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New National Board Dental Examination to begin in 2020

Committee for an Integrated Examination members honored for their work

June 28, 2018

By Kimber Solana

Group photo of CIE members
Gala: From left, Drs. Lisa Heinrich-Null, Joint Commission on National Dental Examinations chair; Mark Christensen, Committee for an Integrated Examination chair; Stephen T. Radack, III, CIE member; Ron J. Seeley, CIE member; B. Ellen Byrne, CIE member; and Bill Robinson, joint commission vice chair pose for a photo during the CIE Gala, held June 19 in Chicago. The joint commission honored the core members of the committee for their nearly decade-long work in creating the Integrated National Board Dental Examination, which will replace the current National Board Dental Examination Part I and Part II. Committee members not picture are Drs. Bruce D. Horn and Andrew Spielman.
Dr. Mark Christensen still remembers when he was asked nearly a decade ago to chair a committee tasked on developing and validating an exam to replace the National Board Dental Examination.

“I don’t think any of us thought we were signing up for such a long journey,” he said during a recognition dinner held June 19 in Chicago. “I guess we had a lot more stamina that we thought.”

Dr. Christensen was among the core members of the Committee for an Integrated Examination honored for their work on creating the Integrated National Board Dental Examination, a new written, cognitive examination for dental licensure scheduled to replace the current National Board Dental Examination Part I and Part II, also known as NBDE, no sooner than August 2020.

Photo of the Joint Commission on National Dental Examinations plaques and glass bowls
Honored: The Joint Commission on National Dental Examinations presented the members of the Committee for an Integrated Examination plaques and glass bowls in recognition for their work in creating the new Integrated National Board Dental Examination.
Other committee members honored were Drs. B. Ellen Byrne, Bruce D. Horn, Stephen T. Radack, III, Ron J. Seeley and Andrew Spielman.

Citing changes in educational curricula and instructional methods over the years, The Joint Commission on National Dental Examinations, the agency responsible for the development and administration of the NBDE, appointed the committee members in 2009 to develop a new examination. They were tasked on looking for specific opportunities, including increasing the appropriateness of test content; improving the examination experience for candidates; and to better assist regulatory agencies.

“We thought we could get it done a lot earlier,” Dr. Seeley said at the event. “But the important thing was to get it right. And we got it right.”

Major overhaul

While changes and modifications have been made to the National Board Dental Examination since it was first administered in 1933, the new integrated exam would represent a major overhaul.

Since 1933, the NBDE saw several changes. This includes changing its format in the early 1950s from essay questions to multiple-choice questions; the adoption of norm-referenced scoring procedures; and the employment of computer scoring and statistical techniques to identify rule violations.

The Joint Commission was formed in 1980, succeeding the Council on National Board Examinations. Previously, the ADA’s National Board of Dental Examiners was the standing committee established in 1928 to provide and conduct written examinations for use by state boards in making licensure decisions.

When it came to creating a new examination for dentistry, also known as INBDE, the committee knew the exam needed to integrate the biomedical, behavioral and clinical sciences to assess entry-level competence, Dr. Christensen said.

“From the outset, it was clear that this was not to be a combination of Part I and Part II but a whole new examination that would more effectively and efficiently serve the same purpose,” he said. “And that’s why it took so long.”

The process began with identifying the field or domain of cognitive knowledge, skills and abilities needed to safely practice general dentistry, Dr. Christensen said.

“So that was the goal: to come up with a new examination, not dependent on traditional disciplines or previous structure but, instead, directly related to the tasks practicing dentists do,” he said.

‘Better for the public’

To fully appreciate the committee’s accomplishment in accomplishing their goal in creating a new exam, one has to begin with the test construction teams, said Dr. Lisa Heinrich-Null, joint commission chair.

The new test relies less on rote knowledge and information recall than the current NBDE examinations do, and instead emphasizes the decision-making process relevant to the safe practice of dentistry, according to the joint commission. For example, the new exam will include questions asking about patient care, how dentists approach the practice of dentistry and how dentists keep up with advances in the profession.

According to the commission, the new exam is designed to assist state boards of dentistry in making decisions about candidates for dental licensure. It added that by integrating content covering the basic, behavioral and clinical sciences, the exam simulates the decision-making required for the safe practice of dentistry.

To determine appropriate content, the committee drew from the clinical competency areas the American Dental Education Association regards as necessary for new dentists to master to perform successfully, and added two areas the Commission on Dental Accreditation considers important.

In addition, two science review panels confirmed the relevance of the content areas, and the committee relied on results from a practice analysis and additional feedback from stakeholders and communities of interest to determine what proportion of questions to devote to each area.

“They took the ‘unknown,’ learned how to make it better and arrived at a wonderful place,” said Dr. Heinrich-Null. “From my perspective, this historic new exam is a superior way to assess the cognitive skills of a sharpened integratively-taught dental professional to present to their state boards and be the best professional to serve the public.”

The joint commission will officially announce the implementation dates for the new exam and the retirement of the National Board Dental Examination Part I and Part II in the next month or so. According to the commission, the last administration of Part I will occur July 31, 2020; and the last administration of Part II will occur July 31, 2022. The new exam is also expected to include 500 items, compared with 900 in total from both NBDE Part I and Part II.

“The new examination will better protect the public, and it will better serve state boards and students and dental education,” Dr. Christensen said. “It will be a significant improvement — a change that will broadly impact and benefit the profession.”

For more information on the Integrated National Board Dental Examination, visit ADA.org/JCNDE/INBDE.