Problem-Based Learning in Dental Education: A Systematic Review of the Literature

Use of a Modified Gradual Release of Responsibility Pedagogy in Student Preparation for an Objective Structured Clinical Examination

PURPOSE

Dental education, especially in pediatric dentistry, faces varied challenges in the pursuit of preparing competent and confident oral health professionals. The authors introduced a modified gradual release of responsibility (GRR) pedagogy designed to balance traditional instruction and active learning strategies. This study assessed the effect of the pedagogy on first-time pass rates of a pediatric dentistry specific Objective Structured Clinical Examination (OSCE) and student's self-efficacy with the course content.

METHODS

Three online modules were created using a modified GRR framework. These modules addressed three critical topics that historically had higher failure rates on the OSCE, namely: local anesthesia maximum dosage calculation, pulpal diagnosis and treatment planning in primary teeth, and management of time-sensitive dental trauma. First-time pass rates and overall exam performance were compared to five-year historical data as the control with the chi-square test of independence. Participants also completed a ten-item, pre- and post-module completion five-point Likert scale questionnaire assessing student self-efficacy, and the results were compared using a Wilcoxon matched-pairs signed-rank test.

RESULTS

First-time pass rates for the test group (n = 228) were significantly improved compared to historical controls (n = 546) for pulpal diagnosis (p = 0.002), dental trauma management (p = 0.002), and overall OSCE performance (p = 0.003). First-time pass rates for local anesthesia calculation were not significantly different (p = 0.09). Student self-efficacy significantly improved for all ten items (p < 0.001).

CONCLUSIONS

Using the GRR pedagogy improved student pass-rates on an OSCE; as well as increased student self-efficacy with the course material. This pedagogy holds promise in developing engaged learners across dental education settings.

Study on the effect of simulation-based case teaching method on the preclinical teaching of tooth defects restoration

BACKGROUND

Clinical decision plays an important role in the prognosis of dental defect restoration. However, the current theoretical teaching and experimental teaching lack the training of clinical decision based on evidence-based medicine. Students have mastered theoretical knowledge and basic operating skills, they are extremely lacking in the ability to handle clinical cases before clinical practice. In order to improve students' clinical decision ability in dental defect restoration and enhance the connection of clinical practice and theory teaching, we applied the simulation-based case teaching (SCT) method in practice teaching courses.

METHODS

The study was carried out with 96 undergraduate dental students at Guanghua School of Stomatology, Sun Yat-sen University, including 51 females and 45 males, aged 17 ~ 20 years, with an average of (18.23 ± 1.02) years. The SCT course included case-based group discussion, teeth preparation, group report, question defense and teacher comments. We obtained effective and comprehensive classroom feedback through teaching effect evaluation by comparing the case analysis results before and after the SCT course, and questionnaire survey from students after class. All statistical analyses were performed using SPSS 25.0. The comparison between the two groups of percentages was made using a Chi-square test. Statistical significance was set at p < 0.05.

RESULTS

The results of objective evaluation of teaching effect showed a statistically significant difference (p < 0.01) between the results before and after SCT in the diagnosis, treatment plans, restoration materials and complications. The results of the questionnaire survey showed that students agreed their improvement in the treatment decision making, aesthetic restoration and dentists-patients communication and recognized their shortcomings in clinical critical thinking and knowledge development.

CONCLUSIONS

The study suggested that SCT is an excellent teaching method to cultivate students' clinical thinking, and we should integrate more imparting of experience related to clinical decision-making and medical humanities in the future preclinical teaching work.

Medical education challenges in Mainland China: An analysis of the application of problem-based learning

BACKGROUND

The medical education system in mainland China faces numerous challenges and the lack of learner-centered approaches may contribute to passive learning and reduced student engagement. While problem-based learning (PBL) is common in Western medical schools, its feasibility in China is questioned due to cultural differences. This systematic review aims to summarize the application of PBL in medical education in mainland China based on existing literature, as well as to identify the challenges and opportunities encountered in its implementation.

METHODS

A systematic literature review was conducted using electronic databases, including MEDLINE, Cochrane Library, EMBASE, Web of Science, Wan fang and CNKI databases. Grey literature sources were explored using Google Scholar. The search was limited to articles that include at least one English abstract up to May 1st, 2023. The inclusion criteria were studies that reported the use of PBL in medical education in mainland China.

RESULTS

A total of 21 articles were included in the final analysis. The findings indicate that PBL is a well-adopted and effective learning method in most medical education, especially for developing critical thinking, problem-solving, and teamwork skills. However, the application of PBL in mainland China is limited due to various challenges, including faculty resistance, inadequate resources and cultural barriers. To effectively address these challenges, it is essential to provide faculty training, develop appropriate assessment methods to evaluate student progress within the PBL framework and create conducive spaces and resources that support collaborative learning and critical thinking.

CONCLUSION

The utilization of PBL in mainland China holds potential for enhancing medical education. However, its successful implementation requires significant efforts to address the identified challenges. It is crucial to engage stakeholders in a collaborative effort to promote the application of PBL and ultimately improve the quality of medical education in mainland China.

The effectiveness of integrating role play into case-based learning in dental education: enhancing critical thinking and teamwork skills

BACKGROUND

Modern dental education necessitates dynamic methodologies to foster critical thinking and teamwork skills, which might include case-based learning (CBL) and role play (RP).

OBJECTIVES

To evaluate the impact of the combined CBL and RP (CBL-RP) approaches on critical thinking and teamwork skills among dental students by comparing pre- and post-RP evaluation scores.

METHODS

This pre-post intervention study was conducted at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. The study involved all 193 third-year dental students, who were organized into groups of 7-9 members to participate in four CBL sessions. Each CBL session consisted of a detailed case scenario, a pre-RP presentation preparation, a CBL-RP session facilitated by a trained instructor, and a post-RP presentation. Case scenarios included demographic data, chief complaints, medical and dental histories, social history, clinical images, radiographs, caries assessment, periodontal charts, and questions targeting specific intended learning outcomes and social factors impacting oral health. Students' performances were evaluated pre- and post-RP using a standardized rubric focused on critical thinking and teamwork, with outcomes assessed through individual and collective scores. Outcomes were analysed using paired samples t-tests and repeated measures ANOVA.

RESULTS

The study revealed significant improvements in total scores, combining critical thinking and teamwork, from pre- to post-RP evaluations across four sessions. Mean scores consistently increased post-RP (P < 0.001 for all sessions). Session scores, calculated as the averages of pre- and post-RP evaluations, showed a progressive increase from session 1 to session 4, indicating significant overall improvement (F = 16.8, P < 0.001). Pairwise comparisons identified session 4 as having significantly higher scores than the earlier sessions. Both teamwork and critical thinking scores showed significant increases from pre- to post-RP evaluations in each session (P < 0.001), with an upward trend in mean scores across sessions.

CONCLUSION

This interventional study demonstrates the effectiveness of integrating RP into CBL sessions in enhancing critical thinking and teamwork skills among dental students. This integration supports the efficacy of active learning and integrated educational strategies in engaging students and enhancing clinical learning outcomes.

Effectiveness of the application of small private online course combined with PBL model based on massive open online course in the teaching of neurology

BACKGROUND

Due to the complex and abstract anatomy of the nervous system, neurology has become a difficult subject for students of clinical disciplines. It is imperative to develop new teaching methods to improve students' enthusiasm for learning this course. Small private online courses (SPOC) combined with problem based learning (PBL) blended teaching models based on massive open online course (MOOC) provides a new direction for future neurology teaching reform. This study aimed to investigate the effectiveness of applying SPOC combined with PBL in neurology teaching.

METHODS

This study was conducted during the 2020 intake of undergraduate students at the Second Hospital and Clinical Medical School, Lanzhou University. A total of 48 students were enrolled in the study and randomly assigned to either a Lecture-Based Learning (LBL) group or a SPOC + PBL group, with 24 participants in each group. After the classes, comparisons were made between the two groups in terms of teaching methods, increases in learning interest, level of participation in learning, satisfaction, and closed-book unit test scores.

RESULTS

The average unit test score of the SPOC + PBL group was 84.29 ± 1.65, the average score of LBL group was 77.0 ± 1.92. The difference in average scores between the two groups was statistically significant (P < 0.01). The proportion of students with 91-100 points in SPOC + PBL group was higher than that of LBL group, and the difference was statistically significant, P < 0.01. Student satisfaction survey in the SPOC + PBL group was significantly higher than that in the LBL group, P < 0.01.

