EXAMINATION OVERVIEW 3 PERFORMANCE EXPECTATIONS 4 INSTRUMENTS 6 EXAM PREPARATION 7 EXAM ADMINISTRATION 8 CLINICAL EXAMINATION 9 FORMS 11 EXAMINATION OVERVIEW CDCA-WREB-CITA administers the ADEX Dental Hygiene Examination, which consists of computer-based and clinical exam components. All examinations are based on specific performance criteria, developed by ADEX and other content experts, used to measure the clinical competency of candidates. This manual covers only the processes of the examination referenced.
Both components of the ADEX Dental Hygiene Examination series must be successfully completed (passing scores) within 18 months of the initial attempt of any component in the series. Refer to the Candidate Guide (policies) available in the Test Prep section of the ADEXtesting.org website for more information regarding the ADEX 18-Month Rule, exam eligibility, registration, and other administrative policies.
A. The Computer Simulated Clinical Examination (CSCE OSCE) assesses various levels of diagnosis and treatment planning knowledge, skills, and abilities. Clinically-based questions are utilized through computer-enhanced photographs, radiographs, optical images of study and working models, laboratory data, and other clinical digitized reproductions. Refer to the separate Computer Simulated Clinical Examination (CSCE OSCE) Candidate Manual for more information.
B. The Simulated Patient Treatment Clinical Examination (SPTCE) is performed on a typodont provided by CDCA- WREB-CITA. Candidates are evaluated on calculus detection, calculus removal, periodontal probing measurements and tissue management. See Performance Expectations for Scoring Rubric, criteria and point values.
Treatment Goals The ADEX Dental Hygiene Simulated Patient Treatment Examination (SPTCE) evaluates a candidate’s ability to:
Candidates are provided maxillary and mandibular typodonts with a unique assignment to evaluate each treatment goal. Each assignment fulfills the criteria listed in the ADEX SPTCE Scoring Rubric.
3 PERFORMANCE EXPECTATIONS Evaluations of candidate performance are made according to defined criteria, on a point accrual basis with the potential of earning 100 points. The criteria and point values are outlined in this manual. Calculus Removal, Periodontal Probing Measurement, Final Case Presentation and Tissue Management are evaluated anonymously by three calibrated examiners. Polishing is not an aspect of the examination. Polishing is not an aspect of the examination. Note that the candidate’s periodontal probing measurements must be within ± 1mm of at least two of the three examiners’ measurements.
Examiners evaluate each presentation of candidate performance independently and enter their evaluations electronically. Each examiner is unable to see the evaluations of the other two examiners for any procedure presentation, and examiners are prohibited from discussing their evaluations during the examination.
ADEX SPTCE Scoring Rubric
Skills Points Criteria Assessment Possible
• 4 assigned maxillary teeth
• 4 surfaces per tooth (M, D, F, L) Calculus Detection 16 • 16 surfaces evaluated for presence or absence of subgingival calculus (1 point each)
NOTE: Tissue management or other penalty points are deducted from total points accrued.
A score of 75 or greater is required to pass this examination. Successful attempts are reported as a Pass only. Failed attempts are reported as a numerical value based on the Scoring Rubric.
4 Standards of Conduct Integrity of the examination process depends on fairness, accuracy and consistency. Standards are required to ensure that these principles are adhered to by examiners and candidates. Penalties are imposed for violations of examination guidelines and the penalties are proportional to the seriousness of the violation. Minor violations may result in a warning or reminder. Serious violations may result in failure of an examination, or in the most serious cases, failure of the entire examination series and prohibition from re-examination within a 1-year period.
Candidates are required to adhere to these standards of conduct while participating in the ADEX Dental Hygiene Examination or any CDCA-WREB-CITA administered examination. Refer to the Candidate Guide for professional misconduct violations of examination guidelines (i.e. infection control, improper patient management, use of prohibited electronic devices, etc.) resulting in penalties or automatic failure of the examination and/or examination series.
Treatment Management Candidates must effectively complete treatment without causing unwarranted hard or soft tissue damage to the simulated dentition and gingiva. Penalty points will be assessed for each area of tissue damage according to the following criteria, and subtracted from the total points accrued during the grading process.
SOFT TISSUE Damage HARD TISSUE Damage
• Penalty Point assessment criteria: • Penalty Point assessment criteria: • One point deducted for each site of minor soft • One point deducted for each site of minor tissue damage, up to three (3) sites. hard tissue damage, up to three (3) sites. • The presence of four (4) or more minor soft • The presence of four (4) or more minor hard tissue damage sites, or one major soft tissue tissue damage sites, or one major hard tissue damage site results in Automatic failure. damage site results in Automatic failure.
