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

Insight on the influence of technology-enhanced learning in orthodontics' education: A systematic review

OBJECTIVES

Technology-enhanced learning (TEL) provides a pliable and current way to present orthodontic curriculum material to students. This review aimed to assess the effectiveness of TEL compared with traditional learning methods in the field of orthodontics.

MATERIALS AND METHODS

The search comprised randomised controlled trials (RCTs) related to orthodontics' interactive learning from the following databases: PubMed, Scopus, CENTRAL, Psyclnfo, ERIC, Web of Science, Dissertations and Theses Global. Two authors performed the screening, data extraction and assessed risk of bias using the Cochrane tool (Rob 2) blindly and in duplicate. Kirkpatrick's 4-level evaluation model was used to evaluate educational outcomes.

RESULTS

A total of 3131 records were identified of which 11 RCT were included. On level 1 (Reaction), students had a positive attitude towards TEL. On level 2 (Learning), included studies did not report any significant knowledge improvement when TEL was compared with traditional learning strategies. One study assessed level 3 (Behaviour), where students felt that flipped classroom learning created feelings of greater confidence. On level 4 (Results), most studies suggested that TEL tools are as equally effective in imparting information as traditional tools and recommended that both methods should be considered in teaching students.

CONCLUSION

Technology-enhanced learning techniques might have the potential to enhance educational outcomes in orthodontic education and students seem to enjoy the implementation of technology in the learning process. These educational tools should be used as an adjunct to the traditional didactic classroom, and not as a replacement, due to the challenges encountered with their application.

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.

Effectiveness of screen-to-screen and face-to-face learning modalities in dental anatomy module during Covid-19 pandemic

The Covid-19 pandemic has forced all dentistry faculties to quickly shift to the online supplementation or replacement of traditional modules to pursue education. However, there is limited research evaluating the effectiveness of this education modality on student performance in dental anatomy and manipulation module. Accordingly, it was aimed to compare the influence of different education modalities on the performances of the students enrolled in this module. The students were requested to perform 11 practical assignments throughout the fall term. A total of 220 face-to-face-educated (F2F) and 138 screen-to-screen-educated (S2S) students were included. To evaluate the influence of education modality on the performances of the students, cumulative success scores were calculated and compared using an independent t-test. The grades of the first (maxillary central), sixth (maxillary premolar), and eleventh assignments (mandibular first molar) were also analyzed to understand the manipulation-skill progress of each student within the same year. The grades of above-mentioned three assignments were converted into nominal data (excellent, very good, good, acceptable, and fail) based on certain thresholds, and a chi-square test was conducted. The cumulative success scores in F2F group were significantly lower than those in S2S group (P = 0.02). Differences between the first and eleventh tasks in both education modalities were significant (P < 0.05). The S2S-educated students achieved significantly higher achievement points in the sixth and eleventh assignments (P < 0.001). The S2S education can be suggested as an applicable modality for teaching dental anatomy and manipulation module. However, further work is needed to ascertain whether this result is replicable throughout dental anatomy education.

Comparison between Virtual and Traditional Learning Methods for Orthodontic Knowledge and Skills in Dental Students: A Quasi-Experimental Study

A gradual transition from traditional face-to-face learning to online learning has been observed globally following the COVID-19 pandemic. The aim of the study was to compare online and traditional learning methods in relation to orthodontic knowledge and skills acquired in undergraduate courses. A quasi-experimental design was used with two consecutive year classes of 198 dental students at Jazan University, Saudi Arabia. The experimental (virtual) group of 92 students received the content of a clinical orthodontic course virtually using the Blackboard Collaborate™ platform. The control (traditional) group consisted of a previous cohort of 106 students who enrolled in the same course but received traditional classroom education. The students were evaluated through a semester, and both groups obtained the same content and exam questions. The students in the virtual group scored higher in the final theory exam than the traditional group (p-value < 0.05). However, no significant difference in the overall orthodontic knowledge and skills was observed between the groups at the end of the course. Both learning methods showed moderate positive correlation between orthodontic knowledge and skills. In conclusion, virtual learning can serve as an effective alternative to traditional face-to-face learning for teaching orthodontic knowledge and skills to the dental students.

Education Technology in Orthodontics and Paediatric Dentistry during the COVID-19 Pandemic: A Systematic Review

Over the last decade, medical education changed from traditional teaching methods to telematic and networking scholar and e-learning approach. The objective of the present systematic review was to evaluate the effectiveness and teachers/student's acceptability of e-learning applied to the field of orthodontics and paediatric dentistry. A database search of the literature was conducted on PubMed and Embase databases from January 2005 to May 2021. A total of 172 articles were identified by the electronic search, while a total of 32 papers were selected for qualitative analysis. Overall, 19 articles investigated the effectiveness of e-learning, and no difference of acceptability was reported between e-learning and traditional methods for a wide part of the articles selected. A total of 25 papers provided a satisfaction questionnaire for learners and all were positive in their attitude towards e-learning. The results showed that e-learning is an effective method of instruction, complementing the traditional teaching methods, and learners had a positive attitude and perception. The evidence of the present study reported a high level of acceptability and knowledge level of e-learning techniques, compared to frontal lecture methods, in the fields of orthodontics and paediatric dentistry.