CONCLUSIONS

The application of SPOC combined with PBL teaching based on MOOC in neurology teaching may be more effective than traditional LBL model. It is expected to help medical students overcome the "fear" of learning neurological diseases, improve the teaching effect of neurology courses, and meet the needs of modern medical education by employing a hybrid course structure and adopting a problem-oriented approach.

The implementation of a diversified teaching model can enhance the quality and efficacy of dental materials science

OBJECTIVE

Dental materials science is one of the fundamental disciplines in stomatology, encompassing clinical areas such as orthodontics, prosthodontics, and endodontics. Due to its extensive knowledge base, strong professional nature, and wide scope, teaching dental materials science presents a challenge. This study aimed to enhance the application of dental materials science in oral teaching by comparing the effectiveness of different teaching methods.

METHODS

This research project was evaluated by the Xi'an Jiaotong University Committee on Human Subjects Research and approved as exempt research. A total of 56 clinical stomatology students from the first year and second year cohorts at the Stomatology Hospital of Xi'an Jiaotong University were selected for the study. The first year cohort served as the nonteaching reform class, while the second year cohort formed the teaching reform class. The impact of the teaching reform was assessed through a questionnaire survey and final examination results.

RESULTS

The questionnaire survey of students in the teaching reform class indicated a significant improvement in their interest in professional courses and overall satisfaction with the teaching. Additionally, the final examination results revealed a significantly greater rate of excellence among students in the teaching reform class than among those in the nonteaching reform class, with no students failing.

CONCLUSION

The use of diverse teaching modes can enhance the quality and effectiveness of dental materials science instruction, offering a new approach for improving teaching in this discipline.

Effectiveness of spaced repetition learning using a mobile flashcard application among dental students: A randomized controlled trial

BACKGROUND

Dental education in India predominantly relies on traditional lecture-based learning (LBL), which may hinder student engagement and learning outcomes. To address these limitations, innovative learning methodologies, such as spaced repetition learning (SRL), are imperative. SRL prioritizes active recall and can enhance long-term knowledge retention. This study aims to assess the effectiveness of SRL delivered through a mobile flashcard application, in enhancing knowledge retention among dental undergraduates.

METHODS

This single-blind randomized controlled trial (CTRI/2023/10/059347), conducted in Belagavi, India, involved 90 dental students who were equally distributed into control (LBL) and test (lecture followed by SRL demonstration) groups after randomization. Rigorous expert review ensured the quality of PowerPoint presentation and mobile flashcard contents. Knowledge assessments were conducted at baseline, first, and third months using a validated and reliable questionnaire. A perception survey on learning techniques was administered after the first month. Analysis methods included descriptive analysis, Pearson's chi-square test, independent t-test, and repeated measures ANOVA with Bonferroni's post hoc test.

RESULTS

The pre- and post-intervention knowledge showed no significant differences, but the SRL group exhibited significantly higher retention at both first month (p ≤ 0.001) and third months (p ≤ 0.001) than the LBL group. Repeated measures ANOVA revealed significant pairwise differences in mean knowledge scores in SRL group. Students had significantly favorable perception toward SRL than LBL group.

CONCLUSION

SRL delivered through mobile flashcards significantly enhances knowledge retention compared to LBL among dental students. Positive student perceptions support SRL's integration into dental curricula, with implications for improving knowledge retention among them.

Students' perceptions of virtual interactive clinical case-based learning: A comparative study with three different cohorts

Background/purpose

Since the introduction of virtual learning into dental education, students' perceptions of the effectiveness of virtual versus in-person learning formats have evolved for interactive clinical case-based learning (ICCBL). This study aimed to undertake a comparative analysis of three different cohorts that received various formats of ICCBL instruction.

Materials and methods

A survey was distributed to the Classes of 2023, 2024, and 2025 following each class completion of interactive clinical case-based-tutorials (ICCBT) as part of the Treatment of Active Disease (TxAD) course at Harvard School of Dental Medicine.

Results

A total of eighty-five participants from the three cohorts, twenty-three students from the Class of 2023 (virtual format, 71.9 % participation rate), thirty-one students from the Class of 2024 (combination of virtual and in-person, 91.2 %), and thirty-one students from the Class of 2025 (in-person, 83.8 %) completed the post-course survey. Across three classes, all cohorts were more likely to perceive the virtual format as more effective than in-person ICCBT. In addition, the classes were more likely to prefer virtual based classes compared to in-person tutorials in the future.

Conclusion

This study highlights the dynamic shifts in educational approaches to align with the evolving demands of contemporary students. Our findings show that all cohorts expressed a preference for virtual ICCBT sessions and perceived virtual ICCBT sessions as somewhat more effective for learning compared to in-person sessions. These findings challenge the notion that such sessions must be conducted in person, prompting further research and the exploration of potentially more effective and optimized educational methods.

Problem-based learning curriculum disconnect on diversity, equitable representation, and inclusion

Diversity, equity, and inclusion (DEI) mission statements continue to be adopted by academic institutions in general, and by dental schools around the globe in particular. But DEI content seems to be under-developed in dental education. The objectives of this study were two-fold: to extract information from all the PBL cases at University of British Columbia's Faculty of Dentistry curriculum in terms of the diversity, equitable representation, and inclusion of patient and provider characteristics, context, and treatment outcomes; and; to compare these findings with the composition of the British Columbia census population, dental practice contextual factors, and the evidence on treatment outcomes within patient care. Information from all the 58 PBL cases was extracted between January and March 2023, focusing on patient and provider characteristics (e.g., age, gender, ethnicity), context (e.g., type of insurance), and treatment outcomes (e.g., successful/unsuccessful). This information was compared with the available literature. From all the 58 PBL cases, 0.4% included non-straight patients, while at least 4% of BC residents self-identify as non-straight; there were no cases involving First Nations patients although they make up 6% of the British Columbia population. Less than 10% of the cases involved older adults who make up almost 20% of the population. Only Treatments involving patients without a disability were 5.74 times more likely to be successful compared to those involving patients with a disability (p<0.05). The characteristics of the patients, practice context, and treatment outcomes portrayed in the existing PBL cases seem to differ from what is known about the composition of the British Columbia population, treatment outcome success, and practice context; a curriculum disconnect seems to exist. The PBL cases should be revised to better represent the population within which most students will practice.

WhatsApp as a Tool in Blended Learning in Dental Education

Background and Objective

Dental education is unique, with clinical/practical learning much different from other professionals. In dentistry, students are exposed much earlier in their curriculum to patients, performing procedures under direct/indirect supervision. Hence, the present review attempted to assess the standing position of dentistry in blended learning worldwide.

Materials and Methods

E-learning modality was at its primitive stage as food for thought among educational task force committees, with only a handful of developed and developing countries equipped with it. During this pandemic, "WhatsApp" became a savior, as it was a widely used educational device among dental teachers and students. Furthermore, it was easily applicable in places where there was difficulty in obtaining regular internet bandwidth, especially in remote/rural areas. It is noteworthy that blended learning/e-learning, when complemented with the conventional teaching method, upskill critical thinking and problem-solving capabilities. Blended learning or virtual reality education should be made feasible without disparity, worldwide. Mind training, both students and staff in hybrid e-learning, is the need of the hour not only to keep pace with digitalized dentistry but to prepare the students to face real-world situations.

Conclusion

The sustainability of dental education should be rethought by dental schools with "Complimented Digital learning" wherever feasible, not only to cope with current trends but also to face unforeseen future challenges.

The Role of Chatbot GPT Technology in Undergraduate Dental Education

This comprehensive article explores the transformative role of Chatbot GPT, based on the GPT-3 architecture, in revolutionizing dental education. The focus is on its impact across various facets, including personalized learning pathways, integration into virtual patient simulation scenarios, 24/7 accessibility, multilingual support, interactive dental dictionary functionality, evidence-based learning, and assessment and evaluation of dental students. The objective is to showcase how Chatbot GPT enhances educational experiences, promotes inclusivity, and aligns with contemporary pedagogical principles. Chatbot GPT emerges as a powerful ally in dental education, offering personalized learning experiences, risk-free clinical simulations, continuous accessibility, multilingual support, instant terminology assistance, evidence-based learning resources, and real-time assessment capabilities. Its adaptability caters to diverse learning needs, fostering a learner-centered approach and promoting lifelong learning for both dental students and practitioners. As a versatile tool, Chatbot GPT not only transforms the educational journey but also serves as a valuable asset for continuous professional development in the dynamic landscape of dentistry.

