Should the U.S. Adopt a National Dental Clinical Licensure Examination? Two Viewpoints: Viewpoint 1: National Licensure Would Provide Multiple Advantages for Practitioners and the Profession and Viewpoint 2: Licensing Authority Should Remain Under State Dental Boards' Jurisdiction.

This Point/Counterpoint article examines the need for and potential impact of implementing a national clinical examination for initial licensure in dentistry. Viewpoint 1 supports a national licensure exam that meets the clinical exam's credentialing requirement for licensure in every state. According to this viewpoint, a national exam will reduce costs, enhance portability of graduates, simplify the transition from dental school to practice or specialty training programs, and standardize requirements for licensure between states. Viewpoint 2 opposes a national licensure exam. This viewpoint supports individual states' dental board decision making process, which is based on identifiable state-specific criteria. The ability to prioritize needs at the state level allows for higher exam standards, easier modifications, more focused requirements, and better calibration in specific exam areas. Viewpoint 2 argues that the delicate balance between licensure agencies and organized dentistry in each state, as well as the involvement of dental schools in the licensure process, must be preserved. This Point/Counterpoint concludes with a joint statement about the prospects for adoption of a national licensure exam.

U.S. Dental Schools' Preparation for the Integrated National Board Dental Examination.

An Integrated National Board Dental Examination (INBDE) combining basic, behavioral, and clinical sciences will be implemented in 2020 to replace the current two-part National Board Dental Examination required for all candidates who seek to practice dentistry in the U.S. The aims of this study were to determine how U.S. dental schools are preparing for implementation of the INBDE and to assess their top administrators' attitudes about the new exam. A total of 150 deans, academic deans, and other administrators at all 64 U.S. dental schools with graduating classes in 2016 were emailed a 19-question electronic survey. The survey questions addressed the respondents' level of support, perceived benefits and challenges, and planned preparation strategies for the INBDE. The individual response rate was 59%, representing 57 of the 64 schools. Approximately 60% of the respondents either agreed or strongly agreed that they support the integrated exam, while roughly 25% either somewhat or strongly disagreed. While most respondents (72%) reported that their institutions would be prepared for the INBDE, 74% reported that the merged exam created additional strain for their institutions. Respondents reported viewing content integration and clinical applicability as benefits of the INBDE, while required curriculum changes and student preparedness and stress were seen as challenges. Most of the respondents reported their schools were currently employing strategies to prepare for the INBDE including meetings with faculty and students and changes to curricula and course content. The beginning of the fourth year and the end of the third year were the most frequently reported times when schools planned to require students to take the INBDE, although almost half of the respondents did not yet know what it would be required at their school. Several schools were reconsidering using the boards as a passing requirement. This study found that support for the INBDE was not universal, but strategies are under way to prepare students, faculty, and curricula for this new means of assessment.

Trends in Generalist and Specialty Advanced Dental Education and Practice, 2005-06 to 2015-16 and Beyond.

This article reviews the data on advanced dental education for the past decade and explores what advanced dental education might look like in the years leading up to 2040, including how its graduates will address the oral health needs of the population. The authors based these projections on published data about advanced dental education collected by the American Dental Association and other organizations. Nevertheless, a certain degree of speculation was involved. The article presents current data and trends in advanced dental education, environmental factors impacting advanced dental education, and lessons drawn from other areas of health care that support the potential scenarios that are described. This article was written as part of the project "Advancing Dental Education in the 21st Century."

Establishment of a dental license regulation authority is required in Korea: results of the Delphi technique.

