Evaluating student performance assessment methods in Objective Structured Clinical Exam: perspectives and comparisons.

PURPOSE: This study aims to evaluate how student performance and perspectives changed when the Objective Structured Clinical Exam (OSCE) assessment system was changed from a composite score to discipline-specific grading at the Harvard School of Dental Medicine. METHODS: The retrospective study population consisted of all students (n = 349) who completed three OSCEs (OSCE 1, 2, and 3) as part of the predoctoral program during the years 2014-2023. Data on the students' OSCE scores were obtained from the Office of Dental Education, and data on students' race/ethnicity and gender were obtained from their admissions data. RESULTS: The likelihood of a student failing the OSCE after the assessment system change significantly increased with an adjusted odds ratio of 20.12. After the change, the number of failed subjects per student decreased with an adjusted mean ratio of 0.48. Students perceived the OSCE as being less useful after the change. Independent of the grading change, OSCEs 1 and 2 were seen as more useful compared to OSCE 3, which is administered in the last year of the Doctor of Dental Medicine program. CONCLUSION: The discipline-specific nature of the new assessment system helps focus on specific areas of remediation, rather than blanket remediation used previously, in order to isolate the actual areas of deficiency and to focus remediation efforts so that students can align their learning needs appropriately. Therefore, although the actual number of fails identified increased for the course, the assessment change has allowed for more directed, actionable information to be gained from the OSCE to prepare students to work toward competency standards.

Perspectives on virtual interviews for dental school admissions.

INTRODUCTION: Admissions interviews are an integral part of the dental school application process. In light of the COVID-19 pandemic, interviews had to adapt and become a part of the virtual realm. The purpose of the study was to evaluate the perspectives of interviewees and interviewers in this process. METHODS: Admission data for all prospective students were compiled for the classes of 2016 through 2025 to compare in-person to virtual interview scores. Additionally, surveys were sent to members of the admissions committee as well as interviewees asking questions regarding the virtual interview experience. A Likert scale was used for the majority of questions and free responses were also an option. RESULTS: The comparison data showed that the virtual candidates may have had higher overall undergraduate and application scores, in addition to better interview scores compared to in-person candidates. Interviewees and interviewers both agreed in their top three rankings of what was enjoyable about the virtual interviews, specifically the lower cost for applicants, the convenience, and the safety during the pandemic. There was also agreement with their top three aspects that were least desirable in the interview process, specifically the absence of visual cues/lack of body language, lack of personal contact, and connectivity issues. Around 74% of committee members would recommend virtual interviews in the future whereas only 49% of interviewees would recommend virtual interviews in the future. CONCLUSION: The pandemic brought about many changes, including the way admissions interviews were conducted. While this was a change made of necessity, it was valuable to explore the appropriateness of implementing virtual interviews in the future as a part of dental school admissions processes.

Defining success in healthcare education: US dental student and faculty perspectives.

PURPOSE/OBJECTIVES: Academic metrics and clinical performance are necessary but alone insufficient in describing success in dental education. This paper identifies themes critical for dental student success as commonly cited by both dental students and faculty. METHODS: Dental faculty interviews and pre-doctoral D2/D3/D4 student focus groups at two dental institutions generated data for thematic analysis. Themes were individually identified then merged, compared, and contrasted to establish a definitive list of key themes reflected in student and faculty comments. RESULTS: Twenty-five pre-doctoral students participated in one of four focus groups (two focus groups at each dental institution). Thirteen dental education faculty across two institutions participated in structured interviews. Thematic analysis produced five overlapping themes identified by both students and faculty across the two institutions: seeking understanding, collaborative spirit, personal ownership, organization, and broadened perspective. Faculty-specific themes identified long-term retention, a strong moral compass, and self-sufficiency as critical for student success. Student-specific themes identified their most successful peers to have a positive attitude, a perspective focused on personal investment and self-care, as well as access to professional mentors. CONCLUSION(S): Both faculty and students in dental education perceive behaviors illustrative of a growth mindset as hallmarks of success in the oral healthcare profession. Relatedly, students exemplifying resilience and/or grit must believe their efforts to be worthwhile and impactful.

Comparison of student and faculty interviewers using ratings data for admissions decisions.

