Background PRISM is a novel approach to support self-reflection and learning appraisal in dental students, based on a visual metaphor. The aim of this study was to evaluate whether PRISM measurments would be reproducible and sensitive to detect learning progress in undergraduate dental students in their clinical years. Methods Voluntarily participating dental students were included. To evaluate reproducibility, a mixed cohort of 10 students each in 3rd, 4th and 5th year (total n = 30) was recruited and received three identically structured PRISM interviews within one week without any other teaching events. To assess perceived learning progress, 29 volunteer 3rd year students participated in three interviews during their clinical simulation course (beginning, middle, end). Distances between Subject and Objects was measured in millimeter; objects were classified into close or branched clusters depending on their distance from each other on the PRISM board. Results Values for perceived competencies within PRISM interviews during one week were comparable between the three time points in the mixed cohort (n = 30; p > 0.05). Comparing the three subgroups (3rd, 4th and 5th year, each n = 10), PRISM indicated that 3rd year students perceived their competencies are significantly lower than the 4th and 5th year students (p < 0.01). 3rd year students had less often a branched cluster of objects than the other two groups (p < 0.05). PRISM showed that over time, 3rd year students perceived a gain in their competencies in conservative dentistry and its sub-disciplines (p ≤ 0.01). The PRISM data indicated that by the end of the simulation course, the students appeared to show higher discrimination of their self-perceptions between sub-topics in conservative dentistry than at the start of the course (p = 0.01). Conclusion PRISM yields a reproducible measure of individual students' learning progress. It is a promising novel approach for appraisal in dental education. Further work is needed to confirm the generalisability of the findings.

Objectives. PRISM (Pictorial Representation of Illness and Self-Measure) is a simple visual tool that has been successfully used as a visual metaphor in medicine. In this pilot study, PRISM was used for the first time to test its potential to support self-reflection and expectations of learning in dental students. Methods. Dental student volunteers (25 3rd year, 10 4th year, and 10 5th year) participated. Using both quantitative and qualitative methods, PRISM interviews were compared with a numerical scale in assessing learning objectives concerning theoretical knowledge, practical skills, interest, and training need in the field of conservative dentistry. Results. Overall, 71% of total student group stated that they would draw personal consequences for their studies due to participating in the PRISM interviews. Compared to the numeric scales, PRISM was rated as more helpful regarding appraisal of students’ theoretical knowledge ( p = 0.02 ), practical skills ( p < 0.01 ), training needs ( p < 0.01 ), importance of dental subspecialties ( p < 0.01 ), and facilitating self-reflection ( p = 0.02 ). In focus groups, students commented that PRISM fostered the development of a trusting relationship with their teacher. Strengths of PRISM mentioned by the students included being able to observe and manipulate a visual summary of their individual learning needs and seeing their different learning needs in relation to one another. Conclusion. In this pilot study, dental students evaluated PRISM to be superior against numeric scales. Furthermore, it ameliorated the communication with teachers. The PRISM task is both simple and brief and warrants further exploration as a useful tool for self-reflection in dental education.