• Minor Soft Tissue Damage. Slight soft tissue trauma • Minor Hard Tissue Damage. Slight hard tissue that is inconsistent with the procedure, including: damage that is inconsistent with the procedure or • A laceration/abrasion that is ≤ 3mm; a pre-existing condition; may include all hard tissue surfaces that would not require additional definitive • A laceration or injury that would not result in treatment. the need for suturing, periodontal packing, or further follow-up treatment. • Major Hard Tissue Damage. Major damage to the hard tissue that is inconsistent with the procedure • Major Soft Tissue Damage. and a pre-existing condition; may include all hard • A laceration/abrasion that is > 3mm and that tissue surfaces that would require additional would require sutures, periodontal packing, or definitive treatment. further follow-up treatment. • A laceration/injury that would result in exposure of alveolar bone, flap, or amputation of papilla. • An unreported broken instrument tip in the sulcus or soft tissue. 5 INSTRUMENTS Examiners are calibrated using the 11/12 explorer and a probe with 1 mm markings. Examiners also use these instruments during evaluation (see examples below).
11/12 Explorer (e.g. ODU 11/12)
Probe marked with 1mm increments
(e.g. UNC 1-12 probe)
Instrument Guidelines • Only instruments utilized within the standard of care for dental hygiene procedures may be utilized for this examination. Use of restorative or non-dental instruments or materials is prohibited and grounds for dismissal from the examination.
• Candidates are encouraged to have additional instruments available during the examination. Instruments should be clean; however, sterilization of instruments is not required for simulated patient (i.e. manikin-based) examinations, unless otherwise specified by the exam site host (see respective Site Info Sheet).
• Ultrasonic use is restricted at some exam locations. For information regarding ultrasonic/sonic or piezo electric scaling device availability and hand piece compatibility, refer to the Site Info Sheet of the respective exam host site. The CDCA-WREB-CITA does not assist candidates with equipment rental.
CONTAMINATED INSTRUMENT PROTOCOL
If an becomes contaminated, the candidate must inform the Chief Examiner to explain the protocol followed for patient care. The candidate may continue using the instrument only after it is disinfected. Use of a contaminated instrument without discussion with the Chief Examiner will result in a 100 point penalty (exam failure).
6 EXAM PREPARATION OFFICIAL RESOURCES
Candidates are responsible for reading and understanding manual(s) and materials published by the CDCA-WREB-CITA. Candidates bear all risk of any misunderstanding resulting from the use of or reliance on unofficial information or materials.
Refer to the Dental Hygiene Examination Overview and Test Prep pages of the ADEXtesting.org website for official resources.
Candidate Guide, Site Info Sheet
Exam Manuals & Forms Visit the Calendar section of the ADEXtesting.org website Refer to the Candidate Guide for CDCA-WREB-CITA for Site Info Sheets regarding host-provided supplies and policies and procedures regarding eligibility requirements, equipment, infection control protocols, PPE, equipment infection control protocols, results release, exam rental, and other valuable information for each clinical administration, and candidate conduct standards. exam location. Contact the site host directly for questions Refer to the Candidate Manual for exam protocols, regarding school-related information listed in their Site procedures, materials, and performance expectations. Info Sheet.
Downloadable sample forms are for candidate reference Submit questions regarding exam availability, registration only, not for exam use. Official printed forms are provided and fees to CDCA-WREB-CITA via Contact Us. at the exam site during Operatory Setup.
Video Tools Q&A Session
Visit the Test Prep page to access videos highlighting The Q&A Session affords Candidates the opportunity the examination day experience. CDCA-WREB-CITA to ask questions about exam processes or other exam- videos are for demonstration purposes only and not related concerns, including host site-specific protocols, in a replacement for information contained within the advance of their clinical examination. Candidate Manual. Registered Candidates are notified of their scheduled Note: CDCA-WREB-CITA does not endorse nor Q&A Session date and time via email; participation is recommend any methodologies expressed in videos strongly encouraged. Sessions may be virtual or onsite, shared by other organizations, agencies, companies, or depending on host site preference/availability. Q&A individuals. Sessions are not recorded by CDCA-WREB-CITA.
Typodonts All candidate assignments are performed on the CDCA- Questions? WREB-CITA provided typodont. The SimPro DH typodont was developed in partnership with Acadental. Contact Us Manikin, shroud and mounting post also provided for candidate use during the examination. 7 EXAM ADMINISTRATION
EXAMINATION TIMELINE The examination timeline below is for example only; actual schedules vary by exam location. Candidates are notified via email once their specific examination schedule is available in their Candidates.ADEXtesting.org profile several weeks prior to the clinical exam.
