Vidya Ramaswamy, Theodora Danciu, Dharini van der Hoeven
Failure to fail remains a systemic challenge in dental education, driven less by individual reluctance and more by institutional culture, assessment inconsistencies, and limited remediation structures. Addressing this phenomenon requires coordinated institutional action, faculty development, and assessment reform to ensure competent, practice‑ready graduates.
PURPOSE: The "failure to fail" phenomenon, faculty reluctance to assign failing grades to underperforming learners, poses persistent challenges in health professions education. This study examines the prevalence, contributing factors, and contextual patterns of this phenomenon in US dental education.
METHODS: A cross‑sectional Qualtrics survey was distributed through Academic Deans to faculty at US dental schools (N = 368-375 respondents). The survey included 14 quantitative items and one open‑ended prompt addressing attitudes toward failure, professional responsibility, barriers to assigning failing grades, and perceived reasons for student underperformance. Quantitative data were analyzed using chi‑square tests with Bonferroni corrections; qualitative responses underwent inductive thematic analysis.
RESULTS: Most faculty agreed that failure supports learning (74%-86%) and reported confidence identifying failing students (78%-82%). However, 30%-36% did not consistently view assigning failing grades as a professional responsibility, and 17%-38% reported passing a student who should have failed within the past year, highest in preclinical and clinical settings. Significant differences emerged across gender, appointment type, experience level, and generation. Institutional/administrative culture was the most influential barrier, followed by assessment‑tool limitations and remediation constraints. Qualitative findings reinforced systemic pressures, misaligned standards, fear of student retaliation, and inconsistencies in assessment calibration.
CONCLUSIONS: Failure to fail remains a systemic challenge in dental education, driven less by individual reluctance and more by institutional culture, assessment inconsistencies, and limited remediation structures. Addressing this phenomenon requires coordinated institutional action, faculty development, and assessment reform to ensure competent, practice‑ready graduates.