June 9, 2020
The COVID-19 pandemic has caused dental schools across America to reimagine many aspects of their programs, including clinical operations, infection control, educational technology — and one of the last major milestones for dental students: licensure exams.
Due to the recent shelter-in-place orders in the San Francisco Bay Area, the Arthur A. Dugoni School of Dentistry needed to take a new approach for its Spring Quarter and how it prepared graduating students for these crucial exams.
Routine dental care was not allowed to be delivered under shelter-in-place, which meant that no patients could be scheduled and graduating students would not be able to treat their patients for the exam.
Dugoni School leadership worked closely with the Western Regional Examining Board (WREB) to come up with alternate options for the licensure exams. WREB is one of the five examination agencies for dentists and dental hygienists in the United States.
Using a simulation-based exam, this new validated process would be able to move forward without patients. In addition, a simulation-based exam would allow the exam to be combined into one weekend — June 6-8 on the Dugoni School campus in San Francisco. Typically, the patient-based exam is scheduled over two weekends.
The Dugoni School’s Building Operations and Clinical Operations teams worked hard to prepare the dental clinics for this new approach. The school turned 72 of its dental clinic operatories on its third floor into simulation stations by removing the headrest and installing dental manikins to serve as patient simulators. This engineered solution allows students and test takers to authentically simulate the patient care experience using exactly the same instrumentation and ergonomics used for direct patient care. Along with a host of safety measures for screening, entry, and flow through the building, the school also utilized a dental laboratory outfitted with simulation stations and ensured that students would have enough physical distance between them during the exam.
The new approach required a change in a California state regulation around licensure exams, so the Dugoni School worked with partner organizations to advocate for the change. The California Dental Association, American Student Dental Association, the Dugoni School and other California dental schools communicated the need for this modified exam to state leaders. This advocacy supported licensure for the graduating students across the state and ultimately the nation. Equally as important, this advocacy allowed for these practitioners to enter practice and begin addressing the pent-up need for oral health care in our communities after a prolonged shelter-in-place. The Dental Board of California and California Department of Consumer Affairs ultimately approved the non-patient-based exam and allowed it to move forward.
Feedback about the simulated exam from students and examiners alike has been positive. The school’s clinical leadership had a debriefing with the WREB chief examiner who was very complimentary about how well prepared the students were for this new exam format.
“It was definitely nerve wracking being one of the first classes to take the manikin-based exam, but the school did a great job of preparing us the week beforehand,” said Leah Life of the DDS Class of 2020. “I’m grateful we had the opportunity to take it so soon after the Dental Board of California approved the manikin-based exam. I think it was a great test of our abilities and have faith our class did great!”
Fellow Class of 2020 member Letitia Edwards commented, “Being the first class in the nation to take an entirely manikin-based licensure examination felt like history in the making. Organized dentistry has been advocating for years to remove the patient-based components of the licensing exams in lieu of a manikin-based portion, and we've finally done it! I hope that this will continue for years to come. I can't thank the Dugoni School family, WREB examiners, and staff members enough for helping us in our journey to become licensed dentists. Everyone truly came together to ensure that the exam ran smoothly, without any hiccups, and that we could perform our best even under these turbulent circumstances.”
“I’m so proud of the entire family here at the University of the Pacific Dugoni School of Dentistry and all of our partners, specially the California Dental Association, who helped make this simulation-based licensure exam a reality,” said Dr. Nader A. Nadershahi, dean of the Dugoni School. “This creative approach ensured that our graduating students could finish up their programs and pass this key milestone before moving to the next phase of their career, instead of having to wait many more months or longer to take the WREB exam. While the pandemic has caused much disruption, it has also allowed us to pursue innovative approaches to dental education and licensure. I am confident that these graduates will help shape an even stronger future for our great profession.”