dental radiology Editor:
LINCOLN American
R. MANSON-HING, Academy
D.M.D., M.S.
of Dental Radiology
School of Dentistry, University 1919 Seventh Avenue South Birmingham, Alabama 35233
of Alabama
A survey of dental radiology evaluation in American dental schools BenjaG?
Ciola, B.S., D.D.S., M.S.D.,” West Ha,ven, Conn.
Evaluation involves the worth of an experience, idea, or process and is an integral part of dental education. The current article discusses a survey of dental radiology evaluation in American dental schools. It is noted that little uniformity exists and few generalizations can be made that are valid for all of the dental schools.
E
valuation involves judging the worth of an experience, idea, or process. The judgment presupposes established standards or criteria. Dental education is a complex process involving the selection of techniques (procedures, theories, acquired skills) and the planning of learning experiences designed to foster mastery of these techniques. Choices must be made in planning a dental curriculum, and the effectiveness of the curriculum must be studied. Evaluation is an integral part of dental education. The purpose of this study is to determine the methods used by American dental schools in evaluating students in dental radiology. The issues to be resolved in clarifying the nature of the evaluation process are associated with the character of the data, the latitude of importance involved in making judgments, and the persons entrusted with making them. There is no issue regarding the presence or absence of evaluation. When one is faced with choice, evaluation, whether conscious or not, is the ultimate outcome. Failure to evaluate systematically in dental education means that evaluation by prejudice, tradition, or rationalization is unavoidable. Such patterns of evaluation are not consistent with the aims of dental education. An adequate teaching program is dependent upon continued evaluation of the teaching material and course content. Assessment of student performance, *Chief
of the Dental
Services at the Veterans
Administration
Hospital,
West Haven,
Conn.
249
250
Oral Surg. August, 197ti
Cioln
formally and informally, provides the individual faculty member with information concerning the comprehensibility of course content and teaching materials. In addition, evaluation provides faculty members with insights concerning their method of presentation, lecture techniques, laboratory procedures, audio-visual aids, and other teaching modalities. Evaluation of students should provide a measure of the level of student understanding, and it generally providts a clue to the relevancy of the information being taught. Evaluation of students in didactic and clinical aspects of dentistry is a frequent topic in dental journals. M,vcrs’ discusses problems associatrcl with evaluation and concludes that large numbers of appraisals of student pcrformante arc essential. Kreutzer2 concluded that practical examinations alone were not a. fair assessment, of student progress. Glass” developed a six-point grading scale for clinical evaluation of students. Vanek” presents evidence to supI)ort the need for greater objectivity ancl reliability in the cralnation of dental students’ manual skills. No information is available on dental student evaluation in dental radiology. MATERIALS
AND
METHODS
A total of fifty-seven letters with a questionnaire were directed to the chairman of the Department of Dental Radiology in each of the dental schools which has approval, conditional approval, or provisional approval by the American Dental Association. The letters were mailed to coincide with the beginning of classes for the fall term. F’ollow-up letters were mailed at 6 and 12 weeks. The questionnaire (Fig. 1) used in the survey categorized dental radiology into three major areas : (1) didactic aspects of dental radiology, (2) technique of dental radiology, and (3) interpretation of dental radiogra,phs. TXdactic aspects of dental radiology were further subdivided into examinations, self-instructional materials, and evaluation of students. Technique of dental radiology was subdivided into preclinical and clinical components. The preclinical component of technique was further divided to include the use of laboratory aids, dried skulls, Dexter (a training aid developed by the Bureau of Radiological Health), and classmates. The clinical component of dental radiology included requirements, block assignments, subjective student evaluation, and honors programs. Tnterpretation of radiographs included written interpretation, oral interpretation, and the department associated with radiographs. The schools which did not respond to the questionnaire were identified, and twelve randomly selected schools were contacted hy telephone. The data were pooled, and methods of evaluation were established on a percentage basis. RESULTS AND
DISCUSSION
Six weeks after the original letter was mailed, twenty-two schools (38.5 per cent) responded. Nine schools responded following the first follow-up letter, resulting in a total of thirt,y-one (54.4 per cent) of the schools participating. After the second follow-up letter, nine additional schools responded (70.1 per cent). Following the telephone interviews, a total of fifty-two (91.2 per cent) of the American dental schools participated in the survey.