Blended learning as an adjunct to tutor-led seminars in undergraduate orthodontics: a randomised controlled trial

Aims To describe the use of blended learning as a method of undergraduate orthodontic teaching delivery and to assess its effectiveness in terms of knowledge gain.Design Randomised controlled trial.Setting Queen Mary University of London.Materials and methods Seventy dental undergraduate students in their fifth year were randomly allocated to receive orthodontic seminar-based teaching either using a blended approach based on an e-learning resource or with no prior teaching. All students were asked to complete tests both before (T0) and after (T1) the study period.Results The mean post-test score in the intervention group was 98.3% (a 19% improvement on baseline), while the mean score in the control group was 97.2% with intra-group improvements being statistically significant in both groups (P <0.001). However, no significant difference in terms of improvement in knowledge was found between the two groups (P = 0.36). In terms of satisfaction, 82% of the blended group and 74% in the control group rated the teaching as 'very good'.Conclusions An undergraduate orthodontic-oral surgery e-learning adjunct to traditional teaching was successfully developed. Blending and traditional seminar teaching appear to be equally effective in terms of short-term knowledge gain, with high levels of learner satisfaction common to both approaches.

Comparative Evaluation of the Effectiveness of Blended Learning Versus Traditional Learning in Cephalometrics for Undergraduates

Objective: To compare the effectiveness of blended learning versus traditional learning in a cephalometric learning module for undergraduates.

Materials and methods: This study was designed as a pre- and posttest trial. 150 undergraduates were randomly allocated to two groups: group 1 for traditional learning, and group 2, for blended learning. Pretest and posttest scores of both groups of 25 MCQs on cephalometrics were obtained. Feedback was obtained from the participants in this study and analyzed.

Results: In group 1, the mean pretest and posttest scores were 13.87 and 16.10, respectively. In group 2, the mean value for the pretest and posttest scores were 14.01 and 22.18, respectively. The mean improvement in knowledge score was significantly higher in group 1 (2.233) compared to the mean score of group 2 (8.171). The level of statistical significance was P < .001. Feedback analysis showed the participants found the experience with Dolphin software better than traditional learning (Dolphin Cephalometric Imaging and Management software [version 11.8.24 Chatsworth,CA,USA]). For over 50% participants, their overall opinion on the cephalometric module was very good (score = 5).

Conclusion: Blended learning increases the effectiveness of cephalometric learning by means of better student performance. Commercially available Cephalometric software can be used for e-learning instead of a specifically designed learning software.

Effectiveness of the Distance Learning Strategy Applied to Orthodontics Education: A Systematic Literature Review

Introduction: Tele-education refers to the use of interactive distance learning technologies. The objective of this systematic review was to evaluate the impact of tele-education in the field of orthodontics. Methods: This systematic review has been registered in PROSPERO and followed PRISMA guidelines. Two independent researchers reviewed the literature available in the databases of PubMed/MEDLINE, Bireme, the Cochrane Library, EMBASE, TRIP, SCIELO, LILAS, SCIENCEDIRECT, and Google Scholar using the following descriptors: "Education, Distance" OR "e-learning" AND "Orthodontics," including only interventional studies. The descriptive synthesis was conducted according to the Center for Reviews and Dissemination. The analysis of the biases was conducted using the MINORS protocol, and the analysis of the interventions using Kirkpatrick's method was evaluated. Results: Of the 15 remaining articles for complete reading, 4 were excluded for not meeting the inclusion criteria, leaving 11 articles for evaluation in the systematic review. Eight articles emphasized the evaluation of the distance education materials available, achieving a high percentage of acceptability among students, two cited only satisfaction, and one article evaluated the practical performance of the students. Conclusion: The results showed that orthodontic distance learning is an effective but complementary element, with no significant differences, to the traditional method of teaching.

Self-Paced Versus Instructor-Paced Preclinical Training in Operative Dentistry: A Case Study

Preclinical operative dentistry courses have traditionally involved a lockstep series of live lectures and laboratory exercises. The aims of this study were to assess the effects of an experimental self-paced operative dentistry course on students' perceptions and performance and to compare performance outcomes for this class with the classes two years prior and two years after, which were instructed with the traditional curriculum. In 2013, all lectures in one of three operative dentistry courses at the University of Minnesota School of Dentistry were placed online as narrated slide sequences. For the study, conducted in 2017, students' performance in the course in all five years was assessed, based on exams taken after the laboratory and lecture segments of the course and the practical exam. The experimental class was also invited to complete an end-of-course survey on perceptions of the learning experience. The number of students in classes using the traditional format (in 2011, 2012, 2014, and 2015) ranged from 103 to 108. In the experimental year (2013), 106 students were in the class; course assessments were done for all 106, and 104 responded to the survey (response rate 98%). The results showed no significant differences in assessments between the experimental class and the traditional classes. However, bench instructors reported feeling students in the experimental class were not as well prepared in laboratory sessions as were the traditionally trained students. On the survey, only 22% of students in the experimental class said they always viewed assigned material before the lab periods, with 78% viewing it often, sometimes, seldom, or never. In this class, 48% preferred the online lectures, 37% preferred live lectures, and 16% had no preference. These mixed results suggest caution when developing self-paced courses.

