Sept. 8, 2017
On September 6, three Marquette ASDA students (Miranda Brown, Ryan Dodge, and I) traveled to Madison to participate in the Dental Examining Board’s public hearing on live patient licensure exams. Also present to testify were representatives from ADEX, the WDA, the ADA, and Dean Lobb. The DEB allowed time for each person attending and time for the board members to ask questions.
What Marquette ASDA brought to the table: Students presented on the darker side of live patient exams. We discussed the ethical concerns of using patients for examination. These patients often receive no follow up care and may receive unnecessary treatment (think about how many patients with low caries risk receive radiographs for screening). We spoke about the bribery and extortion that occurs with convincing patients to sit for exams. We explained how patients can hold students “hostage” by refusing to come in unless they are paid double what was offered. We told personal stories, and used ASDA’s stance on licensure (as explained in the white paper) to the board.
What else was discussed: The ADA introduced the development of their DLOSCE (Dental Licensure Objective Structured Cognitive Exam). This is a non-patient based exam that requires diagnosis, treatment planning, and critical clinical thinking based on cases, models, and radiographs. This exam will be piloted in 2019 and used in 2020. ASDA believes that the OSCE is part of the ideal licensure exam. The board spent a great deal of time discussing ADEX’s Curriculum Integrated Format exam (also known as CIF or the Buffalo Model). This model has examiners come to the school every three weeks. It allows candidates to take the exam over several days at the same time they take their schools exam. The student gets credit for ADEX and for their PBSE. Patients must be patients of record at the school and have an approved treatment plan by the school. There is no penalty if the patient fails the appointment. The DEB discussed that the CIF model diminishes many of the ethical issues with using patients for exams
ASDA’s position on CIF: ASDA’s official position is that CIF exams do not meet our definition of an ideal exam. While it is improved over the current model, it still leads to delaying of treatment, bribing patients, and a one day high stakes clinical environment. CIF exams still use humans as exam subjects, which we believe is unethical. Marquette students urged the board to really explore what benefit live patients accomplished as opposed to a non-live patient exam (such as a mannequin portion and/or an OSCE). Studies have shown that there is no added benefit to a live-patient portion.
What’s next: The DEB agreed to have several speakers back in at their November meeting to revisit licensure exams. If the board comes to an agreement to change licensure, they will recommend a change to Wisconsin law. Changes in licensure will come, but it will be a long process. To keep updated on the information, stay in contact with myself or your Legislative Liaison, Miranda Brown.
To read ASDA’s stance on licensure: https://www.asdanet.org/docs/advocate/asda_white-paper_licensure_web_final.pdf?sfvrsn=6Subjects: Advocacy LegislativeCommittee