Can We Change? Applying Vosniadou's Theory to Assessment Reform in Dental Education

BACKGROUND: Assessment reform in medical education is challenging, often encountering resistance from institutional norms and deeply held educator beliefs. These beliefs influence the success of reform initiatives. Sustained reform requires understanding educators' conceptual models-how they form, persist, and transform over time-so that strategies can better support meaningful change. AIM: To explore dental educators' conceptualizations of assessment and its influence on receptiveness to change in an Australian dental school using Vosniadou's conceptual change theory. METHOD: Guided by a constructivist paradigm, 10 educators participated in one-on-one online interviews to explore their assessment beliefs and practices. During the interview, participants were introduced to progress testing to assess responses to assessment reform. RESULTS: Educators' assessment beliefs centered on two interrelated themes-core assessment ideals and determinants for change, both underpinned by patient safety. Although participants recognized the benefits of progress testing, they had difficulty reconciling it with their core assessment ideals, which limited their acceptance. DISCUSSION: Applying Vosniadou's framework highlighted many assessment ideals functioning as naïve beliefs, such as reliance on high-stakes summative assessments. Frustration with the limitations of current assessment techniques prompted some educators to shift their views spontaneously, but without deliberate instructional support, educators often formed "synthetic models" which reinforced problematic biases. Progress testing exemplified this tension: despite aligning with the goal of patient safety, it conflicted with entrenched naïve beliefs in high-stakes exams. CONCLUSION: Meaningful reform requires more than simply offering evidence. It demands engagement with educators' underlying beliefs and alignment with the goals of patient safety.