Practising case-based learning in oral medicine for dental students in China

Flipped classroom orthodontic education for undergraduate dental students: A factor analysis study

INTRODUCTION

Dental schools have a primary responsibility to devise a curriculum that enhances students' confidence and knowledge in orthodontic case analysis. This study aims to compare the confidence levels and performance of undergraduate students in orthodontic case screening, moderated by faculty in a lecture-based format against their self-analysis of the same cases 1 year later, using a case-based and flipped learning approach.

MATERIALS AND METHODS

This study involved 100 fifth-year students. The same group received predoctoral orthodontics training through an instructor-centered, didactic approach in their fifth year and a case-based, student-centered, flipped classroom approach in their sixth year. At the end of each semester, the students completed an orthodontic case analysis and a self-reflection survey.

RESULTS

This study found no significant differences in diagnostic capabilities for orthodontic findings between the two methods studied. However, the self-evaluation survey data revealed an increase in students' confidence levels. This was specifically in terms of carrying out independent orthodontic case diagnosis, effectively communicating with orthodontic specialists, and their comfort in approaching orthodontic cases following the flipped classroom approach. Despite increased confidence in case diagnosis, the results showed that final-year students are uncertain about creating initial treatment plans and referring cases at an early stage.

CONCLUSION

Despite no observed improvement in students' orthodontic diagnostic abilities after another semester of student-centered learning, their confidence in diagnosing orthodontic cases was notably enhanced.

Dental student readiness to treat special care patients upon graduation

INTRODUCTION

There has been a global increase in patients with special needs. Undergraduate dental curricula need to adjust to meet the needs of these patients. This study aimed to identify how confident final year dental students felt about treating patients with special needs upon graduation and evaluate the influence that the curriculum had on their preparedness based on competencies outlined by the International Association for Disability and Oral Health (iADH).

METHODS

A questionnaire was administered to final year dental students at two different Universities in Scotland and in Spain to: (1) evaluate how prepared students felt when treating patients with special needs and (2) assess the competencies outlined by iADH.

RESULTS

The response rate was 18.4% (30/163 students). Overall, 83.3% of the students (n = 25) perceived they would benefit from more practical sessions with patients with learning and physical disabilities to improve their clinical management of these patients. 53.3% (n = 16) didn't feel that had the knowledge to properly treat all special care dentistry (SCD) patients upon graduation (scored 5 or 6 on the IADH competency framework). 83.3% of the students (n = 25) felt that the mode of teaching should be problem-based complemented with small group seminars.

CONCLUSION

Students from both Universities agreed that more clinical practice might be required for them to further their skills to treat special needs patients upon graduation, which correlates with the need to have more practical sessions to consolidate competency 4 (communication skills with SCD) and competency 6 (clinical management of patients requiring SCD).

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.

WeChat app combined CBL in oral medicine clinical training: A review

Hotly used in student-centered medical education worldwide, case based learning (CBL) is worthen with WeChat, the most popular communication app and is widely used in all walks of life. We have practiced several years combining WeChat and CBL in the clinical training of oral medicine for young doctors, promoting outcomes over traditional bedside training. This article's objective is demonstrating the acceptability and merits of WeChat CBL in the clinical training of oral medicine for young doctor. A total of eighty young doctors and 2 tutors participated in this study for interns of a every 2-month training during January 2018 to 2020. The control group used clinical bedside mode; the experimental group used bedside plus WeChat CBL mode. The evaluations included participation passion, daily routine and final test. Ten clerkships and thirty residents were in same number respectively of experiment and control groups. The participants in the experimental group produced a higher degree of participation in discussions. The twice and above Q&A action percentage is 40% in experimental group rather than 25% in control group. Daily assessment and final examination scores in the experimental group were significantly higher than those in the control group (P < .001). WeChat CBL mode has a positive effect on students' learning enthusiasm, assessments and evaluations in clinical training of oral medicine.

Effectiveness of case-based learning in Chinese dental education: a systematic review and meta-analysis

OBJECTIVE

The application of case-based learning (CBL) pedagogy has been emerging as an improved and more practical learning method across the Chinese dental education system. This article provides a critical overview of CBL pedagogy and further assesses the effectiveness of this teaching model in Chinese dental education.

DESIGN

A systematic review and meta-analysis.

