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“A Stab in the Dark”: Dental Hygiene Programs and the Quest to Predict Student Success

Over the last five years at Virginia Commonwealth University School of Dentistry (VCU SOD), Michelle McGregor, RDH, B.S., M.Ed., has witnessed a seemingly paradoxical trend when it comes to the intersection of student recruitment and student performance.

McGregor, director of the dental hygiene program at VCU SOD, reports that incoming students’ average math and science GPAs have steadily risen from 2.97 in 2015 to 3.01 in 2017 and stayed above 3.20 for the past two years — yet her students “seem to be not as academically strong” in the program itself despite their higher pre-enrollment GPAs.

This absence of a correlation between applicants’ GPAs and their eventual performance in dental hygiene school isn’t isolated to VCU SOD. According to McGregor, many of her peers feel that “it’s a stab in the dark.” She says, “You see these students with low GPAs who seem like they struggled in school but are successful, and then you see students with high GPAs who are struggling.”

But perhaps it’s actually no paradox, after all. VCU SOD’s dental hygiene program is among the growing number of programs across disciplines that are adopting a mission-driven process known as individualized “holistic admissions” or “holistic review” — by which balanced consideration is given in combination to an applicant’s experiences, attributes and academic metrics as a whole in order to determine how the individual might contribute to the academic program and the field of dental hygiene. This admissions approach allows for a review and inclusion of unconventional application materials and interviews, such as auditions or portfolios.

Specifically, the American Dental Education Association (ADEA) defines holistic review as “a flexible, individualized applicant assessment tool” which “provides admissions committees a balanced means of considering candidates’ personal experiences, attributes and academic credentials, along with qualities and characteristics that would prove valuable in both dental school and the oral health profession.”

The VCU SOD dental hygiene program’s admissions rubric features seven criteria for evaluating applicants, including their GPA, community service, leadership, course selection in math and science, letters of recommendation, views about teamwork and personal statements. Applicants can view these criteria once they log in to ADEA DHCAS™, the Liaison-powered Centralized Application Service (CAS™) for applicants to all levels of dental hygiene education programs.

Additionally, because individuals from diverse backgrounds contribute to the learning experience, the VCU SOD dental hygiene program also takes into consideration multiple intersecting factors— academic, non-academic and contextual — that in combination uniquely define each applicant. Examples of non-academic factors include special talents (e.g., musical and athletic), if a student is the first generation in their family to go to college, if they’ve won awards and honors, have done community service and also their socioeconomic status and work experience. For instance, did the applicant hold jobs while going through school, thus exhibiting an exemplary level of work ethic and tenacity? Or how did the applicant balance the demands of schoolwork and working a part-time job?

“I’ve seen 4.0 GPA students who come in here and struggle, and 2.8 students who excel because they have all these other skillsets that they bring to the table, and they work hard and have tenacity. Sometimes it’s hard to tease that out of an application,” says McGregor.

She continues, “We like to know whether prospective students have done volunteer work in the oral health community or outside of it prior to applying. We have so many volunteer opportunities in our program and a huge service-learning component, so civic-mindedness is something that we value in an applicant.”

In this respect, an increasingly holistic process for admissions can help dental hygiene programs like the one at VCU SOD begin to better predict student success, by first acknowledging that conventional academic criteria such as GPA are one piece of a larger puzzle and subsequently designing more well-rounded admissions processes accordingly.

It’s also widely understood that one of the primary goals of a holistic admissions approach is cultivating greater diversity at academic institutions, while simultaneously expanding the definition of the word “diversity” itself to encompass not just race and ethnicity, but a complete picture of the applicant.

In fact, Monica L. Hospenthal, RDH, B.S., M.Ed., director of dental hygiene programs at Pierce College, notes that the program had its most diverse incoming class ever this past year in terms of gender and ethnicity. What spurred that development? As potential factors, Hospenthal cites both college-wide initiatives and her program’s participation in ADEA DHCAS.

“There are not many baccalaureate programs in dental hygiene, so ADEA DHCAS is helpful because it helps prospective students see all their options,” says Hospenthal.

Being part of the ADEA DHCAS network has lent dental hygiene programs at Pierce College increased national visibility.

“It’s important to have this increased exposure, and links well with where our program is going,” she says. “I’m looking forward to watching this to see if ADEA DHCAS has had an effect on the diversity of our student body.”

McGregor, meanwhile, lauds how ADEA DHCAS has streamlined the logistical side of her admissions operation.

“As I send applications out to the faculty, they can go online and review the files,” McGregor says. “With ADEA DHCAS, I can pull out various comprehensive reports to look at how many items applicants are missing, and which items are missing, ultimately helping us communicate better on our website or during our open houses. That way, students know what they need in order to apply and can have all the requirements met.”

Similarly, Hospenthal says the cloud-based ADEA DHCAS platform boosts the effectiveness of her two-person admissions staff. “Since dental hygiene programs are smaller than their counterparts in dentistry, as most of them are affiliated with community colleges rather than universities, they have less personnel to perform application processing work. ADEA DHCAS helps us extend limited resources.”

Nonetheless, dental hygiene programs’ quest to improve their projections on student success is far from complete.

McGregor believes that increased stress for current dental hygiene students might be an additional factor that makes it difficult to assess the correlation between student recruitment and student performance.

“Our programs have continued to add components to our curriculum based on the scope of practice changes, new technologies, accreditation requirements and new research over the years, but we’re still doing it in the same academic timeframe,” she says. “Today’s students are still learning everything that I learned as a dental hygiene student, and more. They have to learn how to use nonsurgical lasers, how to use CAD/CAM technology and intraoral cameras. They participate in interprofessional education. We didn’t take anything away from their plate, yet we’re adding things into the program. Students still need basic foundational knowledge, which makes it difficult to take anything out of the curriculum.”

Hospenthal agrees: “Washington state has had expanded dental hygiene since 1971, which includes local anesthesia and filling and placing amalgam and composite restorations. Balancing this robust curriculum, and what is necessary for ‘entry-level safety’ against the ever-expanding knowledge of practice and science, is not only stressful for students, but also for the faculty who must determine how to guide the teaching of the students. Any opportunity to streamline and work more efficiently in our processes is a positive move forward, like using ADEA DHCAS.”

How can dental hygiene programs determine which students will successfully cope with today’s more rigorous requirements? Since grading and GPA tabulation varies for every school and program, McGregor argues that there needs to be better standardization of evaluation mechanisms.

“We need a better way to assess critical thinking skills and reading comprehension to help us better determine how well our applicants will do once they’re admitted,” says McGregor, noting discussions she’s had with colleagues who’ve reported that applicants who score higher on reading comprehension assessments tend to be more successful in dental hygiene school.

What further muddies the waters of predicting student success, McGregor explains, is the limited number of dental hygiene programs that are using ADEA DHCAS for application processing.

“Where is that discipline-wide information to assess trends in dental hygiene, like we have in dentistry?” McGregor asks. “We’d gain valuable insights from data on more nuanced metrics like how many first-generation students are applying to dental hygiene school, how many students are relocating out of state for programs and how many applicants are pursuing dental hygiene as a second career.”

Indeed, as ADEA DHCAS continues to expand by adding institutional partners, such new data points could be on the horizon — making the prospect of predicting student success in dental hygiene less of “a stab in the dark.”