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We agree with the large majority of leaders in dental education who believe that independent third-party evaluation of dental graduates is appropriate.¹ So in that respect we have no difficulty with Dr. Harper’s contention that the licensure process should fulfill that function. We do have problems with his apparent assumption that clinical licensing examinations as presently conducted provide reliable measures of a candidate’s competence.

One-time clinical observations are demonstrably unreliable,^2,3 and there are much larger sources of variance in the results of such observations than is accounted for by the examiner’s determination.⁴ Our study demonstrated very poor year-to-year consistency of a licensing examination, and negligible internal consistency between clinical sections of that examination. Multiple observations provide greater validity for making decisions than do single observations.⁵ Our faculty (and we presume other faculties) utilize multiple observations for making decisions on pass-fail.

Previous study of results in 2001 demonstrated that decisions made during a clinical licensing examination on ability to do the Class II restorations cited by Dr. Harper did not agree with our faculty’s decisions.⁶ In the face of that lack of consistency, the lack of consistency between clinical licensing examination and faculty determinations seen in our current multiyear study, and the known unreliability of one-shot clinical observation, it is not logical to conclude that it is the clinical licensing examination that provides the correct determination when it is different from the academic decision. In fact, the evidence suggests otherwise.

At the very least, the way licensing examinations are currently done is highly suspect for reliability and validity. Better means of third-party evaluation should be sought.

	REFERENCES

TOP REFERENCES

1. Ranney RR, Haden K, Weaver RG, Valachovic RW. A survey of deans and ADEA activities on dental licensure issues. J Dent Educ 2003;67(10):1149–60.[Abstract]
   
   
2. Chambers DW, Dugoni AA, Paisley I. The case against one-shot testing for initial dental licensure. Calif Dent Assoc J 2004;32(3):243–6, 248–52.
   
   
3. Chambers DW. Portfolios for determining initial licensure competency. JADA 2004; 135(2):173–84.
   
   
4. Chambers DW, Loos L. Analyzing the sources of unreliability in fixed prosthodontics mock board examinations. J Dent Educ 1997; 61(4):346–53.[Abstract]
   
   
5. Cronbach LJ. Test validation. In: Thorndike RL, Angoff WH, Lindquist EF, eds. Educational measurement, Washington: American Council on Education;. 1971: 443–507.
   
   
6. Ranney RR, Wood M, Gunsolley JC. Works in progress: a comparison of dental school experiences between passing and failing NERB candidates, 2001. J Dent Educ 2003;67(3):311–6.[Abstract]
   
   

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ranney, R. R. Articles by Wood, M. Search for Related Content PubMed Articles by Ranney, R. R. Articles by Wood, M.