The Integrated National Board Dental Examination (INBDE) - David M Waldschmidt, Ph.D.

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The Integrated National Board Dental Examination (INBDE) - David M Waldschmidt, Ph.D.
The Integrated National Board Dental
        Examination (INBDE)
        David M Waldschmidt, Ph.D.
          Director, JCNDE and Director,
        ADA Department of Testing Services

                   April 7, 2021
The Integrated National Board Dental Examination (INBDE) - David M Waldschmidt, Ph.D.
Overview
• Background
• The Domain of Dentistry
• Core Facts
• Results Reporting
• Resources and Item Development
• Standard Setting
• Additional Information and Other Relevant
  Examinations
• Q&A
                       © 2020 Joint Commission on National Dental Examinations, All Rights Reserved   2
The Integrated National Board Dental Examination (INBDE) - David M Waldschmidt, Ph.D.
How did the INBDE come about?
• A convergence of factors led to the INBDE, which was
  designed to better serve communities of interest by:
   – Improving test content to make it more appropriate and
     relevant to the practice of dentistry and contemporary
     dental education
   – Improving processes and candidates’ experiences in
     taking the examination
   – Better assisting regulatory agencies
• Examination content trends and the movement toward
  integrated content and clinical relevance also were
  considered.

                               © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   3
The Integrated National Board Dental Examination (INBDE) - David M Waldschmidt, Ph.D.
How did the INBDE come about?
•   In 2009, the JCNDE appointed a Committee for an Integrated Examination
    (CIE) to develop and validate a new examination instrument for dentistry
    that integrates the biomedical, behavioral, and clinical sciences to assess
    entry level competency in dental practice, to supplant NBDE Part I and
    Part II.
•   The Integrated National Board Dental Examination (INBDE) retains the
    same fundamental purpose as NBDE Part I and Part II – to assist state
    boards of dentistry in determining qualifications of dentists who seek
    licensure to practice in the U.S.
•   The INBDE was designed from the ground up to focus on clinical
    relevance, within the JCNDE’s “Domain of Dentistry”
•   The INBDE has relied heavily on subject matter input to inform
    development, with measurement/psychometric guidance provided by the
    Department of Testing Services (DTS)
•   Development and implementation of the INBDE has been an historical
    undertaking for the JCNDE.

                                        © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   4
The Integrated National Board Dental Examination (INBDE) - David M Waldschmidt, Ph.D.
What content is assessed by the INBDE?

•   The Joint Commission has established 56 “clinical content areas” that
    represent the tasks entry-level general dentists must be able to perform to
    practice safely. These content areas are classified into three sections:
         1) Diagnosis and Treatment Planning
         2) Oral Health Management
         3) Practice and Profession
•   The JCNDE also adapted 10 Foundation Knowledge Areas from medicine,
    to represent the knowledge, skills, and abilities necessary to perform the
    aforementioned tasks.
•   The tasks and foundation knowledge areas together form the “Domain of
    Dentistry” which represents the basis for INBDE content

                                          © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   5
The Integrated National Board Dental Examination (INBDE) - David M Waldschmidt, Ph.D.
56 Clinical Content Areas

                            © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   6
The Integrated National Board Dental Examination (INBDE) - David M Waldschmidt, Ph.D.
56 Clinical Content Areas

                            © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   7
The Integrated National Board Dental Examination (INBDE) - David M Waldschmidt, Ph.D.
56 Clinical Content Areas

                            © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   8
The Integrated National Board Dental Examination (INBDE) - David M Waldschmidt, Ph.D.
Content Area Percentages

                           © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   9
The Integrated National Board Dental Examination (INBDE) - David M Waldschmidt, Ph.D.
INBDE Content Specifications
                 INBDE Content by Foundation Knowledge Area
#                     Foundation Knowledge Area                                                          Percent
     Molecular, biochemical, cellular, and systems-level
1
     development, structure and function
                                                                                                                         12.2%
     Physics and chemistry to explain normal biology and
2
     pathobiology
                                                                                                                            6.8%
     Physics and chemistry to explain the characteristics and use of
3
     technologies and materials
                                                                                                                            8.0%
     Principles of genetic, congenital and developmental diseases
4    and conditions and their clinical features to understand patient                                                    10.6%
     risk
     Cellular and molecular bases of immune and non-immune host
5
     defense mechanisms
                                                                                                                            9.0%
6    General and disease-specific pathology to assess patient risk                                                       11.8%
7    Biology of microorganisms in physiology and pathology                                                               10.6%
8    Pharmacology                                                                                                        10.6%
9    Behavioral sciences, ethics, and jurisprudence                                                                      10.6%
10   Research methodology and analysis, and informatics tools                                                             9.8%