PURPOSE: In addition to dental education, a system for the evaluation and management of dental licensing and certification is required to meet the growing societal demand for more competent dentists. In this study, the Delphi technique was used to gather opinions from a variety of professionals on the problems of and remedies for the dental license management system in Korea. METHODS: Delphi surveys were conducted from April 2016 to October 2016 in South Korea. A variety of dental professionals were included and categorized into 3 groups according to their expertise as follows: the basic dentistry group, the clinical dentistry group, and the policy group. The Delphi technique was conducted in 3 rounds of e-mail surveys, each with different questions that probed with increasing depth on the dental license management system. In each successive round, the responses were categorized, scored on a Likert scale, and statistically analyzed. RESULTS: After categorizing the results of the first survey and ranking the results of the second survey using the Delphi technique, regulation by a licensing authority was found to be the most critical issue. This was followed by the license renewal system, continuing education, a tiered licensure system, improvement of foreign license approval, and utilization of retirees, in decreasing order of importance. The third Delphi survey showed a similar ranking, with regulation by a licensing authority being the major concern. Opinions regarding the dental license management system were provided as open-ended responses. The responses of the 3 groups showed statistically significant differences in the scores for the issue of regulation by a licensing authority. After re-grouping into the dentistry group and the policy group, the issue received a significantly higher score in the dentistry group. CONCLUSION: The quality of dental treatment should be managed to protect patients and dental professionals. For this purpose, the establishment of an independent license regulation authority along with legislative changes is required.

Establishment of a dental license regulation authority is required in Korea: results of the Delphi technique / 보건의료교육평가

PURPOSE: In addition to dental education, a system for the evaluation and management of dental licensing and certification is required to meet the growing societal demand for more competent dentists. In this study, the Delphi technique was used to gather opinions from a variety of professionals on the problems of and remedies for the dental license management system in Korea. METHODS: Delphi surveys were conducted from April 2016 to October 2016 in South Korea. A variety of dental professionals were included and categorized into 3 groups according to their expertise as follows: the basic dentistry group, the clinical dentistry group, and the policy group. The Delphi technique was conducted in 3 rounds of e-mail surveys, each with different questions that probed with increasing depth on the dental license management system. In each successive round, the responses were categorized, scored on a Likert scale, and statistically analyzed. RESULTS: After categorizing the results of the first survey and ranking the results of the second survey using the Delphi technique, regulation by a licensing authority was found to be the most critical issue. This was followed by the license renewal system, continuing education, a tiered licensure system, improvement of foreign license approval, and utilization of retirees, in decreasing order of importance. The third Delphi survey showed a similar ranking, with regulation by a licensing authority being the major concern. Opinions regarding the dental license management system were provided as open-ended responses. The responses of the 3 groups showed statistically significant differences in the scores for the issue of regulation by a licensing authority. After re-grouping into the dentistry group and the policy group, the issue received a significantly higher score in the dentistry group. CONCLUSION: The quality of dental treatment should be managed to protect patients and dental professionals. For this purpose, the establishment of an independent license regulation authority along with legislative changes is required.

"Practical skills" - Positioning of the GMA committee for dentistry.

The GMA committee for dentistry of the German Society for Medical Education (GMA) considers its' main purpose the representation and interconnection of all aspects of dentistry with and within the GMA. Teaching and assessing practical skills during training is traditionally of great importance in dental education. This is also reflected in the National Competence Based Catalogue of Learning Objectives for Dental Education (NKLZ). Practical skills are not comprised in a separate chapter as they are in the National Competence Based Catalogue of Learning Objectives for Medical Education (NKLM), but are considered in all sections of the NKLZ for the purpose of interdisciplinary patient- or disease-specific application, targeting the educational level of acting competency. The implementation of the associated joined interdisciplinary integrated educational concept has undoubtedly been a challenge for dental curriculum development against the backdrop of German Dental Licensure Act dating back to 1955.

The Buffalo Model: Shifting the Focus of Clinical Licensure Exams in Dentistry to Address Ethical Concerns Regarding Patient Care.

Most jurisdictions grant dental licensure to graduating students following successful completion of a clinical exam. Testing agencies, which are independent of dental schools, nevertheless conduct their exams at school facilities. Patient participation in these exams raises ethical concerns regarding such issues as unlicensed providers' performing irreversible procedures with minimal supervision and graduates' limited accessibility to provide follow-up treatment. To address these concerns, a collaborative effort between University at Buffalo School of Dental Medicine faculty and testing agency personnel was launched. The aims of this article are to describe the development and implementation of the resulting Buffalo Model, to highlight ethical advantages in its application, and to identify areas of improvement to be addressed in future iterations. With the Buffalo Model, modifications were made to the traditional exam format in order to integrate the exam into the school curriculum, enabling candidates to take it at various points during their fourth year. In addition, after calibration of school faculty members, 98.5% of cases verified by faculty were accepted by the Commission on Dental Competency Assessments for use in the exam. In two cases, restorative treatment completed during the exam did not meet the school's competency standard. This new approach ameliorates ethical concerns associated with clinical licensure exams because treatment is provided only to patients of record within a sequenced treatment plan and timely and appropriate treatment is provided to all patients. The results of this first year of implementation also suggest that calibrated faculty members will not show bias in the selection of lesions or competency evaluations of candidates.

