title: Failing to fail: clinicians' experience of assessing underperforming dental students.
abstract: BACKGROUND
  Anecdotal evidence within a UK dental school indicated that staff's grading did not always match their evaluation of students' clinical proficiency. The invalid assessment of underperforming students, which has considerable ramifications, has been reported internationally for students of nursing and medicine, but a database search revealed no accounts for dental education.
  
  
  OBJECTIVE
  To develop an understanding of clinicians' approaches to assessing underperforming dental students.
  
  
  METHODS
  Seventeen clinical staff were interviewed (eleven females, six males). Interviews were recorded and transcribed verbatim. A grounded theory methodology was used, with simultaneous data collection and analysis. The main analytical technique was constant comparison.
  
  
  RESULTS
  Participants' shared basic problem was Assessing undergraduate students, expressed as how they evaluated and used the assessment system or perceived others to do so. The core category, which explains what clinical staff do to manage their difficulties with assessment, was identified as Failing to Fail and has three subcategories: Evaluating the Assessment System, Shielding the Student and Protecting Myself.
  
  
  CONCLUSIONS
  This study has substantiated the complexity of failing to fail and confirmed that some causes are shared across healthcare professions, although insufficient staff discussion, the avoidance of confrontation and the impact of negative student attitude are not reported elsewhere or are minor findings. It is recommended that clinical staff receive additional training in assessment and that they are made more aware of their learning needs, their attitudes and beliefs. Increased discussion between staff about assessment and about students known to be in difficulty is essential.
authors.affiliation: Cardiff School of Dentistry, Cardiff University, Cardiff, UK.
authors.forename: H M
authors.initials: HM
authors.lastname: Bush
authors.forename: R S
authors.initials: RS
authors.lastname: Schreiber
authors.forename: S J
authors.initials: SJ
authors.lastname: Oliver
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004497:Education, Dental; D004521:Educational Measurement; D004739:England; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D036301:Qualitative Research; D014477:Underachievement
keywords: assessment; failing to fail; grounded theory; staff-student relationships; undergraduate dental students