                                                © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   10
INBDE Implementation and NBDE Discontinuation

                Extended through Dec 31, 2020 due to COVID-19

                             © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   11
INBDE Core Facts
•   Administration: The INBDE contains 500 questions and requires 1½ days
    to administer
     – Administrations occur at Prometric professional testing centers located
       throughout the US and Canada
     – *** NEW *** Administrations can occur on non-consecutive days, with the second
       day of testing occurring within 7 days of the candidate’s first day of testing.
     – Dental examination fees for 2021 are as follows:
         • INBDE              $750
         • NBDE Part II $530
         • DLOSCE             $800*
     – Examination regulations are strictly enforced, with corresponding penalties for
       rule violations (e.g., mandatory wait periods)

     – Irregularity handling and appeal procedures are described in the INBDE
       candidate guide, and mirror those present for other examinations of the JCNDE
       (e.g., NBDE Part II)

* Approved by the JCNDE in October 2020, in light of continuing challenges faced by students due to
COVID-19

                                                   © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   12
INBDE Administration Schedule

                    © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   13
Retest Policy*

 •   Under the JCNDE’s 5 Years/5 Attempts Eligibility Rule, candidates must pass the examination within a) five
     years of their first attempt or b) five examination attempts, whichever comes first. Subsequent to the fifth
     year or fifth attempt, candidates may test once every 12 months after their most recent examination attempt.

* See INBDE Candidate Guide

                                                               © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   14
INBDE Results Reporting
•   Candidate Results: INBDE results are reported as Pass/Fail
     – Candidates who pass simply receive notification they have passed.
     – For remediation purposes, candidates who fail are provided with information
       concerning their performance in the following areas:
         • Foundation Knowledge Areas (10)
         • Clinical Content Sections (3)

•   School Results: Candidate pass/fail status is reported to dental schools
    through the DTS Hub. Monthly and annual school reports are available
    through the DTS Hub.
     – 2020 INBDE Annual Profile Reports for dental programs will be available in the
       DTS Hub by mid-April 2021

•   State Board Results. Candidate pass/fail status is reported to state boards
    through the DTS Hub
     – The DTS Hub indicates whether a candidate has met or not met the National
       Board Dental Examination cognitive skills requirements for dentistry (i.e., no
       distinction will be made among Part I, Part II, or the INBDE)

                                             © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   15
INBDE – Report for Failing Candidates

                     © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   16
INBDE – Report for Failing Candidates

                     © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   17
INBDE – Monthly School Performance Report

                      © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   18
INBDE – Monthly School Performance Report

                      © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   19
INBDE – Annual School Performance Report

                      © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   20
INBDE Resources
•   The JCNDE website contains a number of useful INBDE-related resources
                           http://ada.org/inbde

Resources Related to Examination Content
     –   Foundation Knowledge for the General Dentist
     –   INBDE Test Specifications
     –   INBDE Domain of Dentistry
     –   INBDE Practice Questions
     –   INBDE Item Development Guide
     –   INBDE Technical Report

Resources Related to Policy and Timelines
     –   Formal Notice of INBDE Implementation and NBDE Discontinuation
           •   INBDE implementation timeline
           •   Retest policy
           •   Eligibility
           •   Administration

                                                 © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   21
INBDE Resources – Foundation Knowledge Areas

       https://www.ada.org/en/jcnde/inbde/test-preparation

                                 © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   22
INBDE Item Development
•   Interested in understanding how
    INBDE items are written? See the
    INBDE Item Development Guide!
•   The INBDE item development guide
    was drafted to facilitate item
    development.
•   This guide is available online
    (ada.org/inbde)
•   INBDE Test Construction Team
    (TCT) members are asked to write
    clinically relevant, integrated items
    capable of providing insight as to
    whether a candidate has the
    cognitive skills necessary to safely
    practice entry-level dentistry.

