#ASDAne et Licensure 101 Christian Piers, MFA Editor-in-chief Colorado ‘16

The three types of compensation Mastery  Meaning

Agenda Status quo The controversy What’s happened What’s happening

Three requirements requirements 1.Educational -CODA 2.Written exam -NBDE I and II (JCNDE) 3.Clinical exam -Today’s topic!

Where do I start? First, where do you want to live? Find that state boards’ website

Oh, you thought this was a costume party? Only certain clinical exams are accepted by certain state boards of dentistry. CITA CRDTS NERB SRTA WREB

Subtle Differences ENDO – Manikin PROSTH – Manikin PROSTH – Comp / CSW PERIO – Live Pt PERIO – Comp / CSW REST - Manikin REST – Live Pt DIAG Comp Ex COST* CITA XXXX $2500- $3000 CRDTS XXXX$2095 NERB XXXXX$2085 SRTA XXXXX $2300- $2800 WREB XXXXXX $1760- $2360

Is this really the way it has to be?

ASDA Policy (L1: 2013) The American Student Dental Association believes that any clinical licensing examination intended to measure technical skill via a sequence of independent clinical tasks should: A)be a non-patient based examination emphasizing the recognition, diagnosis, and treatment planning of disease, in conjunction with the treatment of simulated disease by use of a typodont. B)be administered in the final year of dental school. C)provide opportunities for remediation, at the candidates‘ dental school, prior to graduation. D)guarantee anonymity of candidates and examiners. E)be administered by examiners who have been calibrated to provide standardized and consistent scoring. F)not include a written examination that duplicates the content of the National Dental Board Examination Parts 1 or 2. G)be offered to candidates at the lowest reasonable cost possible. H)be universally accepted by all state boards of dentistry. I)be psychometrically sound.

ASDA Policy (L1: 2013) While the American Student Dental Association supports continual improvement of existing examinations and collaborative development of a new examination, the association believes the following alternatives are preferable to the current licensure process: A)Initial licensure without an independent clinical licensing examination. Graduates of a U.S. CODA-accredited dental school should be eligible for initial licensure without taking any additional clinical examination. B)A portfolio-type clinical examination based on cases compiled during the final year of dental school. Such an examination should require a standardized catalog of required clinical procedures and the portfolio should be evaluated by an examiner independent of the dental school. C)A non-traditional patient based clinical licensure examination. Although the American Student Dental Association does not support the use of live patients in traditional clinical licensing examinations, the association recognizes the potential for creation of an ethical, patient based examination. D)An Objective Structured Clinical Examination designed to evaluate a candidate’s diagnostic and treatment planning skills. E)Completion of a one year post graduate residency program. Completion of a U.S. CODA- accredited post graduate program that has a minimum duration of one year should be sufficient to substitute for the clinical licensure examination requirement in any jurisdiction.

Ethics 1.ADA Principles of Ethics and Code of Professional Conduct 2.IRB 3.Proper informed consent 4.Recruitment of individuals 5.Patient compensation 6.Price of the exam 7.Manipulating radiographs The controversy

Accuracy 1.Subjective nature 2.One-day one-shot mentality The controversy

“Best Practices” 1.Unnecessary treatment of incipient caries 2.Invasiveness 3.Comprehensive care 4.Delaying treatment 5.Redundancy of content 6.Reciprocity The controversy

What’s happened 2000: ADA favors the elimination of live patients in clinical licensure exams 2003: NY option to do PGY : ADA supports Universal Licensure 2007: NY mandate to do PGY-1

What’s happened 2007: CA, CT & MN option to do PGY : WA option to do PGY : MN option to take Canadian OSCE 2010: CA option to submit hybrid portfolio

Hybrid Portfolio

Hybrid Portfolio Advantages –Psychometric elements of clinical exam –Conducted with patients of record –Longitudinal not cross-sectional –License upon graduation –Reduced stress –Reduced cost

Hybrid Portfolio Disadvantages –California only

OSCE

Advantages –Non-patient based –Reproducible and objective –Less competition to get board patients OSCE

OSCE Disadvantages –License for Minnesota (and Canada) only

ASDA’s PGY-1 Policy: A-1 Additional Year of Dental Education (1983, revised 2002, 2012) “The American Student Dental Association strongly supports high quality dental education, and favors voluntary postgraduate training and the creation of additional postgraduate opportunities. The American Student Dental Association is opposed to a mandatory one-year postgraduate program or the addition of an additional year to the present dental curriculum. The American Student Dental Association supports students having the option to complete an ADA accredited postgraduate residency program in lieu of a clinical licensure exam for the purpose of initial licensure.”

PGY-1 Advantages –Addresses ethical issues of live patient clinical exam –Residency may be paid Disadvantages –Extra year before beginning practice –Not honored in most states

Quiz: Which states offer PGY-1? Select all that apply. A. Michigan B. Arkansas C. Connecticut D. Delaware E. Wisconsin F. New Jersey G. New York H. Washington I. California J. Missouri K. Minnesota L. Ukraine M. Rhode Island N. Ohio O. Utah

Quiz: Which states offer PGY-1? Select all that apply. A. Michigan B. Arkansas C. Connecticut D. Delaware E. Wisconsin F. New Jersey G. New York H. Washington I. California J. Missouri K. Minnesota L. Ukraine M. Rhode Island N. Ohio O. Utah

Quiz: Bonus: Which state mandates PGY-1? A. Michigan B. Arkansas C. Connecticut D. Delaware E. Wisconsin F. New Jersey G. New York H. Washington I. California J. Missouri K. Minnesota L. Ukraine M. Rhode Island N. Ohio O. Utah

Quiz: Bonus: Which state mandates PGY-1? A. Michigan B. Arkansas C. Connecticut D. Delaware E. Wisconsin F. New Jersey G. New York H. Washington I. California J. Missouri K. Minnesota L. Ukraine M. Rhode Island N. Ohio O. Utah

What’s happening ADEA Task Force (Res:5H-2014)  Report ADEA HoD 2015 with recommendations to advocate for transition to validated OSCE.

State-Level Advocacy by ASDA Pillar 1: Reform State Dental Licensure Policies State Dental Associations State Dental Boards State Legislators National Dental Organizations What’s happening

State-Level Advocacy by ASDA Pillar 2: Awareness and Education Educational resources (presentations, website, articles, programming) White Paper Work Plan What’s happening

Questions?

Contact: LinkedIn: ian-piers/78/605/b5https:// ian-piers/78/605/b5