The case against one-shot testing for initial dental licensure.

Area of Science:

• Dental Education and Assessment
• Psychometrics in Professional Licensure

Background:

• High-stakes licensure examinations are mandated to meet rigorous standards of cost-effectiveness, fairness, transparency, reliability, and validity.
• Existing dental licensure examinations face scrutiny regarding their adherence to these essential standards, with historical adjustments yielding minimal improvements.
• The current system's fundamental limitation lies in its reliance on a single, limited assessment of a practitioner's skills, knowledge, and values.

Purpose of the Study:

• To evaluate the psychometric adequacy of current dental licensure examinations.
• To propose an alternative assessment framework for dental licensure that enhances reliability and validity.
• To advocate for a competency-based approach to ensure practitioners meet modern practice demands.

Main Methods:

• Critical analysis of the 'snapshot' approach inherent in current dental licensure testing.
• Review of decades of adjustments and their impact on examination effectiveness.
• Development of a three-step alternative assessment model based on defined competencies and evidence portfolios.

Main Results:

• The 'snapshot' testing method inherently compromises the reliability and validity of dental licensure assessments.
• Piecemeal adjustments to the existing system have proven insufficient in addressing fundamental flaws.
• A proposed portfolio-based system offers a more robust method for evaluating essential dental competencies.

Conclusions:

• Current dental licensure examinations do not adequately meet established psychometric and practical standards for professional practice.
• A shift towards a competency-based portfolio assessment is recommended for defensible and higher-quality licensure decisions.
• Implementing a structured, multi-faceted evaluation process will better ensure the competence of newly licensed dentists.