BILL ANALYSIS Ó
AB 2331
Page 1
Date of Hearing: April 5, 2016
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Rudy Salas, Chair
AB 2331
(Dababneh) - As Amended March 28, 2016
SUBJECT: Dentistry: applicants to practice.
SUMMARY: Allows an applicant to satisfy the licensure
examination requirement for a dental license by receiving a
passing score on an examination developed by the American Board
of Dental Examiners, Inc. Patient Centered Curriculum Integrated
Dental Examination Format, subject to prior review and approval
of the examination by the Office of Professional Examination
Services, as provided. The bill would also authorize the
Director of Finance to accept funds for the purposes of
implementing the dental examination developed by the American
Board of Dental Examiners, Inc.
EXISTING LAW:
1)Allows for the licensure and regulation of dentists, dental
assistants, and dental hygienists by the Dental Board of
California (DBC). (Business and Professions Code (BPC § 1600
et seq.)
2)Requires applicants for licensure as a dentist to complete
Part I and Part II written examinations of the National Board
Dental Examination of the Joint Commission on National Dental
Examinations. (BPC § 1632 (a))
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3)Requires applicants to complete an examination in California
law and ethics developed and administered by the DBC. (BPC §
1632(b))
4)Requires a passing score on either:
a) a portfolio examination of the applicant's competence to
enter the practice of dentistry, or
b) a clinical and written examination administered by the
Western Regional Examining Board, which the board shall
determine the passing score for that examination. (BPC §
1632.(C))
THIS BILL:
1)Provides that a passing score on an examination developed by
the American Board of Dental Examiners, Inc., Patient Centered
Curriculum Integrated Dental Examination Format, fulfils part
of the examination requirements for the DBC.
2)Specifies that the DBC shall determine the passing score for
the examination.
3)Indicates that the Department of Consumer Affair's Office of
Professional Examination Services shall review the American
Board of Dental Examiners, Inc. examination to ensure
compliance with the requirements of Section 139 and to certify
that the examination process meets those standards, prior to
implementation of the examination.
4)Specifies that if the department determines that the
examination process fails to meet those standards, it shall
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not be implemented. The review of the American Board of Dental
Examiners, Inc. examination shall be conducted during or after
DBC's occupational analysis.
5)Permits the Department of Finance to accept funds for the
purposes of implementing the examination developed by the
American Board of Dental Examiners, Inc.
FISCAL EFFECT: Unknown. This bill has been keyed fiscal by the
Legislative Counsel.
COMMENTS:
Purpose. This bill is sponsored by the American Board of Dental
Examiners, Inc . According to the author, "AB 2331 will
facilitate the recognition of the ADEX Patient Centered
Curriculum Integrated Dental Examination Format (PC-CIF) as an
option for initial licensure in California. This additional
exam option will allow out-of-state dental students seeking to
practice in California, including California residents choosing
to return to their home state, the opportunity to take the ADEX
PC-CIF test in other states where it is administered. This exam
format meets the American Dental Association and California
Dental Associations guidelines for the ethical use of patients
during a licensure exam."
Background. Examination Requirements. The DBC requires that
applicants for licensure as a dentist meet a number of
examination requirements including: 1) passing Parts I and II of
the written examinations of the National Board Dental
Examination of the Joint Commission on National Dental
Examinations, and 2) obtaining a passing score on either the
Western Region Examining Board examination written or clinical
examination, or a portfolio examination. Applicants must also
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complete a California law and ethics examination.
History of the DBC Portfolio Examination. In 2008, the DBC
commissioned Comira Psychometric Services to conduct a study of
competencies in dental education programs. The Board had
concerns about existing clinical examinations, especially in
terms of validity of the content tested and the reliability of
judgments made on examinee performance. Comira identified four
alternatives to initial licensure based on interviews,
observations, and documentation; those alternatives were: 1)
Curriculum Integrated Format (CIF), 2) Objective Standardized
Clinical Examination (OSCE), 3) traditional portfolio, and 4) a
hybrid portfolio examination. The hybrid portfolio examination
was an alternative based upon the synthesis of the traditional
portfolio and test cases (or competency cases) used in the
dental schools for competency evaluations.