Is team-based learning an alternative approach for UK undergraduate dental education? A scoping review of the literature

Introduction Team-based learning (TBL) is a dialectic, student-focused method of teaching which has become increasingly popular in international institutions for delivering undergraduate dental education. Despite several dental schools in the UK using dialectic teaching methods, such as problem-based learning, none appear to use TBL.Aims This scoping review aims to identify the literature investigating the use of TBL compared with other teaching pedagogies in delivering undergraduate dental education.Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines were adopted. A search strategy was developed using appropriate MeSH (medical subject headings) terms and key words. Medline, Scopus and the Cochrane Databases were searched.Results Overall, five studies were identified for inclusion. Of these, three studies compared TBL to traditional, didactic teaching methods (such as lectures) and found both student satisfaction and student performance to be greater with TBL. The remaining two studies compared TBL to other dialectic methods of teaching. The results on student performance in these studies were conflicting.Conclusions There is some limited but promising evidence that TBL is effective at delivering undergraduate dental education; however, the scarcity of research evidence highlights the need for more robust exploration.

Evaluation of the attitude and knowledge level of dentistry undergraduate and specialist students towards epilepsy patients

OBJECTIVE

The objective of this research, which was carried out at a faculty of Dentistry situated in Turkey, was to assess the differences in awareness, knowledge, and attitudes about epilepsy among preclinical and clinical undergraduate students as well as speciality students. Moreover, this study seeks to ascertain the adequacy of the curriculum and clinical training provided to dental students in the context of managing patients with epilepsy. The aim is to ensure a full grasp of the subject matter and the development of practical skills.

MATERIAL-METHOD

At order to facilitate the research done at the Faculty of Dentistry at Afyonkarahisar Health Sciences University, Turkey, a comprehensive questionnaire including eight sections and a total of 60 questions was distributed to students at various stages of their dental education, including preclinical, clinical, and speciality students.

RESULT

The present study used a descriptive, cross-sectional methodology, including a total of 477 participants from various sections (preclinical, clinical, and speciality) within the Faculty of Dentistry at Afyonkarahisar Health Sciences University. When examining the overall understanding of epilepsy, a statistically significant difference was discovered across the various groups. It is noteworthy that a substantial proportion (68.4 %) of students specializing in a particular field displayed a high level of knowledge, which is in stark contrast to the percentages of clinical (40.5 %) and preclinical (29.4 %) students who exhibited similar levels of understanding.

CONCLUSION

This study conducted at a dental college in Turkey revealed a discernible gradient of knowledge, with speciality students exhibiting the greatest degree of knowledge, followed by clinical students, and subsequently preclinical students. In clinical settings, it was observed that students generally had a favorable disposition while interacting with individuals afflicted with epilepsy. Nevertheless, there was a prevailing sentiment of insufficient preparation and instruction. Hence, it is feasible to augment instructional lectures via the use of problem-based or simulation-based learning frameworks.

Evaluation of problem-based learning in dental trauma education: An observational cohort study

BACKGROUND/AIM

Problem-based learning (PBL) allows higher thinking among dental students and has improved first-time pass-rates in predoctoral pediatric dentistry education. The aim of this retrospective observational cohort study was to evaluate the impact of PBL-based, traumatic dental injuries case discussions on predoctoral dental trauma education.

MATERIALS AND METHODS

Student performance and perceptions after receiving dental trauma curriculum with or without PBL-based dental trauma case discussions were evaluated. All the students challenged their simulated patient-based assessments. Three recall-based, objective structured clinical examinations, and critical thinking competencies assessed student knowledge about management of traumatic injuries affecting primary or permanent dentition including avulsion. The scores and number of attempts for each competency were compared between the study cohorts using t-tests. Student's self-perceived learning outcomes were measured through a voluntary, five-question survey. Mantel-Haenszel ordinal Chi-square tests were used to assess for differences in rates of agreement on survey responses from the students. Linear regression was used to assess effect of training on scores adjusting for student type (predoctoral or advanced standing). Pearson's correlations were used to assess association between scores. Significance was set at 0.05.

RESULTS

For the PBL cohort, there was a significant (p > 0.05) improvement in the first-time pass-rates and scores in three out of four competencies. A higher proportion of students in the PBL cohort perceived that their dental trauma education improved their radiographic and diagnostic skills compared to the cohort that did not receive PBL (p > 0.05). There was no correlation between recall-memory versus critical thinking competencies (r < 0.5).

CONCLUSION

The PBL-based dental trauma case discussion had a positive impact on predoctoral student learning and perceived benefits while managing simulated traumatic dental injuries. Due to a lack of correlation between recall-memory and critical thinking assessments, evaluation of predoctoral student's dental trauma competencies should involve multi-model assessment.

Dental public health education in Egypt: a cross-sectional survey

BACKGROUND AND AIM

Dental Public Health (DPH) education prepares future workforce to promote positive oral health behaviors, prevent oral diseases, and monitor disease distribution and trends taking into considerations best practices, needs and available resources. Scarce information is available about dental education in African countries and Egypt has the greatest number of dental schools in Africa. This study assessed the undergraduate DPH education in Egyptian universities including topics taught, methods of teaching, assessment, and the academics' specialties.

METHODS

A survey targeted 43 Egyptian universities with Bachelor of Dentistry (BDS) programs identified on the website of the Supreme Council of Egyptian Universities in 2022. Thirty-six deans could be reached by post and/ or email. The survey appraised the school profile and capacity, and methods of teaching and assessment in DPH courses in undergraduate dental programs. The survey also inquired who taught DPH courses and what was covered in the courses. Descriptive statistics were displayed.

RESULTS

We received 21 (58.3%) responses from 36 deans/ senior officials. Of the universities, 52.4% were private and 47.6% were public. Most participants reported that DPH courses in BDS programs were taught by Pediatric Dentistry academics (71.4%) and DPH academics (57.1%) in 3rd, 4th and 5th years of the 5-year BDS programs. Teaching DPH consisted of face-to-face lectures (100%) and seminars (95.2%) and assessment included written exams with close ended questions (95.2%) and open-ended questions (71.4%). Twenty schools reported teaching the definition of DPH, definition of oral health, and determinants of oral diseases. Nine schools addressed the planning of oral health services and five schools taught about remuneration and payment systems.

CONCLUSION

Teaching and assessment of DPH in Egyptian dental schools use traditional methods with limited active engagement of the students. Variations among the schools exist in the DPH topics covered and most instructors were not primarily specialized in DPH. Development of dental/ oral health services calls for more emphasis on DPH education in the curriculum in Egypt.

A new attempt of applying hybrid team-based and case-based learning approach in dental materials science: Does it work?

INTRODUCTION

Limited studies have been conducted on the use of a hybrid team-based learning (TBL) and case-based learning (CBL) approach in dental education. The present study aims to evaluate students' experience of the hybrid TBL-CBL in learning dental materials science subjects.

METHODS

All second-year undergraduate Bachelor of Dental Surgery (BDS) students were invited to participate in a TBL-CBL session. These participants were randomly allocated to six different groups of 10-12 students, and the session was conducted by one lecturer as the facilitator. A 23-item questionnaire assessing four domains (perceptions of effectiveness, teacher, team interaction and learning environment) was administered at the end of the TBL-CBL session.

RESULTS

The response rate was 91.9% (n = 68). Mean scores for the questionnaire items ranged from 4.13 to 4.60 suggesting a positive perception among the students towards the hybrid TBL-CBL approach. Regarding the open-response questions, students emphasised that the TBL-CBL session was effective for team interaction and group discussions. However, students wished to have a better venue for future sessions.

CONCLUSION

Positive perceptions of the students encourage future educators to consider the use of TBL-CBL approach in teaching dental materials science and to avoid the reliance on standalone conventional lectures. Future research could consider examining its effects on students' academic achievement as well as the perspectives of teachers regarding its adoption in different dental specialities.