Volume Sumber
42 2
Delltal
radiology
evaluatio?~
YES I.
I I.
III.
IV.
DIDACTIC A. EXAHINATIONS 1. WRITTEN QUIZZES 2. ORAL B. SELF-INSTRUCTIONAL MAT’L C. EVALUATION 1. S/U: SATISFACTORY/ UNSATISFACTORY 2. P/F: PASS/FAIL 3. LGr: LETTER GRADE 4. NGr: NUMERICAL GRADE TECHNIQUE A. PRECLINICAL 1. USE OF LABORATORY AIDS a. DRIED SKULL 8. DEXTER 2. USE OF CLASSNATES 3. EVALUATION a. s/u b. P/F c. Lcir d. NGr B. CLINICAL 1. REQU IREHENTS 2. BLOCK ASSIGNMENTS 3. STUDENTS SUBJECTIVELY EVALUATED 4. HONORS PROGRAM 5. EVALUATION a. s/u b. P/F c. LGr d. NGr INTERPRETATION OF RADIOGRAPHS A. WRITTEN INTERPRETATION 1. BECOMES PART OF PAT I ENT RECORD B. ORAL INTERPRETATION C. INTERPRETATION IS A DISCIPLINE OF: 1. DENTAL RADIOLOGY 2. ORAL DIAGNOSIS 3. ORAL MEDICINE ARE YOUR PRDGRAHS UNDERGOING CHANGES IN EVALUATION NOW OR IN THE IliHEDlATE FUTURE7
Fig. 1. Survey questionnaire Didactic
aspects
of dental
on course content
i?~ U.S.
-
de&al
schools
251
COMMI
-
-
and methods of evaluation.
radiology
On the basis of the data obtained, 97.6 per cent of the schools surveyed conducted formalized lectures. The numbers of lectures were not specified. The remaining schools used self-instructional materials exclusively and/or mastery achievement programs. Those schools using self-instructional programs had faculty members available to answer questions which the student might encounter. A total of 32.5 per cent of all the schools used some form of self-instructional materials. In all of the schools surveyed, written examinations and/or mastery achievement quizzes were used with self-instructional programs. Weekly and unannounced quizzes were given by 39.5 per cent of the schools. Twenty-three per cent of the responding schools used a satisfactory/unsatisfactory or pass/fail type of evaluation. Letter and/or numerical grades comprised 76 per cent of
252
Oral Surg. August, 1976
Cioln DIDACTIC
INTERPRETATION
OF RADIOGRAPHS
INTERPRETATION
LECTURES
WRITTEN EXAMS INTERPRETATION A DISCIPLINE OF: DENTAL RADIOLOGY
QUIZZES
ORAL
SELF INSTRUCTIONAL MATERIALS
SATISFACTORY/ UNSATISFACTORY
EVALUATION
II.6
DIAGNOSIS
SATISFACTORY/ UNSATISFACTORY
LETTER
NUMERICAL GRADE
EVALUATION
11.7
GRADE
39.5
27. 9 t 0
I
I 20
I
I 40
I
I 60
I
I 80
,I
t-l 0
100
I 20
I!
PERCENT
Fig. d. Response to didactic evaluation.
the respondents, grades (Fig. 2).
