Introduction of e-learning in dental radiology reveals significantly improved results in final examination

Effectiveness of Online Interactive Education in Dental Radiology

OBJECTIVE

This study aimed to assess the effectiveness of an interactive education approach in oral and maxillofacial radiology for dentists, utilizing the online interactive educational program Mentimeter.

METHOD

Seven continuing education sessions for dentists in oral and maxillofacial radiology were conducted employing Mentimeter. Following these sessions, surveys gauged participants' responses to the learning method and its effectiveness. The questionnaire comprised 20 questions categorized into convenience, active learning, academic achievement, time management, and lecture quality.

RESULT

Among about 300 participants, 222 responded to the survey, with 74 (33.3%) having prior experience in similar education. Across categories of active learning, academic achievement, and lecture quality, participants consistently rated the method with an average score exceeding 4 out of 5, indicating a highly positive response. Statistically significant gender differences were observed in 9 out of 20 questions, with female respondents providing more positive evaluations than males. Respondents without prior similar education reported enhanced focus and understanding compared to those with experience. No statistically significant differences were observed in other survey questions.

CONCLUSION

In the realm of continuing education in oral and maxillofacial radiology for dentists, the interactive educational program Mentimeter emerges as an effective tool, fostering positive academic achievements through active learning.

Is online-only learning as effective as blended learning? A longitudinal study comparing undergraduate students' performance in oral radiology

INTRODUCTION

Blended learning seems to be an effective teaching concept in oral radiology. During the COVID-19 pandemic, blended learning shifted towards online-only learning. The aim of the present study was to compare the effectiveness of pandemic online-only and pre-pandemic blended learning in three consecutive oral radiology courses (C1, C2 and C3) and to examine whether additional video-based e-learning modules (VBLMs) had a positive impact on undergraduate students' performance during pandemic semesters.

MATERIALS AND METHODS

Data from 205 undergraduate dental students participating either in a blended learning or an online-only learning concept were analysed. Pre-pandemic blended learning comprised face-to-face seminars and access to an oral radiology platform (ORP). Pandemic online-only learning comprised online seminars, access to the ORP and additional VBLMs (two VBLMs for C1, four VBLMs for C2 and six VBLMs for C3). Through standardised e-exams at the beginning and end of each semester, performance in final exams and knowledge gain were compared between the two groups.

RESULTS

No significant differences in scores in final exams (p = .11) and knowledge gain (p = .18) were found when comparing the pre-pandemic and pandemic groups. On course level, however, students receiving a lower number of VBLMs performed significantly worse in final exams (C1: p < .01, C2: p = .02) and showed inferior knowledge gain (C2: p < .01) during the pandemic.

CONCLUSIONS

Within the limitations of the study, the present investigation confirmed that pandemic online-only learning involving VBLMs might be as effective as pre-pandemic blended learning.

Effectiveness of blended pedagogy for radiographic interpretation skills in operative dentistry - a comparison of test scores and student experiences at an undergraduate dental school in Pakistan

BACKGROUND

Utilizing Blended pedagogy (BP) in radiographic skills may prove to be an effective teaching strategy. However, studies on the use of BP in dentistry are quite limited in Pakistan, where teaching has mostly been via traditional Didactic Lectures (DL); and radiographic interpretation skills of undergraduate dental students are suboptimal. Therefore, this study aims to assess whether utilizing BP to teach radiographic interpretation skills is an effective teaching methodology in Pakistan.

METHODS

This mixed-method study was conducted on final year dental students at Jinnah Medical and Dental College (JMDC). Two groups of students were utilized for this study, one taught by traditional DL and the other taught by BP for the same module. BP was conducted over six weeks. A post-module test was conducted in both groups. Additionally, the BP group completed a modified Community of Inquiry (CoI) survey tool and volunteered to discuss their experiences through a focused group discussion (FGD). Descriptive statistics were computed and independent sample t-test was used to analyse the difference between the scores of the two groups. Thematic analysis was performed for the qualitative data.

RESULTS

The mean post-test scores were found to be significantly higher in the BP group (61.0 ± 10.2) compared to the DL group (44.4 ± 12.3) (p = < 0.001, CI = 95%, Cronbach Alpha > 0.8). The mean scores for the modified CoI instrument were 4.0 ± 0.29 for the whole instrument; 4.25 ± 0.22 for Teaching Presence, 3.71 ± 0.23 for Social Presence and 3.97 ± 0.16 Cognitive Presence, with all three having a Cronbach's alpha > 0.75. Thematic analysis revealed that BP students mutually agreed that BP method was beneficial with the appreciation of strong support from the facilitator. However, challenges like interrupted power supply and increased effort requirement from students were pointed out.

