Volume 2, Issue 2 October 2010

Spotlight on Ethics
Ethics of Patient-based Exams and California Licensure by Portfolio
As governor Arnold Schwarzenegger signed bill AB
1524 into law on September 29 2010, he created
the first viable alternative to “live patient” clinical
examinations for licensure in California. This bill
outlines in principle the foundations for licensure
by dental school portfolio, whereby students will
be evaluated by their body of work across different
Contents: clinical competencies rather than one “high
stakes” human subject exam. This licensure option
Spotlight is designed to counteract the many complicating
on Ethics Page 1 issues inherent in the human subject clinical
examination such as the current California board
Beautifying Golden Gate exam or the WREB exam often favored over the
Park Page 2 California exam.
District 11 Legislative
Committee Page 3 One of the major driving factors for this recent
movement away from live subject-based exams is
California the stressful parameters of these exams straining
Ethics Day Page 4 the ethical boundaries of licensure candidates. In a
large number of these instances, not also was the
UCLA Children’s Hospital integrity of the student dissolved, but also the
Volunteer Program health of the patient put into question. In a study
Page 4 on clinical licensure exams by Feil et al. it was
determined that at least 13.7% of students
reported that they knew of patients that were
Upcoming Events: coerced into treatment that would not have been
recommended otherwise. Furthermore, 19% of
15 ASDA District students admitted knowledge of other students
Oct Conference treating a lesion prematurely solely for
examination purposes1. The procedures reserved
31 California Ethics for examination are undeniably destructive and
Jan Day these acts represent an inexcusable breach in
academic integrity. More importantly, these
students are betraying the ethical standards of
Editor: patient care that have long distinguished dentistry
Teresa Tran as a respected and trusted field of healthcare. It is
simply against all ethical obligations as health
professionals to alter treatment plans based upon
self-serving motivations.
spectrum of ethical dilemmas raised by these
examination procedures. Dr. Brooke Loftis, former
ASDA president, states that she will “never forget
the students that were delaying treatment of
patients, over-radiating patients, over-treating
lesions, and paying outside services for the supply
of patients to use during the exam”2.
Unfortunately, none of these actions are in line
with expectations of professional integrity nor are
they reflective of the best interests of the patient.
However, the root of the issue does not only lie in
students looking for an edge, but also in the
strenuous and sometimes unreasonable
parameters of the examination process. This is why
ASDA, the CDA and others are so committed to the
successful implementation of licensure by
portfolio. As discussed in ASDA’s white paper on
ethics, now is the time for examination boards to
tailor their methodology to eliminate confusion
about their expectations for professionalism and
ethics. These organizations and others believe that
the bill just signed will represent a new alternative
for licensure that is sensitive to the ethical conflicts
that detriment both students and patients
commonly encountered with patient-based exams.
The California dental association and dental
students across the state are looking forward to
being at the forefront of innovation in dental
licensure. As a result of this innovation, dental
students in California hope to be part of an
examination process that presents a fair, balanced
and ethical evaluation of candidates for licensure.
Matt Sandretti
UCLA Class of 2013
District 11 Ethics Chair

The issues above do not even fully envelop the

For more excellent insight into ASDA and the field of dental ethics, please refer to ASDA’s white paper
on ethics, found at http://www.asdanet.org/uploadedFiles

References
1. Feil P, Meeske J, Fortman J. Knowledge of Ethical Lapses and other experiences on Clinical Licensure examinations. Jounal of Dental
Education. 1999, 63 (6) 453. 2. American Student Dental Association. The American Student Dental Association White Paper on Ethics and
Professionalism in Dental Education. 2009. Chicago. 3. Hitchins B, Cobb J. When Will We be Ready for Academic Integrity? Journal of Dental
Education. March 2008 (72) 3.
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Beautifying Golden Gate Park:
San Francisco Dental Students on a Mission
I’m privileged to serve as this year’s ASDA Northern
California Community Outreach Coordinator. This position
allows me to be an ambassador between the University of
the Pacific, Arthur A. Dugoni School of Dentistry and our
neighbor dental school, the UCSF School of Dentistry. I’m
constantly working to create community service
opportunities which will allow us to collaborate and serve
the city of San Francisco. My goal is to organize one event
per quarter to encourage students from both schools to
serve the community and build relationships with future
colleagues from across town.

Our most recent event was a park beautification effort in

Golden Gate Park. Students from both Pacific and UCSF
woke up early on Saturday, August 21 to join together and
help clean up the park. The area that we worked on was in
the western side of Golden Gate Park, next to the Angler’s
Lodge and the Bison Paddock (yes, there were live bison
roaming in a meadow across the street from us). The
Angler’s lodge is a popular place for fisherman to practice
their casting and while we were there we saw several
children learning how to cast a line. Between the parking
lot and the ponds is a wooded hill with native plants
including beautiful rhododendrons and flowers of all sorts.
They were being overrun and choked out by weeds that
we removed and piled up to be hauled away. When we
were finished the landscape looked significantly better.
The park ranger we worked with told us that we were able
to complete more work in three hours than would
typically happen in three weeks!

While we did a lot of work, the time went by quickly

because the entire time we were getting to know each
other and hearing about all the nuances of a different
dental school experience. Despite going through different
dental programs we share commons goals, including
community service as a priority. We finished off the day at
a nearby picnic area with ice cream and root beer
floats. I’m looking forward to getting to know the UCSF
students even better while exploring and giving back to
San Francisco. Stay tuned for updates from future events!