INTRODUCTION: The aim of this study was to evaluate the correlations of cognitive and noncognitive dental school admission factors with interview ratings provided by faculty and student interviewers. METHODS: Interviewees for the 2019-2021 admissions cycles underwent a 90-minute period consisting of two 45-min interviews and received two interview scores ranging from 1.0 to 2.3. Regression models were utilised to evaluate factors associated with interviewer type and admission status, The correlation strength between faculty and student interview scores was assessed. RESULTS: A total of 177 applicants were interviewed, and 69 students were admitted over two admission cycles. Admitted students received higher interview ratings compared with nonadmitted applicants after adjusting for cognitive and noncognitive admission factors (average difference = -0.068; 95% CI = -0.123, -0.014). No statistically significant relationship was found between any cognitive admissions factor and interview score. However, having prior leadership role experiences was associated with better faculty score, after adjusting for student interviewee score. There was a strong linear correlation (r = .92) between faculty and student interview scores, with 0.809 change in faculty score with each additional student interview score (95% CI = 0.735, 0.883). CONCLUSION: The relationship between faculty and student scores was linear and strongly correlated, suggesting that faculty and student interviewers were comparable in their interview scoring. Leadership experience and potential could be advantageous qualities that improve faculty interviewer ratings. However, having a mix of faculty and Student interviewers may promote evaluation of candidates from different aspects, as students are familiar with the learning environment in dental school and may provide a unique perspective on an applicant's background and suitability for the program.

Is dental education meeting the oral health needs of older adults?

The aim of this article is to highlight the importance of promoting oral health for the geriatric population and implementing change to address their complex oral and systemic health needs. Oral healthcare providers are unequipped to meet the demanding oral health needs of the aging population, resulting in a geriatric oral health crisis that needs immediate attention and action. Despite the advancements in geriatric education over the last two decades, the geriatric curriculum in 2022 is still inadequate, and varies greatly among different US dental schools for both pre- and postdoctoral programs. Predoctoral students are graduating without being sufficiently trained to identify and treat the dental issues of older adults due to lack of a purposely planned curriculum with balanced didactic and clinical exposure. It is critical to have a trained and competent workforce that meets the oral health needs of current and future older adults. To change the present environment, there is a need for curriculum redesign, faculty development, and training. In addition, more research to evaluate pre- and postdoctoral geriatric dentistry curricula, their impact on increasing access to care, and the likelihood of graduating dentists competent to treat functionally dependent and frail older adults is needed. Furthermore, decision-makers in dental education, national dental organizations, and government institutions must support policies that integrate oral health into overall health through robust reimbursement mechanisms, including a dental benefit in Medicare, and recognition of geriatric dentistry as a specialty.

Association of admissions factors with student performance in preclinical operative dentistry.

PURPOSE/OBJECTIVE: Admission to dental school is based on various factors including academic achievements in undergraduate coursework and the Dental Admission Test (DAT) scores. Students' success in an operative course requires fundamental knowledge, hand skills, spatial awareness, and self-assessment ability. The goal of this study is to evaluate how admissions factors, such as Grade Point Average (GPA) and DAT, including the Perceptual Ability Test (PAT), relate to students' academic and preclinical performance and self-assessment skills in preclinical operative dentistry. METHODS: A total of 239 students were included from seven class years (2016-2022). Third-year dental students participated in a preclinical operative dentistry course. At the end of the course, they took the final multiple-choice exam and performed four competency examination procedures: Class II amalgam preparation and restoration and Class III resin-composite preparation and restoration. Calibrated faculty graded students' work independently and students also self-assessed their performance using the same rubrics as faculty. Linear regressions were performed to estimate the association between the admission factors with the mean faculty scores (measuring preclinical performance), student-faculty (S-F) gap scores (evaluating self-assessment skills), and their final didactic exam scores. RESULTS: Overall, students' self-assessment was higher compared to faculty score. Linear regression analysis demonstrated positive correlations between the PAT and students' preclinical performance as well as between the DAT and their didactic exam scores. In general, S-F gap score decreased as PAT score increased, and it was statistically significant lower for the Class III preparation, indicating a better self-assessment skill. No correlations were observed between student performance and GPA scores. CONCLUSION: The findings from the association between student performance and admission factors may play an important role in the dental school admissions process and assist students who may benefit from early faculty intervention and support.

Professional leadership training programs for dental faculty: Perspectives of the US dental school deans.

