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The Buffalo Model
Joseph E. Gambacorta, DDSAssistant Dean for Clinical Affairs
University at Buffalo School of Dental Medicine
Background
In 2012 applications for licensuredecreased in New York State and NYSDA forms PGY1 Task Force. November 2014 first planningsession at UB with CDCA & NYSDA.
PGY1 Task Force Pilot Exam
To assure that patient care is protected. Care on patients of recordin a normal course of treatment. Integrated exam to be offeredcontinuously 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
EXAM DATE
ACCEPTED REJECTED 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.
RESTORATIVE PERIODONTICS
Competency Exams
EXAM DATE Total D4’s
TotalOPER
TotalPERIO
UBPASS
UBFAIL
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-SECTIONREGISTRATION
TOTAL PASS
TOTAL FAIL
JANUARY 20 9 3 6 5 4FEBRUARY 10 17 4 11 17 0MARCH 24 25 10 10 23 2MARCH 28 61 N/A N/A 49 12APRIL 14 27 8 10 24 3MAY 11 11 N/A N/A 11 0MAY 12 9 3 0 8 1
66.6% of UB candidates passed the ADEX exam on their first attempt.
WREB/ADEX
Nine candidates challenged both exams. Only first attempts were considered. Prosthodontic manikin only part of ADEX. Student comments most important result in this
comparison.
EXAM # D4s RESTOR. PERIO. ENDO.
WREB 39 9 9 7
ADEX 61 9 9 9
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