1-3 Sessions Group A Group B Group C
Clinic Entrance, Operatory Setup, 7:30 - 8:00 AM 10:30 - 11:00 AM 1:30 - 2:00 PM Candidate Check-In
NOTE: Although time announcements are made throughout the examination, Candidates are responsible for managing and monitoring their time appropriately to ensure timely arrival and procedure completion according to their assigned examination schedule.
IDENTIFICATION REQUIREMENTS FOR ADMISSION
The following items are required for admission to the clinical examination:
• PHOTO IDENTIFICATION. A government or school issued photo ID. Acceptable forms of non-expired photo identification include such documents as current, valid driver license, passport, military ID, or official school ID.
Recent Name Change. If your legal name has recently changed, bring a copy of the supporting name change document (e.g. marriage certificate, dissolution decree or court document) to the clinical examination.
• CANDIDATE ID NUMBER. A copy of your Candidate ID Number, located in your registration confirmation email and your online candidate profile.
8 CLINICAL EXAMINATION
Candidate ID Number, Badges & Labels
CANDIDATE ID NUMBER. Note that your Candidate ID Number will be used on all badges, labels and forms to maintain your anonymity during the examination; and in conjunction with your name on all post-exam results reports.
BADGES. Upon identity verification, candidates receive a sheet of candidate labels, including two (2) Candidate Photo ID Badge labels. Photo badge labels must be worn on both your outermost garment and on your scrubs during the exam.
LABELS. Affix your Candidate ID Label to all examination materials, including the mandibular typodont arch upon exam completion.
Operatory Setup & Check-In
When clinic entrance time is announced, Candidates will proceed to their assigned workstation and perform the following tasks.
Note that the SimProDH typodont and Assignment and Candidate Findings (ACF) Form are located at each assigned operatory.
1. Affix Candidate ID Label to Assignment and Candidate Findings (ACF) Form in designated area 2. Affix Candidate ID Label to plastic bag containing your treatment arch 3. Mount mandibular arch in provided articulator and shroud 4. Set up exam instruments 5. Adjust chair to a comfortable and appropriate operator position 6. Confirm operatory and supplies are ready for treatment 7. Chief Examiner or Exam Technical Coordinator (ETC) will check the position of mounted typodont 8. Chief Examiner or ETC will ask candidate to confirm the assignment
IMPORTANT REMINDER Notify Chief Examiner immediately of any equipment malfunction.
CDCA-WREB-CITA is not responsible for malfunction of any candidate
equipment or host facility equipment.
9 Clinical Treatment Candidates have up to two (2) hours to complete the assigned treatment and record their findings on the Assignment and Candidate Findings (ACF) Form.
1. Record Calculus Detection
2. Complete Calculus Removal for assigned quadrant 3. Record Periodontal Probing depth measurements only after calculus removal 4. Confirm that all findings are recorded on ACF Form
Chief Examiner is available throughout the exam; notify Chief Examiner immediately of issues or concerns.
Time Announcements IMPORTANT REMINDER
Do not remove Mandibular arch from • Start examination articulator until instructed or end of • 1-hour remaining examination is announced. • 15 minutes remaining Examination attempt is considered complete upon arch removal. • End examination
Exam Completion 1. Notify Chief Examiner or ETC of finished treatment 2. Remove mandibular arch from articulator; dry well 3. Affix Candidate ID Label to mandibular arch 4. Place mandibular arch in plastic bag labeled with Candidate ID Label 5. Confirm recorded ACF Form findings with Chief Examiner or ETC in electronic scoring system 6. Fold ACF Form and place in labeled plastic bag containing mandibular arch 7. Return ACF Form/mandibular arch and any unused labels to Chief Examiner or ETC 8. Dry upper arch and inside of shroud with paper towels and compressed air. (Maxillary arch remains in manikin; DO NOT remove) 9. Clean operatory as directed 10. Gather personal belongings 11. Exit examination area
Candidates are notified via email once examination results to the Candidate Portal.
10 FORMS Assignment and Candidate Findings Form
Downloadable sample forms are for candidate reference only, not for exam use. Official printed forms are provided at exam site during Operatory Setup.
11 Assignment and Candidate Findings Form
Downloadable sample forms are for candidate reference only, not for exam use. Official printed forms are provided at exam site during Operatory Setup.