INTRODUCTION: The purpose of the study was to explore the influence of leadership training programs on career development and to gain insight into the perspectives on faculty training programs according to the current US dental school deans. METHODS: This prospective study analyzed the results of a questionnaire distributed to 67 active Deans of U.S dental schools using a survey instrument that explored the areas of leadership programs that were useful, the support mechanisms received from institutions, and the necessity to integrate formal leadership development programs into training programs for faculty and students. RESULTS: Among 33 participants (49.3% participation rate) in the study, 97% of responders strongly or somewhat agreed that leadership development programs could improve the quality of leadership and administrative skills. The respondents found that the most useful areas in leadership training were conflict resolution, communication skills, organizational change, diversity, inclusion, and belonging. The findings highlighted that critical barriers to accessing leadership training are financial support and lack of protected time for faculty. The results also showed that 73% strongly or somewhat agreed that the leadership training should be integrated into the predoctoral program and 87% into the postdoctoral graduate programs. CONCLUSION: Participation in formal leadership development programs for faculty leaders in dental education is viewed as beneficial and could offer dental educators leadership training to better navigate the academic environment. The findings suggest the need to further explore the availability and effectiveness of leadership development opportunities for developing current and future educators and administrative leaders.

Oral medicine education in predoctoral programs in US dental schools.

OBJECTIVE: the purpose of the study was to explore the structure of oral medicine (OM) education in predoctoral dental programs in the United States and to evaluate the students' perception of OM as a dental specialty. METHODS: Two anonymous Qualtrics surveys (Qualtrics, Provo, UT, USA) were distributed electronically to the academic deans of all the Commission on Dental Accreditation (CODA) accredited dental schools in the United States. Upon completing the survey, the academic deans were asked to forward the student surveys to their students. RESULTS: Note that 26.8% (18/67 dental schools) of academic deans that participated in the survey, 224 senior students responded to the student survey. The results showed that the median number of OM specialists involved in teaching OM to predoctoral students was two. Oral cancer screening and diagnosis and management of oral mucosal diseases were identified by the majority of respondents (95.7%; n = 214 and 96.5%; n = 216), respectively, as part of the scope of practice of OM specialists. Although most students reported Advanced Education in General Dentistry (AEGD) and General Practice Residency (GPR) (18.67% n = 42 each) as postgraduate specialties of interest, students' positive impression in OM increased by a crude average of 0.4 with each additional OM faculty member in the school (p = 0.000; 95% CI 0.207-0.594). CONCLUSION: OM faculty members are in an important position to enhance dental students' perception and interest in OM as a specialty, which would lead to improved awareness of the scope of the specialty and consideration of pursuing specialty training.

The impact of COVID-19 pandemic on student performance and self-evaluation in preclinical operative dentistry.

INTRODUCTION: During the COVID-19 pandemic, dental schools were required to reformat their curricula to accommodate regulations mandated to protect the health of students and faculty. For students enrolled in the Operative Dentistry preclinical courses at the Harvard School of Dental Medicine (HSDM), this modified curriculum included frontloading the course with lectures delivered remotely, followed by in-person laboratory exercises of learned concepts. The aim of this article was to determine the impact that the modifications had on student performance and student self-evaluation capabilities. MATERIALS AND METHODS: Thirty-eight students were introduced to this restructured course. Their performance in a final multiple-choice (MC) examination, four preclinical laboratory competency assessments (class II amalgam preparation and restoration, class III composite preparation and restoration) and their self-assessment of these preclinical competency assessments were then compared with the pre-COVID pandemic (P-CP) classes from years 2014 to 2019 (n = 216 students). Linear regressions were performed to determine differences in mean faculty scores, self-assessment scores, student-faculty score gaps (S-F gaps) and absolute S-F gaps seen between the class impacted by the pandemic and the P-CP classes. RESULTS: The results demonstrated that students during the COVID-19 pandemic (D-CP) had a higher average faculty score in all four preclinical laboratory competency assessments and in the final MC examination. In addition, the S-F gap was smaller in this cohort as compared with the P-CP classes. CONCLUSION: Despite the challenges of restructuring the preclinical curricula, D-CP students performed better than their P-CP predecessors in multiple facets of this Operative Dentistry course including self-assessment accuracy.

Ten-year follow-up of patient-centered comprehensive care using case completion curriculum.

INTRODUCTION: The purpose of this study was to evaluate the patient-based comprehensive model in the student teaching practice at Harvard School of Dental Medicine (HSDM) as a result of the case completion curriculum. The patient-centered assessment system was implemented in 2009 as a clinical reform in clinical education to redirect predoctoral clinical learning from a student requirement-driven assessment system to a patient-centered treatment delivery model. METHODS: The sample for the 10-year retrospective cohort study consisted of the graduating classes of 2010 through 2019 at HSDM and all data regarding case completion and student feedback were obtained from the Office of Dental Education. RESULTS: The average number of completed cases by the predoctoral graduating class has risen from 22.8 in 2010 to 33.26 in 2019, and as a result, the number of completed cases required for graduation has been adjusted twice, from 15 to 20 in 2012, and from 20 to 25 including two pediatric cases in 2018. CONCLUSION: The redesigned clinical component of the curriculum can contribute to improved efforts in providing a patient-based comprehensive care environment and in helping broaden student learning experience in the predoctoral dental education program.

