Attitudes and Perceptions of U.S. Dental Students and Faculty Regarding Dental Licensure

Abstract

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 ive-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.

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

“…We speculated that academic deans’ perspectives on the INBDE could be affected by their more direct role in curricular changes than that of the other respondents; however, there were no significant differences on level of support, readiness, and perceived strain among respondents in different academic positions. In a study published in 2015, 38% of the responding faculty members in ten U.S. dental schools supported integration of the dental board exam 4 . The lower level of support among that study's participating faculty members at the time may be related to their direct level of involvement in implementing these changes.…”

“…Concerns about the student experience included the stress induced by a single examination and preparedness for the breadth of scientific information when all sciences are combined. As one respondent commented, it will be a challenge for “students to maintain in‐depth knowledge of basic sciences into their senior year.” Some respondents (11.5%) expressed concern that the INBDE would create a “single high stakes examination.” A survey of students and faculty members at ten schools published in 2015 also found concerns that an integrated exam would be “large and stressful” and that it would challenging for students to “remember information from their earlier dental school years.” 4 …”

“…The JCNDE currently states that the purpose and general content of the exam are “to assist state boards in determining qualifications of dentists who seek licensure to practice dentistry. The examinations assess the ability to understand important information from the biomedical and dental sciences and the ability to apply such information in a problem‐solving context.” 3 While the two‐part NBDE has functioned well, over the last 20 years the desirability of better integrating basic and clinical sciences as well as debates about score reporting, the exam's relevance to current educational methodologies, and the form of clinical exams sparked consideration of an integrated exam 4 – 7 …”

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

“…Students and educators alike have voiced concerns over the ethics involved with treating patients during dental licensure exams 8 , 9 . In a survey of deans of dental schools, the most problematic issues reported in relation to patient involvement included the provision of financial remuneration to patients to sit for the exam and delayed or inappropriate treatment 6 .…”

“…This study fills that void by introducing the Buffalo Model, developed by the University at Buffalo School of Dental Medicine (UB‐SDM) in collaboration with the Commission on Dental Competency Assessments (CDCA; formerly the North East Regional Board of Dental Examiners, NERB). The Buffalo Model adheres to the ADA's recommendations on CIF development, 1 resolves many of the concerns raised about patient involvement in dental licensure exams, 7 , 8 and assists in addressing logistical issues associated with the traditional exam format. In so doing, the Buffalo Model enables the focus of the exam to shift from the candidate to the ethical treatment of the patient.…”