NMDA Journal Fall 2020

18 New Mexico Dental Journal, Fall 2020 License to Disagree With the use of Standardized Patients (SP) students are introduced to different medical scenarios through a series of Patient Stations. During the Patient Station youmay be recorded for instructional and grading purposes. After each SP interaction, the student will complete their patient note at each Documentation Station. This method has been used extensively in medicine and is currently the national dental examination in Canada. The ADA worked with other interested organizations in devel- oping a version for use in the US. To a large extent, the examining community has resisted involvement. There are currently five states that accept the DLOSCE: Alaska, Colorado, Iowa, Oregon, and Washington. Most of these were rapid adopters in the face of cancelled live patient exams resulting from the COVID-19 pandemic. Although the exam is highly researched and “proven” predictive, it is a newcomer to the examining debate. The state of New York adopted an alternative licensing protocol call PGY1 (post-graduate year one) which requires graduates to complete a residency in-state and grants a license without further testing upon completion. Other states, including Colorado, now accept this protocol. Graduated dentists are required to spend a year in a gen- eral practice residency under supervision. There are simply not enough residencies available to adopt this method as a universal method of assessing competency.  continued from page 16 Various portfolio examinations have been proposed and tried. These have their advocates because they allow examination on live patients in the controlled environ- ments of the dental school. One variation of the portfolio examination that has gained interest is out of the Univer- sity of Buffalo and utilizes the school environment while giving outside examiners access to the process to struc- ture the examination. It has been fairly well-received in this limited application, but it is uncertain that it could be scaled to different jurisdictions and maintain the integrity of the exam. There are many variations on these models that have been tried. Regional exams are now offering manikin exams which allow a high level of standardization but do not have a patient management component. Other emerging technological solutions may simulate treatment conditions more broadly. So far, none have eliminated live patients completely. Ultimately, society is pushing the profession to resolve these debates. Dentistry remains one of the few health care professions without a unified national examination structure. In the end, it may be disruptions like a global pandemic which push dentistry to a universally accepted standard.