Early Clinical Exposure in U.S. Dental Schools and Correlation with Earlier Competencies Evaluation.

Early clinical exposure (ECE), defined as any interaction with patients prior to the portion of the curriculum when den- tal students spend most of their time at school as a primary provider, is a growing trend in curriculum reform across U.S. dental schools in the 21st century. The aims of this study were to characterize the types of ECE implementation in U.S. dental schools and determine if ECE correlated with earlier clinical competency assessments. In September 2018, the academic deans of all 66 U.S. dental schools were invited to respond to an eight-item electronic survey about ECE at their schools. Representatives of 40 schools submitted complete responses, for a response rate of 60.6%. Among the respondents, 85% reported their schools started their principal clinical experience (PCE), the portion of the curriculum when students spend most of their time as the primary provider for patients, during the last quarter of Year 2 or the first quarter of Year 3. Respondents at all 40 schools reported offering some form of ECE as part of the formal curriculum, with shadowing and performing dental prophylaxis the most commonly of- fered types. No statistically significant associations were found between specific types of ECE and related Commission on Dental Accreditation (CODA) clinical standards for both formative and summative assessments. Although U.S. dental schools have been incorporating more ECE into their curricula over the past decade, these findings suggest that it has not led to earlier clinical competency assessments.

Use of team-based learning pedagogy for predoctoral teaching and learning.

PURPOSE: The purpose of the study was to describe the development and implementation of a Team-based Learning (TBL) educational model in a predoctoral education course to assess its effectiveness in promoting student learning as measured by knowledge acquisition and student satisfaction. METHODS: An interprofessional education course used the TBL structure for the second-year dental students, in which students had an opportunity to first work on the questions individually and then in groups. Each instruction session began with a readiness assurance test (RAT), which students were asked to complete in two formats: each student answered on their own, then each team worked on the same questions to arrive at a consensus decision followed by a team-based application exercise. RESULTS: A significant difference existed in which team scores were higher than individual scores and on average, the teams scored higher than when students worked alone. Student feedback showed a strong preference of TBL over the traditional lecture format. Students found that the sessions helped them to understand the clinical cases from the perspective of other health care fields in this pedagogical approach. CONCLUSION: The TBL methods facilitated an interactive learning environment to promote student-centred learning in a predoctoral education course and the teams performed better in correct evaluation compared with the individual students.

Effects of a Research Requirement for Dental Students: A Retrospective Analysis of Students' Perspectives Across Ten Years.

For many years, Harvard School of Dental Medicine (HSDM) has had a research requirement for predoctoral students, but a recent curriculum assessment prompted a re-examination of that requirement and how it is implemented. The aim of this retrospective study was to assess the students' perspectives on research in a predoctoral dental program in which a research experience was mandatory for graduation. Data that had been collected in graduating student surveys from 2008 to 2017 were analyzed to gauge students' perceptions of the research program in the previous curriculum (New Pathways) and to seek insights to improve the next generation of this requirement in the Pathways curriculum. In the results, 74% of the students reported their research experience had a positive impact on their dental education. Half of the students (49%) indicated they would have pursued research even if it had not been a graduation requirement, while 37% were uncertain. A large majority (82%) said they would remain involved in research during their dental career. The majority of these HSDM students had contributed to scholarship with presentations and published results, planning of projects, or preparation of manuscripts. These results show that the research requirement has had a positive effect on students' perspectives on research as a part of their careers.

Can Noncognitive Components of Admissions Data Predict Dental Student Performance and Postdoctoral Program Placement?

The aim of this retrospective cohort study was to evaluate whether the noncognitive factors of the dental student application, including undergraduate major and interview score, predicted success in the predoctoral program and placement in postdoctoral programs. The study population consisted of 169 students in the Harvard School of Dental Medicine DMD graduating Classes of 2012 through 2016. Noncognitive factors in the dental application, including letters of recommendation, extracurricular activities, undergraduate major, and dental school admission interview performance, were collected for the study population. Groups were analyzed for differences among undergraduate majors and any association between postgraduate placement and dental school performance. Dental school performance measures were grades obtained in the third and fourth years in a combination of preclinical and clinical course assessments. The results showed that neither interview score nor undergraduate major was significantly associated with dental school performance or postdoctoral program placement. There was a non-significant association between interview score and performance in the course Treatment of Active Disease. These results suggest that noncognitive factors of the dental school application offered low yield to predicting predoctoral student performance and residency placements, with interview performance possibly outweighing undergraduate major in selection of successful predoctoral candidates.

