Table 1.

MOSLER grading rubric

	Skills demonstrated AT or ABOVE the level of a safe beginner		Skills demonstrated that are NOT at the level of a safe beginner
	Grade 4 Would require no supervision in encounter as a foundation dentist	Grade 3 Would require standard level of supervision in encounter as a foundation dentist	Grade 2 Would require more supervision than usual in encounter as a foundation dentist	Grade 1 Would require direct 1:1 supervision in encounter as a foundation dentist
Communication	Communicates effectively, sensitively, uses appropriate language and terminology Actively listens and responds, sharing ideas concerns and expectations Non-verbal communication appropriate eg positioning/body language	Competent communicator: at the lower end, there may be some hesitancy, occasional lapses in fluency and/or clarity Overall, terminology used does not impede understanding Respects ideas, concerns, and expectations Non-verbal communication does not detract from encounter eg position/body language	Significant lapses of fluency and/or clarity Frequent use of inappropriate/incorrect terminology used that risks or impedes understanding Acknowledges patients' ideas, concerns and expectations but may overly impose own ideas or views Little consideration of non-verbal communication eg position/body language	Little or no competence in use of communication skills, wholly or largely unclear Predominant use of inappropriate/incorrect terminology throughout or language eg swearing Impedes understanding Does not acknowledge or respect patients' ideas, concerns and expectations No consideration of non-verbal communication, distracting, actively detracts from encounter
Information gathering/giving	Engages in shared decision-making, gathers/provides the appropriate information to manage the encounter Succinct and well-structured history/interaction Significant facts elicited with minimal irrelevant detail	Gathers/provides sufficient information to manage the encounter, there may be some omissions Structured history/interaction with minor lapses of organisation Some deficiencies/repetitions/irrelevant details acceptable	Gathers/provides partial information but with significant omissions, understanding may be impeded Structure of history/interaction lacks Numerous repetitions or irrelevancies	Gathers/provides insufficient information to manage the encounter Most significant facts missed, major deviations from line of enquiry Unstructured/disorganised history/interaction
Clinical and diagnostic reasoning, applied knowledge, management	Important and relevant conditions in differential diagnosis supported by comprehensive and rational explanation Justified investigative strategy, does not request irrelevant tests Clear and logical planning supported by sound knowledge and clinical judgement Understands the implications of medical and social history Manages/recommends clinical procedures confidently, safely and efficiently, offers excellent standard of care	Important and relevant conditions in differential diagnosis Appropriate investigative strategy, although this may not be optimised (eg an irrelevant test or some omissions) Appropriate planning supported by knowledge and clinical judgement, some guidance and prompting may be required at the lower end Aware of the implications of medical and social history Manages/recommends appropriate and safe clinical procedures	Some omissions from the differential diagnosis Deficiencies in investigative strategy (eg multiple irrelevant tests/several important omissions) Deficiencies in establishing an appropriate plan, lacks clinical reasoning or justification Medical/social history noted but deficiencies in implications Manages/recommends clinical procedures that are not always appropriate eg under or overtreatment	Omits likely or ‘must not miss' diagnoses Major errors in investigative strategy that would make correct diagnosis unlikely and/or may result in potential harm to the patient Unable to treatment plan. No justification or clinical reasoning. Lacks knowledge and clinical judgement No consideration of medical and social history or its implications Manages/recommends clinical procedures that are inappropriate or unsafe - likely to result in patient harm
Professionalism	Professional behaviour exemplary, decisive, confident, encourages patient/staff confidence and safety Consistently recognises and acts within professional standards, relevant laws, and guidance Respects confidentiality, aware of need for valid consent and their impact on patient management Demonstrates effective team working and insight into multidisciplinary team Actively reflective of own limitations, able to identify and action appropriate onward referral in patient's best interests	Professional behaviour that maintains patient/staff confidence and safety Recognises and generally acts within professional standards, relevant laws, and guidance Respects patient confidentiality, aware of consent issues and that these may impact upon patient management Awareness of their role in multidisciplinary team, their own limitations, able to action an appropriate onward referral	Inconsistent professional behaviour, may impact upon patient/staff confidence Breaches professional standards, laws, or guidance Aware of need for consent but unsure as to necessary level or the impact on patient management Limited or inconsistent approach to working with a multidisciplinary team, lacks awareness of own limitations and need for appropriate onward referral	Inappropriate/unprofessional behaviour, impacts up on patient/staff confidence and/or safety Does not act at all within professional standards, laws, or guidance Acts without consideration, lacks insight into own behaviour Unaware of consent issues or impact on patient management Unaware of role in multidisciplinary team Unaware of own limitations and need for appropriate onward referral