An analysis of the contribution of a patient-based component to a clinical licensure examination

Abstract

The validity and reliability of high-stakes examinations such as those used by national, regional and state or provincial dental boards are under intense scrutiny by candidates, dental schools, dental educators, dental associations, and state or provincial dental boards. The authors followed the progress of 1,063 candidates from nonaccredited dental programs who began the National Dental Examining Board of Canada's (NDEB) clinical examinations between January 1996 and November 1999 through the administration of the examination's final component in December 2003 examine the utility and validity of the patient-based component of the examination process. The results showed that the first three components of the examination were effective in screening out candidates who were not adequately prepared to take the patient-based component. Only 12 (1.1 percent) of the candidates failed the maximum allowed three attempts to pass the patient-based component. The results demonstrated that the patient-based component did not contribute to the overall examination validity or decision making and did not prevent candidates from obtaining certification. Owing to this lack of utility, the associated costs and ethical concerns, NDEB eliminated the patient-based component of the examination and replaced it with the requirement to complete an accredited, qualifying/degree completion dental program followed by completion of NDEB's written and objective structured clinical examination components.