INBDE^® History and purpose

The Integrated National Board Dental Examination is a written, cognitive examination for dental licensure which replaces the National Board Dental Examination (NBDE) Part I and Part II examinations.

The new, integrated exam combines content from several disciplines, requiring text takers to blend their knowledge of science with the clinical know-how involved in the safe practice of dentistry to answer many of the test items.

The INBDE has the same overall purpose as the NBDE Part I and Part II: to assist state boards of dentistry in evaluating candidates for dental licensure. By integrating content covering the basic, behavioral and clinical sciences, the INBDE is expected to be more relevant than NBDE Part I and Part II exams.

The JCNDE developed the new exam in response to changes in educational curricula and instructional methods. A Committee for an Integrated Examination was appointed in 2009 to begin developing a new exam instrument for dentistry that would integrate basic, behavioral and clinical sciences. Specifically, the Committee sought to:

• Increase the appropriateness of test content
• Improve the examination experience for candidates
• Better assist regulatory agencies

The JCNDE formed the Committee for an Integrated Examination (CIE) in 2009 after a strategic planning committee recommended merging the NBDE Part I and Part II. This recommendation stemmed in part from changes in the dental education community that began in 2005, after the American Dental Education Association (ADEA) Commission on Change and Innovation recommended changes in curriculum, instructional methods and assessment and outcome evaluation.

The CIE began work on an integrated examination in 2010. Construction of the test began with a review of the basic science areas and clinical competencies considered important for the safe practice of entry-level dentistry. In determining appropriate content, the CIE drew from the clinical competency areas ADEA regards as necessary for new dentists to master and added two areas the Commission on Dental Accreditation considers important. Two science review panels confirmed the relevance of these content areas.

CIE relied on results from a 2011 practice analysis and additional feedback from stakeholders and communities of interest to determine what proportion of questions to devote to each area. This analysis involved a survey that asked practicing dentists to rate how critical they considered certain competencies.

The practice analysis led to test specifications in 2012. The JCNDE approved INBDE test specifications based on a model of the Domain of Dentistry, which includes 10 areas of Foundation Knowledge for the General Dentist based on science, along with 65 clinical content areas determined through the practice analysis to be at least “moderately important to patient care.” The clinical competencies are grouped into three sections: diagnosis and treatment planning, oral health management, and practice and profession.

Test construction committees began developing items for use on INBDE field tests in August 2014. The following year, NBDE Part II candidates were invited to review and comment on selected INBDE sample items in a model item survey that was briefly reopened in December 2015 to collect additional information.

The survey responses indicated that most participating dental students were able to apply their knowledge and clinical experiences to answer sample INBDE items. Most respondents said the test items were straightforward, clinically relevant and required the integration of clinical know-how and knowledge of biomedical and other science disciplines.

Many liked the patient box item format shown below, with its side-by-side presentation and use of images. Patient box items include case information about a particular patient and require test takers to use the case materials to answer test items. Respondents indicated that the patient box format allowed them to easily extrapolate pertinent information and apply what they have learned in classes and clinical work to answer test items.

Throughout the process, CIE gathered evidence supporting the use of INBDE results for dental licensure through validity arguments confirming that the new exam uses appropriate content based on an accepted Domain of Dentistry and clinical competencies considered important for safe entry-level dental practice.

View Domain of Dentistry document (PDF)

View Foundational Knowledge of Dentistry document (PDF)

This timeline gives complete detail on the development of the INDBE.

2009

The JCNDE adopts a resolution to replace the NBDE Part I and Part II with an Integrated National Board Dental Examination (INBDE) and creates the Committee on Integrated Examination (CIE) to oversee the process.

2010

The CIE holds its inaugural meeting in January and continues to meet throughout the year. The committee begins developing a model of the Domain of Dentistry. A workgroup continues this work, developing a draft model which identifies basic science foundation knowledge areas, including behavioral sciences, and reviews the clinical competencies that currently form the basis of the NBDE Part II.

CIE chair Dr. Mark L. Christensen sends the first update on the INBDE. The Joint Commission Newsletter includes an update of the INBDE. The ASDA e-newsletter, Word of Mouth, has a link to the JCNDE Newsletter so students can get information about the INBDE.

By the end of the year, the CIE has refined the draft model of the Domain of Dentistry and makes plans for the validation of the model.

2011

An official update regarding the INBDE is shared with stakeholders as well as an initial INBDE FAQ. The Joint Commission Newsletter includes an update of the INBDE. The ASDA e-newsletter, Word of Mouth, has a link to the JCNDE Newsletter so students can get information about the INBDE.

The CIE reports on the INBDE to ADEA CCI and ADEA through the NBDE update session. The CIE also reports on the INBDE to NDEAF and JCNDE.

A validation of the Domain of Dentistry model matrix is completed by a group of experts who are dentists with a strong science background.

The CIE meets and the committee considers the results of the validation of the model of the Domain of Dentistry and continues discussion on item types.

The INBDE website is launched, providing an updated FAQ and timeline for the examination.

