Dental Hygiene Licensure Objective Structured Clinical Exam (DHLOSCE)

OSCEs represent a method of measurement that is valid, reliable, and fair.  OSCEs are standardized and diverse in nature, often including stimulus materials such as radiographs, photographs, and/or physical or 3-D models that provide candidates with an opportunity to demonstrate their knowledge, skills, and abilities for evaluation purposes. Standardized patients (i.e., trained actors) have been used in medical OSCEs.

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

Due to their strong measurement properties, OSCEs are widely used in the health sciences, including fields such as optometry, medicine, physical therapy, radiography, rehabilitation medicine, nursing, pharmacy, podiatry, and veterinary medicine. OSCEs are a key component of the US Medical Licensing Examination for all US medical graduates.  The National Dental Examining Board (NDEB) of Canada currently uses an OSCE in its licensure process for general dentists in Canada.

In the US, the Joint Commission on National Dental Examination’s (JCNDE’s) Dental Licensure Objective Structured Clinical Examination (DLOSCE) is a high-stakes clinical licensure examination designed to assess candidates’ clinical judgment and skills.  The DLOSCE is intended for use by US dental boards to provide information concerning whether a candidate for dental licensure possesses the level of clinical judgment and skills that are necessary to safely practice entry-level dentistry. The following states have adopted regulations that permit either full or partial acceptance of the DLOSCE: Alaska, Colorado, Indiana, Iowa, Oregon, and Washington.*

* In Alaska and Iowa, the DLOSCE partially fulfills these states clinical licensure examination requirement.

There has been a tremendous amount of interest in the JCNDE’s DLOSCE, for use by US dental boards in licensure decision making pertaining to aspiring dentists. Correspondingly, there has been interest and questions as to whether development of a Dental Hygiene Licensure Objective Structured Clinical Examination (DHLOSCE) might also be considered to address state boards’ dental hygiene clinical examination requirement. Requests from individuals for a DHLOSCE grew significantly during 2020. COVID-19 shed light on a desire for the dental hygiene community to have a valid clinical licensure examination that does not require the demonstration of clinical skills on patients. More specifically, the call for a DHLOSCE came informally from a number of different sources, including members of the academic community, state dental boards, the American Dental Hygienists’ Association (ADHA), and candidates. 

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. DTS developed this plan, and the plan was reviewed by several JCNDE standing committees (i.e., 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 dental and dental hygiene subject matter experts, based on practice analysis findings and in accordance with industry best practices and professional standards (e.g., the Standards for Educational and Psychological Testing [AERA, APA, & NCME, 2014]). The JCNDE and DTS pursue rigorous development procedures rooted in psychometrics; these procedures typically require several years to execute. 

DHLOSCE development is expected to proceed as follows:
• 2021: Establish Steering Committee and working committees
• 2022: Build core examination content
• 2023: Develop items and supplemental materials (3D models, stimulus materials, etc.), conducting focused field investigations where necessary 
• 2024: Launch examination and follow-up

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. Candidates will register for this examination on the DHLOSCE website when the site is launched. The examination will be offered during specific testing windows, which will be determined closer to the anticipated launch date (2024).  Please check back to this webpage for future updates.

* In Alaska and Iowa, the DLOSCE partially fulfills these states clinical licensure examination requirement.