The purpose of this assessment project was to explore what grading methods are available in the dental hygiene dental materials course. When researching other assessment instruments, the research group became aware that nothing had been redesigned for several decades. We designed a comprehensive rubric as a new assessment tool to evaluate dental hygiene students’ maxillary alginate impression practical. These knowledge and skills are an integral competency at Concorde Career College and Baylor College of Dentistry. Our goal for the rubric is to be implemented as a new assessment method within future dental hygiene dental materials courses to include peer assessment and guide student learning.
Table of Contents
Group 8 in the Assessment and Evaluation in Education course is navigating through uncharted territory to design an assessment instrument within a dental materials laboratory course. The dental materials course, especially the laboratory portion of the course, has not been assessed for about 25 years. According to the American Dental Education Association, both a theoretical and laboratory/clinical practice foundation of knowledge should be established in the dental hygiene dental materials course. The article states that faculty involved in the curriculum should have experience in educational methods, testing, measurement and evaluation (ADEA, 2005). The scope of literature reviewed to research the topic, Developing a Grading Rubric for the Dental Hygiene Dental Materials Course, reveals a need for a variety of reliable and valid educational assessment techniques to evaluate educational courses and student learning. Many assessment methodologies and instruments exist for assessment and evaluation of student learning. Research to further address the topic will be explored.
The laboratory portion of the dental materials course is taught for the purposes of exposing the dental hygiene student a sound knowledge base of information which can be useful to patients once out in practice. This information and skill, is gained through psychomotor and critical thinking skills that will endeavor to enhance the clinical dental hygiene student. According to American Education Association, Compendium of Curriculum Guidelines, The curriculum should provide the dental hygiene student with a sound knowledge base in the science of dental materials. (Association A. D., 2005)The students needed hands-on experience will provide a well-rounded dental hygienist once out in practice. The rubric that we designed should be aligned with learning goals and objectives, including active learning and educative assessment techniques providing a powerful learning experience (Keselyak et al., 2009). Student learning within the dental materials course will bring about trial and error making the learning process an effective strategy that can provide an understanding on how effective these learning outcomes can be assessed.
Research has shown there is a disconnect between current knowledge and existing practice (Asadoorian et al., 2010). The gap we have noticed is a lack of evidence based dentistry relating to the dental materials course in a dental hygiene program. In order to challenge the student, it becomes incumbent to show that learners can construct knowledge through interaction (Pahinis et al., 2007). And that is what a dental materials lab course is, a direct interaction with students teaching each other how a procedure is done.
To assess knowledge and practice in the dental hygiene dental materials course, a reliable and valid assessment instrument is needed. According to commission on dental and dental hygiene accreditation, the evaluation methods used in the dental hygiene program should include process and end- product assessments of student performance, as well as a variety of objective testing measures (Accreditation, 2013). For this particular study, we constructed a rubric to assess the practical aspect of taking a maxillary alginate impression.
The Scoring of Rubrics: Reliability and Validity and Educational Consequences article, revealed that when testing for reliability in assessment, rubrics should make expectations and criteria explicit (Jonsson & Svingby, 2007). The authors state that scoring with a rubric is more reliable than without using a rubric. Rubrics can always be changed to make them more concise without disrupting the content and the final product. We know that the three dimensional rubric we have designed is easier than a five dimensional model. This is more inter-reliable because less personal judgment comes into play, thereby increasing the validity of the use of the rubric.
If a laboratory course is to be implemented in the curriculum, then different assessment techniques are needed to evaluate student learning. A rubric is one assessment technique that can define the criteria for performance and establish clear rules for evaluation. Learning expectations and outcomes can be established through rubrics. A rubric can also provide the dental hygiene student with clear expectations of performance, an opportunity to self-assess, and feedback from the instructor (O’Donnell et al., 2011). This will ensure the dental materials course is an integral part of the dental hygiene curriculum and give the student an opportunity to connect knowledge with practice.
