Assessment
Development and Implementation of Online National Board Dental Examination Review Courses Cynthia C. Gadbury-Amyot, M.S.D.H., Ed.D.; Kylie Siruta Austin, M.S.D.H.; Pamela R. Overman, B.S., Ed.D. Abstract: Failure on the National Board Dental Examination (NBDE) Parts I and II has troubling consequences for dental students, faculty members, and school administrators. Since the NBDE is a high-stakes exam for all involved, it is important to determine effective strategies to help students prepare. The purpose of this article is to describe the development and implementation of online NBDE Parts I and II Review Courses by the faculty and administration at the University of Missouri-Kansas City School of Dentistry. The courses are taught by faculty members who are content experts. By utilizing distance technology, students in any geographic location can review the material at the time, place, and pace that are most convenient. Early outcomes show that 592 students from thirty-two states have participated in the courses since they were first offered in 2010-11. In post-course evaluations, students report that participation in the courses encouraged them to spend more time preparing for the exam and that the associated PowerPoint slides/handouts provided structure for their review. The literature suggests that multiple modalities are most effective in preparing for the NBDE. These online review courses can serve as a beneficial component of a student’s preparation regimen. Dr. Gadbury-Amyot is Professor and Associate Dean of Instructional Technology and Faculty Development, School of Dentistry, University of Missouri-Kansas City; Ms. Austin is a consultant, School of Dentistry, University of Missouri-Kansas City; and Dr. Overman is Professor and Associate Dean of Academic Affairs, School of Dentistry, University of Missouri-Kansas City. Direct correspondence and requests for reprints to Dr. Cynthia C. Gadbury-Amyot, University of Missouri-Kansas City School of Dentistry, 650 E. 25th Street, Kansas City, MO 64108; 816-235-2054;
[email protected]. Keywords: dental education, dental students, National Board Dental Examination, dental licensure, test preparation Submitted for publication 1/22/13; accepted 4/2/13
D
ental students, faculty members, and school administrators are concerned about how students perform on the National Board Dental Examination (NBDE) Parts I and II because the consequences of failing are troubling for all. Failure to pass the NBDE results in delayed employment, loss of income, psychological consequences, and additional expenses for students. For faculty members with the responsibility of teaching curricular content, their concern is focused on the integrity of coursework, while for administrators, the integrity of the educational program is at stake since pass rates are an important part of outcomes assessment. Therefore, it is critical that dental schools consider strategies for helping students to succeed on the high-stakes NBDE. Although the requirements for licensure vary across states, all require four main components: an educational requirement, a written exam requirement, a clinical exam requirement, and a jurisprudence
1556
exam that evaluates knowledge of the state’s laws and statutes.1 The NBDE Parts I and II typically fulfill the written exam requirement. The purpose of the NBDE as defined by the Joint Commission on National Dental Examinations, the body responsible for development and administration of the exams, is to assist each state’s board of dentistry in assessing the qualifications of dentists who seek licensure to practice.1 The NBDE Part I is taken by dental students to determine their comprehension of the basic biomedical sciences. This part is typically taken following the second year of dental coursework to verify that students possess the basic biomedical science knowledge that dentists should have before beginning clinical practice. The NBDE Part II is comprised of discipline-based and case-based questions from various disciplines within the curriculum. Although the schedule varies from institution to institution and student to student, the NBDE Part II is typically taken towards the end of the fall semester
Journal of Dental Education ■ Volume 77, Number 12
during students’ fourth and final year of study. In 2007, the format of the exams was modified from paper and pencil to web-based; the exam can now be completed at an assigned testing site at any time as long as the student meets the testing requirements of either being enrolled in an accredited dental school (and certified by an academic dean) or obtaining a certification of eligibility.2 On the exams, candidates are evaluated in relation to a standard criterion of performance. Exam results are intended to show if the candidate has met that standard and therefore has the minimum level of knowledge for safe, entry-level dental practice or specialty training.3 A candidate’s total score is computed by the total number of correct answers selected. The total score is then converted to a scaled score, which adjusts for any minor differences in difficulty across the exam forms. The score scale ranges from 49 to 99, with a 75 representing the minimum passing score.1 An individual state may place any limits on acceptance of NBDE results that it deems appropriate. As of January 2012, the scoring is reported using a pass/fail system, rather than with a numerical score. A candidate whose score is reported as a “pass” is deemed to understand important information about basic and dental sciences and have the ability to apply such information in a problem-solving context.1 This article begins with an overview of strategies students have been reported to use in preparing for licensure examinations in the health professions, followed by a look at previous online review courses for such high-stakes exams. It then describes the development and implementation of online NBDE Parts I and II Review Courses by the faculty and administration of the University of Missouri-Kansas City School of Dentistry.
