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CONTENT AND SCORING

The examination scoring system was developed in consultation with three different measurement specialists; the scoring system is criterion-based and was developed using an analytical model.
 
Only State Boards of Dentistry are legally authorized to determine standards of competence for licensure in their respective jurisdictions. However, in developing the examination, CRDTS has recommended a score of 75 to be a demonstration of sufficient competence; and participating State Boards of Dentistry have agreed to accept that standard. In order to achieve “CRDTS status” and be eligible for licensure in a participating state, candidates must achieve a score of 75 or more on the examination.
 
Each examination score is based on 100 points. If all sections of an examination are not taken, a score of “0” will be recorded for that specific examination.
 
SCORING SYSTEM: RESTORATIVE PROCEDURES
 
CRDTS and other testing agencies have worked together on a national level to draft and refine the performance criteria for each procedure in this examination. For the majority of those criteria, gradations of competence are described across a 4-level rating scale. Those criteria appear in this manual and are the basis of the scoring system. Those four rating levels may be generally described as follows:
 
SATISFACTORY
The treatment is of good to excellent quality, demonstrating competence in clinical judgment, knowledge and skill. The treatment adheres to accepted mechanical and physiological principles permitting the restoration of the tooth to normal health, form and function.
 
MINIMALLY ACCEPTABLE
The treatment is of acceptable quality, demonstrating competence in clinical judgment, knowledge and skill to be acceptable; however, slight deviations from the mechanical and physiological principles of the satisfactory level exist which do not damage nor significantly shorten the expected life of the restoration.
 
MARGINALLY SUBSTANDARD
The treatment is of poor quality, demonstrating a significant degree of incompetence in clinical judgment, knowledge or skill of the mechanical and physiological principles of restorative dentistry, which if left unmodified, will cause damage to or substantially shorten the life of the restoration.
 
CRITICALLY DEFICIENT
The treatment is of unacceptable quality, demonstrating critical areas of incompetence in clinical judgment, knowledge or skill of the mechanical and physiological principles of restorative dentistry. The treatment plan must be altered and additional care provided, possibly temporization in order to sustain the function of the tooth and oral health and well-being 
  
A rating is assigned for each criterion in every procedure by three different examiners evaluating independently. Based on the level at which a criterion is rated by at least two of the three examiners, points may be awarded to the candidate. In any instance that none of the three examiners’ ratings are in agreement, the median score is assigned. However, if any criterion is assigned a rating of critically deficient by two or more of the examiners, no points are awarded for that procedure or for the Examination Part, even though other criteria within that procedure may have been rated as satisfactory. A description of the number of criteria that are evaluated for the procedures appears below:
 
RESTORATIVE EXAMINATION - 100 Points 
Class II Amalgam Finished Restoration #3MO 7 Criteria* 
  OR   
Class II Composite Finished Restoration #3MO 7 Crtieria* 
AND
Class III Composite Finished Restoration #9ML  7 Criteria* 
 * 1 category split into 2 for clarity; scored as 1 criteria
 
 
To compute the score for each individual procedure, the number of points the candidate has earned for each criterion is totaled, divided by the maximum number of possible points for that procedure and the results are multiplied by 100. This computation converts scores for each procedure to a basis of 100 points. Any penalties that may have been assessed during the treatment process are deducted after the total score for the Examination Part has been converted to a basis of 100 points.
 
If no critical deficiency has been confirmed by the examiners, the total score for each of the procedures is computed by adding the number of points that the candidate has earned and that sum is divided by the number of possible points for both procedures. If a critical deficiency has been confirmed by the examiners, an automatic failure is recorded for both the procedure and the Examination. An example for computing scores that include no critical deficiency is shown below: 
 
 PROCEDURE # CRITERIA  POINTS EARNED  POINTS POSSIBLE  COMPUTED SCORE 
 Amalgam Restoration 7 Criteria   26  28  92.85 
 Anterior Composite  Restoration 7 Criteria 24 28  85.71 
 TOTALS 14 Criteria 50 56  89.28 
 
 
Although there are 2 procedures that are scored separately for restorative clinical skills, within the exam, a compensatory system is used to compute the final score, as long as there is no critical deficiency. The computed score for each procedure is not averaged, but instead is numerically weighted by the ratio of its number of scorable criteria to the total number of scorable criteria. For example, the Amalgam Restoration has a total of 7 scorable criteria which represents 28 possible points out of the total of 56 possible points. As shown in the example above, the candidate earned 50 out of 56 possible points for the 2 procedures for a final score of 89.28 points. If any penalties were assessed, the points would be deducted as percentage points from the final score.
 
PENALTY DEDUCTIONS
Throughout the examination, not only clinical performance will be evaluated, but also the candidate’s professional demeanor will be evaluated. A number of considerations will weigh in determining the candidate's final grades and penalties may be assessed for violation of examination standards, as defined within this manual, or for certain procedural errors as described below: 
 
Any of the following may result in a deduction of poitns from the score of the entire examination Part or dismissal from the exam in any of the clinical procedures: 
  1. Violation of universal precautions or infection control; gross asepsis; operating area is grossly unclean, unsanitary or offensive in appearance; failure to dispose of potentially infection material and clean the operatory after individual examinations
  2. Poor Professional Demeanor -- unkempt, unclean, or unprofessional appearance; inconsiderate or uncooperative with other candidates, examiners or testing site personnel.
  3. Improper Operator / Manikin position
  4. Improper record keeping
  5. Corroborated errors for Treatment Management criteria or assigned by examiners
    The following Infractions will result in a loss of all points of the entire examination Part:
  1. Violation of Examination Standards, Rules or Guidelines
  2. Treatment of teeth or surfaces other than those approved by examiners
  3. Gross damdage to an adjacent tooth
  4. Critical Lack of Clinical Judgement Skills - This penalty would be applied when the prognosis of the restorative placement is seriously jeopardized.
       Examples include but are not limited to: 
    1. Inability to carry out instructions for modifications that any competent practitioner should be able to complete. 
The penalties or deficiencies listed above do not imply limitations, since obviously some procedures will be classified as unsatisfactory for other reasons, or for a combination of several deficiencies. Corroborated errors for the treatment management criteria for each Restorative procedure – will be deducted as penalty points.
 
Professional Conduct - All substantiated evidence of falsification or intentional misrepresentation of application requirements, collusion, dishonesty, or use of unwarranted assistance during the course of the examination shall automatically result in failure of the entire examination by any candidate.
 
In addition, there will be no refund of examination fees and that candidate cannot apply for re-examination for one full year from the time of the infraction. Any of the following will result in failure of the entire examination:
  1. Falsification or intentional misrepresentation of application requirements
  2. Cheating (Candidate will be dismissed immediately)
  3. Any candidate demonstrating complete disregard for the oral structures, welfare of hte manikin and/or complete lack of skill and dexterity to perform the required clinical procedures
  4. Misappropriation of equipment (theft)
  5. Receiving unwarranted assistance
  6. Alteration of examination records and/or radiographs
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