The clinical competency examination (CCE) is a vehicle to ensure attainment of skill, knowledge, and value by dental students in a specific discipline.
At Penn Dental Medicine (PDM), administration of an Oral Cancer CCE is within the domain of the Department of Oral Medicine. The Oral Cancer CCE relates to the institutional competency statement of recognition of the normal range of clinical findings, deviations, and establishing a differential diagnosis for orofacial abnormalities and pathology.
PROBLEM
Due to the COVID‐19 pandemic, conventional didactic and clinical dental education came to an abrupt halt.
Several fourth‐year dental students at PDM had not yet completed the Oral Cancer CCE required for graduation. The problem was how to administer the Oral Cancer CCE to these students in light of cessation of clinical instruction due to the current pandemic.
SOLUTION
Virtual platforms used by PDM, such as Canvas (Instructure, Salt Lake City, UT, USA) and BlueJeans (Verizon Communications, Mountain View, CA, USA), were utilized to address to this problem. Oral Medicine faculty developed a virtual Oral Cancer CCE with 2 components, for those students with this outstanding requirement who previously completed formative assessments in this subject area. Component A involved the student independently reviewing a detailed case presentation, developed by Oral Medicine faculty, on Canvas in a restricted 30‐minute window prior to immediately completing Component B of the CCE. The case presentation included a detailed medical history, clinical findings, and photographs of a patient with a persistent oral mass consistent with oral squamous cell carcinoma. The student was informed of the Pass/Fail grading rubric, outlining competency and critical failure criteria, within each of the 5 examination domains [(a) Medical History/Evaluation, (b) Medication History, (c) Physical Exam, (d) Oral Cancer Exam/Risk Assessment, and (e) Management/Treatment Modification/Prognosis] for this CCE, with opportunity for self‐assessment. In Component B of the CCE, each student met individually with an Oral Medicine faculty member via BlueJeans to answer 5 questions posed by the faculty member, based on the case, for a maximum of 15 minutes. An answer key with correct and critical failure responses for each question was developed and utilized by faculty for student assessment. The student was informed of the outcome upon completion of the CCE.
RESULTS
Each examination was successfully administered, with all students successfully completing the Oral Cancer CCE on their first attempt. Faculty members firmly believed this method of examination was effective in assessing clinical competency related to oral cancer in lieu of a live clinical scenario. Student and faculty feedback regarding this exercise was positive, particularly noting efficiency of exam administration. Exam construction allowed the student to independently assess the case, followed by objective assessment by a faculty member in a restricted time frame. This CCE model may serve as an example for other institutions to develop their own CCEs given the existing status of clinical dental education due to the current pandemic.