Armin Vahidnia
ASDA Northern California Community Outreach Coordinator
University of the Pacific Arthur A. Dugoni School of Dentistry
Class of 2012

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 Welcome to the District 11 Legislative Committee
This committee is designed to facilitate the transfer of
legislative information from national, state, and local sources
to the California ASDA chapters. Additionally, bimonthly
conference calls are conducted in order to enhance
communication and collaboration between the Legislative
Liaisons at each of the 6 California dental schools. Primary
goals of the committee are to serve as a resource for chapter
activities such as legislative lunch n’ learns, voter registration
drives, and promotion of advocacy through ADPAC drives. The
District Licensure Chair also serves as an integral part of the
committee by keeping chapters updated on national and state
licensure policies. The district legislative committee will serve
as a means of coordination between the California ASDA
chapters for the National Dental Student Lobby Day which is
jointly hosted by ASDA and ADEA. With current legislative
changes such as national healthcare, the introduction of mid-
level providers and the drive to eliminate the live patient
licensing exam, now is an exciting time to be a dental student
and make your voice heard!
Brittany Hazard
District 11 Legislative Liaison
UCLA School of Dentistry 2013
britthaz@ucla.edu

National Health Care

Obama’s Health Care Reform has been a topic of national debate since it surfaced.
Dentistry is an integral component of health care and the ADA took a strong stance
against the bill in March 2010. The ADA’s view is based on the fact that the bill will
not improve access to oral health care for millions of low-income Americans
because of the lack of funding delegated toward Medicaid dental services. Through
allied efforts, progress has been made and the Senate Appropriations Committee
has increased oral health care funding for the 2011 fiscal year, but it has yet to go to
the Senate floor.

Original ADA statement: http://www.ada.org/news/3507.aspx

Current news: http://www.ada.org/2389.aspx

Mid-level Providers and Access to Care

Access to care is a substantial issue facing dentistry today and the introduction of
mid-level providers is becoming a popular solution. Alaska and Minnesota have
already incorporated mid-level providers into their dental systems and other states
are quickly following suit. The trend is weaving its way into California. If dentists
want to have an impact on the decision making process rather than leaving it up to
the lawmakers, then it is necessary to approach the issue by introducing alternative
solutions rather than simply voicing their disapproval of the mid-level provider
concept. In June 2010, Tim Stuart, the president of the CDA, held an all-member
conference call to address this concern.

To access the recorded conference call, login to the CDA website

Conference call recording:
http://www.cda.org/advocacy_&_the_law/access_to_care

Licensure by Portfolio
In an attempt to eliminate the live patient licensing exam, Canada and Minnesota
have both implemented alternative testing methods. Currently, California is on the
forefront of this effort by creating a “licensure by portfolio” method of assessment.
The bill was signed by Governor Schwarzenegger on September 29th, 2010. The
portfolio method of licensure will replace the California state dental board exam in
January 2011. However, the date of implementation may be postponed as the
Dental Board of California develops a method to standardize evaluators for the
portfolio competencies.

California State Senate: http://info.sen.ca.gov

Click on the “Legislation” link on the left-hand side
Bill #1524

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 Upcoming Event:
California Dental Ethics Day
Presented by ASDA District 11
A series of seminars and lunch meetings at California dental
schools designed to raise awareness and promote discussion of
ethical issues currently affecting California dental students.

Scheduled for January 31, 2011

Speaker and sponsor opportunities still available

For more information, please contact Matthew Sandretti at

sandrettim@ucla.edu

UCLA School of Dentistry

Children’s Hospital Volunteer Program
At UCLA School of Dentistry, the student body is relentlessly
pursuing means of reaching out to children of all ages and
backgrounds in efforts to provide oral health instruction and
ideals for preventative care. In an endeavor to continue the
practice of reaching to children of all background, UCLA’s
dental students have developed and fostered a program in
which we make monthly visits to Children’s Hospitals in the
community. Starting with Children’s Hospital Los Angeles,
students have had monthly visits in which we interact with
medically compromised patients and their families. These
children, which are receiving care through hospital dentistry,
have typically had severe medical challenges which
overshadow their oral health needs. Many of these children
come from lower socio-economic families in which oral health
care is not emphasized until a concern has arisen. In order to
try to provide oral health awareness, as well as to reach out to
these children and their families, our dental students have
raised money to donate bags with toothbrushes, toothpaste,
stickers, floss, coloring books, and mouthwash given to each
child and any of his/her siblings. We take advantage of our
time with them to speak to their parents and to the children
about maintaining their smiles.
While we cannot interact and reach out to many of the in-
patient children such as those currently being treated at
Mattel Children’s Hospital at UCLA as well as those at CHLA,
we have a continued effort to raise money in order to donate
these materials to the children, which we have successfully
done at Mattel’s. Our future goals are to continue our visits at
hospital dentistry at the various Children’s hospitals as well as
to continue donating to those children whom we cannot
physically visit with. If nothing at all, this program allows the
dental students to not only interact with these kids, but to
learn something from their perseverance as well as their
families’. We just hope we can somehow put a smile on their
faces.
To Donate or Learn More Contact:
Adi Avital UCLA School of Dentistry c/o 2013 -
adiavital25@ucla.edu
Or Kerry Hahn UCLA School of Dentistry c/o 2013 -
kfhahn15@ucla.edu

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