Portfolio Historical Information
Licensure of dentists practicing in the State of California has been one of the primary duties of the Dental Board of California (Board) and has its roots imbedded in the Dental Practice Act which charges the Board to test candidates for minimum competency to insure public protection. It prescribes for a written and clinical examination and asks for an acceptable clinical performance in a given time period on both patients and mannequins. The California Clinical Examination, and as of late, the Western Regional Board Examination for the most part have mimicked the other stand alone Regional examinations in their content. All have evolved over the years with constant changes to better address questions of relevancy, competency, fairness and bias. The changes continue today with calls for a National examination that would be universally accepted by all the States.
In January of 2007, the Board initiated the process of reevaluating the California Clinical Examination, and working with the five dental schools in California (University of California, Los Angeles; University of California, San Francisco; Loma Linda University; University of the Pacific; and the University of Southern California), started to explore alternative methods of assessing a dental school candidate for licensure. The Portfolio Assessment was born out of the desire to eliminate the need to give a stand alone exam to those student candidates who could meet the requirements set by the Board. While this new type of assessment would exceed the present requirements for testing on patients, it is also based on achieving a required number of Clinical Experiences. The required Clinical Experiences in diagnosis and treatment planning, periodontics, direct and indirect restorative, prosthodontics, and endodontics, will be tested on patients of record in the five dental schools by way of Competency Examinations with oversight by the Board. Calibration, standardization, verification and cooperation will be important components of this new and novel approach to assessing candidates.
Before the Board went into sunset in July 2008, it unanimously passed the Portfolio Assessment Concept and directed staff to have it evaluated by testing experts before writing the legislation needed for implementation. The first phase of the process is complete and concluded that a Hybrid Portfolio is a viable pathway to qualify for licensure in California.
The second phase of the process is the development of the methodology to implement the Hybrid Portfolio Pathway Examination to Qualify for a California Dental License, which will be completed in September of 2009. Legislation has been introduced in the California State Assembly to establish by law the Hybrid Portfolio as an alternative pathway to licensure in California.
It is a very exciting time to be part of this dynamic and evolving process.
- The Hybrid Portfolio is an initial licensure pathway that allows the Dental Board of California (Board) to delegate the administration of the clinical examination as legally mandated by the California State Business and Professions Code to the five CODA approved Dental Schools in the State of California. The Clinical Competency Exams will be administered under direct oversight and regular auditing by the Board and will utilize the psychometric principles of standardization, calibration, and verification.
- Currently, the required clinical examination is administered at the various dental schools within the state by either the Board or the Western Regional Examining Board (WREB), a private examining group, at the various dental schools within the state.
- The current clinical examination tests in only four clinical areas and is considered a "snap-shot", one point in time exam, as the candidate is assessed in a high-stakes evaluation of competency.
- Candidates pay an examination fee as high as $2,000.00. Additionally, candidates are required to supply patients to sit for the examination.
- Patients may or may not be patients of record of the Dental School, and can be family members, friends, or obtained by other means,
including Craig's List.
Several patients are needed for the exam and are often purchased from a third party for up to $2000 per patient
- Post-examination care is difficult at best if the patient involved with the clinical examination is not a patient of record for the participating Dental School.
- Hybrid Portfolio has been developed by the Board in conjunction with the five Dental Schools, and validated and modified by psychometric analysis.
- The Hybrid Portfolio will be much broader based. It will test in seven clinical areas on patients of record with Competency Exams requiring an "on demand acceptable clinical performance".
- The Hybrid Portfolio consists of sequential candidate evaluation and passing a Competency Exam utilizing a
patient of record in each of the following areas:
- Oral Diagnosis and Treatment Planning; Completed case
- Periodontics: Diagnosis, Scaling and Root Planing procedures
- Direct Restorative: Class II amalgam or composite, and Class III composite
- Indirect Restorative: Fixed Prosthodontics, Crown and Bridge Procedures
- Endodontics: Completed case
- Removable Prosthetics: Completed case
- The 5 Dental Schools have agreed to minimum Clinical Experiences that their students will achieve as a pre-requisite before the student will be deemed ready and thus allowed to sit for the Clinical Examination.
- These minimum clinical experiences are common requirements, and are within the individual school requirements for graduation. Consequently, a student will still need to meet all academic requirements for that Dental School for graduation, allowing for academic autonomy of individual Dental Schools.
- One advantage is that the student candidate can perform the required Competency Examinations throughout their dental school tenure utilizing normal standards of patient care while insuring patient protection in the process. Consequently, the examination is no longer a high pressure, high stakes, snap-shot evaluation.
- Additionally, the procedures are performed on patients who are of record of the individual Dental Schools, ensuring that follow-up care can be obtained if necessary for those involved with this process. Also, the pressure of acquiring patients is alleviated, as the Clinical Examination can be performed at any time once the Clinical Experience requirements have been met. This allows for public protection and safety, minimizing the potential exposure of the patient involved in the current snap-shot examination process.
- The student candidate competency during the Clinical Exams will be evaluated by calibrated examiners who are members of the Dental School faculty. This method has been found to be appropriate by psychometric analysis.
- The Board will continue to maintain authority over this process, assigning the final grade of Pass/Fail to the candidate at the completion of the seven Clinical Examinations.
- Candidates will be required to satisfactorily pass Parts 1 and 2 of the National Board examination and the California Law and Ethics Examination as well, and must be in good Academic Standing as reported by the Dean of each Dental School. They must have no pending ethical issues.
- The finger-printing and background check required by the Board will continue to be part of the application process.
- In order to ensure public safety, the Board will maintain oversight of the process utilizing current Dental Board Examiners.
- The fiscal impact will be significant, as the Board will no longer be required to perform a stand-alone clinical examination which will save considerable licensing funds.