Development of a dynamic clinical assessment for finals.

Different dental schools assess 'finals' in different ways. Assessment of applied clinical knowledge and skills are commonly based on either objective structured clinical examinations or multiple 'long cases'. While iterative changes naturally occur throughout education and assessment, it is important to step back and question what skills should be assessed and either identify or develop new assessment methods. At the point of graduation, these should capture the professional attributes expected of a 'qualified dentist'. New graduate attributes we consider valuable, which can often be challenging to assess summatively in a high-stakes examination, include effective communication skills in a variety of contexts, the ability to be reactive and responsive, and to manage case complexity appropriately for the graduate level.Here, we report a dynamic assessment incorporating candidate interaction with a range of stakeholders. To reflect progression of changing clinical situations, we move away from solely traditional case-based discussions, which principally assess interaction with an examiner, and have introduced multiple scenarios with rapid situation changes, long-term follow-up, treatment complications and challenging communications. A cross-cutting assessment rubric was developed to assess candidates' information gathering/giving, communication, clinical and diagnostic reasoning, applied knowledge, management and professionalism.