What it is
The CSCE OSCE (computer simulated clinical examination) is a computer‑based, multiple‑choice clinical simulation exam. ADEX, the American Board of Dental Examiners, gives the exam (CDCA‑WREB‑CITA merged into ADEX in August 2025), and the CSCE OSCE is taken at a computer testing center.
You can take it before or after the clinical part. ADEX's 18‑month rule and its 3‑time failure rule apply to both parts.
Length and formats
- About 2.5 hours in the seat, including a tutorial, with 1 hour 55 minutes of exam time.
- Roughly 100 scored items, plus a varying number of unscored pilot questions.
- Item types: multiple choice (single and multiple response), extended match, drop down, fill in the blank, hot spot, and drag and drop.
- Simulated patient cases, shown with photographs, radiographs, images of study and working models, lab data and other clinical material.
- Time limits are per subsection. You can skip and mark items within a subsection, but you can't go back once you've submitted it.
About 2.5 hours in the seat, including a tutorial, with 1 hour 55 minutes of exam time and roughly 100 scored items. Six item types: multiple choice with single and multiple response, extended match, drop down, fill in the blank, hot spot, and drag and drop.
How it's scored
Some items are worth more than 1 point, and partial credit is possible. Your score is the percentage of points earned, scaled so scores compare from year to year. A scaled score of 75 or higher passes, and scores aren't rounded up.
A scale for the The CSCE OSCE with a line at a scaled score of 75: scores at or above it pass, scores below it don't. The scaled score isn't the percentage of questions answered correctly.
How to prepare
- Practice identifying conditions from intraoral and extraoral photos and radiographs.
- Work through full simulated patients: assessment, then care planning.
- Practice the unusual formats, like hot spot and drag and drop, so they don't cost you time.
- Do at least 1 timed run at full length, with the subsection time limits.
ADEX doesn't name a single textbook. Any current textbook used in accredited hygiene programs is suitable.
Which exam does your state want?
ADEX isn't the only clinical exam. Other agencies, such as CRDTS and SRTA, give their own, and each state board decides which it accepts. Check your state board before you register.
Read the ADHA's overview of clinical exams (PDF) (opens in a new tab)