NMDA Journal Fall 2020

10 New Mexico Dental Journal, Fall 2020 Dr. Thompson: I would also add the new DLOSCE exam. In addition to eliminating that live patient exam that Dr. Manz was discussing, the DLOSCE is a part of that movement that really creates more of a universal, national, examina- tion procedure. It eliminates the live patient, but it also pro- vides an examination that really targets the assessment of the candidate's clinical judgment. It uses stations with 3D models. The 3D models allow the candidates to work through scenarios which can allow examiners to assess the candidate’s critical thinking and diagnostic skills. It also avoids the aggregation of examiners, examinees, and patients during the COVID-19 pandemic which Dr. Martin was discussing as well. NMDA: Dr. Martin, there has been reluctance bymany of the Boards to adopt some of these other issues. Can you explain at all what the reservations that some Boardmembers have about some of these alternative exams? Dr. Martin: Some of the concerns that have come up with alternatives like manikins or OSCE are whether they are reliable and whether they represent the skills that you would actually be performing in practice. NMDA: Are there other examination modalities that we have not talked about? Dr. Martin: One other examination process is the post- graduate residency. Right now, New York is utilizing that as an adjunct to licensure. They can take a post-graduate year in New York and successfully complete it in lieu of tak- ing a regional exam. The issue arises, however, when that student from New York would like to come to New Mexico, they don’t have the proper credentials required for our state. The problem of portability is still an issue with the PGY-1 program. Dr. Thompson: Dr. Manz touched on the portfolio type of examination which typically involves the third and fourth year of dental school. In this model, students identify the patient's needs, work through the treatment plan, and then document the treatment as it occurs. Ideally, it is reviewed objectively by an independent objective examiner. NMDA: So is there any reconciling the concerns examiners currently have with some of these other issues and finding acceptable testing alternatives? Dr. Thompson: There may have to be a combination of the different modalities because each has its pros and cons. Perhaps by combining, for example the DLOSCE with the portfolio, the exam could capture enough pros on both sides and reduce the number of cons to satisfy all the dif- ferent interests. Dr. Manz: I would also say that improvements in technol- ogy are going to show us opportunity that we have not had in the past. I think that we will see that the ability to do very good modelling and using manikins that are detailed well-created reproductions is going to improve over time. We are seeing this already in the education world where we can do a tremendous amount with computers and 3D modelling that was never even thought of before. I would say that technology is going to come into play at some point as well. Dr. Thompson: Especially since the regional testing agen- cies just this year have moved forward with their manikin testing. I think as this method is being further developed and validated, we will have new insights into the testing process. Dr. Martin: I just would like to add that our task force came up with five focus areas that we really put in priority order as far as testing. Our number one consideration was to protect the public. Next was to hold dental schools accountable with third-party evaluation. I think there were some concerns that there would be some bias within the dental schools and so we felt like we wanted there to be some type of third-party accountability. We wanted to ensure portability with minimal cost. We also wanted to hold the candidates ultimately accountable so that they would meet expectations. I think that is why we were lean- ing toward combining a standardized test with a clinical component. NMDA: My understanding is that the task force is not completedwith their work and will continue to address these kinds of things. What would you like to see that task force do in the coming year? Dr. Martin: Our charge was to develop a policy and because of COVID we needed to defer final recommenda- tions to the NMDA Board and the Board of Dental Health Care. We decided that we needed to come up with an appropriate policy for New Mexico, however that might look. We want to develop a consensus before making a recommendation on how to proceed. Dr. Thompson: I think we need to keep an open mind because too often dentists come to the table in this conver- sation with a history and a preconceived notion of where we should be. Moving forward, it will be really important for us to continue the conversation. Have open minds about the idea of modernizing dental licensure, keeping in mind that we all want public safety and patient safety, and fairness to play into that as well. NMDA:Thank you all for your insights.This is certainly an important but contentious issue that will require real leadership. Moving forward, it will be really important for us to continue the conversation. Have open minds about the idea of modernizing dental licensure, keeping in mind that we all want public safety and patient safety, and fairness to play into that as well.  continued from page 9 A Conversation on Licensing and Examinations