Does problem-based learning facilitate enactment of learner agency in undergraduate dental curricula? A Q study

INTRODUCTION

Addressing a literature gap on leaner agency in health profession education, this study explores students' perceptions on which aspects of a problem-based learning (PBL) environment cradle their leaner agency enactment.

METHODS

Thirty-eight students from a newly established undergraduate dental medicine programme in Qatar participated in the study. Q methodology was adopted to collect and analyse data both qualitatively and quantitatively. A 40-statement Q-set was established based on a proposed conceptual framework of learner agency in PBL, including three dimensions-intrapersonal, behavioural and environmental.

RESULTS

Q methodological factor analysis identified four significantly different student viewpoints, which underscored participants' enactment of learner agency addressing the intrapersonal, behavioural and environmental dimensions of the conceptual framework. Despite differences in opinion regarding sources of learner agency, the four student viewpoints unanimously underscore the importance of PBL facilitators' expertise to nurture and develop agency amongst undergraduate students. Post-sorting qualitative data further confirmed the quantitative analysis. Time constraints and workload were identified as the main challenges by the participants.

CONCLUSIONS

This study explored enactment of learner agency as perceived by undergraduate dental students in a PBL curriculum. The findings of this study provide new insights into participants' subjective understanding of learner agency in a PBL curriculum in dentistry. Structured support is needed for students having no prior PBL experiences to develop their learner agency at both intrapersonal and behavioural (self-regulated learning) dimensions, and to ensure they interact with their learning environment proactively.

Active learning in undergraduate classroom dental education- a scoping review

INTRODUCTION

Previous reviews on active learning in dental education have not comprehensibly summarized the research activity on this topic as they have largely focused on specific active learning strategies. This scoping review aimed to map the breadth and depth of the research activity on active learning strategies in undergraduate classroom dental education.

METHODS

The review was guided by Arksey & O'Malley's multi-step framework and followed the PRISMA Extension Scoping Reviews guidelines. MEDLINE, ERIC, EMBASE, and Scopus databases were searched from January 2005 to October 2022. Peer-reviewed, primary research articles published in English were selected. Reference lists of relevant studies were verified to improve the search. Two trained researchers independently screened titles, abstracts, and full-texts articles for eligibility and extracted the relevant data.

RESULTS

In total, 93 studies were included in the review. All studies performed outcome evaluations, including reaction evaluation alone (n = 32; 34.4%), learning evaluation alone (n = 19; 20.4%), and reaction and learning evaluations combined (n = 42; 45.1%). Most studies used quantitative approaches (n = 85; 91.3%), performed post-intervention evaluations (n = 70; 75.3%), and measured student satisfaction (n = 73; 78.5%) and knowledge acquisition (n = 61; 65.6%) using direct and indirect (self-report) measures. Only 4 studies (4.3%) reported faculty data in addition to student data. Flipped learning, group discussion, problem-based learning, and team-based learning were the active learning strategies most frequently evaluated (≥6 studies). Overall, most studies found that active learning improved satisfaction and knowledge acquisition and was superior to traditional lectures based on direct and indirect outcome measures.

CONCLUSION

Active learning has the potential to enhance student learning in undergraduate classroom dental education; however, robust process and outcome evaluation designs are needed to demonstrate its effectiveness in this educational context. Further research is warranted to evaluate the impact of active learning strategies on skill development and behavioral change in order to support the competency-based approach in dental education.

Evaluation of national dental curriculum in Iran using senior dental students' feedback

BACKGROUND

Dental curriculums require regular revision to stay up to date in scientifical and societal fields. Senior dental students are among the main stakeholders of such curriculums. The present study investigated the opinions of Iranian senior dental students regarding the adequacy of their dentistry program and the national dental curriculum in training a competent dentist, the program's content, and its structure.

METHODS

A previously designed and validated questionnaire on the opinion of senior dental students regarding curriculum adequacy was sent to a representative in each of the country's dental schools. Before the COVID pandemic terminated data collection, a total of 16 schools (438 students) managed to respond (37%). The questionnaire asked the students to assess the adequacy of the training received in curriculum's theoretical and practical competencies with the help of a five-point Likert scale that ranged from "Completely inadequate" to "Completely adequate". It also questioned them on its teaching methods and intensity. SPSS software version 24 and Chi-square test served for statistical analysis.

RESULTS

In total, the study has 438 participants, 245 female and 193 male. Significant sex differences were spotted in the responses concerning both theoretical and practical training. Regarding general training adequacy, 50 (22.6%) female students and 50 male ones (30.7%), P = 0.08 agreed that the program was acceptable. The numbers for students of old (more than 15 years of activity) and new schools were 47 (21.7%) and 53 (31.7%), respectively (P = 0.03). Nearly one-third deemed the teaching methods appropriate. Regarding the duration of curriculum phases, 33 students (8.3%) believed that basic science required extension, while 108 (28.6%) and 266 (69.1%) reported such need for pre-clinical and clinical phases. The school's years of activity emerged as significant, as 38.1% of students from new schools versus 21.7% of those from old ones deemed the extension of pre-clinical phase necessary (P < 0.001).

CONCLUSION

A significant number of Iranian senior dental students found the undergraduate dental curriculum inadequate regarding competencies, content, and teaching. Further investigations will determine whether it's the curriculum or its implementation that warrants revision.

Evaluating dental students' perspectives on the concurrent teaching of didactic and case-based courses

PURPOSE

To evaluate student perception of integrating biomedical and clinical sciences based on survey of dental students on the concurrent teaching of a didactic systems-based course and a case-based course.

METHODS

First-year to fourth-year students (DS1-DS4) students were surveyed for their experiences in concurrent teaching. Student response rate for the survey was 55% (229/420). Pearson's Chi-squared tests and Kruskal-Wallis rank sum tests were used to assess statistical significance (p < 0.05).

RESULTS

Of the students surveyed, 83% strongly agreed or agreed that concurrent teaching of the didactic and case-based courses helped them better understand the biomedical science background and the clinical ramifications (p < 0.001). On average, 75% percent strongly agreed or agreed that concurrent teaching kept them engaged, motivated, think critically, apply the course content and prepare for clinical practice (p < 0.001). Of the students surveyed, 69% support expanding concurrent teaching to all four years (p < 0.001). Mean responses from DS1 and DS4 students differed for questions relating to understanding of biomedical sciences, critical thinking and application to clinic (p < 0.01). Qualitative data showed that students enjoyed the reinforcement of concepts and application to clinical scenarios.

CONCLUSIONS

Concurrent teaching of didactic and case-based learning courses, thus showing clinical relevance of biomedical sciences in the first year of dental curriculum, is perceived by students as an effective method of educating dental students. Such integrative learning process with horizontal and vertical integration and concurrent curriculum is even more relevant with the implementation of the integrated national board dental examination.

Distance learning course improves primary care dentists' diagnosis and self-efficacy in the management of oral lesions

Oral cancer represents a public health issue because of its high mortality rate, resulting mainly from diagnostic delays. Insufficient training in oral diagnosis is usually perceived by dentists. Distance learning could be used as an auxiliary tool to bridge that gap. This study evaluated the impact of a distance learning course on oral mucosal lesion diagnosis offered to public healthcare dentists. Participants of an online course answered a pretest/posttest comprising clinical images of 30 clinical cases. Participants were questioned about the diagnosis and informed their decision on the cases (referring the cases to a specialist or managing them themselves), as a parameter of perceived self-efficacy. A total of 442 dentists enrolled in the course. Their pass rate was 97%. Classification of the nature of the lesions, diagnostic hypotheses, sensitivity, and specificity improved by 13.4%, 10.0%, 13.4%, and 6.6%, respectively (p<0.01, Wilcoxon test). Regarding management, there was a 16.6% reduction in the intention to refer cases, while confidence in the diagnosis of benign lesions increased by 40%. A distance learning course may be useful in continuing education actions for primary care dentists, improving their diagnostic abilities and encouraging them in the management of oral lesions. Moreover, this strategy could contribute to disseminating knowledge to remote regions, particularly among primary health care professionals.

