Types of Feedback in Competency-Based Predoctoral Orthodontics: Effects on Students' Attitudes and Confidence.

Feedback can exert a powerful influence on learning and achievement although its effect varies. The aim of this study was to investigate the effects of three types of feedback on dental students' attitudes and confidence in a competency-based course in predoctoral orthodontics at New York University College of Dentistry. In 2013-14, all 253 third-year students in a course using test-enhanced instructional methods received written feedback on formative assessments. The type of feedback varied across three groups: pass/fail grades (PF) N=77, emoticons (EM) N=90, or written comments (WC) N=86. At the end of the course, students completed surveys that included four statements addressing their attitudes toward course instruction and confidence in their abilities. The survey response rate ranged from 75% to 100% among groups. The lowest response rate (75%) was in the PF group. In attitudes toward course instruction and confidence in their abilities, the WC group trended to more positive responses than the other groups, while the PF group trended to negative responses. On two of the four statements, the trend for the WC group was significant (95% CI). In both statements concerning attitudes toward instruction, the PF group trended to negative responses that were significant (95% CI). These results support the effectiveness of descriptive written comments over pass/fail grades or emoticons in improving dental students' confidence in their abilities and their attitudes toward instruction.