In February 2009, Comira prepared a report for the DBC entitled
Alternative Pathways for Initial Licensure for General Dentists,
Final Report, February 9, 2009 which provided findings and
evidence to support the feasibility of an additional examination
for the DBC to add as a pathway to initial licensure. The
report supported the conclusion that the hybrid portfolio
examination model satisfied the criteria identified by the DBC
and the psychometric consultants. Subsequently, Comira prepared
an additional report for the DBC entitled Portfolio Examination
to Qualify for California Dental Licensure, December 1, 2009
which defined the competencies to be tested in the portfolio
examination and provided background research for the
examination's implementation process.
Using the findings of these two reports, the DBC sponsored
legislation, AB 1524 (Hayashi, Chapter 446, Statutes of 2010).
Assembly Bill 1524 eliminated the clinical and written
examination administered by the DBC and replaced it with a
portfolio examination of an applicant's competence to enter the
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practice of dentistry, to be conducted while the applicant is
enrolled in a DBC-approved dental school located in California.
The DBC implemented the Portfolio Examination process in 2014.
The Portfolio Exam is currently offered at four of the six
dental schools in California including: 1) University of
California, Los Angeles, 2) University of California, San
Francisco, 3) University of the Pacific, and 4) University of
Southern California
Portfolio Examination Application Process. The portfolio
examination is to be conducted while the applicant is still
enrolled in a DBC-approved dental school located in California.
The portfolio examination is required to utilize uniform
standards of clinical experiences and competencies approved by
the DBC. An applicant is required to pass a final assessment of
the submitted portfolio at the end of his or her dental school
program. Before the portfolio may be submitted to the DBC, the
applicant must pay the Board a $350 application fee and provide
a letter of good standing signed by the dean of the dental
school, or his or her delegate, stating that the applicant has
graduated or will graduate with no pending ethical issues.
The ADEX Examination. The ADEX examination has been recognized
in 43 states. The new PC-CIF, which the author compares to the
DBC's Portfolio Exam, is only recognized in New York. The PC-CIF
includes structured patient involvement, informed consent, and
patient follow-up.
The author purports that graduates from out-of-state dental
programs, including California residents, have to pass the WREB
examination which requires out-of-state students to travel to
California to take the examination. The author believes that by
adding the ADEX's PC-CIF as an option, students will be able to
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take this examination in the state they are located in
Occupational Analysis. An occupational analysis generally
employs survey methodology to gather job information. That
information may be used to help establish recruitment and
selection criteria for entry into the occupation, and identify
training standards for evaluating training efficacy and
efficiency. Prior to the DBC accepting the ADEX PC-CIF, an
occupational analysis must be completed. In addition, this
measure allows the DBC to accept funding from entities to cover
the costs associated with conducting the occupational analysis
of the ADEX examination to ensure it meets California's
standards.
ARGUMENTS IN SUPPORT:
The American Board of Dental Examiners, Inc. writes in its
letter of support, "AB 2331 will allow the California Board of
Dentistry to recognize the ADEX PC-CIF exam so that students
outside of California can choose this exam for admission to the
state. This provides these students with an exam option that
complies with the patient-centered guidelines established by the
industry leaders."
AMENDMENT:
The author should amend the bill to specify that the provisions
of the bill will go into effect only after the occupational
analysis and psychometric study of the examination are provided
to the DBC.
REGISTERED SUPPORT:
AB 2331
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American Board of Dental Examiners, Inc. (sponsor)
REGISTERED OPPOSITION:
None on file.
Analysis Prepared by:Le Ondra Clark Harvey, Ph.D. / B. & P. /
(916) 319-3301