Transcript The Buffalo Exam

The Buffalo Model
Joseph E. Gambacorta, DDS
Assistant Dean for Clinical Affairs
University at Buffalo School of Dental Medicine
Background

In 2012 applications for licensure
decreased in New York State and
NYSDA forms PGY1 Task Force.

November 2014 first planning
session at UB with CDCA & NYSDA.
PGY1 Task Force
Pilot Exam

To assure that patient care is
protected.

Care on patients of record
in a normal course of treatment.

Integrated exam to be offered
continuously throughout the D3
and D4 year.
Establishing a Process

PGY1 Task Force Report used as
a basis to formulate exam model.

Advisory Group formed
UB Clinical Staff
D3/D4 Group Directors
Student Leadership
CDCA
NYSDA
Curriculum
Integrated Format - CIF
In 2007 ADA House defined CIF as:

Treatment performed on patients of
record with sequenced treatment plan.

Exam assessment integrated into
dental school curriculum.

Multiple exams scheduled during
the academic year.
The Buffalo Model
Is a modification of the traditional
licensure exam format which enables
the focus of the exam to shift from
the candidate to the patient.
Exam Modifications

Faculty & Curriculum integration

Patient eligibility restricted

Multiple exam dates available

Exam part of normal clinic day
Faculty/Curriculum
Integration


CDCA faculty calibration session
Revised faculty role includes:
Prior to Exam
- lesion/case approval
Exam Day
- competency assessment
- documentation
- supervise definitive treatment
Patient Eligibility
Treatment MUST be rendered on
patients of record as part of
an appropriately sequenced
treatment plan.
Exam Schedule

Six exams were scheduled every 3 weeks
January – May.

Manikin Exam – one session

Retakes offered at all exams.

Eligible candidates were allowed to
register with only two sections of the
clinical exam approved.
Normal Clinic Day
Seamless integration of the exam
was achieved as a result of:

Control in populating exam

UB faculty, staff and student support

Available clinic space

Flexibility of CDCA

CDCA and UB faculty interaction on
the clinic floor.
Intended Consequence
The Buffalo Model
is the
Curriculum Integrated Format
in action.
Orientation
Before each exam UB and CDCA held
a joint orientation session to:

Schedule exam patients into database.

Review parameters of ADEX exam.

Discuss faculty role.

Outline documentation requirements.
Exam Day

CDCA established a Buffalo exam team.

UB staff coordinate clinical activities.

Prescheduled clinical assignments
continue uninterrupted.

Continuous interaction between
Examiners and UB faculty/staff.

Definitive treatment model established.
Results

Case Approval

Competency Exams

Class of 2015 Results

WREB/ADEX Comparison
Case Approval
RESTORATIVE
EXAM DATE
ACCEPTED
REJECTED
PERIODONTICS
ACCEPTED
REJECTED
JANUARY 20
15
0
9
0
FEBRUARY 10
31
0
14
0
MARCH 24
40
2
16
0
APRIL 14
37
0
23
1
MAY 12
10
0
5
0
98.5% of the restorative lesions and periodontal cases
pre-approved by UB faculty were accepted by
CDCA examiners.
Competency Exams
EXAM DATE
Total
D4’s
Total
OPER
Total
PERIO
UB
PASS
UB
FAIL
ADEX
PASS
ADEX
FAIL
JANUARY 20
9
8
4
8
4
8
4
FEBRUARY 10
17
9
3
12
0
12
0
MARCH 24
25
11
2
11
2
13
0
APRIL 14
27
8
7
15
0
15
0
TOTAL
78
26
16
46
6
48
4
- NO COMPENCIES OFFERED DURING MAY 12th EXAM.
- NO FAILURES IN PERIO.
- TWO CANDIDATES PASSED ADEX BUT NOT UB COMPETENCY.
- COMPETENCY OPTION WELL UTILIZED BY STUDENTS.
Class of 2015 Results
EXAM DATE
# D4
s
2-SECTION
REGISTRATION
3-SECTION
REGISTRATIO
N
TOTAL
PASS
TOTAL
FAIL
JANUARY 20
9
3
6
5
4
FEBRUARY 10
17
4
11
17
0
MARCH 24
25
10
10
23
2
MARCH 28
61
N/A
N/A
49
12
APRIL 14
27
8
10
24
3
MAY 11
11
N/A
N/A
11
0
MAY 12
9
3
0
8
1
66.6% of UB candidates passed the ADEX
exam on their first attempt.
WREB/ADEX
EXAM
# D4s
RESTOR
.
PERIO.
ENDO.
WREB
39
9
9
7
ADEX
61
9
9
9

Nine candidates challenged both exams.

Only first attempts were considered.

Prosthodontic manikin only part of ADEX.

Student comments most important result in this
comparison.
Student Perspective

Presence of faculty helped establish trust
between students and examiners.

No need to search for “ideal” lesions.

Flexible scheduling reduced the stress of “all
or nothing weekend exam”.

No extracted teeth to mount and radiographs
to take.

It felt like a regular day at school.
UB Next Steps

Establish faculty, da, and runner
coverage schedule.

Pre-exam chart review.

Treatment plan submitted as part of
patient intake.

Move manikin exam to fall semester.

Certify D3 candidates to challenge at
the end of the spring semester.
Next Steps Nationally

Educate the dental community
– 2016 ADEA Annual Session
– seminars/publications

Pilot The Buffalo Model at other
dental schools – CDCA survey.

Standardization of the process to
facilitate ease in implementation.
Thank You

Dr. Michael Glick

UB faculty, staff and students

CDCA examiners and staff

ADEX

NYSDA – PGY1 Task Force

Mr. Michael Zeder

Dr. David Perkins

Dr. Guy Shampaine
questions