Dental Hygiene Licensure Objective Structured Clinical Exam (DHLOSCE™)

OSCEs are widely used in the health sciences, including optometry, medicine, physical therapy, radiography, rehabilitation medicine, nursing, pharmacy, podiatry, and veterinary medicine. Since their inception in the 1970s, OSCEs are now part of the U.S. Medical Licensing Examination for all medical graduates.

THE OSCE exam format often includes stimulus materials such as radiographs, photographs, models, and prescription writing. Standardized patients (actors) have been used in medical OSCEs. The National Dental Examining Board (NDEB) of Canada uses an OSCE for dental licensure throughout the country. The exam is presented as a written, multiple-choice examination that presents stimulus materials in multiple stations. Advances in simulated patient and haptic technologies suggest that simulations may be incorporated in a dental OSCE sooner rather than later.

OSCEs were developed to help accurately assess the complex notion of clinical competence in the medical field. More specifically, Harden, Stevenson, Wilson Downie, and Wilson (1975) indicated that they introduced the OSCE format to avoid many of the weaknesses and disadvantages of traditional clinical examinations.

The JCNDE launched the Dental Licensure Objective Structured Clinical Examination (DLOSCE) in 2022 as a high-stakes clinical licensure examination for U.S. dentists. Dental boards will use examination results to help them determine whether a candidate shows the level of clinical judgment and skills needed to safely practice entry-level dentistry.

Learn more about the DLOSCE

There has been tremendous interest in the creation of an OSCE exam that U.S. dental boards can use in evaluating dental hygiene candidates. Requests for an exam of this kind grew significantly in 2020, as COVID-19 shed light on the need for a valid clinical licensure exam that does not require candidates to work with live patients. The call for a dental hygiene OSCE came from many sources, including members of the academic community, state dental boards and the American Dental Hygienists’ Association, as well as test candidates themselves.

In June 2020, the JCNDE adopted a resolution directing the Department of Testing Services (DTS) to create a business plan concerning the potential development of a DHLOSCE. After DTS developed the plan, it was reviewed by several JCNDE committees, including the Committees on Administration, Dental Hygiene, Examination Development, and Research and Development. The plan was considered by the full JCNDE in June 2021, at which time development of the DHLOSCE was approved.

DHLOSCE content will be determined by subject matter experts in dentistry and dental hygiene, based on practice analysis findings and in accordance with industry best practices and professional standards such as the Standards for Educational and Psychological Testing (AERA, APA, & NCME, 2014). The JCNDE and DTS follow rigorous development procedures rooted in psychometrics, which typically require several years to execute.

DHLOSCE development is already underway, with steering and working committees established in 2021 and core content being built in 2022. Steps for 2023 include development of test items and materials such as 3D models and stimulus materials. Focused field investigations will also be conducted as needed. The examination is expected to launch in the 4th quarter of 2025.

The Dental Hygiene Licensure Objective Structured Clinical Examination (DHLOSCE) is now accepted in the following states in fulfillment of board clinical licensure examination requirements. Please refer to each state board’s website for specific details, clarifications, and updated policies.

Arizona

Kentucky

Oregon

No. The DHLOSCE will be a national examination measuring the clinical judgment and skills required to perform clinical dental hygiene tasks identified through a dental hygiene practice analysis.

Application procedures are likely to mirror procedures currently in place for the National Board Dental Hygiene Examination (NBDHE). Candidates will register for the examination online via the JCNDE website. The examination will be offered during specific testing windows, which will be determined closer to the anticipated launch date in the 4th quarter of 2025. Please check back here for future updates.