Clinical Competency Assessment Redesign Project


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

My role

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

Published by Emily

I'm an instructional designer and gardener based in Ann Arbor, Michigan. Free moments find me in my garden or the forest, hugging trees and all that jazz.

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