USC University of Southern California

Triple Jump Examinations a Reliable Way to Assess Dental Students’ Reasoning

Mahvash Navazesh
Mahvash Navazesh, Associate Dean of Academic Affairs and Student Life

By Beth Newcomb

Triple jump examinations administered by the Herman Ostrow School of Dentistry of USC are reliable and consistent in the way they assess dental students’ reasoning and critical thinking skills, according to an article published in the Journal of Dental Education.

Lead author Mahvash Navazesh, professor and Ostrow School of Dentistry Associate Dean of Academic Affairs and Student Life, said while the triple jump examination (TJE) is noted by the American Dental Education Association for effectively testing students’ analysis and critical thinking skills, they are used by only one percent of all U.S. dental schools.

As Navazesh detailed in the article, there are three steps in a pre-clinical TJE administered at the Ostrow School of Dentistry. The initial step encompasses a one-hour, written analysis of the patient case scenario provided (in a clinical TJE, a live patient would be interviewed and examined).

The student’s analysis includes determining the patient’s presenting or chief complaint and its pertinent facts, formulating mechanistic-oriented hypotheses that may explain the patient’s problems, and listing learning topics to be investigated with regard to each hypothesis. As a second step, the student conducts an overnight gathering of information to contribute to his or her learning for an oral presentation the next day.

For the third step, two faculty members – one with clinical and one with biomedical expertise – assess the student’s performance in the oral presentation and provide feedback with interactive discussion and questioning in a 30-minute session. The students are expected to use their reasoning ability to explain whether they accept or reject their hypotheses from the previous day and how they will approach a continuance of learning for the case, formulate new and revised hypotheses, and address lingering questions or further gaps in their knowledge.

Faculty evaluators engage in discussion with the students and provide immediate verbal feedback on the student’s critical analysis and reasoning. On a written TJE assessment form, the student is graded independently by the two examiners on their performance level in each of three steps of the examination. Following the session, the student submits their anonymous evaluations of the participating faculty raters. Faculty members receive electronic copies of the evaluations and student feedback is used for further development of faculty.

The seemingly subjective nature of the faculty evaluations may give other dental schools pause when considering the use of the TJE for their student assessments, Navazesh said.

However, when examining the scores given by different faculty raters to the same student presentations, raters generally agreed on scores for each criterion over 99 percent of the time, with over 77 percent of the ratings in exact agreement, she said.

The study examined more than 19,000 ratings over a three-year period. Besides the high level of consistency and reliability between raters’ scores of the same student presentations, there appeared to be no significant difference in scoring consistency between raters who had different levels of experience with scoring the TJE, Navazesh added.

The results indicate that the triple jump examination format is a consistent, reliable tool for testing dental students’ critical thinking and higher-order thinking skills, she said.

“It’s very valuable for us to be able to assess not only a student’s memorization of facts but also their ability to analyze information, identify the important questions and think critically in order to solve problems and ultimately offer their patients the best available care.,” Navazesh said.

Journal of Dental Education: “Triple Jump Examinations for Dental Student Assessment”