CONCLUSION

Students taught radiographic interpretation skills with BP in comparison to DL had higher test scores and expressed a positive experience demonstrated via a modified CoI survey and FGD. Considering the encouraging results found, dental schools should incorporate BP in their teaching methodology and follow-up studies are needed to further support the use of BP as an effective teaching methodology in Dentistry.

Effectiveness of e-learning to promote oral health education: A systematic review and meta-analysis

BACKGROUND

In recent times during and after the COVID-19 pandemic, e-learning is increasingly being used to give oral health education. However, the efficacy of e-learning in improving and promoting the oral hygiene and oral health knowledge, attitude and practice is unclear. Therefore, this systematic review and meta-analysis aim to clarify the effectiveness of e-learning compared to other conventional education methods for providing oral health.

METHODS

An electronic database search was performed on PubMed-Medline, Scopus, and CENTRAL (Central Register Cochrane of Controlled trials). Randomized controlled trials (RCTs), including cluster or group RCTs, were collected in this study. The risk of bias was assessed with the Cochrane Handbook for Systematic Reviews of Interventions. Five different meta-analyses were conducted for plaque index, gingival index, oral health knowledge, oral health attitude, and oral health practice using a random effects model.

RESULTS

A total of 282 articles were found through the database search; 19 articles were included in the qualitative synthesis and 9 articles in the quantitative synthesis. The meta-analysis found that compared with conventional education, e-learning exhibited no positive effect. However, the use of e-learning was superior to conventional education methods for oral health practice for adults in subgroup analysis.

CONCLUSIONS

This paper could not indicate the effectiveness of e-learning in comparison with conventional education for oral health in total. However, for adults, it may be effective to get the oral health practice compared to the conventional education. Our study limitation is that there are only few studies that have assessed the effectiveness of e-learning. Therefore, numerous further high-quality studies should be conducted regarding the efficacy of e-learning compared with conventional education methods for oral health promotion.

Virtual reality simulation of panoramic radiographic anatomy for dental students

PURPOSE

This work aimed to utilize virtual reality (VR) in dental radiographic anatomical interpretation in junior dental students and test if it can enhance student learning, engagement, and performance.

METHODS

VR software for panoramic anatomy was developed. Sixty-nine first-year dental students were divided into a control group (lecture-based) and an experimental group (VR) to learn panoramic radiographic anatomy. Both groups were then tested on knowledge via a 20-question quiz. Student feedback on VR experience was collected via an online survey.

RESULTS

There was a statistically significant difference between lecture-based and VR students in the correct identification of anatomical landmarks. Lecture-based students scored higher in identifying the ear lobe, hyoid bone, condylar neck, and external oblique ridge, whereas VR students scored higher in identifying zygoma (Chi-squared test, p < 0.005). The VR group reported high evaluation on all perception items of the online feedback survey on their experience (Student t-test, p < 0.005).

CONCLUSIONS

Lecture-based students generally showed better performance in panoramic radiographic anatomy. Several structures were not correctly identified in both groups of novice students. The positive feedback of VR experience encourages future implementation in education to augment conventional methods of radiographic anatomy in dentistry with considerations to repeated exposures throughout undergraduate dental education.

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.

Evaluation of different teaching methods in the radiographic diagnosis of proximal carious lesions

OBJECTIVES

To evaluate four different teaching methodologies in the radiographic diagnosis of proximal carious lesions and in the students' perception of these methodologies.

METHODS

71 undergraduate dental students were subdivided into 4 groups according to the teaching methodologies used (traditional, hybrid, e-learning and problem-based learning). All methods were applied by two properly trained researchers. Initially, students completed a pre-methodology test (index test). After applying the teaching methodologies, the students were submitted to a post-methodology test containing periapical radiographs for evaluation of proximal carious lesions. Then, the students answered a questionnaire to verify their perception of the different teaching methodologies. Statistical analysis was done.

RESULTS

There were no relationship between the results of pre- and post-methodologies tests, irrespective of the teaching methodology employed (p > 0.05). No differences between the teaching methodologies studied (p > 0.05) were found regarding the amount of correct answers. However, the students who participated in the active (e-learning and problem-based learning) and hybrid teaching methodology reported a positive impact in relation to their diagnostic skills at the questionnaire.

