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Caries Removal by First-Year Dental Students: A Multisource Competency Assessment Strategy for Reflective Practice
Tracy L de Peralta1, Vidya Ramaswamy2, Elisabeta Karl2
1Dr. de Peralta is Clinical Associate Professor, Department of Cariology, Restorative Sciences, Endodontics, and Director of Curriculum and Assessment Integration, School of Dentistry, University of Michigan; Dr. Ramaswamy is Associate Director of Curriculum and Program Evaluation, Office of Academic Affairs, School of Dentistry, University of Michigan; Dr. Karl is Clinical Assistant Professor, Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan; Dr. Van Tubergen is Clinical Assistant Professor, Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan; Dr. McLean is Clinical Associate Professor, Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan; and Dr. Fitzgerald is Associate Chair and Associate Professor, Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan. tdeperal@umich.edu.
Abstract:
Multisource assessment (MSA) uses multiple assessors to provide feedback. Little is known about the validity of using MSA feedback for improving students' ability to self-assess in a preclinical environment. Therefore, the aim of this study was to measure the validity of using a defined reflective process involving an MSA tool for building skill in dental students' self-evaluation of caries excavation on extracted teeth. As part of this process, 104 first-year students at one U.S. dental school used a self-generated study plan (SGSP) for structured reflection on MSA feedback during the 2013-14 academic year. Interrater agreement, determined through calculation of percentage-agreements in scoring, was measured among three assessor groups (self-, peer, and expert assessors) in formative assessment and between two assessor groups (self- and expert assessors) in summative assessment two weeks apart, allowing for reflective practice and completion of an SGSP between assessments. Validity for improving self-assessment was determined by measuring significance in positive shifts of agreement between self- and expert assessors. The results showed that interrater agreement between the self- and expert assessors increased significantly: from a 28% agreement in formative assessment to a 60% agreement in summative assessment. Significance in percentage shifts between assessments was demonstrated with a McNemar score of 0.26 (p<0.001). These results suggest that the described MSA tool and reflective process in an SGSP may be valid methods for improving skill in student self-evaluation of competence in caries excavation on extracted teeth.
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