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Record W3048712772 · doi:10.2341/1559-2863-45.4.341b

COVID-19 Pandemic Is Here, Airplanes Crash, and the Profession Has an Educational Dilemma

2020· article· en· W3048712772 on OpenAlex
Jill Anderson

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

aboutThe title or abstract carries a Canadian signal from the geographic lexicon.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenueOperative Dentistry · 2020
Typearticle
Languageen
FieldDentistry
TopicDental Research and COVID-19
Canadian institutionsnot available
Fundersnot available
KeywordsLicensureObjective structured clinical examinationMedical educationCompetence (human resources)MedicineAccreditationPandemicPsychologyCoronavirus disease 2019 (COVID-19)Pathology

Abstract

fetched live from OpenAlex

It has been said that “one should beware when the camel's nose is beneath the tent.” The camel's nose is a metaphor, of course, for a situation where the permitting of a small, seemingly innocuous act will open the door for larger, clearly undesirable actions.Recently (January 2018), the American Dental Association (ADA) took action to support its policy calling for the elimination of patients from the dental licensure examination process. The ADA requested that the Council on Dental Education and Licensure direct the development of a Dental Licensure Objective Structured Clinical Examination (DLOSCE).The ADA DLOSCE would be a written exam (much like the OSCE-administered exam in Canada) that excludes the assessment of clinical skills completed on a live patient. Written tests are an effective way to find out what level of knowledge has been acquired. No part of the OSCE assesses the applicant's clinical skills or patient management.The Western Regional Examining Board (WREB) dental examination is a highly developed and respected clinical examination that is already accepted by about 44 states for licensure. Most dental schools also test students for clinical competency with patients at some point. The issue, however, is whether schools' testing and determination regarding candidate readiness is sufficient to eliminate a third-party, high-fidelity, patient-based assessment. There is a small but consistent number of candidates who, despite graduating from an accredited program, are still unable to demonstrate acceptable competence when working independently. These students are unable to perform a simple restoration on a patient even after multiple attempts. Dental schools are either (a) knowingly graduating a small number of non-ready candidates, relying on an independent, third-party clinical exam to “apprehend” them, or (b) unknowingly allowing this small number of candidates to get through via an insufficient assessment of minimal competency… which is more disturbing. It is especially disturbing this year, as the COVID-19 pandemic has caused most dental schools (just weeks before graduation) to close classroom lectures and provide only limited care to patients. Clinical competency examinations may be severely compromised or eliminated entirely. These issues make existing clinical board exams very important in keeping a small number of candidates (about 3%) from practicing until they are able to demonstrate minimal clinical competence on a patient.The WREB operative dentistry clinical examination includes the following topics: local anesthesia and pain management, moisture control and soft tissue management, communication and patient management, disease management and removal, instrumentation with material handling skills, and anatomic/functional skills. If dental schools are not testing students with live patient clinical examinations, then who can be trusted to protect the public? One might even ask: What is the point of having examinations at all, especially if the number of failures is so small? Consider the following: most people trying to board airplanes are not terrorists, but the millions of people trying to board go through elaborate security procedures every day. Are these procedures 100% foolproof and perfect? No, but scrapping them for no screening at all would reduce public safety. And if the COVID-19 pandemic means dental students are unable to complete their clinical requirements or their clinical competency examinations, how will dental schools certify student readiness to practice dentistry? The educational dilemma is worsened because outside testing agencies (like the WREB) will likewise have similar difficulties giving clinical examinations if the COVID-19 pandemic persists.In education, most will agree that “trust is the coin of the realm.” The public would like to trust our educators, and the following questions might help with understanding the educational dilemma:The ADA is an immensely powerful and influential lobby. The deans of dental schools have a vested interest in getting their students a dental license to practice and will undoubtedly also have great influence. Without a doubt, both will argue vigorously for the development and implementation of OSCEs. That said, the public should be wary. Poorly tested pilots, poorly tested airplanes, and dentists who are inadequately tested on live patients can be hugely dangerous to the public.These are strange and challenging times for dental educators.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesInsufficient payload (model declined to judge)
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.058
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0010.001
Scholarly communication0.0010.000
Open science0.0010.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0060.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.115
GPT teacher head0.426
Teacher spread0.312 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it