The rubrics from both Concorde College and Baylor College of Dentistry were used as a template to create a common rubric we used to score our students for maxillary alginate impressions. There are many such instruments in dental and dental hygiene schools available. But, to be able to create such an instrument from two different schools shows a cooperation and a different perspective from two different types of programs. Within the commission of dental hygiene education on dental materials it states, The content offers an educational background that is needed to provide students the knowledge and skills necessary to ensure that quality dental hygiene care is provided to the patients they treat. (Association A. D., 2015)
For our purpose in this review, we will assess the learning capabilities of junior dental hygiene students and focus on the objectives and learning goals in making maxillary alginate impressions. Our design for developing this grading rubric was to decrease student’s questions by listing a standard of criteria for completing the required competency. A rubric is a necessary component within any teaching atmosphere to appraise students in learning outcomes which involve the synthesizing of information (Lane, 2007) thereby increasing a students’ ability to critically think through the developing process. This procedure is a necessary component for the dental hygiene student to accomplish when they become licensed to practice. Their ability to perform making impressions ensures a more rounded and knowledgeable dental hygienist. A rubric was designed as the assessment tool to measure student knowledge and practice. Our objective for this paper is to develop a grading rubric for taking alginate impressions in a dental hygiene laboratory course.
The question to be addressed in this project focused on the problem of what assessment methods and techniques would be available within the dental hygiene dental materials course. The plan of intervention was to create a rubric to assess and evaluate the dental hygiene student’s alginate impression laboratory practical. The rubric was developed and compared with other evaluation templates which were already available within the dental hygiene and first year dental student’s dental materials laboratory grading armamentarium. The outcome revealed a comprehensive and effective rubric to assess the dental hygiene student’s maxillary alginate impression within the dental materials laboratory course.
Group 8 consisted of a Registered Dental Hygienist instructor and a Doctor of Dental Surgery instructor, both of whom have experience teaching within the dental hygiene dental materials laboratory. The group assessment project was selected to target the laboratory course within the dental materials program and design a current assessment technique for a practical exam. A rubric was developed to assess and evaluate the dental hygiene student’s maxillary alginate impression practical. The rubric was implemented in the laboratory course as a way to examine its effectiveness in peer review and guiding student learning. A random sample of ten student’s alginate impressions from Concorde College were graded based on the final rubric design in order to see if this was a successful and comprehensive assessment technique. Ten random first year dental hygiene students from Baylor College of Dentistry were selected to address the questions if the rubric guided student learning and the addition of peer assessment enhanced learning.
Assessment templates from the Clinical Aspects of Dental Materials textbook (figure 1), Concorde Career College dental hygiene dental materials course (figure 2), and Baylor College of Dentistry first year dental student dental materials course (figure 3), were used to format and develop the final comprehensive rubric. An evaluation of criteria in the template assessment sheets was used to compile the criteria used in the final rubric. These templates had previously been approved to accurately assess competencies addressing the making of an alginate impression. The final rubric was reviewed and edited by the course directors in the first year dental hygiene dental materials course at Baylor College of Dentistry. Upon review of this new instrument, it was determined the rubric addressed all needed areas to achieve competency within the skills assessment.
The rubric for a dental materials maxillary impression utilized a set of instrument values gauging the quality of an impression which should look as if there were no errors, 2 to 3 errors and if the impression is completely not acceptable. In evaluating the student, the values used were 5 for satisfactory, 3 for needs improvement, and 0 for unsatisfactory or unacceptable. There were a total of 20 rows of criteria for a maximum total of 100 points. The self, peer, and faculty columns would be averaged to determine the final grade. The rubric made expectations and criteria explicit, which would facilitate feedback and self-assessment. We provided valid data for student learning. In this way, we could elicit feedback based on the use of our rubric. In the design of the rubric, we used several program rubrics to make one that is both beneficial and useful for students to demonstrate their ability to critically think through exercises and come up with a final product.
Group eight utilized ten students from Concorde College to grade their skills assessment for a maxillary alginate impression based on the rubric we designed. The peer group from Concorde also used the rubric to grade their partner’s impression. Ten students from the first year dental hygiene dental materials course at Baylor College of Dentistry were also called upon to evaluate the rubric and provide feedback on the effectiveness of the assessment instrument.
The practical at Concorde College first observed the infection control practices of each student to make sure the students understood the practice of safe guarding not only themselves but that of their future patients. Our second observation was the gathering and setting up of materials that the student needed to make ready to take the maxillary impression first. Equipment consisted of a basic setup, the alginate, powder scoop, water measuring cylinder, a rubber bowl, a wide-bladed spatula, the impression tray, utility wax (for lengthening or smoothing out the roughness in the tray), a saliva ejector, disinfecting solution, zippered plastic bag, and paper towels.
