Licensure Exams: What Truly Conveys a Hygiene Student’s Competency?


Sumary of Licensure Exams: What Truly Conveys a Hygiene Student’s Competency?:

  • Assessment Dental hygiene diagnosis (based on the unmet human needs of the patient) Planning Implementation Evaluation Documentation A Debate on Clinical Licensure Exams?.
  • Objective clinical structured examinations (OSCE), such as mock boards, are consistently used in dental hygiene education..
  • In a survey of dental hygiene educators (125 directors participated), approximately 97% of the programs utilize OSCEs, and 75% use a mock board style evaluation.7 These OSCEs can be used to simulate the environment and stress of high-stakes clinical licensure exams at varying times in a student education..
  • The intention is that a mock board experience can assess a student competency with clinical skills and is often used to predict the student readiness for the clinical licensure exam..
  • If mock board performance correlates positively with performance on the one-shot licensure exams, then clinical licensure exams are superfluous or redundant at best..
  • The Western Regional Examination Board (WREB) calculates 75% of the student final grade based on calculus removal.5 For the Commission on Dental Competency Assessments (CODA) final score, it is 66%.11 OSCEs, included with students’ entire portfolio of accomplishments during their education, are a better measure of total patient care and, more importantly, patient safety..
  • Student performance on OSCEs is not highly correlated with performance on licensure exams, and it has been suggested that OSCE exams more likely measure other qualities, such as problem-solving, critical thinking, and communication.4 A recent study has shown a correlation between OSCE progress test scores and future performance on high-stakes examinations.9 However, further research has suggested that although there may be a correlation between mock boards and licensure exams, the existing research is “conflicting and limited”.
  • and that additional dental hygiene programs should be included in future studies to “incorporate additional testing agencies board exams and a variety of mock board experiences.”7 A 2005 study published in the Journal of Dental Education discussed the “predictive validity”.
  • of competency assessments gathered during dental hygiene school compared to one-shot clinical licensure exams.6 The research pointed out that dental hygiene educators have too often seen very clinically competent students fail their clinical exams and witnessed how devastating it is for them..
  • What is concerning is the pass rate on the second attempt, where 77% of candidates pass, for a total of a 98.4% pass rate.11 For a student to fail their clinical exam and then be able to pass the next day without any remediation illustrates the issues with the validity of these types of exams..
  • Educators Are the Gatekeepers An assessment of this relationship is relevant because there is evidence that OSCEs do a better job of assessing clinical competency than clinical licensure exams.10 Determining a correlation might impact how mock boards are used in the future..
  • An accredited dental hygiene program must provide evidence that students receive ample instruction to become competent in ethical reasoning, the scope of practice, problem-solving, and the ability to understand research and remain current regarding scientific literature..
  • Removing calculus on one or two quadrants of a person mouth falls exceedingly short of the quality of care to which patients should be entitled..
  • Questionable Value of Clinical Exam The additional stress and expense that candidates for licensure are made to endure for an exam that tells us so little about a dental hygiene student competency are hard to comprehend..
  • The ethical issues inherent in live patient exams have been debated for decades.2 Live patient exams put the patient at unnecessary risk..
  • Furthermore, students are put into the ethical dilemma of deciding whether putting off necessary treatment for months to save their patient for boards is the right course of action..
  • Requiring an exam that puts people at risk and has very little evidence-based support raises significant ethical concerns..
  • A review of the literature shows that mini-mock and mock boards are not necessarily the best predictors for how students score on their clinical licensing exams….

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