Monday, July 13, 2020

A review of the dental school pass/fail curriculum

Among the many curriculum debates that have occupied dental schools in recent years, one question has begun to take on a particularly frenetic public discourse: Should dental schools adopt the pass/fail curriculum?

This year, Arizona School of Dentistry and Oral Health became one of several schools across the nation implementing the pass-fail grading system. Factoring equity as a prime motivator, the school’s curriculum committee convened for its semi-annual meeting and presented the transition as an opportunity for a reduction in student stress and promotion of a less competitive environment.

Not all students were pleased with the new system. Some have raised concerns of a decrement in academic performance and a lack of distinction for students interested in postdoctoral opportunities such as application to residency and job applications. Some believed that high letter grades are better in postdoctoral admissions than pass grades on a pass-fail arrangement. My take on this issue is that it is too early to tell. Admissions offices still have a lot of decisions to make, and with more dental schools considering curricular transitions, they will need to figure out how their assessments will affect their students’ future opportunities. One thing is certain: The benefit of the pass-fail system will be limited by the heavy emphasis that graduate and professional schools put on grades.

According to a December 2018 Journal of Dental Education article, there is little agreement on the type of grading system that should be used in academic health care institutions. In addition, there are relatively few studies specifically regarding success or failure of differing grading system implementations in dental schools.

As a corollary, 108 medical schools have used pass-fail grading, according to the Association of American Medical Colleges (AAMC). A November 2018 Southern Medical Journal study said that pass/fail programs in medical school have been shown to lower stress for students, increase student happiness, increase student satisfaction with education and home life, as well as create more group cooperation among students. Furthermore, the results showed that despite changes in curriculum to pass/fail type grading systems, there is little to no difference in student performance, residency placement and residency performance or national board examinations such as United States Medical Licensing Examination (USMLE) Step 1 scores, compared to students from a traditional grading system.

Despite the promising results seen in medical schools, a pass/fail system can also create unforeseen issues. For example, it can increase reliance on non-graded measures of performance for students who may feel it necessary to go above and beyond to stand out as residency program candidates. Additionally, it has been noted that many dental residency program directors, with a lack of objective data on students from pass/fail schools, may tend to abstain from reviewing applications from pass/fail institutions. There is limited evidence, though, that there is any notable difference in achievement between dental students in pass/fail versus traditional grading systems.

Like many young people, dental students are constantly plotting their future based on what they thought was ahead of them. But the world is changing at a dramatically fast pace, and the road ahead will always look different from the one they pictured. This is important to keep in mind as we try to piece together what our lives will look like in the coming months and years. 

~Sophia Oak, Arizona ’22, ASDA Contributing Editor


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