.The DAII role is not utilized in most of South Central Virginia. I am an educator of a high school DA program and have been for 5 years. I have also practiced hygiene in various areas all over Virginia. The students that graduate from the high school program does not have a problem getting hired here due to not being Certified or DAII, in fact, most DDS in this area do not pay for Certified or expanded DA's in this area.  

I feel like a DAII may be considered for largely populated areas of Virginia like Northern VA or maybe the Tidewater area (although I know several DA's there that are neither Certified or DAII and have no intention of becoming so because it will not be reflected in pay for them).

I think DAII should be competency based because people work at different paces and levels and their competency of needed requirements may be achieved at different levels.

I also feel like this is a moot point for most of Virginia until Certification is more recognized all over the state, then having another level attainable would be worth the effort for a Dental Assistant in this state.