Background | Aim | Description | Process | Evaluation | Contact
 
 

Background

Under our previous clinical assessment procedures, tutors working in a clinical setting with five to seven students may have kept notes about individual students' performance, and gave summative assessments at the end of a Semester to the staff coordinator of the discipline.  This often resulted in inadequate day-to-day feedback to students about their clinical progress, and kept the assessment secretive.

Tutors generally come from outside the University; some did not feel confident in providing feedback and there was the potential for a wide variation in assessments across tutors and disciplines.

With the development of the new Problem-Based Curriculum in Dentistry, see Drilling for Gold: A Problem-Based Approach in Oral Diagnosis there was a golden opportunity to revamp clinical assessment, making it a uniform system across all years and disciplines.   We also wanted to change the assessment process from a secretive one, with grades given only at the end of a Semester, to a truly continuous assessment in which the students have a major input, particularly in learning to accurately reflect about the quality of their work.

Aim

To develop a system in which students learnt to effectively assess the quality of their clinical work and other professionally-related issues (eg time management, infection control),  using a range of specific criteria which had been developed for each area of dental clinical practice.

Description

Assessment in Dental Clinical Practice consists of the following components:

• A portfolio of ideas and information collected by each student
• Self assessment against provided criteria
• Self assessment compared with tutors' assessment of performance
• Staff mentor discussions.
  
  

Of particular interest in this case study are Self Assessment and the Staff Mentor discussions.

Self Assessment

Each student is provided with a self assessment booklet containing duplicate pages. Each page provides space for student and tutor ratings and comments on four areas:

• infection control;
• knowledge base;
• skills base;
• professional behaviour.

Following a procedure, students carry out the self assessment, hand the booklet to the tutor for comment and then tear out the top sheet and give it to the tutor. By retaining the copy in the booklet the student then has a compilation of self-assessment across disciplines in one booklet. The booklet is shown to Staff Mentors during reviews of progress.

Staff Mentor Discussions

Throughout the year staff members (other than tutors) meet with six to eight students on a regular basis for review self assessments and to discuss any areas of concern. The Staff Mentor also works through each student's portfolio and list of patients with them. If the Staff Mentor is concerned with any particular issue then he/she follows-up with the appropriate clinical tutor. This practice allows one member of staff to have an overview of the overall progress of a number of students in all disciplines.

Process

For staff involved in developing the assessment, the key factor was determining the criteria. Without clear and easily understood criteria for students and their tutors the system would not have worked.

Evaluation

At the end of the first semester following introduction of the system students were provided with a questionnaire. A number of improvements were made to the system as a result. The formal assessment, which had been a component in first semester, was discontinued because students perceived that the formal assessments put them under additional stress. The important aspect of clinical self assessment that we want to encourage is for it to be part of the way things are done every day in the clinic, rather than a specific/unusual event that is feared or avoided. In addition, where the tutor had taken responsibility for keeping the assessment pads in first semester comments from the questionnaire indicated that it would be far more efficient and effective for students to maintain their own documentation. This is now the practice.

Students were given a news sheet which informed them of the results of the questionnaire and of the changes which were to commence from the beginning of second semester.

As this process has only been conducted for one semester it is still in the pilot stage and further evaluation is planned. Comments would be most welcome and can be made to Dr Hirsch, see contact details below.

Contact
Dr Robert Hirsch can be contacted as follows:

Department of Dentistry
Adelaide University, Australia 5005

Tel: +61 8 303 4614
Fax: +61 8 303 3444
E-mail: robert.hirsch@adelaide.edu.au