indicating
Interpretation
radiographs
of
t 40
1 60
r,
i 10
I 100
PERCENT
and interpretive
aspects of dental
that a preponderance
radiology
and methods of
of schools used formalized
Interpretation of radiographs was divided into written interpretation and oral interpretation (Fig. 2). The departmental status of dental radiology was also ascertained. The schools responded in the following manner : 41.8 per cent of the schools required written interpretation, and 51.1 per cent used oral interpretation. From the manner in which schools responded, the lack of well-defined objectives was apparent. Satisfactory/unsatisfactory and pass/fail results, when combined were reported by 25 per cent of the responding schools. Letter and numerical grades were report,ed by 42 per cent of the responding schools. The remaining schools did not respond. These data suggest that guidelines for evaluating students in interpretation of dental radiology are not well-defined. As for the departmental status of dental radiology, 58.1 per cent of the surveyed schools interpreted radiographs in the Department of Oral Diagnosis, 37.2 per cent departmentalized dental radiology, and 2.3 per cent interpreted radiographs through the Department of Oral Medicine. Preclinical
technique
Laboratory aids consisting of extracted teeth, coins, and other objects were used in 79 per cent of the surveyed schools (Fig. 3). Dry skulls were used in 72
Volume Sumhr
L)extal radiology
42 2
evaluation
ix C.S. dental schools
PRECLINICAL TECHNIQUE
253
CLINICAL
EVALUATION EVALUATION
SATISFACTORY/ UNSATISFACTORY
LETTER
N ““2”~lG
LETTER
27.9
GRADE
GR4DE
NUMERICAL GRADE
25.5 e I 0
I
I 20
II
I 40
I 60
I
Ill 80
39.5
34.8 t 0'
100
100 PERCENT
PERCENT
Fig. 3. Response to preclinical
11.7
technique
and clinical
methods of evaluation.
per cent of the teaching programs. Dexter was used in 53.4 per cent of the schools. Classmates were used in preclinical technique in 65 per cent of the schools for radiographic film placement and for diagnostic radiographs. The combined satisfactory/unsatisfactory and pass/fail evaluation of students in preclinical work was approximately the same as letter and numerical grades. In some instances schools did not use grades obtained from preclinical techniques as part of a student’s final grade. Of the areas surveyed, responses to preclinical evaluation were most frequently unansvvered. This suggests that there is less formality in the evaluation of students in preclinical technique. Clinical
technique
The clinical aspect of dental radiology was subdivided into the following components : requirements, block assignments, subject evaluation of students, and honors program (Fig. 3). The schools responded in the following fashion: 30.2 per cent had requirements, 46.5 per cent had block assignments, 41.8 per cent evaluated students subjectively, and 11.6 per cent had honors programs. In evaluating the students in their clinical performance, 11.7 per cent had a satisfactory/unsatisfactory grading system, 13.8 per cent used pass/fail, 39.5 per cent used letter grades, and 34.8 per cent used numerical grades. These data indicate that the majority of schools (74 per cent) used letter grades or its equiva-
254
Oral Surg. August, 1976
Cioln
lent numerical grade. It appears that clinical component of student evaluation.
evaluation
imparts
an important,
CONCLUSIONS
The variety of evaluation methods used in American dental schools illustrates that little uniformity exists. Only through a continuing program of evaluation can the strengths and weaknesses of any course be identified. Few generalizations can be made that are valid for all dental schools; this suggests that each school and its faculty members utilize methods of evaluation that are developed on a local level. The lack of uniformity in the evaluation process of the schools surveyed may also serve as an indicator for the lack of uniformity of curriculum. Development of clearly defined objectives would be beneficial in establishing reliable methods of evaluation. When such evaluations are analyzed, the need for changes in the curriculum becomes apparent. It should be noted that with every change, whether it be in the students, the faculty, or the curriculum, a new eraluation becomes necessary. REFERENCES 1. Myers,
2. 3. 4. 5. 6.
Raymond E.: A Method of Evaluating Student Achievement in Clinical Practice, J. Dent. Educ. 13: 69-85, 1949. Kreutzer, J. : Evaluation of Clinical Accomplishments of Students, J. Dent. Educ. 14: 145152, 1950. Glass, Robert L.: Evaluation of Student Clinical Performance, J. Dent. Educ. 29: 256-259, 1965. Vanek, A. G.: Objective Evaluation of Dental Student Technic Products, J. Dent. Educ. 33: 140-144, 1969. Report on the Development and Evaluation of the Dental AssistBuxbaum, J. D.: Initial ants Course in Dental Radiology, J. Maryland Dent. Assoc. 13: 8-11, 1970. ORAL Dental School Curriculum: Dental Radiology, Wuehrmann, A. H.: Undergraduate SURG. 24: 191-195, 1967.