CONCLUSIONS

All the tested methodologies had a similar performance; however, the traditional methodology showed less acceptance by the students when analyzed subjectively and comparatively. The results of the present study increase comprehension about teaching methodologies for radiographic diagnosis of proximal carious lesions, and there is a potential to build on the knowledge base and provide practical support for students and educators.

Efficacy of smartphone-based Mobile learning versus lecture-based learning for instruction of Cephalometric landmark identification

BACKGROUND

Considering the increasing popularity of electronic learning, particularly smartphone-based mobile learning, and its reportedly optimal efficacy for instruction of complicated topics, this study aimed to compare the efficacy of smartphone-based mobile learning versus lecture-based learning for instruction of cephalometric landmark identification.

METHODS

This quasi-experimental interventional study evaluated 53 dental students (4th year) in two groups of intervention (n = 27; smartphone instruction using an application) and control (n = 26, traditional lecture-based instruction). Two weeks after the instructions, dental students were asked to identify four landmarks namely the posterior nasal spine (PNS), orbitale (Or), articulare (Ar) and gonion (Go) on lateral cephalograms. The mean coordinates of each landmark identified by orthodontists served as the reference point, and the mean distance from each identified point to the reference point was reported as the mean consistency while the standard deviation of this mean was reported as the precision of measurement. Data were analyzed using SPSS version 18 via independent sample t-test.

RESULTS

No significant difference was noted between the two groups in identification of PNS, Ar or Go (P > 0.05). However, the mean error rate in identification of Or was significantly lower in smartphone group compared with the traditional learning group (P = 0.020).

CONCLUSIONS

Smartphone-based mobile learning had a comparable, and even slightly superior, efficacy to lecture-based learning for instruction of cephalometric landmark identification, and may be considered, at least as an adjunct, to enhance the instruction of complicated topics.

TRIAL REGISTRATION NUMBER

This is not a human subject research. https://ethics.

RESEARCH

ac.ir/ProposalCertificateEn.php?id=33714&Print=true&NoPrintHeader=true&NoPrintFooter=true&NoPrintPageBorder=true&LetterPrint=true .

Using mobile multimedia platforms in teaching dental diagnosis

OBJECTIVE

Mobile Multimedia Platforms (MMPs) are prolific tools that can be used by individuals and corporations to share content. However, few studies have shown the effectiveness of MMPs as educational tools. Through this study, we aimed to evaluate the effectiveness of MMPs in improving basic dental diagnostic skills. In addition, we captured student feedback on the use of MMPs in a dental curriculum.

METHOD

In this voluntary interventional study on 89 senior dental students, we created pilot learning modules through an MMP called Instagram Stories to teach dental diagnosis. We evaluated the efficacy of the modules through diagnostic tests that were given to dental students who were close to graduating.

RESULTS

The students showed a significant increase in diagnostic test scores from 49% to 73% (p < 0.05) after the use of an MMP. Furthermore, the students' feedback on the MMP indicated that most students found it easy and enjoyable to use.

CONCLUSION

Our study data show that MMPs may be used to improve training in basic dental diagnostic skills and can serve as an adjunct teaching tool. Moreover, MMP modules can potentially enrich professional education in developing countries where access to educational resources is limited.

Effect of virtual versus traditional education on theoretical knowledge and reporting skills of dental students in radiographic interpretation of bony lesions of the jaw

BACKGROUND

This study aimed to compare the effect of virtual and traditional education on theoretical knowledge and reporting skills of dental students in radiographic interpretation of bony lesions of the jaw.

METHODS

This experimental study evaluated 39 dental students who had not received any instruction regarding radiographic interpretation of bony lesions of the jaw. They were randomly divided into two groups of virtual (n = 20) and traditional education (n = 19) and matched in terms of their grade point average (GPA). The virtual group received a virtual learning package while the traditional group received traditional classroom instruction for 6 one-hour sessions. Similar contents were taught to both groups by the same mentor. All students participated in a theoretical test with multiple-choice questions and an objective structured clinical examination (OSCE). Similar exams were also held 2 months later to assess knowledge retention. Data were analyzed using independent sample t-test and repeated measures ANOVA.

RESULTS

The mean scores of theoretical test (P < 0.05) and OSCE (P > 0.05) in the virtual education group (16.60 ± 0.91 and 15.13 ± 0.78) were higher than those in the traditional education group (14.89 ± 0.99 and 14.71 ± 0.92). In both methods of instruction, the mean scores of theoretical test and OSCE at 2 months were lower than the scores acquired immediately after instruction but this difference was not statistically significant (P > 0.05). Type of education had a significant effect on the theoretical test score (P < 0.001) but had no significant effect on the clinical score (P = 0.072).

