Licensure Panel Discussion

Dr. Buck Conard Vice Chair, Joint Commission on National Dental Examinations, Huntington, West Virginia (cell)

Dr. Brian Kennedy

WHAT IS A PATIENT-BASED EXAM? Traditional board exam Regional boards/independent state exams High stakes/snapshot

STILL PATIENT-BASED PGY-1 Portfolio True Curriculum Integrated Format

NON PATIENT-BASED Objective Structured Clinical Exam (OSCE) OSCE is one part of the two-part Canadian National Board Dental Examination. There is a written exam and the OSCE. Minnesota offers the exam to their students after they demonstrate specific clinical competencies. Simulators/virtual reality

THE ISSUES Manual dexterity Independent evaluation Protection of the public

THE ISSUE Are states boards comfortable, confident or satisfied with each school’s diligence in preparing the student for unsupervised practice? NO!!!!!

ADA POLICY 64H Resolved, that the Association supports the elimination of the use of human subjects in the clinical licensure examination process by 2005, and be it further Resolved, that the Association transmit this policy to all clinical testing agencies.

ADA POLICY 20H Resolved, that the Association supports the elimination of human subjects/patients in the clinical licensure process with the exception of the curriculum integrated format within dental schools, and be it further, Resolved, that the Association encourages all states to adopt methodologies for licensure that are consistent with this policy.

26S-1 WORKGROUP (NBDE III) ADA Board of Trustees considered report and a proposed resolution from the 26S-1 Workgroup at July meeting Forwarded Resolution 42 to the House of Delegates for consideration in Orlando

RESOLUTION Resolved, that a Request for Proposals (RFP) process be initiated calling for the development of a model portfolio-style examination for licensure purposes designed to assess dental graduates’ clinical competence, including a complementary written/interactive examination to assess issues not deemed adequately addressed in the portfolio model such as ethics and professionalism, and be it further

RESOLUTION cont Resolved, that a new workgroup composed of two representatives from the Board of Trustees, three from the Council on Dental Education and Licensure (one appointee each from the ADA, ADEA and AADB), one from the Committee on the New Dentist, and one from the American Student Dental Association be appointed to oversee the development and announcement of the RFP process in 2011 and consideration of the received proposals in 2012, and be it further

RESOLUTION cont Resolved, that the workgroup meet with representatives from the CODA to share with them their concerns regarding the accreditation of dental education programs and make recommendations that will restore confidence and trust in the processes used to evaluate these programs, and be it further Resolved, that appropriate progress reports be made available to both the 2011 and 2012 House of Delegates.

ASDA Licensure Report Naomi Sever ASDA Vice President

Policy What is a policy?  Merriam Webster definition: A definite course or method of action selected from among alternatives and in light of given conditions to guide and determine present and future decision A high-level overall plan embracing the general goals and acceptable procedures especially of a governmental body

Policy How does ASDA set policy?  Board of Trustees Adopt Interim Policies  House of Delegates from 1972 to 2010

Policy What kind of policies does ASDA have?  A-J, L-N policies organized by subject-matter  Largest subject areas A policies on Dental Education Administration E policies on Dental School Administration and Student Government I policies on Health Status and Health Promotion/Infection Control  72 total policies

Example Policy N-1 Use of Recyclable Materials (1991)  The American Student Dental Association supports the use of environmentally safe and recyclable materials.

Why is it important that ASDA have policies? The beliefs of our association Representatives know how the members stand on certain issues It does NOT have to agree with status quo

ASDA Licensure Policies L-1  Initial Licensure Pathways L-2  Foreign Dental Students L-3  Curriculum Integrated Format (CIF) L-4  National Board of Dental Examiners

Licensure Part I pass/fail  L-4 Policy  “….single exam that is secure and valid for quantitative scoring.”

Licensure NBDE Part II Failure Rate  Joint Commission of National Dental Examiners ASDA has 2 representatives that serve 2 year terms Meet once per year in April JCNDE is NOT the ADA

Part III aka Clinical Licensure aka Board Exams

Clinical Licensure What are the primary concerns about current formats?  Ethics Delayed Treatment Over-exposure to x-rays Clinical inability vs. Bad diagnosis and decision making  High-stakes one shot exam Not necessarily related to clinical performance

Clinical Licensure Board Exams  L-1 Policy ASDA supports “…universal acceptance of all and state clinical licensing exams.” Alternatives

Alternative Licensure Pathways Dental School  Graduates of dental school accredited by Commission on Dental Accreditation (CODA) program should be eligible without any further clinical examination

Alternative Licensure Formats Portfolio Exam  Curriculum Integrated Format (CIF) Supported by both ADA and ASDA policy  Projected to be adopted by California this coming January  More details to come at Annual Session

Alternative Licensure Formats OSCE (objective structured clinical exam)  Assess treatment planning and diagnostic skills  Based on the Canadian Boards  Currently accepted only in Minnesota  Must be a graduate of the University of Minnesota School of Dentistry  More details to come at Annual Session

Alternative Licensure Formats Non-mandatory one year post graduate residency program  PGY1 (Post-graduate Year 1) mandatory for licensure in New York state since 2007

Alternative Licensure Formats Non-traditional patient based clinical exam  Ethical, patient based exam  Not currently in existence