Bulletin of Dental Education

Moving Toward a National Clinical Licensure Exam? A Status Report

(Allied, Curriculum, Licensure, Policy, Students) Permanent link   All Posts

Over the past couple of years, ADEA has been at the forefront of efforts expected to result in a major change in dentistry and dental hygiene: the transition from a system of disparate state and regional testing for clinical licensure to a uniform national exam. Since dental and dental hygiene graduates must pass licensure exams before they can practice, this development has significant implications for schools and students, as well as the public the system is designed to protect.

    “The oral health of the public is a responsibility shared by all parts of the dental profession and motivates everything we do,” said Dr. Frank A. Catalanotto, ADEA President. “Since protecting the public is not exclusively the purview of any one group, it has been incumbent on all of us—educators, practitioners, and examiners alike—to work together toward a system that best fulfills that responsibility. That is what we have been endeavoring to do.” 

    The current system of licensure exams has long been controversial and has come under increasing criticism in recent years. Ethical and practical questions about the use of human subjects, regional variations in examinations and results, and the reliability and validity of the exams have been some of the sources of concern. Although the National Board Examination Parts I and II are developed and administered by the ADA’s Joint Commission on National Dental Examinations (which includes representatives from the ADA, ADEA, the American Association of Dental Examiners, the American Dental Hygienists’ Association, and the American Student Dental Association, as does the Commission on Dental Accreditation), the licensure exams are conducted by regional and, in some cases, state examining boards.

    ADEA’s attention to this issue was elevated considerably a year ago when the 2004 ADEA House of Delegates, meeting in Seattle in March, passed a resolution endorsing a national clinical exam. With the concurrence of ADEA and ADA representatives to the ADA Council on Dental Education and Licensure (CDEL), in April 2004 CDEL approved a motion to support the concept that a “dental student who has graduated from a Commission on Dental Accreditation accredited dental school be able to take a single clinical examination that would have national acceptance.” Subsequent to this CDEL motion, AADE held a meeting in June 2004 to determine how it should respond. Participants in this meeting accepted a motion for AADE to develop a uniform national exam for clinical licensure to be administered by the states and regional testing agencies.

    Both ADEA and the ADA have expressed to AADE the need for all communities of interest to have input into the development of a new clinical examination for licensure. In October 2004, the ADA House of Delegates approved a resolution (23S-1) to create a National Clinical Licensing Examination Consensus Committee to advance the development of a common national examination for evaluation of clinical competency of candidates for licensure. The goal of this resolution is to ensure a collaborative process for developing such an exam.

    On October 14, 2004, Dr. Frank Catalanotto, ADEA President, wrote to the President of AADE, expressing ADEA’s grave concerns about the unilateral approach with which AADE has approached this work. “This letter further emphasized that ADEA does not believe that AADE’s proposed examination serves the public interest,” said Dr. Catalanotto. “Therefore, ADEA does not support AADE’s current effort. Any suggestions that we do are misinformed and incorrect. To this juncture, neither ADEA nor the ADA has been invited to participate in the development or the governance of the new clinical examination.”

In February 2005, the ADA Consensus Committee will hold two meetings—one with representatives from ADEA, AADE, and the American Dental Licensing Examination Committee (an oversight exam development group formed by AADE); and the other with representatives from state boards and testing agencies. The goal of these meetings is to determine how the communities of interest can work together to achieve consensus on a uniform national examination process. Should these meetings fail to result in a consensus for collaboration, the ADA Board of Trustees will then consider initiating an ADA-led effort to develop a national clinical licensure examination.

“ADEA plans to attend this meeting and has encouraged and will continue to encourage AADE to participate,” said Dr. Richard Valachovic, ADEA Executive Director. “We are committed to a national clinical licensure exam, but it must be one that is valid and reliable, one that involves patients in an ethical way, and one that has been developed with input and governance from all the communities of interest."

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