METHODS

Studies published up to December 2019 were searched in the following electronic databases: China National Knowledge Infrastructure, China Science Periodical Database, Chinese Biomedical documental database, Wanfang data, PubMed, EMBASE and Cochrane Central Register of Control Trials. All randomised controlled trials (RCTs) that compared the effectiveness of the CBL teaching model and the traditional lecture-based learning (LBL) model in all dental disciplines were included. The assessment of methodological quality was based on the guidelines described in the Cochrane Handbook for Systematic Reviews, and the meta-analysis was performed using the software RevMan V.5.3 RESULTS: A total of 30 RCTs were finally included, with a total sample size of 2356 dental students. The CBL pedagogy significantly increased knowledge scores (standardised mean difference (SMD)=1.58, 95% CI: 0.95 to 2.20, p<0.0001), skill scores (SMD=1.22, 95% CI: 0.34 to 2.11, p<0.0001), comprehensive ability scores (SMD=1.91, 95% CI: 1.74 to 4.07, p<0.0001) and teaching satisfaction (risk ratio=1.38; 95% CI: 1.15 to 1.65; p=0.01) compared with the LBL teaching model among the dental students. Additionally, a subgroup analysis showed significant differences in the effects of CBL on knowledge scores, skill scores and comprehensive ability scores when comparing theoretical and practical courses.

CONCLUSIONS

The meta-analysis and systematic review of the eligible literature showed that the CBL pedagogy in Chinese dental education is an effective way to increase knowledge scores, skill scores, comprehensive ability scores and teaching satisfaction. Successful adaptation of this teaching model could solve the scarcity of highly skilled and professional dentists in dental schools and hospitals across China.

Problem-based learning and case-based learning in dental education

Background

Numerous novel teaching methods have been developed in recent times for use in medical education. Of these methods, problem-based learning (PBL) and case-based learning (CBL) have attracted the most attention. We evaluated and compared the efficiency of these two teaching methods in dental education and discussed the importance of teachers to these courses. This study aims to evaluate the efficiency of PBL and CBL in dental education, and discuss the importance of teachers to the courses.

Methods

In this study, 28 students enrolled in a seven-year program at the College of Stomatology at Shanghai Jiao Tong University were chosen as participants. In the fourth year, PBL combined with independent learning was used to teach students the theory of oral mucosal diseases. During the internship, CBL was used to present specific cases. Both methods were carried out with group discussion. After the PBL course, teachers assessed its effect by the students’ class performance, their ability to collect data, and group cooperation. After the CBL course, its effect was assessed by the students’ ability in history-taking, diagnosis and antidiastole, and case analysis. In addition, the teachers’ roles in both methods were assessed by both the students and the teachers themselves. Data was collected by questionnaire survey and statistically analyzed with SPSS Statistics 20.

Results

PBL significantly improved students’ self-learning abilities in the theory course. CBL helped students make diagnoses and develop treatment plans for actual cases in the internship. Both students and teachers thought that teachers were indispensable to both PBL and CBL. There was no difference between student and teacher views.

Conclusions

Although PBL and CBL have different focuses, their combination may enhance teaching effectiveness in dental education. Additionally, teachers play an important role in the application of both these teaching methods.

Dental students' perceptions of case-based learning method and the impact of clinical information in imaging diagnosis

INTRODUCTION

Education in oral imaging diagnosis is provided early in most dental curricula worldwide. Stressing the importance of clinical and radiographic information for oral diagnosis is of utmost importance for dental students. In this context, active learning methods, such as case-based learning (CBL), represent contemporary tools in the armamentarium of dental education. This study aimed to investigate (a) dental students' perceptions on CBL and (b) the importance of clinical data for image-based diagnosis.

METHODS

Fifteen cases of bone lesions were presented to 56 undergraduate students; group 1 (n = 24) was provided with the imaging data alone from each case, while group 2 (n = 32) received clinical information followed by the imaging data. Students' performance and perception on the teaching approach were assessed using a structured questionnaire. Their differential diagnoses for each of the lesions figured as variables to be compared with the known diagnosis.

RESULTS

All the students reported a positive experience with the case-based teaching method and confirmed this approach as a valuable tool in dental education. The diagnosis of a simple bone cyst, a periapical cyst or an ameloblastoma improved when they were provided with clinical data prior to the complementary images. No significant difference was detected, however, when the total amount of correct diagnoses were combined together and compared between groups (P > .05).

CONCLUSION

Case-based learning was corroborated as an optimal method for educating undergraduate dental students. Clinical data might contribute to diagnostic imaging, especially regarding lesions with multiple differential diagnoses.