Once the student had seated the patient, the patient napkin was placed and protective goggles given to the patient. The student then selected an appropriate tray, portioned off three scoops of alginate powder and placed it in the bowl where three measures of water had already been added. By adding the alginate to water, this makes for a homogenous combination. The student next loaded the tray and making sure not to over fill the palate portion so as not to gag the patient. The student then inserted the tray into the patient’s mouth, making sure to seat the posterior part of the tray first and then moving to the anterior portion of the mouth. After ninety seconds to two minutes, the student then removed the tray with a quick snap or having had the patient “blow to puff out the cheeks” and then snapped the tray out of the mouth. The tray was then removed, rinsed under running water and disinfected in order to show how the students followed proper infection control protocol. The student along with the peer and instructor then inspected the impression for accuracy by utilizing the criteria within the rubric.
Upon completion of the assessment process for the maxillary alginate impression, a discussion on whether the rubric was an effective assessment technique for the dental hygiene dental materials course was conducted.
Figure 1. Assessment template for an alginate impression from the dental hygiene dental
Figure 2. Assessment template for a maxillary alginate impression used in the dental hygiene dental materials course at Concorde College.
Figure 3. Assessment template for a maxillary alginate impression used in the first year dental
student dental materials course at Baylor College of Dentistry.
The final result was the newly designed rubric, as shown below in figure four. The assessment tool for the dental hygiene dental materials course was a compilation of grading methods from the Clinical Aspects of the Dental Materials textbook, Concorde Career College dental hygiene dental materials course, and Baylor College of Dentistry first year dental student dental materials course. The time started, time completed, additional comments and various grading criteria in all blocks were obtained from the Clinical Aspects of Dental Materials textbook. The title, grading scale, performance objectives, and grading criteria from the first and third block were obtained from the Concorde College assessment sheet. The clinical photo of an acceptable maxillary alginate impression and grading criteria in the second block were adapted from the Baylor College of Dentistry first year dental students’ dental materials evaluation form. All three assessment methods included columns for the student and instructor’s evaluations. A column for the addition of peer evaluation was an added feature to the final rubric of group eight’s assessment project (figure 4).
Research was conducted to investigate what literature reviews might have revealed about assessment methods in the dental hygiene dental materials course. It was found instructors needed to use a variety of assessment techniques to best evaluate student performance and enhance student learning. We further gathered what assessment methods were currently in use for the evaluation of a maxillary alginate impression practical in the dental materials course. Figure one above reveals an assessment technique template published in the dental hygiene dental materials textbook. Figure two displays the grading components for the maxillary alginate impression within the dental materials course at Concorde College. The project also included a grading template from Baylor College of Dentistry first year dental student’s dental materials course for a maxillary alginate impression. We wanted to ensure that the dental hygiene competencies would be compatible with that of the dental student competency. The listed rubrics format and structure aided in the development of group eight’s assessment tool. The final rubric included areas that research revealed were important components in advancing student’s knowledge and clinical skills.
Nine out of ten first year dental hygiene students from Baylor College of Dentistry reviewed the rubric. One student did not submit the form on time. All nine students stated that the rubric was an effective assessment method to measure the maxillary alginate impression competency. All students agreed that the rubric supplemented and guided student learning. Seven out of the nine students revealed that the peer evaluation section was a beneficial addition to the rubric. Two students did not believe the peer evaluation section enhanced learning, and they felt the other student may not be competent or know how to assess properly.
In the evaluation of the rubric, we had a total of 10 students from Concorde that actually took the maxillary impression practical. Out of the 10 students participating, 4 did not rate themselves at all and the peer group did not rate any zeros for the students. The steps listed in the methods section for the making of a maxillary alginate impression were obtained from Hatrick, Eakle, & Bird.
One student had to redo the whole impression technique over because she had not portioned the alginate powder out correctly, causing the mix to set up on her as she was putting it in the patients’ mouth. The students were specifically informed that if they didn't grade themselves the results would indicate that they would fail. Their input to self-grade would assure them that even though the impression did not come out the way they had hoped, with 2 other participants grading them, the grading would ensure them that they would indeed pass this practical. The students appreciated the fact that a peer was also grading them. From the results of the grading, the students felt peer evaluation tended to be more objective, while offering a learning curve in areas the student hadn’t previously thought about.
Figure five depicts the total number of points (0, 3, 5) given for each criterion listed in the table by the student, peer, and faculty. There are a total of 20 rows of criteria in the grading rubric. For that criteria, the student, peer, or faculty could give a score of 0, 3, or 5. The numbers were counted from the results at Concorde College. Faculty observations and grading tended to be more stringent, with seventeen unsatisfactory marks (0 points). The peer group gave the most amount of 5 points (satisfactory) with a total of 162 (figure 5).
