Practice transition with intelligence and grace.

Viable practices change with the professional and personal needs of dentists and with trends in society. There is no single way for transitioning out of practice--concluding a direct sale, remaining as an associate, and even purchasing a new practice to better match one's more mature lifestyle and practiced preferences. Changing ratios of dentists to patients currently favor a seller's market and emergence of corporate models provide new options. An analysis is given of the Canadian practice market. Planning advice is also offered.

Beginning the discussion of commercialism in dentistry.

There is increasing concern over commercialism in dentistry. Multiple factors contribute to this trend, which has the potential for fragmenting the profession, exacerbating the access issue, and eroding the public's confidence in dentistry. There are both positive and negative aspects of commercialism. Positive approaches for promoting oral health in the face of commercialism hold the greatest promise. The core theme in the recommendations from Ethics Summit on Commercialism is that competent, comprehensive, and continuous oral health care is appropriate and should be promoted to the American public.

Review and revision of the competencies for a beginning dental practitioner in Canada.

In 1994, the first dental competency document developed at a national level was adopted in Canada by all stakeholders. As a result of a recommendation made by the consensus workshop involved in the original process, a 10-year review and revision of the competencies for a beginning dental practitioner in Canada was undertaken and completed. As of November 2005, the revised competencies have been adopted by all stakeholders and are being used as a reference for curriculum management, program accreditation and the development of certification examinations.

Competencies for the beginning dental practitioner in Canada: a validity survey.

As part of the recommended review of the national competencies for beginning general dentists in Canada, a validation survey was distributed to 731 dentists. The survey asked participants to supply demographic information and rate each of the forty-six competencies on a 5-point Likert scale. The response rate was 43.1 percent (315 total usable responses). Self-reported demographic data was used to create respondent subgroups. The participants rated all of the competencies quite high with thirty-six of the forty-six receiving rankings averaging 4.0 or higher on the 5-point scale. No competency received a ranking averaging lower than 3.0. Competencies rated as most important by the entire sample were also rated as most important by all respondent subgroups. The results of this validation survey provide evidence of content validity and reinforce the value of a national competency document that can serve as a reference for curriculum management, program accreditation, and development of certification examinations.

An analysis of the contribution of a patient-based component to a clinical licensure examination.

BACKGROUND: The validity and reliability of high-stakes examinations such as those used by national, regional and state or provincial dental boards are under intense scrutiny by candidates, dental schools, dental educators, dental associations, and state or provincial dental boards. METHODS: The authors followed the progress of 1,063 candidates from nonaccredited dental programs who began the National Dental Examining Board of Canada's (NDEB) clinical examinations between January 1996 and November 1999 through the administration of the examination's final component in December 2003 examine the utility and validity of the patient-based component of the examination process. RESULTS: The results showed that the first three components of the examination were effective in screening out candidates who were not adequately prepared to take the patient-based component. Only 12 (1.1 percent) of the candidates failed the maximum allowed three attempts to pass the patient-based component. CONCLUSIONS: The results demonstrated that the patient-based component did not contribute to the overall examination validity or decision making and did not prevent candidates from obtaining certification. PRACTICE IMPLICATIONS: Owing to this lack of utility, the associated costs and ethical concerns, NDEB eliminated the patient-based component of the examination and replaced it with the requirement to complete an accredited, qualifying/degree completion dental program followed by completion of NDEB's written and objective structured clinical examination components.

Concurrent validity of written and OSCE components of the Canadian dental certification examinations.

The purpose of this study was to assess the concurrent validity of the National Dental Examining Board of Canada (NDEB) Written Examination and Objective Structured Clinical Examination (OSCE) by correlating students' scores with their performance in the final year of the D.D.S./D.M.D. program. The subjects of this study were the 2,317 students at nine Canadian dental schools who completed both NDEB examinations between 1995 and 2000. The findings indicate positive correlations (r = 0.43 and r = 0.46, p < .001, for the written and OSCE examinations respectively) between students' examination scores and final year results. Year-to-year and school-to-school variations were minimal. These findings supported the concurrent validity of both NDEB examinations.

Portability of licensure in Canada based on accreditation and certification.

Although registration and licensure of dentists in Canada is the purview of the ten provincial licensing authorities in Canada, establishment of standards and certification of candidates has for fifty years been the responsibility of the National Dental Examining Board. The NDEB administers a validated set of written and objective standardized clinical examinations to educationally qualified candidates. Such candidates include those who have graduated from accredited Canadian and United States schools and graduates of non-accredited schools who have satisfactorily finished a qualifying program. The NDEB cooperates closely with U.S. educational and accreditation programs and the American Dental Association.

1.3 Development of professional competences.

Competency-based education, introduced approximately 10 years ago, has become the preferred method and generally the accepted norm for delivering and assessing the outcomes of undergraduate (European) or predoctoral (North America) dental education in many parts of the world. As a philosophical approach, the competency statements drive national agencies in external programme review and at the institutional level in the definition of curriculum development, student assessment and programme evaluation. It would be presumptuous of this group to prescribe competences for various parts of the world; the application of this approach on a global basis may define what is the absolute minimum knowledge base and behavioural standard expected of a 'dentist' in the health care setting, while respecting local limitations and values. The review of documents and distillation of recommendations is presented as a reference and consideration for dental undergraduate programmes and their administration.