CONCLUSIONS

Virtual learning was superior to traditional lecture-based method for enhancement of knowledge acquisition in radiographic interpretation of bony lesions of the jaw. However, to improve our students' reporting skills, we need to revise our virtual educational program so that the students have more opportunities to engage in reporting skills.

Assessing students' confidence in interpreting dental radiographs following a blended learning module

OBJECTIVE

This study assessed senior dental hygiene (DH) students' self-reported confidence in interpreting dental radiographs following the introduction of a blended learning (BL) module for radiology interpretation. The assessment of students was conducted five months prior to graduation.

METHODS

A BL oral radiology module was designed. In order to capture the context, descriptions and differences of students' experience and confidence, a qualitative research approach was selected. Data were captured using a semi-structured interview process and analysed using phenomenographic methods.

RESULTS

Sixteen students were interviewed. Blinded transcripts were analysed, and the main themes relating to confidence were extracted and arranged into categories. The categories were coded as to how confident (low, medium or high) each of the students felt specific to varying contexts and complexities of radiographic interpretation.

CONCLUSION

Predominately, the BL model had a positive impact on DH students' confidence in the interpretation of radiographic findings. However, when asked about their level of overall confidence in interpreting dental radiographs, students still did not describe themselves as confident for all potential findings on radiographs at this point in their education. The students highlighted the importance of having patient history details and clinical assessment findings included in the interpretation exercises and expressed a desire to collaborate with other professionals when interpreting radiographs.

An systematic review of e-learning outcomes in undergraduate dental radiology curricula-levels of learning and implications for researchers and curriculum planners

OBJECTIVES

To examine the outcomes of e-learning or blended learning interventions in undergraduate dental radiology curricula and analyze the nature of the knowledge levels addressed in learning interventions.

METHODS

A systematic literature review was performed using a search strategy based on MeSH key words specific to the focus question and indexed in the MEDLINE database. The search again was supplemented by hand-searching of selected journals. Data were extracted relating to outcomes of knowledge and student perceptions. Analysis of the e-learning intervention was performed using a new framework to examine the level of knowledge undertaken: (1) remember/understand (2) analysis or evaluation or diagnosis and (3) performance ("knows how" or "shows how").

RESULTS

From the selected 17 papers, 11 were positive about student reported outcomes of the interventions, and 8 reported evidence that e-learning interventions enhanced learning. Out of the included studies, 8 used e-learning at the level of remember/understand, 4 at the level of analysis/evaluate/diagnosis, and 5 at the level of performance ("knows how," "shows how").

CONCLUSIONS

The learning objectives, e-learning intervention, outcome measures and reporting methods were diverse and not well reported. This makes comparison between studies and an understanding of how interventions contributed to learning impractical. Future studies need to define "knowledge" levels and performance tasks undertaken in the planning and execution of e-learning interventions and their assessment methods. Such a framework and approach will focus our understanding in what ways e-learning is effective and how it contributes to better evidence-based e-learning experiences.

Interactive audience response systems in oral and maxillofacial radiology undergraduate lectures

OBJECTIVES

To evaluate the impact of audience response systems (ARS) on student participation (SP) during Oral and Maxillofacial Radiology (OMR) undergraduate lectures and on final examination scores (FES). Furthermore, an analysis of unanimity assessed the influence of ARS on students' responses. Students' perceptions were also assessed.

METHODS

A controlled crossover study was designed. Four lectures covering topics of OMR were each taught with ARS and without ARS (i.e. hand-raising method). SP and FES were compared between ARS and HR groups. Unanimity of answers was analyzed for both groups. Questionnaires assessed students' impressions about ARS.

RESULTS

Mean SP of ARS and HR groups were 97.6% and 47.3%, respectively, and this difference was statistically significant (P<.05). Mean FES for the ARS group (77%) was slightly higher than HR group (75.1%), however, not statistically significant. There was positive correlation between SP and FES. With ARS, only 5.7% of the questions were unanimous, whilst 51.4% were unanimous with HR method. Most students reported that the use of ARS had positive influence on their attention (92%), participation (96%), classmates' participation (82.7%), interest (74.7%), and learning (86.7%). For the five-point scale ratings of the relevance of ARS features, anonymity had an average 3.6, whilst other items received an average 4.6 or higher.

