Dr. Cataldo Leone, associate dean of academic affairs at Boston University Henry M. Goldman School of Dental Medicine, had three years of experience on the Joint Commission on National Dental Examinations before being appointed as the commission’s chair last fall – but that experience still didn’t fully prepare him for the challenges posed by COVID-19.
“Testing centers were closing,” Leone said, describing just one example of an unexpected hurdle he and the commission had to overcome this past year. “We had over 5,000 dental graduates potentially, and an additional 5,000 plus hygiene graduates, who couldn’t get licensed because they couldn’t go to a testing center to take the exam. So we were working, and are still working feverishly, with those testing centers to figure out when they could open, what the physical distancing will be, and how to prioritize the many individuals that need to be scheduled.”
The Joint Commission on National Dental Examinations (JCNDE) is the agency responsible for the development and administration of the National Board Dental Examinations (NBDE). This 15-member Commission includes representatives from dental schools, dental practice, state dental examining boards, dental hygiene, dental students, and the public.
The American Dental Education Association (ADEA) appointed Leone to the four-year term on the commission in 2016. He was elected vice-chair in 2018, and was elevated to chair in 2019 for the 2019-2020 cycle.
“Dr. Leone’s leadership on and service to the Joint Commission on National Dental Examinations has been extraordinary,” said Dean Jeffrey W. Hutter. “In particular, over his term as chair, he has had to tackle issues that no one could have anticipated, and in doing so, has demonstrated tremendous creativity, flexibility, and ingenuity. I am sure I speak for our whole school when I congratulate him on a job very well done.”
As chair of the JCNDE, Leone oversaw the implementation of two different exams: the integrated National Dental Board Exam (INBDE), and the Dental Licensing Objective Structured Clinical Exam (DLOSCE).
“I’ve been a full-time educator for decades,” Leone said. “In my capacity as the associate dean for academic affairs, I really wanted to have a better understanding of the board processes, what went into these exams, some of the background rationale, and even the mechanics of how the questions and the exams are designed.”
The INDBE replaces the National Dental Board Exams (NBDE), a two-part exam. Historically, students took Part I sometime between their first and second years, and Part II sometime between their third and fourth years. Going forward, students will most likely take the INBDE between their third and fourth years.
Leone said moving toward one integrated exam will make the exam more clinically relevant and will allows schools to modify their curriculum.
“Part one [of the exam] traditionally covered the basic sciences and some of the behavioral sciences, and then Part two was primarily clinical sciences,” Leone said. “So, you had this curriculum over four years where the first two years were largely designed for the part one, and then the third and fourth years, the second half, were clinical. Almost as if you had a rite of passage to go from the preliminary basic material to the real dental instruction, you know? And now that there is an integrated exam, then that excuse no longer exists. So schools can design the curriculum in any way they want.”
The first official, scored administration of the INBDE took place on August 1, 2020—the NBDE Part I will be offered until December 31, 2020 (extended due to COVID-19). The last administration of the NBDE Part II will occur on July 31, 2022. After this date, licensure candidates will be expected to take the INBDE.
COVID-19 did affect the implementation of the INDBE. Many testing centers were closed, which left students without a place to take the exam.
“There were schools that had cohorts of students that were going to be impacted,” Leone said. “They needed to take it to be promoted and they were begging to extend the termination times.”
In order to accommodate this, the JCNDE implemented a series of measures, including extending the deadlines for examinations and scheduling additional appointments once the testing centers reopened.
Leone also oversaw the implementation of the DLOSCE, an exam that has been designed as an alternative to the traditional clinical licensing exams that students take during their final year or after graduating from dental school.
Until recently, these licensing exams did not fall under the purview of the JCNDE.
“There are these state and regional clinical licensing boards,” said Leone. “The problem has been is that they still involve the live patient. And we in academia and others have been trying to move away from that for many years.”
The JCNDE, however, has a successful track record of delivering high quality, high stakes examinations for licensure purposes; they also have mechanisms in place to reduce conflicts of interest and help ensure that no single community of interest has an undue influence on governance decisions.
Currently, Alaska, Colorado, Indiana, Iowa, Oregon and Washington are accepting the DLOSCE; other states are considering the DLOSCE for initial licensure.
The DLOSCE was not supposed to be launched until late spring or early summer of 2021. However, due to COVID-19, graduates were unable to take state licensing exams.
“We fast tracked it to be launched in mid-June 2020 as a replacement,” Leone said. “We had to launch it ahead of schedule because the licensing exams with the live patients couldn’t be done, and those groups were scrambling to try to figure out how to give these exams.”
Despite the challenges faced this year, Leone—whose tenure as chair ends in October with the closing session of the annual American Dental Association meeting—said that he will miss his time on the JCNDE. He said that one of the most rewarding parts of being on the commission was learning more about getting to work alongside other individuals so passionate about dental education.
“It’s my last year, and so I’m not only rotating off as chair, I’m rotating off completely as a commissioner,” said Leone. “I really enjoyed my time here. I’ve made some good acquaintances, friendships as well. I look forward to the continued success of the Joint Commission under new leadership.”