Effects of Problem-Based Learning on the Problem-Solving Ability and Self-Efficacy of Students Majoring in Dental Hygiene

This study developed a problem-based learning (PBL) module to improve integrated thinking and problem-solving ability in students of dental hygiene. After applying PBL, the study tested the improvement in the problem-solving ability and self-efficacy of students. The subjects were 31 fourth-year students of the Department of Dental Hygiene at G University. The PBL process was applied to three topics for 15 weeks, and the tools for evaluating problem-solving ability and self-efficacy were reconstructed and used before and after the application to examine the effects of the module. The result indicates that the mean of problem-solving ability (32 detailed items) increased from 3.37 to 3.65 (an increase of 0.28) after classes (p < 0.001). Alternatively, the average for self-efficacy (22 detailed questions) increased from 0.21 to 2.89 (p < 0.05; an increase of 2.67). The study also confirmed the correlation between problem-solving ability and the total posttest score for self-efficacy (p < 0.001). Thus, the problem-solving ability and self-efficacy of learners were improved in the class to which PBL was applied. These improvements exerted a significant effect on the improvement of problem-solving ability. This finding confirmed the effect of the PBL method on dental hygiene education.

Knowledge about oral manifestations of systemic diseases among medical and dental students from Jordan: An interdisciplinary educational gap

OBJECTIVE

To assess the ability of medical students to recognize oral manifestation of selected systemic diseases and compare their performance with dental students.

MATERIALS AND METHODS

A total of 400 senior medical and dental students were approached to participate. The study protocol involved two parts; a self-administered survey and a direct interview involving clinical photographs for oral signs of systemic diseases.

RESULTS

A total of 283 (70.8%) agreed to participate and completed the two- part study. The study population was made of 110 (38.9%) [82 females and 28 males] dental students, and 173(61.1%) [98 females and 75 males] medical students. The knowledge score regarding questions about the normal mouth and oral structures was 15.7 ± 6 out of 22. Dental students had a significantly higher knowledge score about normal mouth and oral structures (20.9 ± 4; range from 17 to 22) compared to medical students (10.6 ± 7; range from 4 to 21) (p = .029). The knowledge score regarding questions about oral manifestations of systemic diseases was 26.8 ± 6 out of 40. Dental students had a significantly higher knowledge score about oral manifestations of systemic diseases (30.8 ± 7; range from 15 to 37) compared to medical students (22.9 ± 4; range from 10 to 36) (p = .031). Only 24.3% (n = 42) medical students reported having adequate training to be able to distinguish between normal mouth and diseases. Nearly all medical students (91.3%; n = 158) felt that it is important to have more formal training in oral examination and disease diagnosis.

CONCLUSION

Medical students lack adequate knowledge, diagnostic ability, and confidence with regard to diagnosis of oral signs of systemic diseases. To ensure that medical students have necessary skills in assessing oral diseases, curricula revisions and modifications are required, and specific oral health-related learning outcomes should be introduced and reinforced through clinical training.

Special Teaching Formats during the COVID-19 Pandemic-A Survey with Implications for a Crisis-Proof Education

Modern teaching formats have not been considered necessary during the COVID-19 pandemic with uncertain acceptance by students. The study’s aim was to describe and evaluate all measures undertaken for theoretical and practical knowledge/skill transfer, which included objective structured practical examinations (OSPEs) covering a communication skills training. The students’ performance in the OSPE as well as the theoretical knowledge level were assessed, of which the latter was compared with previous terms. In conservative dentistry and periodontology (4th and 5th year courses), theoretical teaching formats were provided online and completed by a multiple-choice test. Practical education continued without patients in small groups using the phantom-head, 3D printed teeth, and objective structured practical examinations (OSPEs) including communication skills training. Formats were evaluated by a questionnaire. The organization was rated as very good/good (88.6%), besides poor Internet connection (22.8%) and Zoom^® (14.2%) causing problems. Lectures with audio were best approved (1.48), followed by practical videos (1.54), live stream lectures (1.81), treatment checklists (1.81), and virtual problem-based learning (2.1). Lectures such as .pdf files without audio, articles, or scripts were rated worse (2.15–2.30). Phantom-heads were considered the best substitute for patient treatment (59.5%), while additional methodical efforts for more realistic settings led to increased appraisal. However, students performed significantly worse in the multiple-choice test compared to the previous terms (p < 0.0001) and the OSPEs revealed deficits in the students’ communication skills. In the future, permanent available lectures with audio and efforts toward realistic treatment settings in the case of suspended patient treatment will be pursued.

Effectiveness of Problem-Based Learning versus Traditional Teaching Methods in Improving Acquisition of Radiographic Interpretation Skills among Dental Students-A Systematic Review and Meta-Analysis

Problem-based learning is an experiential and student-centred learning method to practice important skills like querying, critical thinking, and collaboration through pair and group work. The study is aimed at comparing the effectiveness of problem-based learning (PBL) and traditional teaching (TT) methods in improving acquisition of radiographic interpretation skills among dental students. Clinical trials (randomized and nonrandomized) were conducted with the help of dental students studying oral radiology using PBL and TT methods and assessing radiographic interpretation skills, knowledge scores, and satisfaction level as outcomes. Articles published from PubMed/MEDLINE, DOAJ, Cochrane Central Register of Controlled Trials, and Web of Science were searched. The quality of the studies was evaluated using the Cochrane Collaboration Tool, the MINORS Checklist, and the Risk of Bias in Nonrandomized Studies of Interventions (ROBIN-I) tool. Meta-analysis was done using Review Manager 5.3. There were twenty-four articles for qualitative synthesis and 13 for meta-analysis. The cumulative mean difference was found to be 0.54 (0.18, 0.90), 4.15 (-0.35, 8.65), and -0.14 (-0.36, 0.08) for radiographic interpretation skills, knowledge scores, and satisfaction level, respectively, showing significant difference favouring PBL as compared to TT except for satisfaction level which favoured the TT group. To understand the long-term effectiveness of PBL over TT methods in oral radiology among dental students, well-designed long-term randomized controlled trials are needed.

Perception and outcomes after implementation of problem-based learning in predoctoral pediatric dentistry clinical education

PURPOSE

Problem-based learning (PBL) has been a useful addition to health-based curricula by supporting learning with contributory discussion, research, and critical analysis of evidence in a peer-supported learning format. The aim of this study was to determine the impact of PBL on pediatric dentistry clinical education.

METHODS

First-time pass-rates in clinical and objective structured clinical examinations were measured in student cohorts receiving pediatric curricular formats with (PBL+) or without a PBL (PBL-) experience. Student perceived learning outcomes were measured through a voluntary survey. The numbers of each competency attempt were compared between the study groups (PBL+ or PBL-) using Wilcoxon Rank-Sum tests or Fisher's exact tests. Mantel-Hanzel ordinal chi-square tested for differences in rates of agreement on survey responses from students in the PBL+ or PBL- groups. Significance was set at 0.05.

RESULTS

There was a significant improvement in the first-time pass-rates in five of seven competencies in the PBL+ group. A significantly higher proportion of students in the PBL+ group perceived that their predoctoral pediatric dentistry rotation improved their diagnostic skills compared to the students in the PBL- group (p < 0.001). However, there was no significant difference (p > 0.05) between the perceptions on satisfaction of clinical or non-clinical staff support, perceived self-improvement in radiographic or clinical skills or overall benefits of the predoctoral pediatric dentistry rotation.

CONCLUSION

The addition of a PBL component to a traditional curricular format in a pediatric dentistry clinical rotation had a positive impact on learning in a predoctoral dental program.

An observational study of learning effects of peer-assisted learning tests in COVID-19 pandemic times

Purpose

This study aimed to determine whether peer‐assisted learning (PAL) is a more effective learning and test method in terms of oral‐ and maxillofacial surgery.

Material and methods

In July 2020, a total of 267 students took a PAL‐based exam on fictional patients with surgical issues, in which they had to evaluate two fellow students and were themselves evaluated by two fellow students. The students evaluated their experience with the PAL‐based exam through a questionnaire which consisted of five given statements (answer possibilities: agree, disagree, neutral) and two questions (answer possibilities: better, equal, worse) to rate.

Results

In the survey, 77.9% of the students rated PAL as a better learning method and 21% rated it as at least equally effective to the known multiple‐choice (MC) test. A total of 74.9% of the students indicated that they learned more content with PAL and 20.2% said they learned the same amount; 83.7% said that their “clinical thinking has improved” through PAL. In the comments, 73% of the students noted that they think PAL is a good learning method, and at least 22% rated it as useful but in need of improvements. Only 5% did not see PAL as an acceptable learning method. In contrast to this, 1.3% saw PAL as a “bad alternative to MC tests.”

