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Abstract

Purpose. Educators have noted that grades may have negative impacts on students’ clinical performance; however, dental students’ perceptions of grading practices remains unknown. This study aims to: (i) identify the most prevalent grade perceptions and the underlying driving factors, and (ii) explore how students perceive the impact of grades on their learning and clinical development.

Methods. To address our aims, we used a mixed-methods research approach with a population of dentistry students at our institution. We distributed online surveys (Winter 2021; n=68), and conducted virtual semi-structured interviews (Fall 2021; n=6) and a focus group (Fall 2021; n=3). Qualitative data was analyzed through an inductive and deductive thematic process.

Results. Sixty-eight students participated in the online survey (26% response rate), and nine students participated in the interviews and focus group. Dentistry students predominantly perceived grades as a ranking tool to competitively distinguish themselves from their peers (29% of quotes), driven mainly by residency and specialty admission processes (34%). Percentage grades were also perceived as a barrier to learning and ineffective at guiding clinical development. Respondents identified that grades distracted from learning and did not indicate whether a student had achieved a clinically acceptable level of performance.

Conclusions. Given these findings, grading practices in dental education should be further evaluated. Some students perceive that percentage grades are more harmful than helpful for professional development. Further, participants suggested that ordinal grading may be more beneficial for evaluating clinical competence. This study provides important considerations for clinical educators and academic institutions wishing to reflect on the use of grades as a conventional academic metric.

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