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Recovering from failing the dental hygiene clinical board exam

One dental hygienist describes her experience of working through failure to ultimately triumph and realize that past failures don’t define future outcomes.

“The comeback is always greater than the setback.” This was a familiar quote but it wasn’t until December 16th, 2020 that this quote fully resonated with me. Let’s rewind a little.

In March of 2020, I had been gearing up to finish my final semester of dental hygiene school. I was eagerly awaiting graduation when the world came to a halt. For myself, it felt extremely overwhelming to navigate while trying to complete my education so that I could start my career that I had been working hard for. Nonetheless, I completed Zoom courses, computerized exams, and completed clinic requirements after a four-month delay.

In October 2020 I donned my PPE and very anxiously set off to take the clinical board exam. The last examination I needed to acquire licensure. With shaky hands, I got through the first steps and sent my patient off to the examiners. As I prepared for my next steps, I heard the voices of my instructors in my head; “Do not send the patient to examiners if you are not confident.” Did I ever truly feel confident in high-pressure settings? What choice did I have? Clinical examinations were being canceled left and right. Patient availability was minimal. During the pandemic, patients’ willingness to participate was extremely low. On top of all that, Pennsylvania was not accepting manikin examinations for licensure. My friend and I worked hard screening patients and had comparable cases, or so we thought.

After what felt like an eternity my patient came back and I started my examination. Upon completion, I started my checkout process when the chief examiner pulled me aside. My heart began to race and my stomach dropped, I knew immediately what had happened. I was brought into a room and told that the examiners disagreed and didn’t feel that my patient qualified for the examination. As a result, I failed. I was told over and over that this was not related to my clinical skills, however, I was truly devastated and embarrassed. I cleaned my cubicle, packed my belongings, and cried for days.

After a few days, I started the process of retaking my clinical examination. I had to keep pushing forward. I screened patients as often as I could and eventually found another candidate. I rescheduled the exam multiple times due to the pandemic. On December 16th, 2020 in the middle of a snowstorm, my patient made a two-hour commute to sit for my clinical board. Thankfully it all worked out and today I finally feel confident when sharing my story. It is overwhelming to look back at that time in my life and reflect on everything that happened. A lot of it feels like a blur. I would be lying if I said it was easy to move on from that experience. I would also be lying if I said that I never question my clinical skills or abilities as a hygienist. One thing that is for certain is how much I have learned about myself through the experience.

Dental hygiene school is a complete whirlwind, to say the least. I completed my bachelor’s degree and I can without a doubt say that completing dental hygiene school was more difficult than my prior education. Day in and day out students are graded, evaluated, and judged based on things that are oftentimes out of their control. They are being graded on skills that they are learning and may not have had ample opportunity to try out. How can someone be graded fairly and properly when there are multiple variables and lack of standardization? How can one be fairly evaluated and graded based on what is or is not present on a patient? For example, my first option for a patient for clinical boards had not received dental treatment in 10-plus years. They had all of their adult teeth present in the mouth, including an extra set of fully erupted wisdom teeth. Yes, they had four sets of molars present in the mouth! This meant that when treating this patient for the exam I would need to properly clean the extra teeth present on top of the large amount of heavy build-up present. My second option was a patient that had not received dental treatment in two years and had significantly less build-up present. These two cases have completely different situations with varying degrees of case difficulty. Again, how can a student’s skills be fairly evaluated under these circumstances?

All this to say, do not be so hard on yourself. As a student, your job is to learn. Ask questions, ask for feedback, ask for guidance. Try your best to remember that you will not be perfect on your first attempt, and maybe you won’t be successful on your second or third. That is more than okay! Practice, practice, practice. Know that these skills really take time to develop. As a hygienist that has now been practicing for two and a half years, my skills are still developing. Hygienists, remember all that you have learned and accomplished. Remember that each patient and situation is different. Remember that as much as we want to be perfect, we are human. We do the best that we can in each scenario and that is all we can do. Clinical skills are continually developing, it is a continued work in progress. Keep that drive to learn and do the best you can and you will be sure to succeed. Most importantly, remember that past failures do not define you.

Letitia Hill ,BS, RDH

Letitia Hill BS, RDH, PHDHP, writer, speaker, and founder of Sunday Scalies Podcast, entered the dental hygiene field in 2020. Working as a new grad through the Pandemic, along with her personal experiences, ignited her passion for speaking and writing about burnout and mental health as a dental hygienist. She created Sunday Scalies to support new graduates and guide them through their transition into \"real world hygiene\". You can connect with her on instagram @toothfairytish!

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