Conclusion

PAL, especially peer assessment, might represent a better learning method as it might encourage students to deal more intensively with the learning content and to improve clinical thinking.

Influence of dental college funding and time established on the satisfaction of dental graduates with their undergraduate experience in Saudi Arabia

OBJECTIVE

With the emergence of graduates from all government and private-funded dental colleges in Saudi Arabia (SA), it is pressing to explore the graduates' satisfaction with the dental undergraduate education and training they received. The aim of the present study was to investigate the graduates' satisfaction with their education and training according to college funding arrangements (government vs private-funded) and time since establishment (established- >15 years vs new-<15 years).

METHODS

A piloted, electronic questionnaire was emailed to all the members of the Saudi Dental Society who had graduated from government and and private dental colleges in SA (2,185 registrants).

RESULTS

The response rate was 36.4%, with 580 government-funded college graduates (72.9%) and 216 private college graduates (27.1%) having completed and returned the questionnaire. The distribution of participants between established and new colleges was 'established' 396 (49.8%) and 'new' 400 (50.2%). Levels of dissatisfaction were recorded for graduates from established and new, government-funded and private colleges. The levels of dissatisfaction were greater amongst the graduates of established and government-funded colleges.

CONCLUSION

The findings of the present study indicate concerning levels of dissatisfaction with important aspects of dental education in SA. It is suggested that there is a pressing need for more integration of basic and clinical sciences and an emphasis on hands-on training. National coordination of arrangements for dental curricula could make a major contribution to addressing the problems identified.

A nationwide survey assessing the satisfaction of dental colleges graduates with their undergraduate experience in Saudi Arabia

OBJECTIVE

To date, there are no publications on the Saudi graduates' perceived value of their dental curriculum. The aim of this nation-wide survey was to investigate graduates' satisfaction with specific disciplines of their dental education and training. The first part of this study addressed findings according to the respondents' gender and the number of years of postgraduate experience (Graduate-related factors).

METHODS

An electronic questionnaire was emailed to registrants of the Saudi Dental Society, specifically dental interns, general dentists, and specialized dentists who graduated from private and governmental dental colleges in Saudi Arabia (n = 2185).

RESULTS

The response rate was 36.4 %. The number of male respondents was (n = 352, 44.2 %), the remainder being female (n = 444, 55.8 %). The number of recent dentists (≤ 5 years since graduation) was (n = 428, 53.8 %) and experienced dentists (n = 368, 46.2 %). There were statistically significant gender variations in satisfaction levels, and among dentists with different post-graduation experiences. Although male and female dental students are taught similar curriculums and have similar graduation requirements, there were statistically significant differences in various subjects covered. Similarly, recent and experienced dentists reported statistically significant differences in satisfaction in various subjects.

CONCLUSION

This study provides graduates' perspectives on the strengths and weaknesses of their dental education in Saudi Arabia. The findings help in curriculum reform and collaborations between the dental colleges nationally. Ultimately this can lead to formulating a national dental accreditation and assessment body.

CLINICAL SIGNIFICANCE

The findings of this study provide graduates' perspective on the dental education received in Saudi Arabia. This will help stimulate discussion and collaboration within and amongst the colleges on improving their curriculum in this fast-paced, evolving field of dentistry.

Students' views on the sustained impact of a learning approach developed by blending pedagogy to prepare for professional practice: Introducing "Daybook"

INTRODUCTION

Daybook is an enquiry-based teaching and learning approach that blends various adult learning theories. It is designed to equip and prepare a new graduate to do a designated job in the workplace. It supports the safe beginner to undertake high-level thinking that permits adaptation to unfamiliar challenges of the job, as well as use of continuous learning strategies to do the job better. Its aim is to support four main pedagogic pillars of learning: preparing for practice, educating for employability, enhancing capability over competence and lifelong learning.

METHODS

A study using three successive student cohorts evaluated the perceived sustained impact of Daybook on learners' clinical practice following graduation and entry into the workplace. Using a questionnaire with open-ended, opinion and closed questions, descriptive quantitative analysis was used on numerical data, and qualitative data underwent a deductive thematic analysis.

RESULTS

Quantitative and qualitative results supported one another to identify that the four pedagogic pillars of learning were all impacted positively by use of Daybook. Enhancing capability was the most influenced area. Each of the four areas, although discrete academic entities, demonstrated overlap and commonality.

CONCLUSIONS

Although an academic exercise, Daybook is perceived to support users' undergraduate learning across the four domains of educating for employability, preparing for practice, enhancing capability and lifelong learning, and this impact sustains through the transition from student to independent practitioner when they qualify.

Exploration of constructive feedback practices in dental education chairside teaching: A case study

BACKGROUND

Chairside teaching is one of the teaching-learning methods in clinical dental education in which direct care is provided to patients. When students have been deemed competent in carrying out procedures on a dental phantom, they need clinical experience on patients, with guidance and constructive feedback from clinical teachers. Constructive feedback is an important learning platform in helping students analyse the strong and the weak aspects of their performance in order to identify required improvements. This study aimed to explore the practice of giving constructive feedback in chairside teaching.

METHOD

A qualitative method with a case study design. Data were collected through in-depth interviews and focus group discussions (FGDs) with clinical teachers and students in clinical rotation. Data triangulation was carried out by observing the practice of giving constructive feedback in chairside teaching and document analysis from January to April 2019. Results of the in-depth interviews and FGDs were transcribed verbatim and analysed using a thematic analysis approach.

RESULT

In-depth interviews with five programme coordinators and FGDs with two groups of clinical teachers (N = 8 and N = 6) and two clinical student groups (N = 8 each). Three main themes emerged in this study: ways to provide feedback, challenges on feedback provision and challenges on feedback follow-up.

CONCLUSION

Differences in perception between clinical teachers and students were identified, influenced by students' interactions with the learning environment. Interventions are to be encouraged that involve teachers, students and institutions, and the interactions amongst the three.

Development of e-portfolio in undergraduate clinical dentistry: How trainees select and reflect on evidence

INTRODUCTION

Self-reflection is a fundamental part of health professional development, especially in the unstructured clinical stage of dentistry, medical and health profession education, since it plays important role in experiential learning. A portfolio-both conventional and digital-records various aspects of knowledge, skills and attitudes over a long period of time to help students develop their professionalism by conducting self-reflection. This study aims to explore the process of selecting and reflecting on professionalism evidence recorded in e-portfolios during undergraduate clinical dentistry training.

METHOD

This pilot study is a qualitative study with a phenomenological design. The selection of respondents was conducted using a maximum variety sampling method. Following a 6-week pilot programme, a total of six in-depth interviews and five focus group discussions were conducted with undergraduate students representing different clinical rotations to explore the process conducted by undergraduate clinical dentistry students in e-portfolio development. The study of documents was also conducted on the respondents' reflective writing from the e-portfolio back-end data to explore their self-reflection skills.

RESULT

The results of the present study highlighted two different approaches used amongst trainees in developing a reflective e-portfolio: selective and non-selective. The observed reflective e-portfolio utilisation frequency and trainees' self-reflection skills were low, with several affecting factors identified. These identified factors consisted of external factors, such as the undergraduate clinical dentistry programme curriculum, the hidden curriculum, the availability of feedback, the availability of role models, and features of the e-portfolio and internal factors, such as understanding the self-reflection concept, the availability of time and mood, cultural factors, and understanding the content reflected.

CONCLUSION

Through the process of independently selecting and recording learning activities in e-portfolios as well as repeatedly conducting self-reflection, trainees can improve their overall reflective abilities. However, producing a systematic approach to forming a reflective learning environment is necessary to aid the implementation of reflective e-portfolios, especially at the early stage of e-portfolio implementation.

Introducing career skills for dental students as an undergraduate course at the University of Szeged, Hungary

BACKGROUND

In the last three decades there is a growing recognition in the dental profession that dental education must go beyond teaching the technicalities of dentistry and include professionalism and communication skills that the future dentist may need. Such skills are best taught in a student-centered way. Literature suggests that student-centered elements are difficult to introduce in traditional, teacher-centered curricula. This is especially true in post-communist countries where higher education was under strict state control for decades. The aim of the piece of research presented here was to investigate how difficult it is to introduce a student-centered career skills course in a traditionally teacher-centered dental curriculum.

