Judges: LARRY J. SARTIN
Agency: Department of Health
Latest Update: Jul. 22, 1987
Summary: Whether the Petitioner earned a passing grade on the May, 1986, dental mannequin examination?Petitioner failed to prove she earned passing grade on May 1986 dental mannequin exam.
87-0208.PDFSTATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
DR. BAO-KIEM DAM, )
)
Petitioner, )
)
vs. ) CASE NO. 87-0208
) DEPARTMENT OF PROFESSIONAL REGULATION, ) BOARD OF DENTISTRY, )
)
Respondent. )
)
RECOMMENDED ORDER
Pursuant to written notice a formal hearing was held in this case before Larry J. Sartin, a duly designated Hearing Officer of the Division of Administrative Hearings, on May 29, 1987, in Tallahassee, Florida.
APPEARANCES
For Petitioner: Dr. Bao-Kiem Dam, Pro Se
4581 Charnock Drive
Irvine, California 92714
For Respondent: Chester G. Senf, Esquire
Department of Professional Regulation
130 North Monroe Street Tallahassee, Florida 32399-0750
PROCEDURAL STATEMENT
The Petitioner, Dr. Bao-Kiem Dam, was informed by the Respondent, the Board of Dentistry, that she had failed to receive a passing grade on a regrade of the dental mannequin examination which she took in May, 1986. The Petitioner timely requested an administrative hearing to contest this determination.
At the final hearing the Petitioner testified on her own behalf. The Respondent presented the testimony of Lucinda Ann Richards and Sue Ellen Hamilton, D.D.S. The Respondent also offered 2 exhibits which were marked as "DPR" exhibits and accepted into evidence.
By letter dated June 19, 1987, the Petitioner presented a written summary of her position. Attached to the letter is what appears to be some type of needle or drill. This needle or drill was not submitted at the final hearing and therefore cannot be considered as part of the evidence in this case.
The Petitioner's written summary of her position will be treated as a proposed recommended order. To the extent that it contains proposed findings of fact, those proposed findings of fact have been accepted or rejected in the Appendix attached hereto. The Respondent did not submit a proposed recommended order.
ISSUE
Whether the Petitioner earned a passing grade on the May, 1986, dental mannequin examination?
FINDINGS OF FACT
The Petitioner took the May, 1986, State of Florida dental mannequin examination.
In August, 1986, the Petitioner was notified that she had failed the dental mannequin examination. She was awarded an overall score for the 9 procedures of the examination which were graded, of 2.80. A score of 3.00 is the minimum passing score for this examination. The Petitioner was also sent a document which informed her that she could request a copy of the grade sheets completed by the examiners who graded her exam and that she could request a face-to-face meeting to discuss her grades or she could send written objections which would be considered in reviewing her score.
The Petitioner's scores for each of the 9 procedures were as follows:
Procedure | Average Score |
1 | 3.33 |
2 | 4.00 |
3 | 3.33 |
4 | 3.00 |
5 | 1.33 |
6 | 3.33 |
7 | 3.00 |
8 | 2.66 |
9 | 1.00 |
By letter dated August 8, 1986, the Petitioner requested that the individual examiners' grade sheets for each of the procedures be sent to her.
On August 22, 1986, the Petitioner requested the grade sheets by telephone.
By letter dated September 3, 1986, the Petitioner again requested that her grade sheets be sent to her and requested that an appointment be scheduled for her to meet with the Respondent's consultant to review her May, 1986 dental mannequin examination scores. The Petitioner believed that she was required to attend a face-to-face meeting with the Respondent's consultant who reviewed objections to the results of the May, 1986 dental mannequin examination. Because of the Petitioner's difficulty understanding English, she did not understand that she could send written objections in lieu of actually attending a review session with the Respondent's consultant.
By letter dated September 8, 1986, the Petitioner was sent the grade sheets she had requested.
By letter dated September 11, 1986, the Petitioner was notified that an appointment for September 26, 1986, had been scheduled for the Petitioner to meet with the Respondent's consultant to review her May, 1986 dental mannequin examination scores or, in the alternative, for the Petitioner's written objections to be considered.
