A new admission procedure to dental education at The Karolinska Institute. An initial evaluation

Insights on selection of undergraduate dental students

INTRODUCTION

The goal of selection to dental education was to find those with the greatest aptitude for dentistry. Recently, schools have introduced a variety of tools; however, these have often been adopted without appropriate evaluation regarding existing evidence for fairness, reliability or validity. We explore dental admissions staff beliefs about the quality of different selection tools, with the objective of exploring their decision-making in implementing selection practices.

METHODS

This qualitative study is underpinned by a social constructionist epistemology, in which our principal concern is "explicating the processes by which people come to describe, explain or otherwise account for the world (including themselves) in which they live." We conducted individual interviews with 15 of the 16 UK dental admission leads to elicit their views around admissions processes and aims. Data coding and analysis were initially inductive, using thematic analysis. After the themes emerged, we applied a deductive framework of affordances to group themes and then examined these for heuristics.

RESULTS AND DISCUSSION

We identified three main themes; "Selection Tool Use," "Widening Participation Practices," and "Professionalising the Admission Lead Role." Admission leads spoke favourably of tools that allowed a "holistic" view of the applicants "potential". Selection tools were favoured if they enabled "Gut feeling". Leads spoke of evaluating candidates, making sure they were "rounded", and "know what dentistry is all about." In justifying the use of elements of their procedure, the use of heuristics was prominent.

CONCLUSION

In order to minimise the potential consequences of poor selection decisions, it is important to acknowledge that dental admission leads are at risk of depending on sub-optimal heuristics to make judgements about effective selection (shaped by previous practices) rather than using more rational decision-making processes based on the extant evidence (regarding the quality of different selection tools). Future research may be usefully informed by the knowledge translation literature to offer solutions for improving selection practices in dental education.

The Effect of Distance Education Conducted during the COVID-19 Pandemic Period on the Psychomotor Skill Development of a Dental School Students

Purpose

This study compared the development of face-to-face (F2F) psychomotor skills vs. a modified online dental anatomy course during the COVID-19 pandemic.

Methods

The 9-HPT is regularly applied for the students' psychomotor skill assessment in the Faculty of Dentistry of Süleyman Demirel University. In the 2020-21 academic year, 92.2% of students who took the dental anatomy course in distance education voluntarily participated in this study (observation group). These data were compared with 34.6% of students who applied for 9-HPT in 2019-2020 in F2F education (control group). The Mann–Whitney U test and t-test were used for comparison. The significance level was taken as p < 0.05.

Results

Based on the dominant hand 9-HPT score, a positive change occurred in 81.8% of the F2F and 61.6% of the online education students. Based on both dominant and nondominant hand 9-HPT scores, a statistically significant difference between the change in scores according to the fall/spring term measurements was observed in both F2F and distance education (p < 0.001). However, the F2F-educated group students showed better psychomotor skill development than those exposed to the online-educated group in 9-HPT. The results showed statistical significance for both dominant and nondominant hands (p < 0.001).

Conclusion

The F2F education is the gold standard in psychomotor skill training; however, in cases where this approach cannot be realized, practical training protocols modified for online training may contribute to the motor development of students.

A literature review of the predictive validity of European dental school selection methods

INTRODUCTION

Selection to dental school is the point at which there is the potential to assess a wide range of candidate attributes and select those most likely to learn, train and work within the profession. Despite this, little is known in terms of what works and what does not work in dental selection in terms of predicting future performance accurately and fairly. Given this, our aim was to synthesise the last 30 years of research investigating the predictive validity of dental school selection methods.

METHODS

A search of the electronic databases SCOPUS, Pubmed and Embase was conducted. Results were limited to English language studies published between January 1987 and January 2017.

RESULTS

Twenty-one studies were included. Selection tools fell into five broad categories: tests of personal qualities; cognitive ability; academic attainment; psychomotor skills and combined ability tests. Most were retrospective, single-site studies limited to early years of dental school. Weak correlations were reported, but in most cases, these were between small sections of the selection tool and/or the outcome measure.

DISCUSSION

There was a notable dearth of published research examining dental schools selection processes across Europe over the last 30 years. Current literature was limited by weak study design and lack of long-term follow-up.

CONCLUSION

There is insufficient high-quality evidence from which to draw any conclusions as to the best selection methods to use in dental school selection. Without this, designing selection frameworks for dentistry which are appropriately weighted, reliable and valid remains a challenge.

A predictive model for alternative admission to dental education

AIM

To compare academic progress and performance of students admitted through two admission systems and to analyse the predictive power of different components in an alternative admission.

