1. What are the ABO exam eligibility requirements?
Examinees are eligible to take the Written Examination once they have completed at least 18 months of a CODA-accredited orthodontic program. All examinees who have graduated from a CODA accredited orthodontic program and successfully completed the ABO Written Examination are then eligible for the Scenario-based Oral Clinical Examination. Once you become board certified, the Certification Renewal requirements must be fulfilled every 10 years.
2. What are the benefits of a Scenario-based Clinical Examination?
There are numerous benefits to a scenario-based examination. Most importantly, all orthodontists taking the examination will be objectively tested on their knowledge, skills, and critical thinking abilities. A scenario-based exam utilizes the most fair, reliable and valid testing methodology. Ultimately, this will benefit the general public to ensure the ABO has certified orthodontists to uphold our mission of elevating the standard of care.
Additionally, all orthodontists now have the ability to go through the certification process regardless of their practice environment and where they are within their career. The challenge of finding the cases with specific criteria and submission requirements is no longer a barrier.
3. How do orthodontic residency programs prepare residents for the Scenario-based Clinical Examination?
The ABO continues to collaborate and work with educators to ensure residents are prepared for the certification examination. The academic knowledge and clinical experience obtained throughout residency in itself will help prepare residents. Additionally, we encourage examinees to continue to focus on clinical self-evaluation and outcomes assessments, as the scenario-based examination will test for knowledge and critical thinking skills that apply to these areas.
The ABO will continue to use assessment instruments including cast radiograph evaluation (CRE) and the case management form (CMF) within the scenario-based examination. If a resident is not proficient in outcomes assessments utilizing these instruments, or is not able to interpret the results of superimpositions, he or she may perform weaker in this portion of the examination.
The ABO meets with educators regularly and will continue to gain feedback on how we can best support the orthodontic programs so that the Scenario-based Clinical Examination is complementing the curriculum the educators are teaching in their programs. Many programs have expressed that they will continue to hold mock board exams and advocacy visits, and will begin putting a larger focus on critical thinking skills. The ABO also provides detailed examination results to the educators to let them know where their resident’s strengths and weaknesses rank on the Scenario-based Clinical Examination.
4. How is the Scenario-based Clinical Examination Structured? What should be expected on the day of the exam?
The scenario-based examination will require an orthodontist to be proficient in four key domain areas: 1) data gathering and diagnosis, 2) treatment objectives and planning, 3) treatment implementation and management, and 4) critical analysis and outcomes assessment.
The examinee will be exposed to six exam rooms, each of which will have 2-3 examiners. The examiners will present scenario cases and ask specific questions that will be answered orally by the examinee.
Different scenario cases and questions will be presented in each room, and these cases will change for the different examination windows offered. The number of cases an examinee is being tested on will vary as some examiners may present a scenario case with a full set of records and associated questions, and other examiners may include multiple scenario cases with partial records and associated questions. Some examiners may present single unrelated records that require individual analysis.
5. Will examinees be tested on cast radiograph evaluation (CRE), and cephalometric superimposition technique and interpretation on the Scenario-based Clinical Examination?
Yes, assessment and case evaluation will remain a critical component of the examination. The tools previously developed by the ABO for case evaluation will still be utilized within the scenario-based examination.
An example of this may include an examinee being asked to complete measurements on ABO-provided cases. In addition, a potential scenario case may include tracings that an examinee is asked to superimpose. Another way that the exam may test for an examinee’s knowledge on these tools may involve asking an examinee to review ABO-provided measurements and/or superimpositions, and complete a growth analysis and/or discuss the growth effect versus the treatment effect of the case outcome. For scenarios that require the calculation of CRE, the ABO measurement chart will be made available to examinees for reference during the exam.
6. How does an examinee best prepare for the Scenario-based Clinical Examination?
Self-evaluation of clinical patient cases will play a large part in the preparation process. Participation in “mock boards” and continuing to use the tools previously developed the by ABO for outcomes assessments will also play an important role as examinees prepare for the exam. In addition, a study guide and sample cases with scenario-based questions, answers and recordings are available on the ABO website. ABO Open House/Info Sessions are held during the AAO Annual Session where ABO directors and staff are available to answer individual questions and review examination materials.