By letter dated September 17, 1986, the Petitioner submitted written objections to the Respondent.
The Respondent acknowledged receipt of the Petitioner's written objections on September 24, 1986.
On September 26, 1986, the Petitioner met with Sue Ellen Hamilton, D.D.S, the Respondent's consultant. As a result of this meeting and the Petitioner's written objections, Dr. Hamilton recommended that procedures 1 and
be regraded.
The Petitioner requested a response to her written objections from the Respondent by letter dated November 11, 1986.
The Respondent informed the Petitioner by letter dated November 18, 1986, that the results of the regrade of procedures 1 and 2 had resulted in a decrease in her overall score from 2.80 to 2.60. In particular, the Petitioner was awarded a score of 3.00 for procedure 1 and a score of 2.66 for procedure 2.
By letter dated December 16, 1986, the Petitioner requested a formal administrative hearing.
The Respondent receives 100 to 200 objections to the results of dental mannequin examinations which must be processed. Due to the volume of objections received by the Respondent, and the procedures which the Respondent must follow to review objections, it takes 2 and 1/2 to 3 months to review a candidate's objections. The time which it took the Respondent to review the Petitioner's objections was reasonable.
The State of Florida dental mannequin examination is a practical examination designed to test several specified clinical skills. Each of 9 separate procedures are separately graded. Each of the procedures are graded by
different examiners. Each examiner grades a procedure independently.
A grade of from 0 to 5 is assigned by each examiner. The final score for each procedure is determined by averaging the 3 grades given to that procedure by the 3 examiners.
The final score for the 9 procedures is a weighted average of the sum of the 9 scores.
Examiners are experienced Florida dentists selected by the Board of Dentistry. They must have at least 5 years of experience as a dentist.
Examiners receive 8 to 12 hours of training prior to participating in an examination. The training, referred to as a "standardization exercise," involves review of the criteria by which each procedure is required by rule to be judged.
Some of the dentists who take the standardization exercise who are not designated as examiners act as monitors. Monitors are present during the
examination. They are instructed not to assist candidates during the examination and candidates are told that monitors are not there to assist them. If a candidate wishes to note a problem, they are instructed to do so and the monitors acknowledge that a problem has been noted by the candidate. Monitors do not, however, confirm that a problem exists and candidates are so informed before the examination.
Application of the grading criteria is not a mathematically precise exercise. There is no mathematical formula for deducting any specific number of points or fractions of a point for shortcomings in a candidate's performance. Examiners use an holistic approach to grade each procedure.
Examiners record the grade they award to a procedure on a form. If a failing score is given on a procedure, the examiner is required to include on the form written comments sufficient to justify the failing grade. These comments do not have to include everything the examiner thinks is wrong with the procedure, but must include enough to justify a failing grade.
No information concerning the Petitioner's identity was disclosed to the examiners during the examination. The Petitioner was assigned an identification number which was recorded on her work and her grade sheets. The examiners did not, however, see the Petitioner or know anything about her. The examination was conducted in a laboratory, the Petitioner's work was placed in a box by a monitor and the box was taken to another room by a monitor where it was graded.
If a regrade is recommended by a consultant, as was done in this case, the procedures for which a regrade is recommended must be sent to 3 different examiners throughout the State. These new examiners regrade the procedure and return their results to the Respondent. The regraders do not know the identity of the candidate being regraded.
The average grade given to the Petitioner for her performance on the dental mannequin examination of May, 1986, was fair and reasonable for her performance on each of the procedures.
Procedure number 5 is a endodontic procedure--instrumenting of the canal of a tooth that has been infected, so that the canal can be drained of matter which might become infected and the ultimate filling of the tooth. In layman's terms, the procedure is the performance of a root canal.
Ideally, the canal should be cleared to within 5 millimeters from the apex of the tooth. The tooth on which the Petitioner performed this procedure was only cleared to within 2.5 millimeters from the apex. This is unacceptable. The passage did not go any further because ledging had occurred. Ledging was caused by the Petitioner and occurred when the instruments used to clear the canal went out of the canal at an angle into the tooth. When this occurs the problem usually cannot be corrected and the portion of the canal below the ledging cannot be cleared.