Reprint requests to : Dr. Benjamin Ciola Veterans Administration Hospital West Spring Street West Haven, Conn. 06515
LINCOLN American
R. MANSON-HING, Academy
D.M.D., M.S.
of Dental Radiology
School of Dentistry, University 1919 Seventh Avenue South Birmingham, Alabama 35233
of Alabama
A survey of dental radiology evaluation in American dental schools BenjaG?
Ciola, B.S., D.D.S., M.S.D.,” West Ha,ven, Conn.
Evaluation involves the worth of an experience, idea, or process and is an integral part of dental education. The current article discusses a survey of dental radiology evaluation in American dental schools. It is noted that little uniformity exists and few generalizations can be made that are valid for all of the dental schools.
E
valuation involves judging the worth of an experience, idea, or process. The judgment presupposes established standards or criteria. Dental education is a complex process involving the selection of techniques (procedures, theories, acquired skills) and the planning of learning experiences designed to foster mastery of these techniques. Choices must be made in planning a dental curriculum, and the effectiveness of the curriculum must be studied. Evaluation is an integral part of dental education. The purpose of this study is to determine the methods used by American dental schools in evaluating students in dental radiology. The issues to be resolved in clarifying the nature of the evaluation process are associated with the character of the data, the latitude of importance involved in making judgments, and the persons entrusted with making them. There is no issue regarding the presence or absence of evaluation. When one is faced with choice, evaluation, whether conscious or not, is the ultimate outcome. Failure to evaluate systematically in dental education means that evaluation by prejudice, tradition, or rationalization is unavoidable. Such patterns of evaluation are not consistent with the aims of dental education. An adequate teaching program is dependent upon continued evaluation of the teaching material and course content. Assessment of student performance, *Chief
of the Dental
Services at the Veterans
Administration
Hospital,
West Haven,
Conn.
249
250
Oral Surg. August, 197ti
Cioln
formally and informally, provides the individual faculty member with information concerning the comprehensibility of course content and teaching materials. In addition, evaluation provides faculty members with insights concerning their method of presentation, lecture techniques, laboratory procedures, audio-visual aids, and other teaching modalities. Evaluation of students should provide a measure of the level of student understanding, and it generally providts a clue to the relevancy of the information being taught. Evaluation of students in didactic and clinical aspects of dentistry is a frequent topic in dental journals. M,vcrs’ discusses problems associatrcl with evaluation and concludes that large numbers of appraisals of student pcrformante arc essential. Kreutzer2 concluded that practical examinations alone were not a. fair assessment, of student progress. Glass” developed a six-point grading scale for clinical evaluation of students. Vanek” presents evidence to supI)ort the need for greater objectivity ancl reliability in the cralnation of dental students’ manual skills. No information is available on dental student evaluation in dental radiology. MATERIALS
AND
METHODS
A total of fifty-seven letters with a questionnaire were directed to the chairman of the Department of Dental Radiology in each of the dental schools which has approval, conditional approval, or provisional approval by the American Dental Association. The letters were mailed to coincide with the beginning of classes for the fall term. F’ollow-up letters were mailed at 6 and 12 weeks. The questionnaire (Fig. 1) used in the survey categorized dental radiology into three major areas : (1) didactic aspects of dental radiology, (2) technique of dental radiology, and (3) interpretation of dental radiogra,phs. TXdactic aspects of dental radiology were further subdivided into examinations, self-instructional materials, and evaluation of students. Technique of dental radiology was subdivided into preclinical and clinical components. The preclinical component of technique was further divided to include the use of laboratory aids, dried skulls, Dexter (a training aid developed by the Bureau of Radiological Health), and classmates. The clinical component of dental radiology included requirements, block assignments, subjective student evaluation, and honors programs. Tnterpretation of radiographs included written interpretation, oral interpretation, and the department associated with radiographs. The schools which did not respond to the questionnaire were identified, and twelve randomly selected schools were contacted hy telephone. The data were pooled, and methods of evaluation were established on a percentage basis. RESULTS AND
DISCUSSION
Six weeks after the original letter was mailed, twenty-two schools (38.5 per cent) responded. Nine schools responded following the first follow-up letter, resulting in a total of thirt,y-one (54.4 per cent) of the schools participating. After the second follow-up letter, nine additional schools responded (70.1 per cent). Following the telephone interviews, a total of fifty-two (91.2 per cent) of the American dental schools participated in the survey.