CONCLUSIONS

ARS significantly increased participation in OMR lectures; however, an increase in FES could not be associated with ARS by itself. Not taking into consideration which method was used to answer questions posed during lectures, higher participation correlated with higher scores. ARS is well-accepted and students believe that these devices positively influence their performance. Among the recognized advantages of ARS, anonymity was considered the least relevant.

E-learning for health professionals

BACKGROUND

The use of e-learning, defined as any educational intervention mediated electronically via the Internet, has steadily increased among health professionals worldwide. Several studies have attempted to measure the effects of e-learning in medical practice, which has often been associated with large positive effects when compared to no intervention and with small positive effects when compared with traditional learning (without access to e-learning). However, results are not conclusive.

OBJECTIVES

To assess the effects of e-learning programmes versus traditional learning in licensed health professionals for improving patient outcomes or health professionals' behaviours, skills and knowledge.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, five other databases and three trial registers up to July 2016, without any restrictions based on language or status of publication. We examined the reference lists of the included studies and other relevant reviews. If necessary, we contacted the study authors to collect additional information on studies.

SELECTION CRITERIA

Randomised trials assessing the effectiveness of e-learning versus traditional learning for health professionals. We excluded non-randomised trials and trials involving undergraduate health professionals.

DATA COLLECTION AND ANALYSIS

Two authors independently selected studies, extracted data and assessed risk of bias. We graded the certainty of evidence for each outcome using the GRADE approach and standardised the outcome effects using relative risks (risk ratio (RR) or odds ratio (OR)) or standardised mean difference (SMD) when possible.

MAIN RESULTS

We included 16 randomised trials involving 5679 licensed health professionals (4759 mixed health professionals, 587 nurses, 300 doctors and 33 childcare health consultants).When compared with traditional learning at 12-month follow-up, low-certainty evidence suggests that e-learning may make little or no difference for the following patient outcomes: the proportion of patients with low-density lipoprotein (LDL) cholesterol of less than 100 mg/dL (adjusted difference 4.0%, 95% confidence interval (CI) -0.3 to 7.9, N = 6399 patients, 1 study) and the proportion with glycated haemoglobin level of less than 8% (adjusted difference 4.6%, 95% CI -1.5 to 9.8, 3114 patients, 1 study). At 3- to 12-month follow-up, low-certainty evidence indicates that e-learning may make little or no difference on the following behaviours in health professionals: screening for dyslipidaemia (OR 0.90, 95% CI 0.77 to 1.06, 6027 patients, 2 studies) and treatment for dyslipidaemia (OR 1.15, 95% CI 0.89 to 1.48, 5491 patients, 2 studies). It is uncertain whether e-learning improves or reduces health professionals' skills (2912 health professionals; 6 studies; very low-certainty evidence), and it may make little or no difference in health professionals' knowledge (3236 participants; 11 studies; low-certainty evidence).Due to the paucity of studies and data, we were unable to explore differences in effects across different subgroups. Owing to poor reporting, we were unable to collect sufficient information to complete a meaningful 'Risk of bias' assessment for most of the quality criteria. We evaluated the risk of bias as unclear for most studies, but we classified the largest trial as being at low risk of bias. Missing data represented a potential source of bias in several studies.

AUTHORS' CONCLUSIONS

When compared to traditional learning, e-learning may make little or no difference in patient outcomes or health professionals' behaviours, skills or knowledge. Even if e-learning could be more successful than traditional learning in particular medical education settings, general claims of it as inherently more effective than traditional learning may be misleading.

Online Interactive Case-Based Instruction in Prostate Magnetic Resonance Imaging Interpretation Using Prostate Imaging and Reporting Data System Version 2: Effect for Novice Readers

PURPOSE

To assess the effect on reader performance of an interactive case-based online tutorial for prostate magnetic resonance imaging (MRI) interpretation using Prostate Imaging and Reporting Data System (PI-RADS).

METHODS

An educational website was developed incorporating scrollable multiparametric prostate MRI examinations with annotated solutions based on PI-RADS version 2. Three second-year radiology residents evaluated a separate set of 60 prostate MRI examinations both before and after review of the online case material, identifying and scoring dominant lesions. These 60 examinations included 30 benign cases and 30 cases with a dominant lesion demonstrating Gleason score ≥3 + 4 tumor on fusion-targeted biopsy. The readers' pooled performance was compared between the 2 sessions using logistic regression and Wilcoxon signed rank tests.

