Non‐Graded Clinical Evaluation of Dental Students in a Competency‐Based Education Program

Abstract

The objective of this article is to report the development, implementation, and early results of a non-graded normative dental student clinical performance assessment system based on our competencies documents. The normative system (student performance is compared to evidence-based clinical standards) was used and evaluated during the 2002-03 academic year and is now gradually replacing the traditional summative (numerical) grading system previously used at Baylor College of Dentistry. The methodology included: 1) consensus development of new clinical performance assessment forms over the summer of 2002; 2) concurrent fourth-year clinical faculty calibration to the new forms; 3) implementation at the beginning of the senior year for the Class of 2003; and 4) faculty and student evaluation surveys in May 2003. Every step of each clinical procedure was recorded, weekly performance summaries by both students and faculty were collected, and periodic workshops were held to refine the forms and further calibrate faculty. The results showed strong positive responses to the new system by graduates and faculty alike. We conclude that early results warrant broadened efforts toward a continuously improved schoolwide normative student clinical performance assessment system.

Competency‐based education in undergraduate clinical prosthodontics: A paradigm shift in training

“…Clinical training of prosthodontics using TE systems is liable to faculty personal variations and subjective evaluations of students, with no clear calibration standards (Gerrow et al., 1996; Taleghani et al., 2004). Gerrow et al.…”

“…Another limitation of the TE was being a patient‐centered process, in which the delivery of clinical experience in TE from teacher to apprentice witnessed a lot of discrepancies in achieving the intended learning outcomes and resulted in some students graduating with more or less clinical skills than others (Gerrow et al., 1996; Taleghani et al., 2004). This study, however, claimed that the CBE permitted the immediate visualization of students lagging behind their colleagues, during the academic year by the mentors of the student groups, who examined the assessment sheets and detected the competency levels that students were not able to achieve, and by giving them a feedback about their clinical performance, students were able to learn, in their own pace, how to improve their results.…”

“…This grading system granted a numerical degree for each level, so that the students could relate their performance to a numerical value and became motivated in achieving a higher grade, until they reached the competent level; however, Taleghani et al. (2004) claimed that CBE should be a pass–fail process, which eliminates the daily grading process, and allow the students to work under the supervision of the faculty members in a friendlier and cooperative environment. No doubt, the pass–fail approach overcomes the leniency of assessment of some faculty members, granting students fixed ranges of grades of high, medium, or low values; however, the pass–fail approach only evaluate the capability of the graduate students to perform the clinical procedure or not, whereas the grading system, according to Gerrow et al.…”

“…To improve the reliability and validity of graduates, it is tempting to embrace the change and adopt new methods of teaching and learning, by which the students graduate with specific desired capabilities that mark them as safe beginners (Field et al., 2017; Telang, Rathod, Supe, Nebhinani, & Mathai, 2017). Competency‐based education (CBE) is claimed to fulfill these requirements and overcome the shortcomings of traditional education (TE) (Caccia, Nakajima, & Kent, 2015; Fernandez et al., 2012; Frank et al., 2010; Gerrow, Boyd, Doyle, & Scott, 1996; Gruppen et al., 2016; Taber et al., 2010; Taleghani, Solomon, & Wathen, 2004).…”

“…Competency‐based education dictates a shift from the TE which is teacher‐centered, examination‐driven, time‐based, and discipline‐based (Khanna & Mehrotra, 2019; Taleghani et al., 2004; Yip & Smales, 2000), to a student‐centered education that enriches the students' skills in critical thinking, problem‐solving, and autonomous self‐assessment, which further help them perform better comprehensive patient care and develop ethical values and professionalism for better community‐based services (Behbehani, 2003; Deogade & Naitam, 2016; Field, Cowpe, & Walmsley, 2017; Ghafoor, 2019; Hendricson & Cohen, 1999; Hsu et al., 2015; Khanna & Mehrotra, 2019; Puryer, Woods, Terry, Sandy, & Ireland, 2018; Roudsari, 2018; Whitney, Walton, Aleksejuniene, & Schönwetter, 2015; Yip & Smales, 2000).…”