The CIE meets via conference call to plan another science panel meeting.

A validation of the Domain of Dentistry model matrix is completed by a group of general dentists who have been in practice five years or less.

The JCNDE and CIE release two draft documents for external review: Foundation Knowledge for the General Dentist and Model of the Domain of Dentistry. The Joint Commission issues a call for feedback to communities of interest and announces a six-month window for feedback.

The CIE meets and considers the results from the science panels and begins discussion on composition of test construction committee members, test construction/design, potential new item types and methods to improve communication with stakeholder groups.

2012

Preliminary feedback on the first two draft documents (Foundation Knowledge for the General Dentist and Model of the Domain of Dentistry) is reviewed with a deadline of April 30, 2012.

The CIE meets and reviews feedback from stakeholders and communities of interest on the draft documents: Foundation Knowledge for the General Dentist and the Model of the Domain of Dentistry. CIE edits the documents based on this feedback, discusses the validation process for the INBDE, works on development of test specifications, discusses potential item types and considers additional ways to communicate information about the INBDE to all stakeholders and communities of interest. As documents and processes are finalized, they are posted on the INBDE website for review and comment.

The INBDE Test Construction/Design Workgroup meets and continues work on development of test specifications and potential item types.

Several presentations were made by the JCNDE and CIE regarding the INBDE, including to ADEA Academic Deans, Council of Sections (COS), and the Council of Students, Residents, and Fellows (COSRF), ADEA CCI, ADA Board of Trustees, and AADB.

The CIE conducts and reviews a stakeholder and community of interest analysis, to better understand the concerns of these groups and identify potential deliverables that could help to address concerns.

The CIE recommends approval of four key deliverables and votes to forward this report (“Content Domain and Test Specifications”) to the Joint Commission's R&D Committee for review and recommendation at its meeting on February 22, 2013:

1. Model of the Domain of Dentistry
2. Statements and annotations underpinning the Foundation Knowledge for the General Dentist
3. The percentage of items devoted to the ten Foundation Knowledge areas
4. The percentage of items devoted to the three clinical component sections

2013

The Joint Commission's R&D Committee reviews the four deliverables from the CIE and recommends the Joint Commission approve these deliverables at its next meeting. The Joint Commission convenes an INBDE information meeting involving the Joint Commission Chair, standing Committee Chairs, CIE Chair, and a member of the CIE, with the goal of improving internal alignment and communication.

The Joint Commission decided the following at its annual meeting:

• At least four years' notice will be provided before full implementation of the INBDE. Previous statements regarding INBDE launch dates are no longer in effect.
• The INBDE Content Domain and Test Specifications were approved as recommended by the R&D Committee in February.
• To improve communication and alignment, the Chairs of the Joint Commission, NBDE (Standing) Committees (Administration, Examination Development, and R&D) will also be ex-officio members of the CIE. The Chair of the CIE will attend the Joint Commission meeting and, as appropriate, Joint Commission subcommittee meetings. An INBDE briefing will be included in an enhanced orientation for new Commissioners at the beginning of their term.
• NBDE communications to stakeholders and communities of interest will be distributed by the Secretary of the Joint Commission, and replace the Communique from the CIE Chair. A presentation will be provided and maintained on the INBDE website to keep stakeholders and communities of interest up-to-date.

The JCNDE presents a model for developing INBDE test specifications at the National Council for Measurement in Education (NCME) annual conference. The Joint Commission provides an update on INBDE progress to ADA Board of Trustees.

Major updates are applied to all areas of the INBDE website.

The CIE meets in October 2013.

As part of the onboarding process, new members of the Joint Commission are provided with comprehensive training on the INBDE to ensure a solid understanding of the new examination.

2014

The Joint Commission's R&D Committee reviews and endorses two deliverables from the CIE. These deliverables include: 1) a comprehensive set of operational recommendations concerning the INBDE, and 2) model INBDE items for use by INBDE test construction committees. Additionally, the Chair of the Committee on Research and Development refers the deliverables to the Committee on Examination Development for its review.

The Joint Commission's Committee on Examination Development reviews and endorses the two deliverables from the CIE. The Joint Commission reviews and endorses the two deliverables from the CIE.

The Joint Commission delivers an update on INBDE progress to the National Dental Examiners' Advisory Forum (NDEAF) at the AADB midyear meeting.

The Joint Commission's website is redesigned to facilitate accessing the website using mobile devices (smartphones, tablets). The INBDE website content is updated to reflect new INBDE activities.

The INBDE Test Construction Committee (TCC) item writing session convenes for the first time and meets again later in the year.

The CIE meets in June 2014 and October 2014.

2015

The Joint Commission's Committee on Research and Development reviews and endorses five deliverables from the CIE:

1. Updated Domain of Dentistry presentation
2. Comparison of Foundation Knowledge areas
3. Additional INBDE Preliminary Operational Recommendations
4. Updates on the INBDE Item Development Guide
5. INBDE Preliminary Model Items

The Joint Commission presents a session devoted to the INBDE at the ADEA Conference. The Joint Commission delivers an update on INBDE progress during the National Dental Examiner's Advisory Forum (NDEAF) at the AADB Mid-Year Meeting.

