EFDA Employer Assessment Support

This form is to be completed by the current employer-dentist of the EFDA applicant.

The purpose of this form is to evaluate each applicant applying to the EFDA Continuing Education course at The Ohio State University for evidence of the skills needed to become an EFDA in Ohio. Information contained in this form will be held in strict confidence and will be used solely by the course directors in making decisions about annual admittance into this course.

Deadline: Applications, Employer Assessment & Support, and Recommendation Letters must be submitted on or before August 6, 2023. Late entries will not be accepted.

Applicant Details
The following evaluation should be based on demonstrated performance compared to that reasonably expected of an auxiliary at her or his level of training, experience and background.
Questions Poor Fair Good Superior Not Observed
Employer Information
Please include area code. (Ex. xxx-xxx-xxxx)
Employer Support

This course requires that participants complete weekly assignments on typodonts as homework. Homework assignments include completion of amalgam and composite restorations. These assignments require time, facilities (operatory or lab space with handpiece connections and basic supplies), and philosophical support from an employer-dentist. Please indicate, in the form below, the extent to which you are willing to support your employee.

Employer Clinical Support

The OSDB requires EFDA students to complete at least 80 hours of restorative clinical experience.

The EFDA students will be required to complete the clinical hours at their employer, under supervision of their employer-dentist(s).
 

The employer-dentist responsibilities will include:

  • Complete our online orientation/calibration training (approx 1 hour)
  • Supervise the EFDA student when completing restorations
  • Evaluate the student’s restorations following the guidelines we provide
  • Make sure the student has liability insurance (or is covered under the office policy)

 

For questions, please contact the CE office at 614-292-9790 or osucde@osu.edu.

Clinical Hours (Required)

For additional information on the OSU EFDA program, please visit go.osu.edu/efda

Dental Emergency Care Clinic

Monday-Thursday
7:30 a.m.-12 p.m.

Friday
7:30 a.m.-10:30 a.m.

Student Dental Clinics

Monday-Friday
8:00 a.m.-4:00 p.m.

Ohio State Dental Faculty Practice

Monday-Friday
7:30 a.m.-4:30 p.m.

Upper Arlington Dental Clinic

Monday
7:30 a.m.-5:30 p.m.

Tuesday-Thursday
7:30 a.m.-4:30 p.m.

Friday
7:30 a.m.-12:30 p.m.