METHODS

Considering the needs of our final-year dental students and Super's model of career development, we created an undergraduate curricular career skills course running for two semesters in two languages (Hungarian and English). The primary aim of the course is to help students with their career expectations and develop their identity as a professional workforce. The secondary aim is to teach skills that students can use when applying for a job. At the end of the semesters, we assessed our students' satisfaction with various aspects of the course by using a questionnaire. Results were analyzed item-wise and according to the main aspects of the course (i.e., groups of items organized around a particular aspect).

RESULTS

General satisfaction with the course was high, and practical skills training (such as CV and motivation letter writing) got the highest scores. From the answers it appears that the students were the least comfortable with having to deal with their personal values and preferences.

CONCLUSIONS

While it is common for universities to offer various forms of career intervention, to our knowledge, no other university offers a curricular career skills course specifically for dental students. Our student-centered course designed in a problem-based learning framework worked even in a traditionally teacher-centered educational environment, where university students are rarely encouraged to be active participants in courses. By sharing our experience, we would like to encourage our fellow dental educators working in similar environments to devise and offer such courses.

Raising awareness about microbial antibiotic resistance in undergraduate dental students: a research-based strategy for teaching non-laboratory elements of a microbiology curriculum

BACKGROUND

Resistance to antimicrobial agents has become a problem in modern society. Antibiotic resistant bacteria undermine the prevention and treatment of infections. Undergraduate dental students in Europe are required to receive information in aspects of microbiology relevant for dental practice, including oral microbial pathogens and resistance mechanisms against antimicrobial compounds. The objective of this study was to implement a research-based strategy to aid the understanding of the increase in antimicrobial resistance in undergraduate dental student training. The primary outcome of this project is the efficacious delivery of the learning objectives.

METHODS

Ten volunteer undergraduate student "ambassadors" were recruited to manage the project with assistance from lead academics. Student ambassadors were a source of peer learning for their colleagues. The project consisted of three phases: Pre-project preparation (in which the ambassadors received special instruction and training); Practical experience (in which the ambassadors worked with volunteer student colleagues to carry out the project); Public presentation of results (in which ambassadors presented study results at a scientific conference of their choosing).

RESULTS

A total of 1164 students volunteered for the project, corresponding to an average participation rate of 76.4% students per year of the course. Following final debriefing, student participants and ambassadors were strongly positive in their evaluation of the achievement of 8 key student learning objectives. The results demonstrate that most volunteers improved their knowledge related to antimicrobial resistance mechanisms in microbiology. Additional benefits of participation in this project included an improvement in dental knowledge and ethics in biomedical research for the student volunteers, whilst the student ambassadors reported improved knowledge about critical thinking and study design, as well as a deeper understanding about microbiological analysis methods.

CONCLUSIONS

To the best of our knowledge, this the first instance of the application of project-based methodologies to the teaching of a traditionally non-laboratory component of a subject taught in the dentistry curriculum. Results from both students and ambassadors highlighted the increase in dental knowledge and an increased awareness of antimicrobial resistance as the key outcomes of this project.

Enhancing Dental Carving Skills of Preclinical Dental Hygiene Students Using Online Dental Anatomy Resources

Background:

A key role of dental carving is enhancing manual proficiency and dexterity of dental hygiene students. Yet, utilizing Supplementary Online Dental Anatomy Resources (SODAR) as a supportive teaching approach has demonstrated the ability to improve carving skills.

Objective:

This study aims to examine the effectiveness of SODAR training in improving the quality of dental carving skills and knowledge among preclinical Saudi male students in Saudi Arabia.

Methods:

A basic double-blinded randomized controlled trial of 30 preclinical Saudi dental male students was conducted between January and April 2019. Participants were classified into an experimental group that received SODAR training (n= 15) and a control group comprising students who did not receive SODAR training (n= 15). Thet-test and Fisher’s exact test were performed to assess differences in theoretical knowledge between the two groups. While Cohen’s d test,t-test, and Pearson correlation were conducted to evaluate differences in students’ dental carvings.

Results:

Students with SODAR training performed better on practical carving sessions than those without intervention (P-value < 0.001). However, SODAR intervention had no significant effect on the theoretical knowledge evaluations in both the groups.

Conclusion:

SODAR training demonstrated its ability to support students learning in practical carving sessions; however, no effect on theoretical knowledge was observed. Future research should focus on factors that impact carving teaching strategies, including the quality and depth of online learning content, students’ perceptions of online learning, and experiences of teachers who run the online resources.

Innovative Trends in Implant Dentistry Training and Education: A Narrative Review

BACKGROUND

The field of implant dentistry education is rapidly evolving as new technologies permit innovative methods to teach the fundamentals of implant dentistry.

METHODS

Literature from the fields of active learning, blended learning, augmented reality, artificial intelligence, haptics, and mixed reality were reviewed and combined with the experience and opinions of expert authors. Both positive and negative aspects of the learning methods are presented.

RESULTS AND CONCLUSION

The fundamental objectives of teaching and learning remain unchanged, yet the opportunities to reach larger audiences and integrate their learning into active experiences are evolving due to the introduction of new teaching and learning methodologies. The ability to reach a global audience has never been more apparent. Nevertheless, as much as new technology can be alluring, each new method comes with unique limitations.

Impact of a diagnostic workshop on undergraduate teaching-learning process for the diagnosis and management of tooth restorations-A randomised controlled study

OBJECTIVE

The aim of this study was to investigate the impact of a diagnostic workshop on undergraduate teaching-learning process for the diagnosis and management of tooth restorations.

METHODS

The first stage of the study was a randomised controlled study with two parallel groups: lecture (L) and lecture coupled with a diagnostic workshop (LW). A pool of cases of tooth restorations including secondary caries and marginal defects was used for training. Theoretical knowledge, perception about the activity and practical abilities were evaluated. The second stage of the study assessed students' theoretical knowledge retention six months following intervention. All students included in the first stage of the study were exposed to LW. Hence, a new control group of students not exposed to LW was selected. One-way analysis of variance, Fisher's exact test, Kruskal-Wallis test and multilevel regression analysis were used as part of statistical analysis.

RESULTS

The LW group had greater scores for the assignment of lesion severity and activity, presence of marginal defect and treatment indication than the L group (P < 0.05). Multilevel regression analysis showed a positive impact of the workshop diagnosis in the correct assessment of lesion activity (P = 0.03). There was no statistical difference between the LW and L groups in students' perception of the activity. The LW group showed greater knowledge retention after six months than the L group (P = 0.027).

CONCLUSION

Lecture coupled with diagnostic workshop improved students' practical skills of diagnosis restorations and knowledge retention in the six months following intervention.

Students' self-assessment of competencies in the phantom course of operative dentistry

INTRODUCTION

The aim was to assess the competencies of undergraduate students in their roles of dental expert, scholar, communicator, collaborator, health advocate, manager and professional.

MATERIALS AND METHODS

For this retrospective, pseudonymised observational study (pre-/post-testing), students in two cohorts in their first clinical semester in operative dentistry were asked to judge their competencies (1 = very good to 6 = insufficient) with a learning objective catalogue designed at the Goethe University Frankfurt (modelled after the National Competency-Based Learning Objective Catalogue Dentistry), at the beginning and end of their phantom course. In order to relate the students' subjective competency judgements to objective evidence of their skills, at the end of the semester their marks from the summative Objective Structured Practical Examination (OSPE) were compared with the subjective judgement of their exam performance before the final results were known.

RESULTS

The reliability of the evaluation sheet was evaluated with Cronbach's alpha 0.98. The students judged their competencies as "sufficient" (4.23 ± 0.51) at the beginning and "satisfactory" (2.82 ± 0.43) at the end. A significant improvement in competencies was observed within all roles. The students' subjective judgement of the exam results (3.66 ± 0.62) was significantly correlated with the actual marks (3.69 ± 0.83) in the OSPE at 0.3547 (P = 0.0015).

CONCLUSION

The evaluation instrument showed excellent reliability. The students judged that their competencies significantly increased during the semester. The triangulation with the actual marks in the context of an OSPE demonstrated a significant correlation with the students' exam judgements.

