Dental Licensure Objective Structured Clinical Examination (DLOSCE) FAQ

The Joint Commission on National Dental Examination’s (JCNDE's) Dental Licensure OSCE (DLOSCE) is envisioned as a high-stakes examination consisting of multiple, standardized stations each of which will require candidates to use their clinical skills to successfully complete one or more dental problem solving tasks.  The OSCE format often includes physical materials, such as radiographs, photographs, models, and order/prescription writing. Standardized patients (actors) have been used in medical OSCEs.  The National Dental Examining Board (NDEB) of Canada’s OSCE is presented as a written, multiple-choice examination that presents stimulus materials in multiple stations. Advances in simulated patient and haptic technologies suggest that simulations may be incorporated in a dental OSCE sooner rather than later.

OSCEs were developed to help accurately assess the complex notion of clinical competence in the medical field.  More specifically, Harden, Stevenson, Wilson Downie, and Wilson (1975) indicated that they introduced the OSCE format to avoid many of the weaknesses and disadvantages of traditional clinical examinations.

OSCEs are widely used in the health sciences, including: optometry, medicine, physical therapy, radiography, rehabilitation medicine, nursing, pharmacy, podiatry, and veterinary medicine. Since their inception in the 1970s, OSCEs are now part of the US Medical Licensing Examination for all US medical graduates. Similarly, the NDEB Canada OSCE is used for dental licensure in Canada. 

Colorado accepts an OSCE for initial licensure. Minnesota accepts the Canadian OSCE for initial licensure. The Canadian OSCE is administered annually at the University of Minnesota, exclusively for graduates of that institution.  Other states are currently considering an OSCE for initial licensure. The JCNDE DLOSCE will serve as another tool state boards can use to help determine candidate clinical qualifications for licensure. Each dental board will make its own choice as to whether to use or not use the DLOSCE.

None of the regional clinical examination agencies (CDCA, CITA, CRDTS, SRTA and WREB) currently offers or administers a dental licensure examination in the OSCE format.

The Joint Commission on National Dental Examination's (JCNDE's) DLOSCE will be designed to provide information to US dental boards, concerning whether a candidate for dental licensure possesses the necessary level of clinical skills to safely practice entry-level dentistry. This will be accomplished through the use of a valid and reliable examination that has been professionally developed. 

There are many reasons why the JCNDE is developing a DLOSCE and why the JCNDE feels it is uniquely positioned to build a high quality clinical licensure examination:

• The JCNDE has a long and successful track record of delivering high quality, high stakes examinations for licensure purposes, that help protect the public.
• As the governing body that oversees both the NBDE and DLOSCE Programs, the JCNDE is positioned to provide a comprehensive evaluation of the skills necessary to safely practice dentistry. 
• The JCNDE is a Commission with mechanisms in place to reduce conflicts of interest and help ensure that no single community of interest has an undue influence on governance decisions related to the DLOSCE.  
• The JCNDE possesses the in-house expertise to develop an OSCE through the Department of Testing Services (DTS), which is staffed by testing professionals with advanced degrees in psychological measurement and related fields.
• Lastly and most importantly, the JCNDE feels that a DLOSCE can protect the public health more effectively than existing clinical licensure solutions.

It is anticipated that a pilot exam will be available in 2020, with deployment occurring in 2021.

The Board of Trustees authorized formation of a DLOSCE Steering Committee charged with the task of developing and validating the DLOSCE. In January 2020, the Board of Trustees approved the transfer of final development and future administration oversight of the DLOSCE to the Joint Commission on National Dental Examinations (JCNDE).

The DLOSCE Steering Committee is composed of the following individuals, based on criteria established by the Board of Trustees:

• Roy Thompson, TN, Chair
• Craig Armstrong, TX

• Edward J. Hebert, LA
• Prabu Raman, MO

• Michael Kanellis, IA
• Frank Licari, UT

• David Carsten, WA
• Mark R. Stetzel, IN

• Cataldo Leone (Chair), MA
• William Robinson, FL

• Identify and establish content areas and test specifications for the examination (using results from a practice analysis)
• Establish the general structure of the examination (number of stations) and permissible item formats (manikin, haptic feedback device, etc.)
• Identify and contract with key vendors (e.g., technology, administration) in support of the examination
• Identify and establish test construction committee (TCC) structure
• Identify the first state(s)/region(s) for the DLOSCE field test
• Develop the candidate guide
• Prepare software tools (e.g. Aptify) for DLOSCE candidates and test users
• Identify an appropriate governance structure for DLOSCE administration