title: The case against one-shot testing for initial dental licensure.
abstract: High-stakes testing are expected to meet standards for cost-effectiveness, fairness, transparency, high reliability, and high validity. It is questionable whether initial licensure examinations in dentistry meet such standards. Decades of piecemeal adjustments in the system have resulted in limited improvement. The essential flaw in the system is reliance on a one-shot sample of a small segment of the skills, understanding, and supporting values needed for today's professional practice of dentistry. The "snapshot" approach to testing produces inherently substandard levels of reliability and validity. A three-step alternative is proposed: boards should (1) define the competencies required of beginning practitioners, (2) establish the psychometric standards needed to make defensible judgments about candidates, and (3) base licensure decisions only on portfolios of evidence that test for defined competencies at established levels of quality.
authors.affiliation: University of the Pacific School of Dentistry, San Francisco, Calif 94115, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Chambers
authors.forename: Arthur A
authors.initials: AA
authors.lastname: Dugoni
authors.forename: Ian
authors.initials: I
authors.lastname: Paisley
mesh_terms: D002140:California; D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D008005:Licensure, Dental