From 2015-2018, I co-chaired the University of Michigan School of Dentistry’s Competency Assessment Team (CAT). The charge of this team was to redesign the method for assessing clinical competencies in the DDS program. Formerly, each discipline (such as endodontics, prosthodontics, orthodontics, etc.) set its own assessment guidelines, schedule, and grading scale. This led to two issues:
- Students reported being more stressed about navigating their requirements than about treating patients.
- Students were treating patients as simple discipline-specific cases – “an orthodontics case” or “a root canal” or “an upper denture” – rather than as whole humans with complex needs.
The first step to move the school closer to its vision of true “whole-patient” care as to bring together all the discipline-specific courses together into one Comprehensive Care course in the early 2000s. This created one massive 32 credit course, delivered over six semesters, called Comprehensive Care. During this course, students provide oral health care to patients in a school clinic under the supervision of faculty members in each of the eleven disciplines within the school.
By 2015, it was clear that the next step of integration was needed to reduce student stress and confusion around requirements. The next phase of the program, where I began my involvment, aimed to standardize assessment across disciplines. This had three steps:
- Using a common grading scale across all disciplines
- Using a common grading process across all disciplines
- Posting all requirements, instructions, and grades in one electronic system
As co-chair of the Competency Assessment Team, my purview was to map the entire clinical curriculum (no single document at the school existed to describe all the requirements), propose a model for an integrated electronic grading system, select and customize software, train faculty and students in its use, and oversee the rollout and initial revisions to the system. Simply mapping the existing curriculum and processes took nearly six months. Standardizing rubrics and developing a new basic workflow took another six months, and software selection and development took approximately two years. Nearly 20 systems were investigated, and in the end, a combination of existing technologies was used to grade the clinical competencies.
In the spring of 2018, we rolled out the new system to the DDS and DH programs. In the first semester, more than 5000 grades were entered into the system. The number of electronic systems students needed to consult was reduced from 8 to 2 seamlessly integrated systems, and eliminated the need for a paper record to check their grades. Faculty and students rapidly developed new ways of working with grade data, and in the first semester, additional tools were built to facilitate grading and reporting.
Sample materials I developed
- Visualization of grading workflows and reports (before and after)
- Visualization of D3 Comprehensive Care requirements – previously, when anyone at the school (including the director of clinical education) wanted to know what the requirements were for Comprehensive Care, there was no single document that contained the answer. Even the “Comprehensive Care Manual” only had about 75% of the information, because several disciplines maintained their own manuals.
- New Comprehensive Care Manual (previous version) Google Drive format allows individual pages to be embedded in Canvas, eliminating the need for students to refer to a separate 150+ page PDF to find and complete requirements
- Student Council presentation on grading updates – outlining the input gathered from students and the changes made to address the issues raised
- Student video on updates (1:34)
- Clinical Grading in Canvas Admin Guide – rationales, procedures, and technical support for maintaining the system