I m p ressio n s
Integration: A Broad Impact
Years in the Making
by Dr. Stephen T. Radack III, Editor
By now you may have seen in ADA News
(June 28, 2018 - https://www.ada.org/
en/publications/ada-news/2018-archive/
june/new-national-board-dental-
examination) that there is a new National Dental Board Exam
(NDBE) on its way to replace the current exams fondly known
by all dentists as “Part 1” and “Part 2.” The new exam is an
integrated exam and not just a combining of the two current
exams. The exam will integrate the basic sciences with the clinical
sciences. It is scheduled to make its debut in August 2020.
When I sat on the Joint Commission of National Dental Exams
(JCNDE) from 2007-2011, there were several meetings where
developing an integrated national dental board exam (INDBE)
was discussed. In 2009 that discussion turned to action when
an ad hoc committee, the Committee for the Integrated Exam
(CIE), was formed to develop the new exam. Our chair at the
time was Dr. Ron Seeley, a general dentist from North Dakota.
It was up to him to recruit the six members for this new
committee. The final committee was four general dentists, two
representing the American Dental Association (ADA), two
representing the American Association of Dental Boards (AADB)
and two dental educators representing the American Dental
Education Association (ADEA). This committee was formed in
2009 and completed its charge this year after 31 meetings. I can
tell you with complete confidence that no one that volunteered
to serve on the CIE thought the process would take nine years.
If you remember the national boards when you took them,
most of us took Part 1 during or soon after our second year of
dental school. This exam covered the basic sciences that we
were taught in the first two years of school. Part 2 was then
taken, for most students, in the fourth year, and covered the
clinical sciences. This exam had standalone questions, but also
presented cases and asked questions about the patient and
patient treatment in those cases. The inherent problem with
these exams was that once you passed Part 1 and made it to
the clinic, most everything we learned about the basic sciences
got buried deep inside our brains or just disappeared.
The concept of the new integrated exam tests the ability to use
that basic science knowledge and apply it to everyday clinical
situations an entry level dentist will need not only for initial
licensure, but for their careers. One of the first roadblocks the
committee considered when we started our work 8 ½ years ago
was the state of dental education at that time. Most dental
schools taught the way the exam was taken, in silos with the
basic sciences for those first two years, and not in an integrated
approach that would be necessary to take this new INDBE. One
of the first communications that the committee put out was
to make sure that ADEA and the dental schools knew this new
integrated exam was coming and that a change in the way
dental education is taught would be necessary.
Over the many years and many meetings since the committee
was formed, there were many hours of discussion to construct
the building blocks of the new exam. The “Domain of Dentistry”
had to be developed. That consists of three separate parts that
forms the integration: Foundation Knowledge for the General
Dentist (made of 10 parts), the Clinical Competencies (there are
65 of these) and the three Component Sections. A grid with these
three areas intersecting created the basis for the subject and
number of questions in each subject that would be constructed.
The new exam concept has been reviewed by two scientific
panels, and test questions have gone through three field tests
to this point. New test construction teams have been formed
and are currently writing new integrated questions to build
an item bank of questions for the new exam. There are several
of our PDA colleagues who volunteer their time to be test
constructors. Their input is invaluable and they deserve a big
thank you. The change from traditional question writing for
Part 1 and 2 to integrated question writing is a big change, and
there has been a learning curve, but most test constructors
have done a great job.
This is truly an exciting and important time in testing, and if you
would like more information about the INDBE or to see some
sample questions, I would encourage you to check out the
website at: https://www.ada.org/en/JCNDE/INBDE.
JU LY/AU G U ST 2018 | P EN N SYLVAN IA DEN TAL JOURNAL
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