A comparison of continuous clinical assessment and summative clinical assessment in restorative dentistry.

A possible measure of clinical competency for undergraduates may be students' continuous clinical assessment marks. This study compared each student's continuous clinical assessment (CCA) mark with their summative clinical assessments (SCA) in Paedodontics, Crown and Bridgework, Endodontics and Basic Restorative Dentistry. This was done in order to evaluate the predictive potential of the former against the latter, more conventional measure of assessment. The criterion to determine clinical competence was 60% and any assessment achieved above this would imply clinical competency. Comparisons were made between CCA and SCA for the 39 BChD V undergraduates in the disciplines of Crown and Bridgework, Paedodontics and Endodontics, as well as for the 59 BChD IV undergraduates in the discipline of Basic Restorative Dentistry, for the 2004 academic year. Data were analysed using a two-sample t-test and were also subjected to a Spearman Rank Order Correlation test. For the BChD V students, differences between the two assessment measures were significant for Crown and Bridgework (p=0.00) and Endodontics (p=0.03), but not so for Paedodontics (p=0.22). For the BChD IV students the difference between CCA and SCA for Basic Restorative Dentistry (p=0.00) was significant. The Spearman test produced generally weak correlation values (p<0.4), while the average assessment for Crown and Bridgework for the BChD V group of <60% suggests that, on the basis of the results of this study, continuous clinical assessment cannot be used as a predictor of clinical competence in this discipline.

Criteria referenced student self-assesment in restorative dentistry.

The application of criteria referenced assessment has been previously reported, however, criteria referenced self-assessment has not yet been studied. The objective of this study was to develop and use clear and explicit criteria, linked to a level of competency and a score, as well as a checklist, for student self-assessment in Restorative Dentistry. A comparison of student self-assessment and supervisor-assessment was also undertaken to determine the validity and reliability of the criteria. Six levels of competency were adapted from the literature and a criterion was developed for each level of competency and used for student self-assessment of clinical procedures in Restorative Dentistry (BChD IV and BChD V). Each level of competency was given a score: U = Unqualified (0), NBQ = Not becoming Qualified (1), BQB = Becoming Qualified as a Beginner (2), BQL = Becoming Qualified as a Learner (3), Q = Qualified (4), E = Exceptional (5). The students used the criteria on the assessment form, to assess themselves accordingly (U, NBQ, BQB, BQL, Q, E) and this was compared to the supervisor assessment using the same criteria. The results were subjected to a Spearman Rank-Order Correlation test. The Spearman Correlation Coefficient for the BChD V group was 0.882 and 0.927 for the BChD IV group in the first semester and 0.923 for the BChD V group and 0.900 for the BChD IV group in the second semester. The results were highly significant (p< 0.05). There were no significant differences between student self-assessment and supervisor-assessment. The criteria referenced assessment system used to assess clinical competency in Restorative Dentistry is valid and reliable.

Amelogenesis imperfecta: functional and esthetic restoration of a severely compromised dentition.

The treatment of patients with severe forms of amelogenesis imperfecta presents an interesting challenge to the dental team. A 16-year-old girl presented with a severely compromised occlusion and poor esthetics that had lowered her self-esteem. Preoperative investigations included the determination of completion of growth, an accurate diagnostic waxup, and an evaluation of clinical crown lengths. Periodontal full-flap surgery was planned to lengthen clinical crowns and create gingival harmony. This was to be followed by placement of 28 complete crowns to restore occlusal function and gain a pleasing esthetic result. All-porcelain crowns were placed from premolar to premolar in each arch (20 crowns), and porcelain-fused-to-metal crowns were placed on each molar tooth in each arch (8 crowns). The final treatment result provided this patient with a mutually protective occlusion and with esthetics that greatly enhanced her self-image.