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.

An assessment of student experiences and learning based on a novel undergraduate e-learning resource

Purpose/objectives The aims of this study were to describe the development of a novel e-learning resource and to assess its impact on student learning experiences and orthodontic knowledge.Methods Thirty-two 4th year dental undergraduate students at Queen Mary University of London were randomly allocated to receive electronic access to e-learning material covering various undergraduate orthodontic topics over a 6-week period. Thirty-one control students were not given access during the study period. All students were asked to complete electronic quizzes both before (T0) and after (T1) the study period and a general questionnaire concerning familiarity with e-learning. The test group also completed a user satisfaction questionnaire at T1. Two focus groups were also undertaken to explore learners' experiences and suggestions in relation to the resource.Results The mean quiz result improved by 3.9% and 4.5% in the control and test groups, respectively. An independent t-test, however, demonstrated a lack of statistical significance in knowledge gain between control and test groups (P = 0.941). The qualitative feedback indicated that students believed that use of the resource enhanced knowledge and basic understanding with students expressing a wish to ingrain similar resources in other areas of undergraduate teaching.Conclusions Use of the novel orthodontic e-resource by 4th year undergraduate students over a 6-week period did not result in a significant improvement in subject knowledge. However, the e-learning has proven popular among undergraduates and the resources will continue to be refined.

E-learning and Blended Learning in Orthodontic Education

The purpose of this article is to evaluate how effective and efficient e-learning and blended learning is when compared with traditional face-to-face learning in orthodontic education. This article also provides a comparison between face-to-face learning, e-learning, and blended learning. An open PubMed literature search was done from 1980 to 2015, and a total of 23 relevant key articles were reviewed. Information emerging from studies in orthodontic education has indicated that e-learning classes are at least as good as and/or better than face-to-face classroom learning. Till date, only one study stated that the face-to-face conventional learning is better than e-learning. Two studies stated that blended approach using both traditional face-to-face learning and e-learning is the best method. In one study, the advantages of e-learning observed in the theoretical fields of orthodontics were not achieved in learning practical procedures for manual skills. Few studies found improvements in the efficiency of learning with e-learning program. Studies performed through questionnaires showed that student’s attitude and acceptance toward the use of e-learning was positive and favorable; however, blended learning was always rated high. Future research should be based on experiences of both faculty and student on a large scale for implementation of e-learning and blended learning in academic institutions. There is also need to provide professional development for faculty who will be teaching both in the physical and virtual environments.

A survey of undergraduate orthodontic teaching and factors affecting pursuit of postgraduate training

Background Undergraduate orthodontic teaching has been focused on developing an understanding of occlusal development in an effort to equip practitioners to make appropriate referrals for specialist-delivered care. However, there is a growing interest among general dentists in delivering more specialised treatments, including short-term orthodontic alignment. This study aimed to assess the levels of knowledge of occlusal problems among final year undergraduate dental students, as well as their interest in various orthodontics techniques and training.Methods A 36-item electronic questionnaire was sent to all final year undergraduate students in four dental institutes in the UK (Barts and the London, Kings College London, Cardiff and Dundee). The questionnaire explored satisfaction with undergraduate orthodontic teaching; students' perception of knowledge, based on General Dental Council learning outcomes; perceptions of the need for specialist involvement in the management of dental problems; interest in further training in orthodontics; and potential barriers to undertaking specialist training.Results The overall response rate was 66% (239/362). The majority of students (84.1%) were aware of GDC guidance in terms of undergraduate teaching. Students reported a preference for case-based and practical teaching sessions in orthodontics, with less interest in lectures or problem-based learning approaches. A high percentage were interested in further teaching in interceptive orthodontics (60.3%) and fixed appliance therapy (55.7%). Further training including specialist orthodontic training (36.4%), Invisalign (59%) and Six Month Smiles (41%) courses appealed to undergraduates. Levels of student debt, course fees and geographical issues were seen as potential barriers to formal, specialist training pathways.Conclusions Satisfaction with undergraduate orthodontic teaching is high and interest in further training, including specialist training pathways, continues to be high. While short-term orthodontics is not taught at undergraduate level, there appears to be an appetite to undertake alternatives to conventional orthodontics among dental students.