Comparing case-based and lecture-based learning strategies for orthodontic case diagnosis: A randomized controlled trial

BACKGROUND

Case-based learning (CBL), in contrast to traditional lecture-based learning (LBL), is an andragogical method carrying an earnest teaching approach that uses demonstration of clinical cases as an active learning tool.

OBJECTIVE

To compare the effectiveness of knowledge delivery and student satisfaction between CBL and LBL strategies to diagnose orthodontic cases.

METHODS

A single-blinded randomized controlled trial was performed. The sample of dental undergraduate students was randomly divided into 2 groups. Average GPA among the groups was compared to establish the baseline measure. Visual slides of 6 orthodontic diagnostic cases were presented to the students after implementing the teaching strategies, and a rubrics-based assessment method was adopted to assess the effectiveness in diagnosis. A questionnaire was distributed to compare the level of satisfaction between the groups exposed to CBL and LBL. A t-test was performed to assess the difference in effectiveness, while Cochran-Armitage trend analysis was performed to analyze the difference in the level of satisfaction between LBL and CBL experiences.

RESULTS

We detected no significant (P = 0.11) relation of gender with effective orthodontic diagnosis. The orthodontic diagnostic ability of students for the 6 cases was significantly different (P < 0.05) in the CBL and LBL groups. The satisfaction score obtained for the CBL group was higher than for the LBL group (P < 0.05).

CONCLUSION

The current study provides evidence that CBL is an effective and acceptable teaching strategy in comparison to traditional LBL among undergraduate dental students embarking on an orthodontic diagnostic course.

Reforming teaching methods by integrating dental theory with clinical practice for dental students

Background

Transitioning from theoretical medicine to clinical practice is both an important and difficult process in dental education. Thus, there is an urgent need for teaching methods that can improve the ability of dental students to integrate dental theory with clinical practice.

Methods

First, we conducted training for problem-based learning based on real clinical cases for dental students. The students were then assigned to dentist/patient roles to rehearse and perform simulated clinical scenarios. Finally, questionnaires, clinical patient care scores, and performance assessments were utilized to evaluate and compare the effectiveness of this training with that of traditional teaching methods.

Results

Students’ abilities to treat and communicate with patients markedly improved after using this reformed teaching method. Among the 30 enrolled students, 29 liked the method, found it time-efficient, and believed that it could help enhance their problem-solving confidence and interest in prosthodontics. They also believed that this teaching method could help them gain a good understanding of related theoretical material, generally thought that the reformed teaching method was more valuable than the traditional approach, and would like to introduce it to others.

Conclusion

After the reformed teaching method was implemented, the students not only achieved better scholastically, but also demonstrated greater accuracy in diagnosing the conditions of patients and formulating treatment plans. They were also more frequently acknowledged by patients, indicating that this method is effective for dental students.

Current differences in dental education between Chinese and Western models

Dental education is the foundation of a country's development of dental science. Economic conditions and cultural backgrounds vary across countries; hence, there are some differences in dental education between Chinese and Western models, including the education programmes, licensures, curricula, teaching methods, facilities. These differences may become obstacles for mutual communication and the development of dental education. In the last 5 years, China has introduced several policies and published some standards, such as the residency programmes and Accreditation Standards for Undergraduate Dental Education Programs. These actions aim to improve the current situation of dental education and reduce the gap between Chinese and Western education models. Indeed, some changes have been made. This article provides a brief introduction of the existing differences and changes and can, thus, serve as a reference for educators.

Case-based learning: A study to ascertain the effectiveness in enhancing the knowledge among interns of an Indian dental institute

OBJECTIVE

Time and again, it has been shown that active learning promotes critical thinking, and this environment has to be fostered in dental education too. Therefore, the present study was carried out with an aim to know the effectiveness of case-based learning (CBL) in enhancing the knowledge of dental interns of a dental institute in India.

MATERIALS AND METHODS

This pre-post single-blinded, experimental study was conducted in two sessions on a purposive sample of 45 dental interns who gave informed consent. The interns answered a pretest questionnaire comprising questions related to their knowledge of hyperplastic tissue in complete denture patients. The interns were randomly allocated into three subgroups for thorough discussion. Each group viewed all three parts of a case related to hyperplastic tissue and presented the case in the presence of a facilitator. The facilitator discussed the subject with the three subgroups. A post-test was conducted immediately, and the results were compared with the pretest. The facilitator explained about hyperplastic tissue with an audio-visual aid after the post-test was administered. The perception of interns toward CBL was assessed by a standard questionnaire.