                                            © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   23
Guiding Principles in INBDE item development
• Examination purpose drives all development decisions.
• Focus on clinical relevance.
• Promote the clinical relevance of the biomedical sciences by
  placing foundation knowledge areas within the context of
  clinical content areas.
• Increased focus on the general dentist in item writing.
• Standardized presentation format and conventions for
  presenting information.
• Direct and concise wording that focuses examinees on the
  concept tested as opposed to language/item wording.
• Increased accuracy, validity, and fairness/sensitivity through
  a thorough, multi-faceted item development and review
  process that capitalizes on the unique expertise of the
  individuals involved.
                                © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   24
INBDE Patient Box: Patient Section
Patient
                                             Section                 Patient
   Female, 28 years old.
                                                                     • This section presents patient
Chief Complaint
                                                                       demographic characteristics
   “I haven’t been able to open my mouth     Description
      for two days.”                                                   (gender, age, and potentially
                                                                       ethnicity).

Background and/or Patient History                         • Male or Female, x years old.
   Three days prior, left mandibular third
                                             Presentation • Ethnicity may be included if
    molar extraction.                        Format         relevant.

Current Findings                             Example                 • Female, 28 years old.
   Maximum opening is 10 mm

                                                © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   25
INBDE Patient Box: Chief Complaint Section
  Patient
                                               Section                 Chief Complaint
     Female, 28 years old.
                                                                       • This section presents the chief
  Chief Complaint
                                               Description               complaint as described by the
     “I haven’t been able to open my mouth
        for two days.”
                                                                         patient or a guardian.

                                                            • If quoted directly from the
  Background and/or Patient History                           patient, enclose the statement
                                               Presentation
     Three days prior, left mandibular third
                                               Format
                                                              in quotation marks and voice
      molar extraction.
                                                              the statement in the first
                                                              person.

  Current Findings
                                                                       • “I’ve been unable to open my
     Maximum opening is 10 mm                  Example
                                                                         mouth for two days.”

                                                  © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   26
INBDE Patient Box: Background/Patient History
 Patient
                                              Section                 Background/Patient History
    Female, 28 years old.
                                                                      • This section presents
 Chief Complaint                                                        background information such
    “I haven’t been able to open my mouth                               as history of dental diagnosis
       for two days.”                         Description
                                                                        and treatment, medical
                                                                        conditions, allergies, social
                                                                        history, etc.
 Background and/or Patient History

    Three days prior, left mandibular third
     molar extraction.
                                                                      • The information is assumed to
                                              Presentation
                                              Format
                                                                        be factual and provided by the
                                                                        treating dentist.
 Current Findings

    Maximum opening is 10 mm

                                                                      • Three days prior, left
                                              Example                   mandibular third molar
                                                                        extraction.

                                                 © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   27
INBDE Patient Box: Current Findings Section
  Patient
                                               Section                 Current Findings
     Female, 28 years old.                                             • This section presents
                                                                         information collected by dental
  Chief Complaint                              Description
                                                                         professionals during the
     “I haven’t been able to open my mouth
        for two days.”
                                                                         current visit.
                                                            • Can include information such
                                                              as height and weight, vital
  Background and/or Patient History            Presentation   signs, results of diagnostic
     Three days prior, left mandibular third   Format         tests, and a general
      molar extraction.
                                                              assessment of the patient
                                                              condition.
                                                                       • Facial edema
  Current Findings
                                                                       • Lymphadenopathy
     Maximum opening is 10 mm                                          • Extensive apical radiolucency
                                               Example                   associated with tooth 6
                                                                       • Temp. 100.3°
                                                                       • Blood glucose 240 mg/dL
                                                                       • BP 150/93

                                                  © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   28
Case-Based Item Sets and Standalone Items
•    Approximately 70% of INBDE items contain a patient box; these include
     “Standalone Items” and items that are part of “Case-Based Item Sets.”
•    A “Case-Based Item Set” consists of two or more items that reference a
     common set of stimulus materials (e.g., a patient box and an image). INBDE
     item sets typically involve 2 to 5 items.
•    Case-Based Item Sets make up 40% of the INBDE.
•    Standalone items make up the remaining 60% of INBDE content
•    Standalone items are written to be clinically relevant and integrated; they
     can contain patient boxes and images.
•    If a question involves a patient, the question will include a Patient Box.
     However, item writers are discouraged from including a patient or patient
     box where doing so would simply add unnecessary verbiage to an item that
     is already clinically relevant.

                                           © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   29
INBDE Sample Questions

•   The JCNDE has provided 43 sample questions written by JCNDE Test Construction
    Teams for communities of interest (https://www.ada.org/en/jcnde/inbde/test-preparation)
•   These questions were provided to help familiarize candidates with how INBDE questions
    are presented and formatted.
•   The JCNDE does not currently have plans to increase the number of sample questions.