When the Petitioner experienced the ledging, she believed that the canal had an obstruction in it. The x-rays of the tooth, however, showed the ledging and that there was no obstruction in the canal.
The Petitioner asked a monitor to verify that she had encountered an obstruction. Monitors are instructed not to assist or approve in any way a candidate's work. The Petitioner was told this before the examination. The monitor, therefore, did not and could not verify that there was an obstruction in the tooth the Petitioner was working with.
Once the Petitioner experienced a problem with the tooth, it was her responsibility to deal with it in the best manner possible. Again, the Petitioner was confused as to the function of the monitor because of her language problem.
CONCLUSIONS OF LAW
The Division of Administrative Hearings has jurisdiction of the parties to, and the subject matter of, this proceeding. Section 120.57(1), Florida Statutes (1986 Supp.).
Section 466.006, Florida Statutes (1986 Supp.), provides the requirements which must be met in order for a person to be licensed in the State of Florida as a dentist. In pertinent part, Section 466.0O6(3)(c), Florida Statutes (1986 Supp.), requires the following:
(3) If an applicant is a graduate of a dental college or school not accredited in
accordance with paragraph (2)(b) or of a dental college or school not approved by the board, he shall not be entitled to take the examinations required in this section
to practice dentistry until he meets the following requirements:
(c) Satisfy one of the following:
2. Exhibits manual skills on a laboratory model pursuant to rules of the board ...
If the applicant fails to exhibit competent clinical skills in two attempts, he shall not be entitled to take the examinations authorized in subsection (4).
Rule 21G-2.019, Florida Administrative Code, implements the above quoted statutory provision. This Rule specifies that the examination is to consist of 10 procedures, only 9 of which are to be graded. Pursuant to Rule 21G-2.019(1)(b), Florida Administrative Code, each procedure must be graded by 3 examiners. During the final hearing of this case, the Petitioner argued that only 2 examiners should grade the procedures. This suggestion is, however, contrary to the requirements of the Rule, which must be followed by the Respondent.
Rule 21G-2.019, Florida Administrative Code, also contains detailed provisions specifying the criteria which are to be applied in grading the manual skills of a candidate. Additional provisions governing the manner in which the dental mannequin examination is to be graded are contained in Rules 21G- 2.013 and 21G-2.017, Florida Administrative Code.
Based upon the evidence presented during this proceeding, the May, 1986 dental mannequin examination was administered and graded in accordance with the applicable statutory and rule provisions. The evidence failed to prove that the failing grade awarded to the Petitioner was an incorrect grade.
At the final hearing, the Petitioner raised several arguments. First, the Petitioner argued that she had been treated in a discriminatory manner by the Respondent. The evidence failed to support this argument. Because of the Petitioner's difficulty in understanding the English language, there may have been some confusion about the procedure the Petitioner was to follow in contesting her failing grade. The evidence failed to prove, however, that the Petitioner was treated in a manner different from other candidates who failed the dental mannequin examination of May, 1986, or that the manner in which she was treated affected her final score in any way. The Petitioner was afforded the rights provided by law in taking the examination and in contesting the failing score she received. She was provided with examiners' grade sheets within a reasonable period of time. She was given the opportunity to file written objections and/or to attend a conference. As a result of the conference, a regrade of 2 of the procedures was ordered. The regrade of the 2 procedures was insufficient to improve her overall score to a passing score. In fact, the regrades resulted in a lower score.
The Petitioner also suggested that other candidates who performed no better than she did received passing scores. The evidence failed to prove that this in fact occurred.
Finally, the Petitioner argued that she should have received a higher grade for procedure number 5. The Petitioner received a failing grade for procedure number 5 from all 3 examiners. Procedure number 5 is a endodontic procedure--instrumenting of the canal of a tooth that has been infected, so that the canal can be drained of matter which might become infected and the ultimate filling of the tooth. In layman's terms, the procedure is the performance of a root canal.
