I was quite disappointed when I read the February JADA article by Dr. David Chambers, "Portfolios for Determining Initial Licensure Competency." I was pleased that he emphasized the importance of using patients to adequately evaluate the competence of candidates for licensure. I was disappointed that he treats clinical licensing examinations as though they are all the same and of inferior reliability.
It also bothered me that some of his important references are not current. Dr. Chambers does not reference the current accepted standards for the testing community: the 1999 American Educational Research Association, or AERA; the American Psychological Association, or APA; and the National Council on Measurement in Education, or NCME, standards (with an extensive validity discussion), or the current 2003 American Association of Dental Examiners’ guidance that is being used by at least some of the major dental clinical testing agencies.
Dr. Chambers used outdated definitions and concepts from the outdated AERA, APA and NCME standards, and uses numbers that are not at all reflective of Western Regional Examining Board testing experience. Rather than making blanket assumptions about all clinical examinations, which vary extensively, it would be more appropriate to reference the source of data, and then use the data only in reference to organizations where the data apply.
The points that he makes about portfolios have merit, but the costs involved to do it right and the construct being measured make it a poor replacement for the present system. The present system actually requires a portfolio, which usually includes a candidate degree attainment process (school portfolios can and should be as comprehensive as desired), as well as a national written and a state board–approved clinical examination. This process verifies satisfactory completion of an educational process with the ability to retain and apply some of what was learned.