Examination Preparation in the Health Professions Similar to dentistry, many other health professions require written licensure examinations as a means of ensuring that candidates have achieved the level of knowledge, skill, and judgment necessary to practice in a safe and responsible manner. In preparing their students for taking standardized licensure examinations, many educational programs utilize some form of supplemental instruction. The literature provides many examples of preparation courses and predictors for national examination
December 2013 ■ Journal of Dental Education
success in nursing, medicine, pharmacy, and allied health sciences.2,4-10 These reports document that various preparation methods can significantly improve candidates’ overall confidence and satisfaction when preparing for their licensure examinations. Nursing schools use a variety of techniques to prepare their students for the National Council Licensure Examination (NCLEX). In addition to traditional review courses in the classroom, nursing programs report using support groups with other nursing students, organized test plans, data-based item analysis approaches, and peer-advisor programs.5-8 Likewise, nursing programs have utilized advances in technology to incorporate review websites and other computer-assisted online materials to increase pass rates on the exam.6 A study conducted by Beeman and Waterhouse evaluating factors that significantly influenced NCLEX passing rates found that the number of hours students studied before the examination directly affected their pass rate.11 Similarly, virtually all pharmacy students surveyed by Peak et al. used pharmacy licensure examination preparation tools prior to taking the North American Pharmacist Licensure Examination (NAPLEX) or Multistate Pharmacy Jurisprudence Examination (MPJE).9 Since the number of available preparation tools for this exam continues to grow, the need to differentiate between high-quality versus low-quality resources has been identified. Peak et al.’s investigation found that the students surveyed used up to six preparation tools prior to taking the NAPLEX or MPJE. The average number of tools used by the respondents was 2.9. The students reported using a variety of preparation tools, including review textbooks with accompanying CD-ROM, instructor review sessions, commercial review courses, and a pretest prepared by the National Association of Boards of Pharmacy. No single preparation tool, however, was found to be more likely than another to result in success on the exam. Similar to pharmacy and nursing, dental students report utilizing a variety of resources to prepare for the NBDE Parts I and II. Formal review sessions, Dental Decks, board review books, class notes, and textbooks, along with released exams, have all been identified as the most helpful study materials.10 Hawley et al. found that students preferred using Dental Decks and the released exams as primary methods of preparation.2 As with nursing, the most reliable predictor of performance on the NBDE Parts I and II was the average number of reported hours studied
1557
per week. A very weak correlation was found between the number of reported hours studied per week and the amount of curricular release time provided by the institution; this finding suggests that dental educators may want to evaluate the benefits of dedicated release time to allow student-directed study for the NBDE or to utilize alternate methods of education to provide instruction to students at a time most convenient for them, such as evenings or weekends.2 Other methods of education using distance technology for synchronous and asynchronous interaction could be explored to allow easy access to course material any time of day and allow students to access review materials from any location. Hawley et al.’s investigation also found that the sections the students reported they felt the most and least prepared for were a predictor of their performance in those areas.2 There were significant correlations between the section for which the students felt most prepared and the section in which they scored the highest (r=0.357; p