The Dental School Interview As a Predictor of Dental Students' OSCE Performance.

The aim of this study was to evaluate the use of the dental school admissions interview score as a noncognitive indicator of performance in predoctoral dental education, with specific attention to whether a correlation existed between the admissions interview scores and performance on the objective structured clinical examination (OSCE). The study population consisted of all 175 students in the Harvard School of Dental Medicine (HSDM) DMD Classes of 2012 through 2016. Data on students' gender and age on entering dental school were self-reported using their applications for admission to the HSDM DMD program. Data on students' OSCE scores for three examination sessions were collected from the Office of Dental Education. The results showed that the students' interview scores did not significantly correlate with OSCE performance on any of the three exams. Performance on the first and second OSCEs did, however, correlate with performance on the third OSCE (p<0.05). Age on entering dental school was not significantly associated with performance on any of the three OSCEs; however, among male students, there was a significant negative correlation (p<0.05) between entering age and performance on the second and third OSCEs. There was no significant association between gender and OSCE or interview score. These results suggest that although the admissions interview scores can serve as an important resource in student selection, with the lack of association between interview and OSCE scores, it is possible that the communication skills required for the interview do not directly overlap with those required for OSCE success.

A Reflection Curriculum for Longitudinal Community-Based Clinical Experiences: Impact on Student Perceptions of the Safety Net.

Community-based dental education (CBDE) allows dental students to be immersed in community settings and provide care to populations that are underserved. Exposure to those groups during training may impact provider attitudes, which may be strengthened by supporting students' reflection and exploration of their own attitudes. The aim of this study was to describe the implementation and preliminary results of a pilot longitudinal reflection curriculum integrated into a community-based clinical experience (CBCE) for senior dental students at one U.S. dental school and to report the impact of the reflection curriculum and CBCE on student experiences with populations that are underserved. In academic year 2015-16, all 35 senior dental students at one U.S. dental school were invited to complete an 11-item survey before and after completing a 12-week CBCE with integrated, longitudinal online reflections. Students received feedback from a faculty member after each reflection. All 35 students completed the survey, for a 100% response rate. After the CBCE, the students reported improved clinical efficiency and increased confidence in treatment planning and in treating dental emergencies and dentally anxious patients. They also reported improved understanding of the structure and relevance of community health centers, the role of different health care team members, and the impact of health policy. There was no significant difference in future plans to work with groups that are underserved. These results suggest that the CBCE and reflection curriculum had a positive impact on the students' clinical confidence as well as expanding their understanding of the broader oral health care delivery system. To address persistent oral health disparities, dental schools should continue to adopt CBDE programming that will prepare providers to effectively care for populations that are underserved.

Dental and Medical Students' Use and Perceptions of Learning Resources in a Human Physiology Course.

The aim of this study was to determine the use and perceived utility of various learning resources available during the first-year Integrated Human Physiology course at the dental and medical schools at Harvard University. Dental and medical students of the Class of 2018 were surveyed anonymously online in 2015 regarding their use of 29 learning resources in this combined course. The learning resources had been grouped into four categories to discern frequency of use and perceived usefulness among the categories. The survey was distributed to 169 students, and 73 responded for a response rate of 43.2%. There was no significant difference among the learning resource categories in frequency of use; however, there was a statistically significant difference among categories in students' perceptions of usefulness. No correlation was found between frequency of use and perceived usefulness of each category. Students seemingly were not choosing the most useful resources for them. These results suggest that, in the current educational environment, where new technologies and self-directed learning are highly sought after, there remains a need for instructor-guided learning.

The Impact of Integrating Oral Health Education into a Medical Curriculum.

OBJECTIVE: The purpose of this study was to evaluate our pilot program incorporating oral health education into the medical curriculum by evaluating students' perspectives on the oral health curriculum. SUBJECTS AND METHODS: Two hundred second-year students were asked to fill in a presession survey online regarding their familiarity with basic oral health concepts and their comfort level with performing oral examinations, and a postsession survey on paper that repeated the presession questions and added questions on the effectiveness of the session. RESULTS: Of the 200 students, 164 (82%) participated in the surveys. The pre- and postsurvey results showed that the session helped students become more comfortable with performing oral examinations and recognizing risks for periodontal disease, with an increase from 40 (27%) to 119 (82%) and 51 (35%) to 124 (86%), respectively. CONCLUSION: In this study, the oral health education session contributed to an increase in student awareness and understanding of oral health. Considering the reported effectiveness of the interactive session on student comfort with performing a basic clinical examination, this model shows promise for further use in other institutions.