The TPE measures the skills of students to solve clinical problems and properly implement clinical procedures based on evidence. However, the TPE has the disadvantage of testing a wide range of capabilities necessary for clinical work . The purpose of the DOPS assessment is to increase the assessment of practical skills in the workplace. A student is observed and evaluated by assessors while performing practical procedures during normal clinical work. DOPS can also be included in peer reviews that show improvements in dentists` performance over time . The notes for VDR had greater error limits than those of the OPO. VDR is not only a measure between 2 points (one point on the chin and the other on the tip of the nose), but it should be preceded by a correct analysis and a good understanding of the patient`s condition, which may present different perspectives . Such a process may not be feasible given the stress and time limitations of the examination. The student`s instructions were evaluated, which could have been a source of variation between the counsellors` grades. Another point with respect to the gap within compliance limits is the difference in the methods used to verify the established vertical dimension. While students were trained to use a rule to measure the distance between reference points, the examiner used experience to verify the vertical dimension recorded based on the patient`s aesthetic profile. Both methods are applicable, but the latter is subject to variation  and requires more experience, which may make it unsuitable for students.
Although many ratings were identical between opo and VDR advisors, the differences in VDR marks were noticeable. This is due to the subjective parameters of the VDR assessment, as the appropriate vertical dimension of the occlusion is determined for each patient on the basis of patient-specific biomechanical considerations. This has led to discrepancies in DOPS brands for this step. This pattern has not been observed in OPO, which depends mainly on objective parameters for evaluation. Thus, we can point out that the differences between the registrants had a negative impact on the reliability of inter-rated patients. The plots of difference in VDR marks assigned by advisors and average signs showed a relationship between absolute difference and average value.