Would ending the use of human subjects in the clinical licensure examination be a positive move for dentistry?
In October, the ADA House of Delegates adopted a resolution calling for an end to the use of human subjects in dentistry’s clinical licensure examinations by 2005.
Res. 64H, which details the ADA’s new policy, will be transmitted to all clinical testing agencies. The measure originated with the American Student Dental Association, which hailed the House vote as a positive step toward improving dentistry’s licensure process.
In response to November JADA’s Question of the Month, 78 percent of the 677 respondents said they view the resolution as a positive move. One-third of these respondents (182) identified themselves as dental students.
Respondents’ comments focused mainly on the stress involved and costs students bear, as well as how using mannequins instead of live subjects would help standardize the examinations and make them less subjective. "This will help ensure that each student can be tested on an equal playing field," said reader.
"Now it will be a uniform process," said another. "There are too many variables as it is now: whether the patient shows up, casting failures and finding the right kind of defect in a patient’s tooth to use in the exam."
"I’ve seen people fail the exam because their patients didn’t show up," said a reader. "That is ridiculous."
Some respondents said they believe a clinical examination is not necessary, as students who have graduated from accredited dental schools already have demonstrated their clinical competence. "Neither medical students nor residents have to do this," said one reader. "It is understood that they receive enough technical training in their education."
Asked another, "If testing on live patients is essential, then why don’t other health care professions do it?"
Other readers said they object to using humans in testing. "It’s barbaric," said one.
"A large percentage of the public is against animal testing," said another. "But in my eyes, use of live patients in licensure exams is far more objectionable."
Twenty-one percent of respondents did not view Res. 64H as a positive move. Overall, they said they believe it is best to demonstrate competence on live subjects. "No mannequin can mimic the realities of working ‘wet,’ " said one reader.
"A moving tongue and saliva field are major factors when working on a patient," said another. "These aspects are lost when mannequins are used."
These respondents also raised the patient management issue. "Treating the human patient in an exam setting gives a more complete look at the applicant’s clinical and patient management skills," said a respondent. "It should be retained."
"Dentistry is the not just the treatment of teeth," said another reader. "It is the treatment of patients and their oral health."
One percent of respondents said they don’t know if Res. 64H is a positive move.
"It could be less subjective, which is a positive," said one. "But there are areas like periodontics or prosthodontics that might be hard to duplicate without using human beings."
For more information about Res. 64H, call ASDA at 1-312-440-2795. Or dial the toll-free number on the back of your ADA membership card and ask for Ext. 2698 or call 1-312-440-2698, which will connect you with the ADA Council on Dental Education and Licensure. If you want to encourage your state to adopt this measure, contact your state dental society.