Volume Sumber
42 2
Delltal
radiology
evaluatio?~
YES I.
I I.
III.
IV.
DIDACTIC A. EXAHINATIONS 1. WRITTEN QUIZZES 2. ORAL B. SELF-INSTRUCTIONAL MAT’L C. EVALUATION 1. S/U: SATISFACTORY/ UNSATISFACTORY 2. P/F: PASS/FAIL 3. LGr: LETTER GRADE 4. NGr: NUMERICAL GRADE TECHNIQUE A. PRECLINICAL 1. USE OF LABORATORY AIDS a. DRIED SKULL 8. DEXTER 2. USE OF CLASSNATES 3. EVALUATION a. s/u b. P/F c. Lcir d. NGr B. CLINICAL 1. REQU IREHENTS 2. BLOCK ASSIGNMENTS 3. STUDENTS SUBJECTIVELY EVALUATED 4. HONORS PROGRAM 5. EVALUATION a. s/u b. P/F c. LGr d. NGr INTERPRETATION OF RADIOGRAPHS A. WRITTEN INTERPRETATION 1. BECOMES PART OF PAT I ENT RECORD B. ORAL INTERPRETATION C. INTERPRETATION IS A DISCIPLINE OF: 1. DENTAL RADIOLOGY 2. ORAL DIAGNOSIS 3. ORAL MEDICINE ARE YOUR PRDGRAHS UNDERGOING CHANGES IN EVALUATION NOW OR IN THE IliHEDlATE FUTURE7
Fig. 1. Survey questionnaire Didactic
aspects
of dental
on course content
i?~ U.S.
-
de&al
schools
251
COMMI
-
-
and methods of evaluation.
radiology
On the basis of the data obtained, 97.6 per cent of the schools surveyed conducted formalized lectures. The numbers of lectures were not specified. The remaining schools used self-instructional materials exclusively and/or mastery achievement programs. Those schools using self-instructional programs had faculty members available to answer questions which the student might encounter. A total of 32.5 per cent of all the schools used some form of self-instructional materials. In all of the schools surveyed, written examinations and/or mastery achievement quizzes were used with self-instructional programs. Weekly and unannounced quizzes were given by 39.5 per cent of the schools. Twenty-three per cent of the responding schools used a satisfactory/unsatisfactory or pass/fail type of evaluation. Letter and/or numerical grades comprised 76 per cent of
252
Oral Surg. August, 1976
Cioln DIDACTIC
INTERPRETATION
OF RADIOGRAPHS
INTERPRETATION
LECTURES
WRITTEN EXAMS INTERPRETATION A DISCIPLINE OF: DENTAL RADIOLOGY
QUIZZES
ORAL
SELF INSTRUCTIONAL MATERIALS
SATISFACTORY/ UNSATISFACTORY
EVALUATION
II.6
DIAGNOSIS
SATISFACTORY/ UNSATISFACTORY
LETTER
NUMERICAL GRADE
EVALUATION
11.7
GRADE
39.5
27. 9 t 0
I
I 20
I
I 40
I
I 60
I
I 80
,I
t-l 0
100
I 20
I!
PERCENT
Fig. d. Response to didactic evaluation.
the respondents, grades (Fig. 2).