SAMPLE AND METHODS

The subjects were students admitted to the dental programme at Malmö University, Sweden. The grade admission group was admitted on grades from secondary school (n = 126) and the alternative admission group via an alternative admission procedure (n = 157). The alternative admission procedure consisted of the following components: problem-solving matrices, spatial capacity tested with folding and tin models, manual dexterity, capacity for empathy and interview. Comparisons were made for academic progress (dropouts from the programme and study rate) and academic performance (examinations failed and outcomes of a comprehensive clinical examination). Spearman correlation was calculated for each component of the alternative admission procedure and academic progress as well as academic performance. Multivariate analyses were also carried out.

RESULTS

Compared to the grade admission group, the alternative admission group presented lower rate of dropouts (3% vs. 20%, P < 0.001) and a larger proportion graduated within the expected time (88% vs. 60%, P < 0.01). There was no difference between the groups concerning academic performance. Capacity of empathy was correlated with study rate and outcomes of the clinical examination. The matrices predicted low proportion failed examinations and high students' self-assessments in the clinical examination. Predictive power of folding was limited and so was that of the interview. Manual dexterity was not correlated with academic progress or performance.

CONCLUSIONS

Results support further development of admission selection criteria, particularly emphatic capacity that predicts important student academic achievements.

Career choice and future design of dental students in China and Japan

The purpose of this study was to compare career choice and future plans of dental students in China and Japan. Information was derived from a self-answered questionnaire. Significant differences were detected for eight items between the two countries. Regarding motivation towards career choice, 41% of Japanese students indicated positive motives related to helping others, achieving self-worth and health-care related interests, whereas Chinese students indicated that their choice was mainly for financial and prestige reasons, and for 32% of them, dentistry was a passive choice. More Chinese dental students (74%) wanted further education compared with Japanese students (22%). The majority of Japanese students (56.9%) planned to work as general dentists. Conversely, Chinese students were more likely to specialise (50%). More than 50% of Japanese students wanted to work in dental offices, but the majority of Chinese students (65%) preferred university hospital. We found it is strange that nearly one-fourth of the Chinese students did not want to be a clinical dentist mainly because of the poor health-care environment. This study provides a description of the perspectives of Japanese and Chinese dental students and enables a better understanding of career choices and future course design issues.

Career choice and attitudes towards dental education amongst dental students in Japan and Sweden

The purpose of this study was to identify and compare the perspectives of dental students towards their career choice and dental education in Japan and Sweden. One hundred and fourteen dental students from the Nippon Dental University, Japan and 43 dental students from the Karolinska Institutet, Sweden participated in this study. Information was derived from a self-answered questionnaire consisting of five items for career choice and six items for dental education. Chi-square test and Wilcoxon signed-rank test were used for comparison. Significant differences were detected for 10 questionnaire items between the two countries. Regarding motivation towards the career choice, 44% of Swedish students indicated interpersonal motives related to helping other people, whereas 32% of Japanese students indicated expectations of their family in the dental profession. As future career options, 64% of Japanese and 47% of Swedish students planned to work as general dentists. More Swedish students (37%) preferred specialisation than Japanese students (17%). Nearly three-quarters of the Swedish students were satisfied with the teaching faculty of their school, whilst only 32% of the Japanese students indicated content. The perspectives of dental students were different in Japan and Sweden. This study provides a description of the perspectives of Japanese and Swedish dental students and enables better understanding of career decision and dental curriculum issues.

Students' perceived experience of university admission based on tests and interviews

The aim of the study was to generate an impression, from the perspective of graduating dental students, of the individualised admissions procedures, which they had undergone 5 years before. The subjects comprised 10 randomly selected students, five male and five female, from two different admission rounds. Qualitative research was used and data were collected by means of semi-structured interviews. The results show that even 5 years later, the students remember clearly the different steps in the selection procedure and they found the procedure relevant. In particular, the admission interviews made a lasting impression. The students consider that being interviewed by one admissions committee member at a time reduces the applicant's apprehension and allows a more personal interview. Several believe that the admissions procedure influences academic achievement or improves self-confidence: implicit in their selection by a committee of experienced professionals is affirmation that they have the potential to become good dentists. The students therefore feel encouraged to aspire to higher achievement. All students believe that motivation is an important non-cognitive attribute for success and that students selected through this mode are not only highly motivated but also well informed, with realistic expectations of the undergraduate programme and their future professional career.