RESULTS

All readers completed the online material within four-hours. Review of the online material significantly improved sensitivity (from 57.8%-73.3%, P = 0.003) and negative predictive value (from 69.2%-78.2%, P = 0.049), but not specificity (from 70.0%-67.8%, P = 0.692) or positive predictive value (from 59.6%-64.7%, P = 0.389). Reader confidence (1-10 scale; 10 = maximal confidence) also improved significantly (from 5.6 ± 2.7 to 6.3 ± 2.6, P = 0.026). However, accuracy of assigned PI-RADS scores did not improve significantly (from 45.5%-53.3%, P = 0.149).

CONCLUSION

An online interactive case-based website in prostate MRI interpretation improved novice readers' sensitivity and negative predictive value for tumor detection, as well as readers' confidence. This online material may serve as a resource complementing existing traditional methods of instruction by providing a more flexible educational experience among a larger volume of learners. However, further more targeted educational initiatives regarding the proper application of PI-RADS remain warranted.

What We Do and Do Not Know about Teaching Medical Image Interpretation

Educators in medical image interpretation have difficulty finding scientific evidence as to how they should design their instruction. We review and comment on 81 papers that investigated instructional design in medical image interpretation. We distinguish between studies that evaluated complete offline courses and curricula, studies that evaluated e-learning modules, and studies that evaluated specific educational interventions. Twenty-three percent of all studies evaluated the implementation of complete courses or curricula, and 44% of the studies evaluated the implementation of e-learning modules. We argue that these studies have encouraging results but provide little information for educators: too many differences exist between conditions to unambiguously attribute the learning effects to specific instructional techniques. Moreover, concepts are not uniformly defined and methodological weaknesses further limit the usefulness of evidence provided by these studies. Thirty-two percent of the studies evaluated a specific interventional technique. We discuss three theoretical frameworks that informed these studies: diagnostic reasoning, cognitive schemas and study strategies. Research on diagnostic reasoning suggests teaching students to start with non-analytic reasoning and subsequently applying analytic reasoning, but little is known on how to train non-analytic reasoning. Research on cognitive schemas investigated activities that help the development of appropriate cognitive schemas. Finally, research on study strategies supports the effectiveness of practice testing, but more study strategies could be applicable to learning medical image interpretation. Our commentary highlights the value of evaluating specific instructional techniques, but further evidence is required to optimally inform educators in medical image interpretation.

Interactive learning in oral and maxillofacial radiology

PURPOSE

The use of electronic tools in teaching is growing rapidly in all fields, and there are many options to choose from. We present one such platform, Learning Catalytics™ (LC) (Pearson, New York, NY, USA), which we utilized in our oral and maxillofacial radiology course for second-year dental students.

MATERIALS AND METHODS

The aim of our study was to assess the correlation between students' performance on course exams and self-assessment LC quizzes. The performance of 354 predoctoral dental students from 2 consecutive classes on the course exams and LC quizzes was assessed to identify correlations using the Spearman rank correlation test. The first class was given in-class LC quizzes that were graded for accuracy. The second class was given out-of-class quizzes that were treated as online self-assessment exercises. The grading in the self-assessment exercises was for participation only and not accuracy. All quizzes were scheduled 1-2 weeks before the course examinations.

RESULTS

A positive but weak correlation was found between the overall quiz scores and exam scores when the two classes were combined (P<0.0001). A positive but weak correlation was likewise found between students' performance on exams and on in-class LC quizzes (class of 2016) (P<0.0001) as well as on exams and online LC quizzes (class of 2017) (P<0.0001).

CONCLUSION

It is not just the introduction of technological tools that impacts learning, but also their use in enabling an interactive learning environment. The LC platform provides an excellent technological tool for enhancing learning by improving bidirectional communication in a learning environment.

Role of telemedicine and mid-level dental providers in expanding dental-care access: potential application in rural Australia

Despite great progress in oral health over the past three decades, the rates of caries remain high in Australia, particularly among underserved populations. The reasons for poor oral health amongst underserved populations are multiple, but rests with socio-economic determinants of health. The present review considers international workforce models that have been created to enhance the recruitment and retention of dental providers in rural areas. Several strategies have been developed to address care access problems in rural areas, including the use of telemedicine and mid-level dental providers (MLDPs). Despite ongoing opposition from dentistry organisations, the Alaska and Minnesota workforce models have proven that developing and deploying dental therapists from rural communities has the potential to address the unmet needs of underserved populations. It is more efficient and cost-effective for MLDPs to perform triage and treat simple cases and for dentists to treat complicated cases. The use of MLDPs is intended to increase the capacity of the dental workforce in areas that are too isolated to entice dentists. Telemedicine has emerged as one solution to address limited access to health care, particularly in locations where there is a lack of providers. Telemedicine not only provides access to care, but also offers support, consultations and access to continuing education for practicing dental providers in rural areas. This strategy has the potential to free up resources to increase care access and reduce oral health disparities, thereby contributing to closing the rural-urban oral health gap.