indicating
Interpretation
radiographs
of
t 40
1 60
r,
i 10
I 100
PERCENT
and interpretive
aspects of dental
that a preponderance
radiology
and methods of
of schools used formalized
Interpretation of radiographs was divided into written interpretation and oral interpretation (Fig. 2). The departmental status of dental radiology was also ascertained. The schools responded in the following manner : 41.8 per cent of the schools required written interpretation, and 51.1 per cent used oral interpretation. From the manner in which schools responded, the lack of well-defined objectives was apparent. Satisfactory/unsatisfactory and pass/fail results, when combined were reported by 25 per cent of the responding schools. Letter and numerical grades were report,ed by 42 per cent of the responding schools. The remaining schools did not respond. These data suggest that guidelines for evaluating students in interpretation of dental radiology are not well-defined. As for the departmental status of dental radiology, 58.1 per cent of the surveyed schools interpreted radiographs in the Department of Oral Diagnosis, 37.2 per cent departmentalized dental radiology, and 2.3 per cent interpreted radiographs through the Department of Oral Medicine. Preclinical
technique
Laboratory aids consisting of extracted teeth, coins, and other objects were used in 79 per cent of the surveyed schools (Fig. 3). Dry skulls were used in 72
Volume Sumhr
L)extal radiology
42 2
evaluation
ix C.S. dental schools
PRECLINICAL TECHNIQUE
253
CLINICAL
EVALUATION EVALUATION
SATISFACTORY/ UNSATISFACTORY
LETTER
N ““2”~lG
LETTER
27.9
GRADE
GR4DE
NUMERICAL GRADE
25.5 e I 0
I
I 20
II
I 40
I 60
I
Ill 80
39.5
34.8 t 0'
100
100 PERCENT
PERCENT
Fig. 3. Response to preclinical
11.7
technique
and clinical
methods of evaluation.
per cent of the teaching programs. Dexter was used in 53.4 per cent of the schools. Classmates were used in preclinical technique in 65 per cent of the schools for radiographic film placement and for diagnostic radiographs. The combined satisfactory/unsatisfactory and pass/fail evaluation of students in preclinical work was approximately the same as letter and numerical grades. In some instances schools did not use grades obtained from preclinical techniques as part of a student’s final grade. Of the areas surveyed, responses to preclinical evaluation were most frequently unansvvered. This suggests that there is less formality in the evaluation of students in preclinical technique. Clinical
technique
The clinical aspect of dental radiology was subdivided into the following components : requirements, block assignments, subject evaluation of students, and honors program (Fig. 3). The schools responded in the following fashion: 30.2 per cent had requirements, 46.5 per cent had block assignments, 41.8 per cent evaluated students subjectively, and 11.6 per cent had honors programs. In evaluating the students in their clinical performance, 11.7 per cent had a satisfactory/unsatisfactory grading system, 13.8 per cent used pass/fail, 39.5 per cent used letter grades, and 34.8 per cent used numerical grades. These data indicate that the majority of schools (74 per cent) used letter grades or its equiva-
254
Oral Surg. August, 1976
Cioln
lent numerical grade. It appears that clinical component of student evaluation.
evaluation
imparts
an important,
CONCLUSIONS
The variety of evaluation methods used in American dental schools illustrates that little uniformity exists. Only through a continuing program of evaluation can the strengths and weaknesses of any course be identified. Few generalizations can be made that are valid for all dental schools; this suggests that each school and its faculty members utilize methods of evaluation that are developed on a local level. The lack of uniformity in the evaluation process of the schools surveyed may also serve as an indicator for the lack of uniformity of curriculum. Development of clearly defined objectives would be beneficial in establishing reliable methods of evaluation. When such evaluations are analyzed, the need for changes in the curriculum becomes apparent. It should be noted that with every change, whether it be in the students, the faculty, or the curriculum, a new eraluation becomes necessary. REFERENCES 1. Myers,
2. 3. 4. 5. 6.
Raymond E.: A Method of Evaluating Student Achievement in Clinical Practice, J. Dent. Educ. 13: 69-85, 1949. Kreutzer, J. : Evaluation of Clinical Accomplishments of Students, J. Dent. Educ. 14: 145152, 1950. Glass, Robert L.: Evaluation of Student Clinical Performance, J. Dent. Educ. 29: 256-259, 1965. Vanek, A. G.: Objective Evaluation of Dental Student Technic Products, J. Dent. Educ. 33: 140-144, 1969. Report on the Development and Evaluation of the Dental AssistBuxbaum, J. D.: Initial ants Course in Dental Radiology, J. Maryland Dent. Assoc. 13: 8-11, 1970. ORAL Dental School Curriculum: Dental Radiology, Wuehrmann, A. H.: Undergraduate SURG. 24: 191-195, 1967.
Reprint requests to : Dr. Benjamin Ciola Veterans Administration Hospital West Spring Street West Haven, Conn. 06515