                                                © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   30
Guiding Principles in INBDE item development (continued)
•   The Just Qualified Candidate (JQC) is a hypothetical examinee whose
    knowledge, skills, and abilities (KSAs) represent the lowest level that
    would still be considered acceptable to pass the INBDE. More specifically:
      • The JQC is a candidate, currently pursuing an accredited dental
         education program in dentistry, who possesses the minimally
         acceptable level of knowledge, cognitive skills, and ability in the
         biomedical, dental, clinical dental, and behavioral sciences—including
         the areas of professional ethics and patient management—that is
         necessary for the safe, entry-level general practice of dentistry.
•   The INBDE is intended to differentiate the JQC from those who fall below
    that skill level. This is the focal purpose of the INBDE.
•   The INBDE is NOT intended to differentiate stellar students from average
    students.
•   Items should avoid focusing on trivia and esoteric bits of knowledge.
•   Items should reflect clinically relevant situations that a practicing dentist
    would encounter.

                                        © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   31
Relationship between INBDE and NBDE

Candidate performance on the 2017-2018 INBDE Field
Test was positively correlated with performance on NBDE
Parts I and II

       Correlation Between INBDE Field Test and NBDE Performance
                         (N = 1,180 participants)

                                        Observed                     Disattenuated
                                       Correlation                    Correlation
         NBDE Part I                          .58                                .65
         NBDE Part II                         .74                                .84
         Note. Disattenuated correlations were estimated using the following reliability
         coefficients: Field Test=.87; NBDE Part I=.94; NBDE Part II=.91

                                                    © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   32
INBDE Standard Setting
•   The standard for each examination is criterion-referenced (not norm-
    based) and determined through a process called “standard setting.”
•   INBDE standard setting activities were facilitated in February 2020
    by Dr. Gregory Cizek, a nationally recognized expert in standard
    setting who has authored several books on the subject.
•   The standard setting panel consisted of 10 subject matter experts.
•   Panel members were selected to be broadly representative and
    aligned with the purpose of the examination:
     –   Practitioners
     –   Dental school faculty
     –   Joint Commission members
     –   Members of dental boards
     –   Dental school deans and associate deans (NBDE)
     –   Current and former JCNDE Test Construction Team members
     –   Geographically representative

                                           © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   33
Standard Setting Panelist Feedback
•   Participants were thoroughly trained and underwent a multi-stage exercise.
•   At the conclusion of all activities, participants’ evaluations of all aspects of
    the process were uniformly strong and supportive, with each panelist
    indicating that they supported the final group-recommended performance
    standard.
     –   Panelist feedback on the last item of the final evaluative questionnaire:
                                 Survey Item Number and Statement                                                      Mean
                                                                                                                       Rating

          14. Overall, I support the final group-recommended cut score as
          fairly representing the appropriate performance standard for the                                              4.89
          INBDE.
          Key: Values are on a five-point scale, ranging from 1=Strongly Disagree to 5=Strongly Agree; NR = no
          response. One panelist did not answer evaluation question 14, so the mean rating is based on
          responses from nine of the ten panelists.

•   The panel’s recommendation was approved by the JCNDE in June 2020
    and implemented in August 2020.

                                                         © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   34
INBDE Results
•   Over 1,000 candidates have attempted the INBDE since its release in
    August 2020.
•   INBDE candidate performance information will be shared in the INBDE
    technical report (released subsequent to the report’s approval during
    the JCNDE’s meeting in 2021).
•   At present there are a small number of CODA accredited dental
    programs whose candidates are taking the examination in large
    numbers, but the number of programs is rising.
•   Preliminary data indicates that candidates educated by CODA-
    accredited dental programs are performing very well on the INBDE
•   Preliminary data indicates that candidates educated by programs not
    accredited by CODA are failing in larger numbers, as compared to
    those from CODA accredited programs (similar to what is seen for
    NBDE Part II)

                                      © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   35
Feedback from INBDE Field Test Participants
What insights would you like to share with students who might be
anxious to take this new examination?

“The INBDE is more clinically applicable than NBDE part I, while integrating some
of the same required knowledge. There was a lot of tested information that new
graduates simply should know in order to be good clinicians.”

“It’s not radically different than previous exams and not any harder.”

“If you have paid attention and have studied to the best of your abilities for all the
exams throughout dental school, you will not have a problem with this exam.
Dental school prepares you for it.”

“The exam is case-based so it is very similar to the cases that you currently see
in clinic.”