Perceptions of admission committee members: some aspects on individual admission to dental education at Karolinska Institutet

The aim of the study was to generate an overall impression of the admission committee's (AC) perspective on individualised admission procedures, derived from some perceived experience of the individual committee members using semi-structured interviews. Qualitative research was used and data were collected by use of interviews. The results show that the committee members are highly committed to the task and try to identify desirable, non-cognitive attributes in the applicants, such as motivation, empathy, drive, and tenacity: 'emotional intelligence'. The committee members were of the opinion that it was possible to identify these attributes in an applicant. The AC further believes that the admissions procedure influences academic achievements because students regard themselves as specially selected and therefore aspire to higher achievements.

Appraisal of psychomotor skills of dental students at University Complutense of Madrid

The aim of this study was to evaluate the psychomotor skills of the dental students at University Complutense of Madrid (UCM), using a battery of psychometric tests. The sample comprised 306 students of the 1st, 2nd, 3rd and 4th years of Odontology, who, during the last month of the academic term, took the test on rotation of solid shapes, the Embedded Figures test in its group form (GEFT), the O'Connor Tweezer test, the MacQuarrie test for mechanical ability and the indirect vision test. Before these tests began, some personal data of all students were collected. The results showed some statistically significant correlation between several personal variables (sex, manual dominance and previous skills) and performance in the psychometric tests, although no significant relation was found between these variables and the students' academic qualifications. When comparisons were made between the psychomotor tests and the academic results of the students, significant differences appeared in the tracing and dotting subtests of the MacQuarrie test, whereby those students with higher practical qualifications reached the best punctuation. In the O'Connor Tweezer test, the students who obtained the worst results were those with lower qualifications. These data could serve to detect at an early stage those students who need greater educational support. No relation was found between the GEFT and the indirect vision test.

1.1 Student selection and the influence of their clinical and academic environment on learning

Student selection and recruitment play a vital role in the successful outcome of dental education. To identify key issues and practices in selection and recruitment, the group assessed current processes, philosophies and practices from a range of different educational systems, although it was not possible to gather data from all countries or continents within the timeframe provided. Furthermore, the group explored the effect of the educational learning environment on the successful outcome of teaching dental students. It is clear that a wide variety of practices and philosophies exist and are used in different parts of the world. Measuring the success of any given process used for student selection remains a challenge. In some parts of the world, certain practices have become an integral part of the tertiary educational system, and have been applied in a similar way by many or all of the dental schools in that country. In other countries, methods vary from one dental school to another, often reflecting differences in the structure and philosophy of the educational system. There was great variation in the combinations of selection criteria used and in student recruitment strategies. However, it was clear that there was much to be gained by learning from the experiences of other dental schools in student selection. Lessons learned, best practices and philosophies used and supporting value systems proved to be very helpful for benchmarking the processes used. In the discussion of student selection, a number of important questions were raised which deserve further thought and reflection both in the ongoing debate and as part of the ever-changing world of dental education. Important new matters that require more debate and research include: a) ethical issues, including the nature of funding from the student perspective, and the concern that in some regions dentistry may become a profession only for the elite or wealthy students. b) Health standards of students entering dental school. c) How realistic is the applicant's sense of dentistry as a profession? d) How accurate is the students' sense of their career opportunities and the employment market upon graduation? Finally, the over-arching question remains, how valid, reliable and predictable are existing selection practices? Will it be practical and meaningful to standardize methods used, or will exchanging ideas as part of this global debate assist the thought process of dental leaders to improve selection practices by learning from the experiences of other schools in different parts of the world? The processes of open debate, sharing ideas and opinions and identifying sound practices across the globe is a powerful catalyst for developing innovative answers to the complex problems posed by student selection and recruitment. A 'virtual' global process with wide input from as many dental schools as possible should improve the efficacy of student selection, and allow dental educators to identify the 'potential' of prospective students and predict more accurately dental student outcomes. The debate that we have started will certainly contribute to providing a knowledge base which dental educators will be able to draw on when reviewing selection processes in their own schools.

Organising the introduction of, and evaluating interviewing in, an admissions system

This paper describes the admissions process, especially the organisation of an interviewing system. The method of application to Dental School is discussed and basic selection processes outlined. The introduction of a new interviewing system is explained and criteria for interview selection and marking defined. All interviewers received regular training; the content of training days is described together with the experience of those involved. Changes made to the interview marking system after 1 year are discussed. Criteria marked at interview were monitored against students' success in year 1 and 2 examinations. Results show that students who performed highly at interview for leadership were more likely to succeed in semester 2 of the course and in year 1 examinations overall.