Ideally, the canal should be cleared to within 5 millimeters from the apex of the tooth. The tooth on which the Petitioner performed this procedure was only cleared to within 2.5 millimeters from the apex. This is unacceptable. The passage did not go any further because ledging had occurred. Ledging was caused by the Petitioner and occurred when the instruments used to clear the canal went out of the canal at an angle into the tooth. When this occurs the problem usually cannot be corrected and the portion of the canal below the ledging cannot be cleared.
When the Petitioner experienced the ledging, she believed that the canal had an obstruction in it. The x-rays of the tooth however, showed the ledging and that there was no obstruction in the canal.
The Petitioner asked a monitor to verify that she had encountered an obstruction. Monitors are instructed not to assist or approve in any way a candidate's work. The Petitioner was told this before the examination. The monitor, therefore, did not and could not verify that there was an obstruction in the tooth the Petitioner was working with. Once the Petitioner experienced a problem with the tooth, it was her responsibility to deal with it in the best manner possible. Again, the Petitioner was confused as to the function of the monitor because of her language problem.
Even if the monitor had verified that there was an obstruction in the tooth, it was the Petitioner's responsibility to do the best job possible. The evidence proved that the Petitioner's performance on procedure 5, whether there was an obstruction or ledging, was not acceptable. The evidence also failed to prove that the score she was awarded for procedure 5 was incorrect.
RECOMMENDATION
Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Board of Dentistry issue a final order concluding that
the Petitioner's grade on the May, 1986, dental mannequin examination was a failing grade.
DONE and RECOMMENDED this 22nd day of July, 1987, in Tallahassee, Florida.
LARRY J. SARTIN
Hearing Officer
Division of Administrative Hearings The Oakland Building
2009 Apalachee Parkway
Tallahassee, Florida 32301
(904) 488-9675
Filed with the Clerk of the Division of Administrative Hearings this 22nd day of July, 1987.
APPENDIX TO RECOMMENDED ORDER, CASE NO. 87-0208
The Petitioner has submitted proposed findings of fact. It has been noted below which proposed findings of fact have been generally accepted and the paragraph number(s) in the Recommended Order where they have been accepted, if any. Those proposed findings of fact which have been rejected and the reason for their rejection have also been noted.
Proposed Finding of Paragraph Number in Recommended Order Fact Number of Acceptance or Reason for Rejection
(A) 2-14.
1 4.
2 5.
3 6-7.
4 9.
5 9-13.
Not a proposed finding of fact.
Not supported by the weight of the evidence.
Not supported by the weight of the evidence and irrelevant.
Irrelevant.
10-13 Not supported by the weight of the evidence.
Not supported by the weight of the evidence.
Irrelevant.
(B)-(B)(2) Not supported by the weight of the evidence.
(B)(3) 21. To the extent that this paragraph suggests that the
Respondent's witness denied the truth to protect the Respondent, this proposed finding of fact is not supported by the weight of the evidence.
Not supported by the weight of the evidence.
(C)(1)-(6) Not supported by the weight of the evidence.
(D)(1)-(4) Irrelevant and not a proposed finding of fact.
COPIES FURNISHED:
Dr. Bao-Kiem Dam 4581 Charnock Drive
Irvine, California 92714
Chester G. Senf, Esquire Department of Professional Regulation
130 North Monroe Street Tallahassee, Florida 32399-0750
Van Poole, Secretary Department of Professional Regulation
130 North Monroe Street Tallahassee, Florida 32399-0750
Joseph A. Sole, General Counsel Department of Professional Regulation
130 North Monroe Street Tallahassee, Florida 32399-0750
Pat Guilford, Executive Director Board of Dentistry
130 North Monroe Street Tallahassee, Florida 32399-0750
Docket for Case No: 87-000208
Orders for Case No: 87-000208
| Issue Date |
Document |
Summary |
|
Jul. 22, 1987 |
Recommended Order
|
Petitioner failed to prove she earned passing grade on May 1986 dental mannequin exam.
|