“It is much more clinically focused than the previous format.”

                                           © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   36
Feedback from INBDE Field Test Participants
What insights would you like to share with dental programs and faculty
members who are working to prepare their students to take the INBDE?

“Teach with a case-based model and help your students to learn the basics of
how to take care of their patients and they'll be fine!”

“Focus more on clinical questions and how basic science is used in clinical
dentistry.”

“They need to teach basic sciences while incorporating clinical scenarios in
order to prepare the students.”

“Prepare the students for the majority of the exam to be case based, including
many health conditions and their associated pharmacology.”

“Please try to relate the basic sciences to real-life clinical situations.”

                                           © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   37
Targeted Questions from Candidates
When should students take the INBDE?
    – Dental Programs: When your dental dean indicates you are ready.
    – Dental Boards: As close to the time of licensure as possible.

What periodontal classification system is used on the INBDE?
    – American Academy of Periodontology Classifications (2017)

Will I be able to “zoom in” on radiographs?
    – Unfortunately not at this time.
    – We are working with Prometric concerning this capability.

Do candidates feel DLOSCE content is clinically relevant and
integrated?
    – Survey feedback from live administrations indicates that the vast majority of
      candidates (approx. 90%) feel that DLOSCE content is clinically relevant.
    – Over 90% of candidates indicated that the questions required them to integrate
      their biomedical and discipline-based knowledge with their clinical training.

                                           © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   38
Targeted Questions from Candidates
What is the best way to find a testing appointment? How difficult is it
find an appointment?
    – Make your appointment as far in advance of your desired testing date as
      possible.
    – Appointments can be limited due to smaller-sized test centers.
    – At present DTS staff are not hearing that candidates are having significant
      difficulties scheduling appointments.

                                            © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   39
Targeted Questions from Candidates
How can I best prepare to take the INBDE?
   – The JCNDE does not provide specific recommendations concerning examination
     preparation courses.
   – The INBDE is a clinically relevant examination. Review material related to the
     foundation knowledge areas and clinical content areas. Study the material and
     textbooks you were provided by your dental education program.
   – Candidates who completed the INBDE indicated the following were most helpful
     to them in their preparations:
       • Reviewing course textbooks and/or class notes
       • Reviewing flash cards
       • Participating in an online review course
       • Completing a practice test
   – Current data suggest that candidate endorsement of the following is predictive of
     performance on the INBDE:
       • Met with school faculty and/or staff to create a study plan

                                           © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   40
Targeted Questions from Faculty
How should my course change in light of the INBDE?
   – First and foremost: Academic deans should be consulted on all
     decisions concerning course objectives
   – The “Foundation Knowledge for the General Dentist” document
     referenced previously provides examples of disciplines (e.g.,
     biochemistry) that are relevant to each of the INBDE’s ten foundation
     knowledge areas

Does the INBDE measure critical thinking?
   – Yes! The foundational knowledge areas and clinical content areas
     provide a platform for measuring dental critical thinking skills.

                                      © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   41
Summary

• The INBDE focuses on clinical relevance and is supported
  by strong validity evidence

• INBDE development has relied heavily on input from dental
  subject matter experts, with measurement/psychometric
  guidance provided by the Department of Testing Services
  (DTS)

• Dental programs and students are currently transitioning to
  the INBDE, and must do so before the NBDE Part II is no
  longer available.

                                © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   42
Additional Information and
Other Relevant Examinations:

         COVID-19
JCNDE Response to COVID-19
– The JCNDE and DTS are pursuing solutions that address pressing needs while
  maintaining high psychometric standards (validity, reliability), in recognition of
  the importance of these testing programs
– In the initial 3 months of the crisis, DTS engaged in 6,000 live chats to assist
  candidates (in 3 months handled typical chat volume for 4 years)
– In 60 days Prometric experienced over 450,000 candidate displacements, the
  number they typically experience in 7 years
– Implementation of the Dental Licensure Objective Structured Clinical
  Examination (DLOSCE) is fast-tracked
– Introduction of short-form-NBDHE in mid-July 2020, with accompanying rollout
  to thousands of Pearson VUE test centers
– Delayed discontinuation of NBDE Part I (until Dec 31, 2020) for all qualified
  candidates
– Expanded eligibility periods for candidates (through Dec 31, 2020)
– All test construction team meetings are currently being held remotely
– Integrated National Board Dental Examination (INBDE) successfully launched
  on schedule

                                           © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   44
DTS COVID-19 Update Document

– Posted and updated regularly: www.ada.org/jcnde

                                         © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   45
The Dental Licensure
Objective Structured Clinical
 Examination (DLOSCE)
Join us for a DLOSCE webinar!