A combination of traditional learning and e-learning can be more effective on radiological interpretation skills in medical students: a pre- and post-intervention study

BACKGROUND

The ability to interpret an X-Ray is a vital skill for graduating medical students which guides clinicians towards accurate diagnosis and treatment of the patient. However, research has suggested that radiological interpretation skills are less than satisfactory in not only medical students, but also in residents and consultants.

METHODS

This study investigated the effectiveness of e-learning for the development of X-ray interpretation skills in pre-clinical medical students. Competencies in clinical X-Ray interpretation were assessed by comparison of pre- and post-intervention scores and one year follow up assessment, where the e-learning course was the 'intervention'.

RESULTS

Our results demonstrate improved knowledge and skills in X-ray interpretation in students. Assessment of the post training students showed significantly higher scores than the scores of control group of students undertaking the same assessment at the same time.

CONCLUSIONS

The development of the Internet and advances in multimedia technologies has paved the way for computer-assisted education. As more rural clinical schools are established the electronic delivery of radiology teaching through websites will become a necessity. The use of e-learning to deliver radiology tuition to medical students represents an exciting alternative and is an effective method of developing competency in radiological interpretation for medical students.

Assessment of two e-learning methods teaching undergraduate students cephalometry in orthodontics

AIM

Cephalometry is important for orthodontic diagnosis and treatment planning and is part of the core curriculum for training dentists. Training involves identifying anatomical landmarks. The aim of this investigation was to assess whether e-learning improves learning efficiency; a programme specifically designed for this purpose was compared to commercially available software.

METHODS

Thirty undergraduate students underwent traditional training of cephalometry consisting of lectures and tutorials. Tracing skills were tested immediately afterwards (T0). The students were then randomly allocated to three groups: 10 students served as control (CF); they were asked to improve their skills using the material provided so far. Ten students were given a program specifically designed for this study that was based on a power point presentation (PPT). The last group was given a commercially available program that included teaching elements (SW). The groups were tested at the end the six week training (T1). The test consisted of tracing 30 points on two radiographs and a point score improvement was calculated. The students were interviewed after the second test.

RESULTS

Both e-learning groups improved more than the traditional group. Improvement scores were four for CF; 8.6 for PPT and 2.8 for SW. For PPT all participants improved and the student feedback was the best compared to the other groups. For the other groups some candidates worsened.

CONCLUSIONS

Blended learning produced better learning outcomes compared to using a traditional teaching method alone. The easy to use Power Point based custom software produced better results than the commercially available software.

Evaluation of a digital learning object (DLO) to support the learning process in radiographic dental diagnosis

AIMS

Studies have shown that inappropriate therapeutic strategies may be adopted if crown and root changes are misdiagnosed, potentially leading to undesirable consequences. Therefore, the aim of this study was to evaluate a digital learning object, developed to improve skills in diagnosing radiographic dental changes.

MATERIALS AND METHODS

The object was developed using the Visual Basic Application (VBA) software and evaluated by 62 undergraduate students (male: 24 and female: 38) taking an imaging diagnosis course. Participants were divided in two groups: test group, which used the object and control group, which attended conventional classes. After 3 weeks, students answered a 10-question test and took a practice test to diagnose 20 changes in periapical radiographs.

RESULTS

The results show that test group performed better that control group in both tests, with statistically significant difference (P = 0.004 and 0.003, respectively). In overall, female students were better than male students. Specific aspects of object usability were assessed using a structured questionnaire based on the System Usability Scale (SUS), with a score of 90.5 and 81.6 by male and female students, respectively.

CONCLUSIONS

The results obtained in this study suggest that students who used the DLO performed better than those who used conventional methods. This suggests that the DLO may be a useful teaching tool for dentistry undergraduates, on distance learning courses and as a complementary tool in face-to-face teaching.