RESULTS

On analysis, the comparison of the overall knowledge scores pre- and post-CBL showed a statistically significant increase from 9.8 ± 2.14 to 12.6 ± 1.37 (P < 0.001).

CONCLUSION

CBL proved to be effective in enhancing the knowledge of dental interns.

Bridging the gap in 1(st) year dental material curriculum: A 3 year randomized cross over trial

Background:

Case-oriented small group discussions (COSGDs) can help students to correlate and integrate the basic science of dental materials into clinical application. We used COSGDs along with didactic lectures in dental material curriculum and hypothesized that case-oriented group discussions would be more effective than traditional lecture alone in terms of performance of students, student perception on the above two teaching methodologies and the feasibility in classes of 2010, 2011 and 2012.

Methods:

A total of 170 students were taught using both COSGD and didactic lecture in a randomized controlled crossover trial design. Their performance was assessed through multiple-choice questions (MCQs) as part of the formative assessment, and their perception was assessed through Likert scale questionnaire.

Results:

The mean difference in the scores between case-oriented group discussions with lecture and didactic lecture showed significant difference only in few topics. Around 94–96% of students perceived COSGD with didactic lecture help them understand theory better; 76–92% of students feel more comfortable asking questions in a group discussion; 89–98% of students feel such discussions motivate them and 91–100% of students agree that discussions make the subject interesting in the respective years of 2010, 2011 and 2012.

Conclusion:

Effectiveness of COSGD in terms of scores through MCQs is comparable to traditional lecture. However, most of the students perceive COSGD help them understand the theory better; co-relate clinically; more motivating and interesting than a traditional lecture. Feasibility in institution needs more time and resources to conduct COSGD within the dental material curriculum.

Case-Based Learning and its Application in Medical and Health-Care Fields: A Review of Worldwide Literature

INTRODUCTION

Case-based learning (CBL) is a newer modality of teaching healthcare. In order to evaluate how CBL is currently used, a literature search and review was completed.

METHODS

A literature search was completed using an OVID© database using PubMed as the data source, 1946-8/1/2015. Key words used were "Case-based learning" and "medical education", and 360 articles were retrieved. Of these, 70 articles were selected to review for location, human health care related fields of study, number of students, topics, delivery methods, and student level.

RESULTS

All major continents had studies on CBL. Education levels were 64% undergraduate and 34% graduate. Medicine was the most frequently represented field, with articles on nursing, occupational therapy, allied health, child development and dentistry. Mean number of students per study was 214 (7-3105). The top 3 most common methods of delivery were live presentation in 49%, followed by computer or web-based in 20% followed by mixed modalities in 19%. The top 3 outcome evaluations were: survey of participants, knowledge test, and test plus survey, with practice outcomes less frequent. Selected studies were reviewed in greater detail, highlighting advantages and disadvantages of CBL, comparisons to Problem-based learning, variety of fields in healthcare, variety in student experience, curriculum implementation, and finally impact on patient care.

CONCLUSIONS

CBL is a teaching tool used in a variety of medical fields using human cases to impart relevance and aid in connecting theory to practice. The impact of CBL can reach from simple knowledge gains to changing patient care outcomes.

A Rapid Review of the Factors Affecting Healthcare Students' Satisfaction with Small-Group, Active Learning Methods

PHENOMENON: Problem-based learning (PBL) and other small-group, active learning methodologies have been widely adopted into undergraduate and postgraduate healthcare curricula across the world. Although much research has examined student perceptions of these innovative teaching pedagogies, there are still questions over which factors influence these views. This article aims to identify these key elements that affect healthcare student satisfaction with PBL and other small-group learning methods, including case-based and team-based learning.

APPROACH

A systematic rapid review method was used to identify high-quality original research papers from the healthcare education literature from between 2009 and 2014. All papers were critically appraised before inclusion in line with published guidelines. Narrative synthesis was achieved using an inductively developed, thematic framework approach.

FINDINGS

Fifty-four papers were included in the narrative synthesis. The evidence suggests that, despite an initial period of negative emotion and anxiety, the perspectives of healthcare students toward small-group, active learning methods are generally positive. The key factors influencing this satisfaction level include (a) the facilitator role, (b) tutorial structure, (c) individual student factors, (d) case authenticity, (e) increased feedback, (f) group harmony, and (g) resource availability. Insights: Student satisfaction is an important determinant of healthcare education quality, and the findings of this review may be of value in future curriculum design. The evidence described here suggests that an ideal curriculum may be based on an expert-led, hybrid PBL model.