Attitudes and perceptions of U.S. dental students and faculty regarding dental licensure.

The aim of this study was to assess the attitudes and perceptions of U.S. dental students and faculty members about National Board Dental Examination (NBDE) pass/fail reporting, an Integrated NBDE, clinical examinations, licensure process and strategies, and validity of licensure. A survey instrument consisting of ten statements with response options on a five-point Likert scale and a free-text comment section was developed and distributed through SurveyMonkey. A total of 411 students and 186 faculty members from ten U.S. dental schools participated, with an estimated response rate of 17%. Faculty and student responses were compared using the Mann-Whitney U test. These students' and faculty members' attitudes and perceptions were similar. Both groups showed mixed attitudes about NBDE scores as pass/fail, rather than numerical scores. The Integrated NBDE solicited mixed opinions and concerns that it would be complicated and stressful because students would be challenged to memorize information from earlier years. However, a single national clinical examination was highly preferred by both groups, preferably with simulated rather than real patients. Other strategies, such as background checks and continuing education requirements, were supported by both groups. Most of the licensure process strategies and policies were supported by both student and faculty respondents in the dental schools surveyed.

Development and implementation of online National Board Dental Examination Review Courses.

Failure on the National Board Dental Examination (NBDE) Parts I and II has troubling consequences for dental students, faculty members, and school administrators. Since the NBDE is a high-stakes exam for all involved, it is important to determine effective strategies to help students prepare. The purpose of this article is to describe the development and implementation of online NBDE Parts I and II Review Courses by the faculty and administration at the University of Missouri-Kansas City School of Dentistry. The courses are taught by faculty members who are content experts. By utilizing distance technology, students in any geographic location can review the material at the time, place, and pace that are most convenient. Early outcomes show that 592 students from thirty-two states have participated in the courses since they were first offered in 2010-11. In post-course evaluations, students report that participation in the courses encouraged them to spend more time preparing for the exam and that the associated PowerPoint slides/handouts provided structure for their review. The literature suggests that multiple modalities are most effective in preparing for the NBDE. These online review courses can serve as a beneficial component of a student's preparation regimen.

Perceptions and practices of U.S. dental schools regarding curriculum integrated format and traditional format licensure exams.

The dental licensure exam in the United States has evolved over the past ten years, and two formats-the traditional format and curriculum integrated format-are now available for students to satisfy licensure requirements. The objective of this study was to examine the differences and relative merits of the two formats. A twenty-five-question survey was distributed to the fifty-seven U.S. dental schools at the time. The survey included both quantitative and discrete variables and followed a strategic sequential order. The first set of questions sought to determine what type of board preparatory/mock exam each dental school offered, and the next set of questions asked which licensure exam each school formally offered. The final questions were qualitative in nature and aimed to determine the school representatives' opinions about the curriculum integrated format versus traditional format. Of the fifty-seven schools contacted, thirty-seven agreed to participate (response rate=64.9 percent). Fourteen schools reported that they administer the traditional format only and twelve administer the curriculum integrated format only, while eleven offer both. Thirty-two schools offered mock board exams to their graduating students, and twenty-four of those said their mock exams were identical in format to the actual qualifying clinical exams offered at their institution. The respondents reported no significant advantage to preparing for the curriculum integrated format examination as compared to the traditional format examination with regards to number of clock hours taken from regular curriculum time. In reporting on this study, this article provides an overview of the relative advantages and disadvantages of the two examination formats used for the dental licensure process in the United States.