A review of oral and maxillofacial surgery journals' contribution to undergraduate surgical education

We searched the Medline database of 4 leading international journals of oral and maxillofacial surgery (OMFS) for all articles containing the terms "undergraduate", "medical student", or "dental student" in the abstract, title, or keywords, from the earliest paper to 2013, to identify and review publications that related to the education of undergraduate medical and dental students. We found 130 articles, of which 22 (17%) met the inclusion criteria. Most were published by teams based in the United States, followed by those from the United Kingdom and Germany. The earliest was published in 1986. Since then, most have been published in the Journal of Oral and Maxillofacial Surgery (0.33/year) and the least in the International Journal of Oral and Maxillofacial Surgery (0.11/year). Eleven original research articles concerned dental students and 4 concerned medical students. Three studies looked at both groups and compared them with their qualified counterparts. There is a relative paucity of articles relating to the education of undergraduates, particularly medical students, in OMFS journals, although the number has increased over the last decade. There is a need for more educational papers to be aimed at students interested in pursuing OMFS as a career.

Flap raising on pulsatile perfused cadaveric tissue: a novel method for surgical teaching and exercise

Exercising flap raising procedures on cadavers is considered a prerequisite to prepare for clinical practise. To improve teaching and create conditions as realistic as possible, a perfusion device was developed providing pulsatile flow through the vessels of different donor sites. A plastic bag filled with red stained tab water was placed into a pump, which was driven by an electric motor. The bag was set under rhythmic compression with variable frequency and pressure. The pedicles of the radial forearm, anterolateral thigh, rectus abdominis, fibular and iliac crest flap were cannulated at the origin from their source arteries. Flap raising was performed under pulsatile perfusion in 15 fresh bodies and subsequently in 6 Thiel-embalmed cadavers during a flap raising course. We regularly observed staining of the skin and skin bleeding in fresh bodies and less reliable in embalmed cadavers. All flap pedicles showed pulsatile movements, and the radial pulse became palpable. Most perforators of the anterolateral thigh and osteocutaneous fibular flap could be identified by their pulse. Bleeding from bony tissue and venous return was seldom observed. We conclude that pulsatile perfusion of cadaveric tissue creates more realistic conditions for flap raising and improves teaching for beginners and advanced surgeons.

Using e-learning to train dentists in the development of standardised oral health promotion interventions for persons with disability

BACKGROUND

This study aims to evaluate whether an e-learning curriculum was sufficient to impart the necessary knowledge to dentists to allow them to implement an oral health promotion intervention in an institution for persons with disability.

MATERIALS AND METHODS

Participants were asked to complete a 10-module online training course and to implement a standardised intervention in an institution. The outcome measures were as follows: online tracking of progress; multiple choice questionnaires completed at the end of most modules; self-efficacy questionnaire completed before and after online training; completion of training and calibration in the use of a standardised risk assessment form; initiation and full completion of an oral health promotion intervention in an institution; satisfaction of participants with the online training experience; and evaluation of the impact of the intervention by the institution staff.

RESULTS

The study sample included 26 dentists. The 10 modules were passed by 24 dentists, and the mean value of the highest overall score recorded in the multiple questionnaires was 88.4% (± 4.0). Twenty participants completed the self-efficacy questionnaire before and after training; the mean values of scores after training were statistically different and higher than those at baseline. Questionnaire regarding satisfaction with the online training experience was completed by 22 participants; all of them stated that they were satisfied with the online training experience.

CONCLUSIONS

The results indicate that the online training course helped participants to increase self-efficacy and to provide interventions in institutions. This study could have implications for both undergraduate and postgraduate dental education in France.

Teledentistry: a systematic review of the literature

We conducted a systematic review of teledentistry applications. We searched the MEDLINE/PubMed, Embase and Cochrane Library databases for relevant articles published from 1992 to 2012. The reference lists of all retrieved articles were hand-searched. Studies were included after assessing the eligibility of the full-text article. A total of 878 studies were identified, of which 59 fulfilled the inclusion criteria of the review. The articles covered several dental specialties, mostly oral surgery, oral medicine and oral pathology. The most common type of teledentistry application was education (n = 21), followed by diagnosis (n = 16), consultation (n = 3) and treatment (n = 2). Teledentistry studies were reported in a total of 15 countries. The largest number of studies were conducted in the US (n = 22) and there were no studies from developing countries. Most of the reports referred to pilot projects and short-term outcomes, and most of the studies were descriptive. The review indicates that although teledentistry is an area of expansion, there are still some barriers to its increased use.