Caries Removal by First-Year Dental Students: A Multisource Competency Assessment Strategy for Reflective Practice.

Multisource assessment (MSA) uses multiple assessors to provide feedback. Little is known about the validity of using MSA feedback for improving students' ability to self-assess in a preclinical environment. Therefore, the aim of this study was to measure the validity of using a defined reflective process involving an MSA tool for building skill in dental students' self-evaluation of caries excavation on extracted teeth. As part of this process, 104 first-year students at one U.S. dental school used a self-generated study plan (SGSP) for structured reflection on MSA feedback during the 2013-14 academic year. Interrater agreement, determined through calculation of percentage-agreements in scoring, was measured among three assessor groups (self-, peer, and expert assessors) in formative assessment and between two assessor groups (self- and expert assessors) in summative assessment two weeks apart, allowing for reflective practice and completion of an SGSP between assessments. Validity for improving self-assessment was determined by measuring significance in positive shifts of agreement between self- and expert assessors. The results showed that interrater agreement between the self- and expert assessors increased significantly: from a 28% agreement in formative assessment to a 60% agreement in summative assessment. Significance in percentage shifts between assessments was demonstrated with a McNemar score of 0.26 (p<0.001). These results suggest that the described MSA tool and reflective process in an SGSP may be valid methods for improving skill in student self-evaluation of competence in caries excavation on extracted teeth.