title: The Buffalo Model: Shifting the Focus of Clinical Licensure Exams in Dentistry to Address Ethical Concerns Regarding Patient Care.
abstract: Most jurisdictions grant dental licensure to graduating students following successful completion of a clinical exam. Testing agencies, which are independent of dental schools, nevertheless conduct their exams at school facilities. Patient participation in these exams raises ethical concerns regarding such issues as unlicensed providers' performing irreversible procedures with minimal supervision and graduates' limited accessibility to provide follow-up treatment. To address these concerns, a collaborative effort between University at Buffalo School of Dental Medicine faculty and testing agency personnel was launched. The aims of this article are to describe the development and implementation of the resulting Buffalo Model, to highlight ethical advantages in its application, and to identify areas of improvement to be addressed in future iterations. With the Buffalo Model, modifications were made to the traditional exam format in order to integrate the exam into the school curriculum, enabling candidates to take it at various points during their fourth year. In addition, after calibration of school faculty members, 98.5% of cases verified by faculty were accepted by the Commission on Dental Competency Assessments for use in the exam. In two cases, restorative treatment completed during the exam did not meet the school's competency standard. This new approach ameliorates ethical concerns associated with clinical licensure exams because treatment is provided only to patients of record within a sequenced treatment plan and timely and appropriate treatment is provided to all patients. The results of this first year of implementation also suggest that calibrated faculty members will not show bias in the selection of lesions or competency evaluations of candidates.
authors.affiliation: Dr. Gambacorta is Assistant Dean for Clinical Affairs, University at Buffalo School of Dental Medicine; Dr. Glick is Professor and William M. Feagans Chair, University at Buffalo School of Dental Medicine; Dr. Anker is Research Assistant Professor, University at Buffalo; and Dr. Shampaine is CEO, American Board of Dental Examiners. jeg9@buffalo.edu.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Gambacorta
authors.affiliation: Dr. Gambacorta is Assistant Dean for Clinical Affairs, University at Buffalo School of Dental Medicine; Dr. Glick is Professor and William M. Feagans Chair, University at Buffalo School of Dental Medicine; Dr. Anker is Research Assistant Professor, University at Buffalo; and Dr. Shampaine is CEO, American Board of Dental Examiners.
authors.forename: Michael
authors.initials: M
authors.lastname: Glick
authors.affiliation: Dr. Gambacorta is Assistant Dean for Clinical Affairs, University at Buffalo School of Dental Medicine; Dr. Glick is Professor and William M. Feagans Chair, University at Buffalo School of Dental Medicine; Dr. Anker is Research Assistant Professor, University at Buffalo; and Dr. Shampaine is CEO, American Board of Dental Examiners.
authors.forename: Ashley E
authors.initials: AE
authors.lastname: Anker
authors.affiliation: Dr. Gambacorta is Assistant Dean for Clinical Affairs, University at Buffalo School of Dental Medicine; Dr. Glick is Professor and William M. Feagans Chair, University at Buffalo School of Dental Medicine; Dr. Anker is Research Assistant Professor, University at Buffalo; and Dr. Shampaine is CEO, American Board of Dental Examiners.
authors.forename: Guy S
authors.initials: GS
authors.lastname: Shampaine
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D006801:Humans; D008005:Licensure, Dental / Q000941:ethics* / Q000592:standards; D017145:Models, Educational; D009518:New York; D005791:Patient Care / Q000941:ethics* / Q000592:standards; D010865:Pilot Projects
keywords: alternate pathways to licensure; clinical licensure examination; dental education; dental licensure; ethics