During its annual meeting, the full Joint Commission reviews and endorses the aforementioned five deliverables from the CIE. It approves item-writing conventions for the INBDE Patient Box format of case items, and agrees to provide stakeholders and communities of interest at least four years' notice of official, score implementation of the INBDE. The Joint Commission forms an ad hoc committee on image review to focus on improving images and radiographs for the National Board Examinations, including the INBDE. The Joint Commission reviews and adopts the CIE's preliminary operational recommendations for the INBDE and a change in terminology related to clinical areas.

The CIE meets and reviews model INBDE items, including Patient Box presentations. The committee agrees to launch a model item survey during the summer or fall to obtain feedback on items from students eligible for NBDE Part II. CIE reviews draft INBDE Implementation Plan and approves it for posting to the website.

INBDE TCC item writing sessions continue to be held. At an INBDE TCC item-writing session, the "Concept Map" is presented to provide a visual diagram of the test concepts. Test constructors discuss image quality, case selection, model items, and the Sample Item Field Test.

The CIE meets and discusses results from the INBDE Sample Item Survey, and case and item development.

2016

In a teleconference, the Joint Commission approves the INBDE Implementation Plan (PDF) and directs staff to publish it on the website and communicate it to stakeholders and communities of interest in 2016 in presentations and in a mailing to state dental boards.

The Department of Testing Services sends emails to dental program directors and other dental constituents announcing INBDE test construction committee vacancies.

The JCNDE provides information on the INBDE's development in presentations at the ADEA Annual Session in March, and at the National Dental Examiner's Advisory Forum and the ADA's Council on Dental Education and Licensure (CDEL) meeting in April.

The JCNDE sends an informational letter and the INBDE Implementation Plan to state boards.

The CIE agrees to reappoint INBDE Group B test construction committee members and appoint the new INBDE TCCs for 2017, including:

• Two general INBDE TCCs (Groups C and D, each consisting of 15 positions)
• One General Dentist Case Development TCC (9 positions)
• One General Dentist Form Assembly and Review TCC (5 positions)
• One Item Classification TCC (2 positions)

The JCNDE discusses the INBDE’s development progress during its annual meeting and adopts a resolution establishing a retest policy for the INBDE and for the transition period when candidates will have the option of taking the NBDE Part II or the INBDE. The INBDE Item Development Guide is approved for posting to the JCNDE website.

The CIE discusses Short Form Field Test, scheduled for administration during the fall, and incentives for participation.

The CIE selects and assigns TCC members for 2017 and 2018.

The JCNDE provides an update on the INBDE to the New Jersey State Board of Dentistry.

At a meeting held in Chicago, the CIE recommends adding new CIE members, representing TCCs. The Committee also discusses INBDE item development and review, and the number and composition of TCCs for 2017 and recommends adding a general dentist TCC to assess items for clinical relevance.

The INBDE Short Form Field Test is offered to third- and fourth-year dental students who are eligible to take the NBDE Part II.

New CIE members are appointed for 2017 at the end of this year.

2017

The CIE and TCCs continue development of the INBDE, with a prototype Standard Form Field Test (Field Test C) slated for administration in late 2017 for candidates from accredited dental programs who are eligible for NBDE Part II.

The following meetings pertaining to the INBDE are scheduled for 2017:

• February 24 – Committee for an Integrated Examination conference call to discuss results of the INBDE Short Form Field Test
• March 3 – JCNDE Committee on Research and Development meeting to review results of INBDE Short Form Field Test
• June 14 – At JCNDE Annual Meeting, Commissioners are expected to review INBDE Short Form Field Test results
• July 21 – In-person CIE meeting
• November 10 – In-person CIE meeting

2018

The CIE and JCNDE reviewed results of the Standard Form Field Test (Field Test C) and determined whether additional steps are needed before production of the INBDE begins.

The JCNDE issued a formal notification (PDF) that the Integrated National Board Dental Examination (INBDE) will be available for administration beginning on August 1, 2020.

2019

The INBDE Guide was released.

2020

The first official, scored administration of the INBDE was made available for administration on August 1, 2020.

The last administration of the NBDE Part I took place on July 31, 2020.

2022

The last administration of the NBDE Part II took place on July 31, 2022. After this date, licensure candidates will take the INBDE.

All of the National Board Dental Examinations, including the INBDE, are written cognitive exams. They are not clinical exams. Each state board of dentistry has its own requirements for completing a clinical exam. For more information on clinical exam requirements, check with the state board in the state where you are most likely to practice.

The new test relies less on rote knowledge and information recall than the current NBDE examinations do, and instead it emphasizes the relevance of the basic sciences through test items that link science and clinical application. Test items on the INBDE will require candidates to draw from their knowledge of basic science, behavioral science, and clinical competencies to answer them correctly. For example, INBDE questions will ask about patient care, how dentists approach the practice of dentistry, and how dentists keep up with advances in the profession.