Figure 4. Rubric Design for Maxillary Alginate Impression Skills Assessment
Student Name: __________________________
Time Started: _______ Time Completed: _______
Students: By requesting this evaluation, you have determined you can complete the following skills assessment with no instructor assistance and with a passing score of 75% or above. Each criterion is worth 5 points, for a total of 100 points. The three columns for self, peer, and faculty will be averaged for the final grade.
Performance Objectives: 1) The student will demonstrate knowledge and clinical competency in making and evaluating a maxillary alginate impression 2) The student will obtain a maxillary alginate impression acceptable for a diagnostic cast 3) The student will follow infection control protocol during the procedure 4) The student will properly manage the patient.
Please rate the following criteria as 5, 3, or 0. If needs improvement or unsatisfactory, comment on why and how to improve.
Excess or insufficient alginate material (anterior/posterior)
Impression stable, alginate attached to tray
Evaluated impression, acceptable or unacceptable
Performed disinfecting and storage procedures
Inspected mouth for retained alginate and removed it
Managed patient properly
Maintained infection control throughout procedure
Additional suggestions/comments (please initial):
Peer Name: _______________________________
Instructor Name: __________________________
Grade (self + peer + faculty/3):
Figure 5. Total number of 0, 3, or 5 points given by student, peer and faculty.
The aim of the assessment project was to design a new, comprehensive rubric that instructors in the dental hygiene dental materials course could add to their array of assessment tools. The objective for the rubric was to assess knowledge and clinical competency in making a maxillary alginate impression and add the value of peer assessment.
Students responded positively to the rubric and stated the objectives were clearly outlined. Dental hygiene participants felt the rubric presented to be a valid method to assess the impression making competency by demonstrating all appropriate steps of the procedure and including all items needed to complete an accurate impression. One student commented that a section for self-reflection should be added. We believe this area is addressed in the ‘self’ column, and gives the student an opportunity to rate themselves and comment on how to improve.
Keselyak et al stated that to provide a powerful learning experience, active learning and assessment techniques should be incorporated in the course design (Keselyak et al., 2009). The rubric was designed in detail and thought to ensure that the format and technique enhanced student learning. Student’s comments after evaluating the rubric included that the rubric was effective and a great guide with detailed steps. One student revealed that the step by step criterion did not overwhelm student learning, and overall was an effective assessment method to guide learning.
Assessment methods that are available in the dental hygiene dental materials course include an area for student and faculty evaluation. The rubric was designed in this assessment project to include an area for peer evaluation. Pahinis et al. demonstrated learners can construct knowledge through interaction (Pahinis et al., 2007). We concluded that the addition of peer evaluation in assessment would supplement student learning. Dental hygiene students commented that the column for peer evaluation would be beneficial because they are aware students learn in different ways. They also felt it would be easier to accept criticism from a peer than from an instructor. One student did not agree peer evaluation supplemented student learning, and another stated that it could be distracting if the peer was not competent in the given skill. We will keep the area for peer evaluation and modify in future assessments if necessary.
When discussing with the students in Concorde, they thought the addition of the illustration added to the expected outcome. Here again, the self-reflection was brought up as to where to put their information, when the instructor pointed out there is a column, they said they had overlooked that column thinking it was for another evaluator.
With the faculty member grading the individual impressions, the students and peers were able to critique alongside the instructor and gain insight on what the instructor was also looking for as a final product. Because this was a small sample, it allowed for a more relaxed way to interact with the students. An article revealed that relevant humor reduces students’ anxiety, maintains student interest, improves comprehension, enhances retention, and increases test performance (Schonwetter, Lavigne, Mazurat, & Nazarko, 2006).
There were 2 other faculty observers in the dental hygiene dental materials course to help with grading the students on their impressions at Concorde College. This gave us another pair of eyes and evaluations to assess how they felt this particular instrument was. The faculty gave a much more stringent rating based on the criteria presented within the rubric. The peer evaluating the student often times would note a particular area that needed to be pointed out to the student. This was helpful for the student to understand their error and try and fix it the next time they were to take an impression. Faculty also included notes when it deemed necessary to help the student understand why they got the point value they received.
Group 8 determined this rubric presented with an assessment method we that might improve assessing first year dental hygiene students within a dental materials course. Limitations include it was utilized by a small sample size and only two dental hygiene dental material courses. Given the interaction with other faculty members who also teach within the dental materials course, it was concluded that with this assessment method, we can successfully utilize the rubric and implement it within the laboratory. Future application of the rubric for the maxillary alginate impression practical will give light to whether it is a successful instrument in addition to existing materials.
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