have, keeps it a little bit more general without relating it to something that could be a pressure or sensitive point. Did that come across? Clearly? So there was twos. There was fours. What about fives and sixes? Do we get any? Not as many. But I think this option is interesting because when we were doing this, we were preparing for this lecture today, I didn't really think option five of something like jump to my head, but it makes good sense, right? Are there anything here on option five that. You think stands out. Confirm the pregnancy is option five, but how would you present that? Ask her to do blood work. How many dentists are doing blood work for their pregnant patients? Probably not them. SPEAKER 2 To be. SPEAKER 7 Able to do that. Your referral for optimal health without the consent of the mom if the patient is a minor. SPEAKER 2 Are we? SPEAKER 1 Yes. So again, this is complicated. It depends on the state. But there are there could be in your state. Um. Absurd in clinics, even possibly, as one of your colleagues here pointed out to me, even in high school situations with a school nurse, there might be services accessible to a minor that you don't have to specifically. I mean, you refer them to, but, um, their insurance doesn't need to be taken. Um, and a parent or legal guardian might not have to be informed. It it depends from state to state. Sometimes there are public health regulations that allow you, um, minors without parents or guardians to be informed, to get birth control or get help for STDs. So it can vary. But the point here is, without thinking about those types of things, um, it seems very reasonable to try to provide a resource, um, in the community to a patient, and that could be for really anything. Um, it doesn't have to be a pregnancy. Um, if, if a patient is scared at home or shares that they're an abusive situation for any number of reasons, you might, um, really have a duty to share with your patient what resources there are in the community. So that's something to think about as you prepare to practice in a jurisdiction. Really. And if you're if you have a if you go into pedo, if you have a lot of pediatric patients, um, you should educate yourself about what resources are available in the community. So I think it would be a good thing. Um, and obviously you might not know and you might need to take a minute. You could potentially follow up with Cindy. But from a practical point of view, if you're going to refer to a physician and the minor doesn't know, they're actually pregnant, it's hard not to include a parent, particularly if they have health insurance and you're going to use the insurance. So that's part of the reality. SPEAKER 0 That's really. SPEAKER 2 Good for. SPEAKER 0 To where we'll be going in this course. The last lecture is really focusing on referrals and thinking about how, as dentists, we can partner with folks to help influence behavior change, knowing that we're not always going to be the one that's going to make the most significant impact or change. But sometimes having that information or presenting it in a way that it's an option for them can really make a meaningful, meaningful impact. SPEAKER 1 And it really supports professionalism and being ethical because you're being, you know, providing those services to patients really supports being just and truthful. And it really helps patient autonomy because it helps provide patients with information and a sense of control, potentially in their lives, to give them other sources that are going to really help them and help their health. UNKNOWN Uh, I have a question. SPEAKER 1 So Planned Parenthood would provide all the options available to a young person. SPEAKER 0 I'm glad you answered that question for me. Um, so I just want to thank Mr. Keyes for coming today and actually, really, all of you in the conversations that I overheard today. I think this sets a really great ground level understanding of how we're going to work with our partners and where we're going. So just a few announcements as we close out our class today. Um, pretty good job. Really nice job. Continued. Good job on our discussion board number two. But we're pausing discussion boards for a little bit. If you look back to the syllabus and moving towards our written assignment. Number one. Those of you who are doing really well in discussion boards are looking carefully at the rubrics. I need you to make sure you're looking really carefully at the rubrics as you submit your written assignment. Number one, by one week from today at midnight. That assignment has multiple parts, right? So it's one that you want to make sure maybe you have ten minutes as you sit next to your partner right now, you start planning and making your plan of attack for completing that assignment in a meaningful way. There are three parts, okay. The first part is to script out what you're going to say, and there are requirements. The second is to record it on the FAQ that's posted. People have asked me, do we have to be in person? The answer is no. You can do the recording on zoom, but you're also welcome to do it in person together, if that's what you prefer. But the third part, this is very critical. Your reflection should not be the same as your partner. Is that understood? That you need to make sure you're looking at the rubric for the requirements that you're including, because there is a task where we start seeing how this is relating to some of the information that we've learning in this course. Yeah. Can you? Is it due on Friday? It says Sunday. Okay, Sunday is fine. Okay. Hold on. I want everyone to hear the answers to the course. Can you just email me that? Sarah. So I make sure I update that on every document. Yeah. I can't hear you. How long do I expect the videos? You have a script length requirement, so your video should be your script length. That's why I didn't give you a minutes or times. You might talk faster, Pim, than everybody else, right? That's fine. Okay. Other questions. Yeah. I want everybody to hear this. So we don't have as many questions too. Yeah. Is the script double spaced. I have to look back to answer that in FAQ. I feel like I gave very specific things for a reason. Double spaced two pages is really one page, right? So I don't know if you'll be able to get through everything I want you to practice, but you could do like a space in between the authors. Yep. One day. Yeah, I'll post a couple one more. I got like one minute. Okay. So I'll make sure I update the FAQ. Sarah's going to send me an email that's going to make sure I address the actual due date. I think giving you till Sunday at midnight is fine. Um, I think that there was some changes to the schedule that that's why it was there. So we'll do that if there's any inconsistencies. And thank you. Have a good one. Have a good week.