7. How does the Scenario-based Clinical Examination assess clinical competency?
With the scenario-based testing format, the ABO will be able to make a direct assessment of a candidate’s ability to formulate diagnoses, develop treatment plans, assess implementation of treatment plans, and evaluate outcomes. The test focuses on the cognitive skills and decision-making process that are critical for the proficient practice of orthodontics. Hands-on skills assessment will remain within the residency programs, where it can be done most effectively.
8. How are the Scenario-based Clinical Examination questions and answers standardized?
For each of the questions in a case scenario, there are at least three predetermined model responses approved by the board: (a) a fully proficient model response, (b) a borderline proficient model response (c) a borderline not or not proficient model response. These questions and responses are sent through a thorough process to be reviewed, edited, refined, and validated prior to being used in an examination. The model responses are used to anchor examiners so that their assessment of candidates’ responses applies a consistent standard for all candidates.
During the examination, responses are scored by trained examiners who will use an anchored rating scale to ensure consistency in scoring. The scales will address the purpose(s) of the case (e.g., diagnosis, planning, implementation, critical analysis) and are standardized for all cases serving the specified purpose. Each unit of the scale is anchored with language that helps to ensure that the ABO’s standards are applied by all examiners.
The ABO’s examiner training program educates examiners in the intended application of the scales to candidate responses. The examiner training program provides practice opportunities as well as a required assessment of agreement with criterion ratings for a selection of responses. Examiners are recalibrated by means of an abbreviated refresher (calibration) training immediately prior to each testing and scoring cycle.
9. How are the Scenario-based Clinical Examination results determined and presented?
The weighting system for the clinical examination details the percentage and number of points for each case defined for the four domains, such that the sum of weights for all problems in each version of the test across the domains equals 100%.
The rating scales for the clinical examination are weighted to achieve 25% allocations to each of the four domains covered in the examination.
Data Gathering and Diagnosis
Treatment Objectives and Planning
Treatment Implementation and Management
Critical Analysis and Outcomes Assessment
Points awarded to candidates are determined as a function of the ratings assigned and the weight of the question. Psychometric analyses are performed after each testing cycle.
Exam results are presented in a pass/fail format. Examinees who are unsuccessful on the examination will be provided with feedback outlining their level of success on the four main domains of the examination. Examinees who have been unsuccessful must re-take the entire examination in order to pass, and will not have the ability to be re-tested on individual sections.
Examination feedback will also be provided to residency programs similar to what is currently provided for the Written Examination.
10. What are the travel and logistical requirements of the Scenario-based Clinical Examination?
The Clinical Examinations are held in St. Louis, Missouri at The ABO Exam Center. Your exam will be held on one of the dates of the posted exam cycle. You should plan your individual examination to take approximately 2 hours to complete.
11. When will I receive my Scenario-based Clinical Examination schedule?
Exam schedules are sent 2 months prior to the start of the exam week. Due to the complexity of the examination scheduling (including conflicts of interests), communication and cooperation from all parties involved is essential. This process will ensure that a fair and impartial testing opportunity for all examinees is achieved.
12. What are the options for those who still have “banked” cases?
Examinees in the certification process who have 3 or more cases “banked” have two options to complete the board certification process. Option one requires the examinee to complete the number of online Board Case Exams (BCEs) to match the remaining number of Incomplete/Unsubmitted cases until a total of 6 is met. Option two requires the examinee to mail-in their remaining cases for review until they have completed a total of 6 (original required categories) cases completed.
In addition, examinees with Incomplete BCOE scores are required to take the BCOE Web-based Retake Exam until this portion of the examination is passed. The web-based exam will be conducted live with two examiners during a regularly scheduled ABO exam.
Each examinee is given a 10-year time period from the time they initiated the Clinical Examination to complete all necessary components in order to successfully become board certified.
13. Is Certification Renewal required?
Yes, Certification Renewal is a critical component of the certification process demonstrating ongoing proficiency in orthodontics and a commitment to life-long learning. The certification renewal format currently includes two pathway options to complete the necessary requirements.
14. Why is Certification Renewal important?
Certification Renewal offers an opportunity for board certified orthodontists to pursue continuing education, stay up-to-date on the latest technology and re-evaluate their approach and critical evaluation of cases. As the number of board certified orthodontists increase, we have a stronger voice to collectively strengthen our specialty and re-commit to providing the highest standard of care for our patients.