Undergraduate academic assessment and dental licensing examination outcomes: a single-institution retrospective cohort study in China

BACKGROUND: Licensing examinations provide an external reference for selected knowledge, skills, and professional standards required for entry into clinical practice. In China, the Dental Licensing Qualification Examination (DLQE) marks the transition from undergraduate dental education to licensed practice. This study examined associations between undergraduate academic assessment indicators and DLQE outcomes to inform curriculum-assessment alignment and longitudinal academic monitoring. METHODS: This retrospective cohort study included graduates from Zhejiang Chinese Medical University between 2019 and 2023. Of 315 graduates, 278 had available DLQE outcomes and were included in the overall analysed cohort. Practical-score analyses included all 278 graduates, whereas written-score and cognitive-domain analyses included 276 graduates because two graduates were not eligible for the written examination after not passing the practical examination. Undergraduate course scores were grouped into five predefined credit-weighted course clusters mapped to DLQE written subject areas. Basic Comprehensive Examination (BCE) and Professional Comprehensive Examination (PCE) scores were examined as complementary phase-based indicators among graduates from the 2021-2023 cohorts with complete data (n = 172). Multivariable linear regression models included graduation cohort as a fixed factor. Internship institution type was examined as a broad proxy for clinical training context. RESULTS: Dental clinical course performance showed the most consistent associations with written DLQE scores and written cognitive-domain scores. Basic science course performance showed weaker associations in the primary models, but these were not retained in sensitivity analyses restricted to the 2021-2023 cohorts. Associations with practical DLQE scores were weaker and less consistent. BCE and PCE were associated with written DLQE scores and all three written cognitive-domain scores; BCE showed a weak association with practical scores, whereas PCE was not associated with practical scores. Internship institution type showed no clear independent association with DLQE outcomes after adjustment. CONCLUSIONS: Within this single-institution cohort, undergraduate academic indicators were more consistently associated with written and cognitive-domain DLQE outcomes than with practical examination performance. DLQE outcomes may provide useful but incomplete external reference points for curriculum monitoring and assessment alignment in undergraduate dental education.