The effectiveness of problem-based learning in pediatric medical education in China: A meta-analysis of randomized controlled trials

BACKGROUND

The aim of this meta-analysis is to assess the effectiveness of problem-based learning (PBL) in pediatric medical education in China.

METHODS

We searched Chinese electronic databases, including the China National Knowledge Infrastructure, WanFang Data, the China Science Periodical Database, and the Chinese BioMedical Literature Database. We also searched English electronic databases, including PubMed, Embase, and the Cochrane Central Register of Controlled Trials. We searched for published studies that compared the effects of PBL and traditional lecture-based learning (LBL) on students' theoretical knowledge, skill, and case analysis scores during pediatric medical education in China. All randomized controlled trials (RCTs) were included.

RESULTS

A total of 12 RCTs were included, with a total sample size of 1003 medical students. The PBL teaching model significantly increased theoretical knowledge scores (95% confidence interval [CI], 0.79-1.52; P < .00001), skill scores (95% CI, 0.87-2.25; P < .00001), and case analysis scores (P < .00001, I = 88%) compared with those using the LBL teaching model alone.

CONCLUSION

The current meta-analysis shows that PBL in pediatric medical education in China appears to be more effective than the traditional teaching method in improving theoretical knowledge, skill, and case analysis scores. However, a more controlled design of RCT is needed to confirm the above conclusions in future work.

Effectiveness of PBL methodology in a hybrid dentistry program to enhance students' knowledge and confidence. (a pilot study)

BACKGROUND

Knowledge and self-confidence are two critical determinants of future success of dental students. The present pilot study was conducted with an objective to simultaneously assess both knowledge and confidence gained by dental undergraduate students in the Head and Neck Anatomy course by employing didactic lecture-based and problem-based learning methods.

METHODS

A paper-based assessment tool comprising of 30 Multiple choice questions to assess knowledge, followed by a Likert's scale to assess students' confidence to answer the given knowledge question was designed. This tool was used in a cohort of first year dental students before the commencement of Head and Neck Anatomy course (Pre-course), immediately after the completion of Head and Neck Anatomy course (Post-course), and again in third year before the same cohort entered their clinical courses (Pre-clinics). The difference in students' knowledge and confidence through both pedagogies was evaluated by Paired 't' test. Pearson correlation analysis was done to determine the correlation between knowledge scores and self-reported confidence.

RESULTS

A statistically significant increase (p < 0.05) was noted in the mean knowledge and confidence scores in the post-course evaluation, through both didactic lecture-based and problem-based learning methods. On the other hand, a significant decrease (p < 0.05) in the mean knowledge and confidence scores of didactic lecture-based items in comparison to problem-based items was noted in the pre-clinics evaluation.. The post-course evaluation results yielded a Pearson correlation coefficient of r = 0.514, p = 0.002 for lecture-based items and r = 0.495, p = 0.003 for problem-based items, denoting a positive moderate correlation between the knowledge and confidence scores for both lecture-based and problem-based methods.

CONCLUSION

A significant improvement in both knowledge and self-reported confidence demonstrated at the end of Head and Neck Anatomy course proves both didactic lectures and problem-based learning methods to be equally effective in a hybrid dentistry program in the short term. However, the non-significant reduction in the pre-clinics knowledge and confidence scores among the PBL lessons proves it to be a potent learning tool for long term retention of knowledge, and sustainability of confidence.

Integrating student feedback during "Dental Curriculum Hack-A-thon"

BACKGROUND

The future of dental education is at crossroads. This study used the parameter of the 2016 Dental Curriculum Hack-a-Thon to assess intra- and inter-institutional agreement between student and faculty views regarding dental curriculums to determine if there is an impact in student perceptions towards dental education from before and after the event.

METHODS

This exploratory, cross-sectional study involved two surveys, with Survey 1 being distributed among four faculty-student pairs of the four participating dental schools answering 14 questions. Survey 2 assessed the views of 20 participating dental students through 26 questions in a pre- and post- event survey design. Descriptive statistics were used to explore differences in perceptions towards dental education across both instrument surveys.

RESULTS

The results revealed valuable student insights regarding intra- and inter-institutional agreement relevant for the change in dental curriculum that needs to occur. Survey 2 revealed that mandatory attendance in didactic courses, electronic based examination preferences, and the preference of preclinical courses being held in the first and second years of a four-year dental curriculum were of particular importance to student participants.

CONCLUSIONS

The results of this study indicate that exposure and participation in subjects pertaining to dental education can be influential on student preferences and opinions on how dental education should be delivered in a four-year curriculum.

Dental Students' Perceived Clinical Competence in Prosthodontics: Comparison of Traditional and Problem-Based Learning Methodologies

The aim of this study was to compare the perceived competence for treating prosthodontic patients of two samples of fourth-year dental students: those educated using traditional methodologies and those educated using problem-based learning (PBL). Two cohorts of fourth-year dental students at a dental school in Spain were surveyed: the traditional methods cohort (n=46) was comprised of all students in academic years 2012 and 2013, and the PBL cohort (n=57) was comprised of all students in academic years 2014 and 2015. Students in both cohorts reported the number of prosthodontic treatments they carried out per year and their perceived level of competence in performing such treatments. The results showed that the average number of treatments performed was similar for the two cohorts, except the number of metal-based removable partial dentures was significantly higher for students in the traditional (0.8±1.0) than the PBL (0.4±0.6) cohort. The level of perceived competence to treat complete denture patients for the combined cohorts was significantly higher (7.3±1.1) than that for partial acrylic dentures (6.7±1.5) and combined dentures (5.7±1.3). Students' clinical competence in prosthodontics mainly depended on number of treatments performed as the operator as well as the assistant. Students in the traditional methods cohort considered themselves to be significantly more competent at treating patients for removable partial and fixed prostheses (7.8±1.1 and 7.6±1.1, respectively) than did students in the PBL cohort (6.4±1.5 and 6.6±1.5, respectively). Overall, however, the study found that practical experiences were more important than the teaching method used to achieve students' perceived competence.

Attitudes Towards Problem-Based Learning of Faculty Members at 12 U.S. Medical and Dental Schools: A Comparative Study

Problem-based learning (PBL) is a teaching method used in medical and dental education to promote students' problem-solving skills. It may also be a viable tool for interprofessional education in which medical and dental students learn together, collaborate, and learn about, from, and with each other. The aim of this study was to compare medical and dental faculty members' attitudes about and perceptions of PBL at 12 U.S. medical and dental schools known to use PBL. In 2015, 111 medical and 132 dental faculty members (combined n=243) from six medical and six dental schools completed a survey containing ten statements and an open comment section. The response rate was 42% of those who received the survey. In the results, the medical faculty participants showed significantly higher enthusiasm for and agreement with PBL benefits than did the dental faculty participants (p˂0.05). The two groups agreed that PBL should be used to supplement conventional teaching (p>0.05). There were no opposite attitudes or contrasts found between the two groups with regards to PBL. The strongest themes expressed by both groups were that PBL should not be used as the sole method of instruction and that students needed a solid foundation in the subject prior to engaging in PBL.

An innovative addition to team-based-learning pedagogy to enhance teaching and learning: Students' perceptions of team exams

BACKGROUND AND PURPOSE

The study investigates students' perceptions of the value of implementing a team exam to enhance learning prior to a summative assessment. Team exams are similar to midterm exams, except that answering questions is a team effort.

EDUCATIONAL ACTIVITY AND SETTING

Data was collected from second year pharmacy students at California Northstate University College of Pharmacy (CNUCOP) through a self-administered online survey. The survey questions included closed-ended questions to evaluate students' perception on preparedness for a summative assessment and to rank advantages and disadvantages of the team exams.

FINDINGS

Of the 40 students who completed the survey (38% response rate), 100% of participants agreed that having a team exam prior to a major exam made them feel more prepared for a major summative exam. Ninety-seven percent of students believed that the team exam helped them to identify gaps in their knowledge and 85% agreed that taking a team exam reinforced their knowledge by teaching other students. The survey results did not identify any major disadvantages to holding a team exam.

SUMMARY

Students perceived that taking a team exam prior to a midterm exam is an effective approach to review the course contents and identify areas of improvement.