 Wednesday, April 14, 12:00pm (CST)
       Registration: ada.org/dlosce

               JCNDE Speakers:
    K. “Ragu” Ragunanthan, DDS, MS, Chair
      David M. Waldschmidt, Ph.D., Director

                       © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   47
How do the DLOSCE and INBDE differ?

                                       “Domain of
                                       Dentistry” (INBDE)

                                       DLOSCE Content
                                       Domain. Clinical
                                       content directly
                                       applicable to chairside
                                       treatment. Also
                                       represents overlap
                                       between INBDE and
                                       DLOSCE.

                 © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   48
How do the DLOSCE and INBDE differ?
 The DLOSCE and the Integrated National Board Dental
  Examination (INBDE) both assess clinical skills (e.g., diagnosis
  and treatment planning, oral health management). However, key
  differences also exist:
   • The DLOSCE is focused exclusively on the clinical tasks a
     dentist performs while providing direct, chair-side treatment to
     patients.
       • Micro-judgments, errors and knowledge of success criteria, narrow
         focus

   • The INBDE focuses on cognitive skills.
       • The biomedical underpinnings of clinical decisions, broader focus that
         includes the “why”
       • Practice and profession considerations, evidence based dentistry, being
         good consumers of research, patient oral health care education

                                        © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   49
How do the DLOSCE and INBDE differ?
•    Examples of how the INBDE and DLOSCE conceptually differ:

                       INBDE Example                                      Corresponding DLOSCE Example

    Understand basic principles of pharmacokinetics and          Review patient information and write an appropriate
    pharmacodynamics for major classes of drugs and              prescription.
    over-the-counter products to guide safe and effective
    treatment.

    Understand local and central mechanisms of pain              Identify the final needle position (point of insertion,
    modulation.                                                  angulation, and depth) immediately prior to injection
                                                                 that will best accomplish complete local anesthesia for
                                                                 a given procedure.

    Understand dental material properties, biocompatibility,     Identify one or more flaws present in a metal-ceramic
    and performance, and the interaction among these in          restoration.
    working with oral structures in health and disease.

    Understand the principles and logic of epidemiology          No corresponding DLOSCE example. Epidemiology
    and the analysis of statistical data in the evaluation of    and statistics are not covered on the DLOSCE.
    oral disease risk, etiology, and prognosis.

                                                                © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   50
DLOSCE 3-Dimensional Models

             © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   51
Correlations with Important Outcomes
            The DLOSCE and Performance in 3rd Year Dental Courses1

Updated information as of March 2, 2021. Not yet published in DLOSCE Technical Manual.

1 The third-year courses covered the following areas: Oral Pathology, Oral Surgery, Pediatric Dentistry,
Prosthodontics, Endodontics, Orthodontics, Medical Emergencies, Management of Medically
Compromised Patients, Health Promotion, and Dental Practice Operations. The partially disattenuated
correlations were estimated assuming a reliability coefficient of .66 for the letter of commendation (LOC)
sum scores. The fully disattenuated correlations were estimated assuming reliability coefficients of .66 for
the LOC sum scores and .83 for the DLOSCE scores. *p < .05

                                                       © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   52
The ADA’s Advanced
Dental Admission Test
       (ADAT)
Join us for an ADAT webinar!

  Wednesday, May 5, 12:00pm (CST)
          Registration: ada.org/dlosce

    Department of Testing Services (DTS) Speakers:
Matthew Grady, Ph.D., Senior Manager of Development
Nicholas B. Hussong, MA, Manager, Test Administration

                           © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   54
The ADA’s Advanced Dental Admission Test
The Advanced Dental Admission Test (ADAT) is used by advanced dental education programs to inform
admission decisions. The ADAT is overseen by the ADA’s Council on Dental Education and Licensure (not the
JCNDE). Quantitative results are presented for the following scales: Overall; Biomedical Sciences; Clinical
Sciences; and Data, Research Interpretation, & Evidence Based Dentistry.

                  ADAT Overall Scale Frequency Distribution (2016-2020); N = 1,922

                                                     © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   55
Questions?

     © 2020 Joint Commission on National Dental Examinations. All Rights Reserved.   56
Thank you!

David M Waldschmidt, Ph.D.
    waldschmidtd@ada.org
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