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Joint Commission announces successful implementation of new clinical dental licensure examination

The Joint Commission on National Dental Examinations announced Feb. 24 the successful implementation of its new Dental Licensure Objective Structured Clinical Examination, or DLOSCE, which utilizes 3D models to assess dental licensure candidates’ clinical judgment and skills without the need to involve patients.

The new DLOSCE represents a significant leap forward in new technology in the standardized assessment of aspiring dentist, according to the Joint Commission.

“The DLOSCE provides a comprehensive evaluation of the clinical judgment that is necessary to safely practice dentistry, advancing assessment technology and helping to address ethical concerns with current clinical licensure examinations,” said Joint Commission chair Kanthasamy Ragunanthan, D.D.S. “We are confident that the DLOSCE will prove to be an invaluable tool to support the work of state dental boards in their mission to protect the public health.”

According to the Joint Commission, unlike current clinical dental licensure examinations — and consistent with examination trends in medicine, nursing and other health professions — the DLOSCE does not require candidates to perform procedures on patients. Instead, actual patients are replaced by advanced 3D-models in a controlled virtual environment.

“This examination promotes clinical fidelity, fairness, objectivity and validity at a time of great need in our country,” said Dr. Ragunanthan.

In addition, the DLOSCE can decrease the risk of exposure to COVID-19 and other airborne pathogens for those involved.

Development of the examination was approved in February 2017. At that time, the DLOSCE Steering Committee was formed and charged with the task of developing and validating an examination for clinical dental licensure purposes. Governance of the DLOSCE Program was assigned to the Joint Commission in January 2020. On March 31, 2020, the Joint Commission approved a resolution making the DLOSCE available for use by dental boards in June 2020.

The JCNDE has now successfully completed two administration windows for this examination, and will begin a third window on April 1. The DLOSCE is administered in partnership with Prometric, whose expertise was critical in the deployment of the examination across the Unites States.

The Joint Commission indicates that six states have adopted regulations which permit full or partial acceptance of the DLOSCE. The DLOSCE is comprehensive in its assessment of clinical judgment, including content in the following areas: restorative dentistry; prosthodontics; oral pathology; pain management and temporomandibular disorders; periodontics; oral surgery; endodontics; orthodontics; medical emergencies; and prescriptions. The DLOSCE is supported by content validity arguments, the same type of validity evidence used to support the Joint Commission’s other examination programs, including the National Board Dental Examination Part II, the National Board Dental Hygiene Examination and the Integrated National Board Dental Examination.

At its core, the DLOSCE is designed to help dental boards protect the public health, and the Joint Commission said it believes it does so much more effectively than existing clinical licensure tools.

“The DLOSCE is the first dental licensure examination to employ a laser focus on clinical judgment to help protect the public,” said William F. Robinson, D.D.S, a former member of the Florida Board of Dentistry who also served on the DLOSCE steering committee. “This is an unmatched advancement in dental licensure and will ultimately have a positive impact on the oral and overall health of the public.”


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