Mobile learning app: A novel method to teach clinical decision making in prosthodontics

Determinants of Clinical Decision Making under Uncertainty in Dentistry: A Scoping Review

Clinical decision-making for diagnosing and treating oral and dental diseases consolidates multiple sources of complex information, yet individual clinical judgements are often made intuitively on limited heuristics to simplify decision making, which may lead to errors harmful to patients. This study aimed at systematically evaluating dental practitioners’ clinical decision-making processes during diagnosis and treatment planning under uncertainty. A scoping review was chosen as the optimal study design due to the heterogeneity and complexity of the topic. Key terms and a search strategy were defined, and the articles published in the repository of the National Library of Medicine (MEDLINE/PubMed) were searched, selected, and analysed in accordance with PRISMA-ScR guidelines. Of the 478 studies returned, 64 relevant articles were included in the qualitative synthesis. Studies that were included were based in 27 countries, with the majority from the UK and USA. Articles were dated from 1991 to 2022, with all being observational studies except four, which were experimental studies. Six major recurring themes were identified: clinical factors, clinical experience, patient preferences and perceptions, heuristics and biases, artificial intelligence and informatics, and existing guidelines. These results suggest that inconsistency in treatment recommendations is a real possibility and despite great advancements in dental science, evidence-based practice is but one of a multitude of complex determinants driving clinical decision making in dentistry. In conclusion, clinical decisions, particularly those made individually by a dental practitioner, are potentially prone to sub-optimal treatment and poorer patient outcomes.

Prueba de concordancia de guiones para entrenar el razonamiento clínico en estudiantes de fonoaudiología

La prueba de concordancia de guiones (PCG) ha sido utilizada en el entrenamiento y evaluación del razonamiento clínico (RC) como una estrategia innovadora en la formación de profesionales. Sin embargo, no se dispone de evidencia de su aplicación en el pregrado de fonoaudiología. El objetivo de esta investigación fue analizar el desempeño y la percepción de estudiantes de fonoaudiología con respecto al uso de scripts. Se diseñó un piloto pre-experimental y multicéntrico, complementado con tres grupos focales. Las variables cuantitativas continuas fueron resumidas a través de medias y desviación estándar. La comparación entre grupos se ejecutó con Anova one way y la prueba post hoc de Bonferroni, considerando un nivel de significancia p<.05. La fase cualitativa incorporó un análisis de contenido mediante la codificación abierta de textos y la identificación e interpretación de familias de significado emergentes. El rendimiento promedio de los estudiantes fue de 4.03 (DS= 0.35), observándose un incremento en el rendimiento de RC durante el semestre (p= 0.03). La percepción de los estudiantes resulto positiva y se identificó cuatro familias de significado relacionadas con: razonamiento clínico, oportunidades de mejora implementación de la estrategia y retroalimentación docente. A modo de conclusión, la incorporación de scripts en estudiantes de pregrado de fonoaudiología es factible, incrementa el rendimiento y apoya el desarrollo del RC.

Sustainable Distance Online Educational Process for Dental Students during COVID-19 Pandemic

In this study, we evaluated the perception of distance online learning in undergraduate dental students in two different European countries during the second lockdown of the COVID-19 pandemic to explore sustainable undergraduate educational and examination e-learning forms. Dental students from Dental school of Athens, National and Kapodistrian university of Athens (N1_3rd preclinical year = 131, N2_4th clinical year = 119) and Dental school of Copenhagen (3rd preclinical year N3 = 85) completed the mixed-designed Dental e-Learning process Questionnaire (DeLQ) distributed in a google form. Responses to closed-ended questions were collected on a five-point Likert scale. Descriptive statistics were applied, and non-parametric Kruskal-Wallis tests were used to examine student groups. N1 (90% strongly agree) students reported that "e-learning is a suitable education method for theory in dentistry" at a significant level and more often than N2 (43% strongly disagree). N1 and N2 students strongly agreed that they preferred face-to-face teaching rather than distance e-learning. A relatively low number of N1 (31%) students believed that e-learning prepares them sufficiently for their practical training while none of the (0%) N2 cohort agreed. A low percentage of students in both years (N1 = 31%, N2 = 23%) believed that e-learning prepared them for their exams. Additionally, N1 = 60% and N2 = 66% preferred hybrid learning. Only 26% (N1) and 19.5% (N2) desired e-learning to continue after the COVID-19 pandemic. Nearly half of the participants believed the online exam model to be unreliable (N1 = 49%, N2 = 43%). Overall, students considered distance e-learning as an educational method applicable only to theoretical lessons. However, the lack of physical communication and interaction in distance learning led students to prefer a blended method. Students of the two faculties seemed to agree on many points, but there were also specific differences attributable to the differences in the programs and educational culture of the two countries.

Mobile applications in medical education: A systematic review and meta-analysis

Objective

This review evaluates the effectiveness of smartphone applications in improving academic performance and clinical practice among healthcare professionals and students.

Methods

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were retrieved from PubMed, Scopus, and Cochrane library through a comprehensive search strategy. Studies that included medical, dental, nursing, allied healthcare professional, undergraduates, postgraduates, and interns from the same disciplines who used mobile applications for their academic learning and/or daily clinical practice were considered.

Results

52 studies with a total of 4057 learner participants were included in this review. 33 studies (15 RCTs, 1 cluster RCT, 7 quasi-experimental studies, 9 interventional cohort studies and 1 cross-sectional study) reported that mobile applications were an effective tool that contributed to a significant improvement in the knowledge level of the participants. The pooled effect of 15 studies with 962 participants showed that the knowledge score improved significantly in the group using mobile applications when compared to the group who did not use mobile applications (SMD = 0.94, 95% CI = 0.57 to1.31, P<0.00001). 19 studies (11 RCTs, 3 quasi-experimental studies and 5 interventional cohort studies) reported that mobile applications were effective in significantly improving skills among the participants.

Conclusion

Mobile applications are effective tools in enhancing knowledge and skills. They can be considered as effective adjunct tools in medical education by considering their low expense, high versatility, reduced dependency on regional or site boundaries, online and offline, simulation, and flexible learning features of mobile apps.

Script concordance tests: A call for action in dental education

The Script Concordance Test (SCT) is an educational tool that aims to assess the ability to interpret medical information under conditions of uncertainty. It is widely used and validated in health education, but almost unknown in dentistry. Based on authentic clinical problem-solving situations, it allows to assess clinical reasoning that experienced health workers develop over the years. A specific scoring system, dedicated to SCT, considers the variability of responses of practitioners in the same clinical situations. Finally, the scores generated by SCT reflect the respondents' ability to interpret clinical data compared to experienced clinicians. This article aims to familiarise the dental educators' community with SCT construction, optimisation and its possible applications.

Effect of mobile learning on academic achievement and attitude of Sudanese dental students: a preliminary study

BACKGROUND

Despite the great development of smart phone programs and applications, and the wide-spread of these devices among students, their use for the educational purposes remains weak. The study aimed to investigate to what extent utilizing mobile learning as an adjunct to classic classroom lectures affect students' academic achievement and, to assess their attitude toward using mobile application as an instructional method in dental education.

METHODS

A quasi-experimental study was conducted among undergraduate dental students from two Sudanese universities. A total of 67 students who voluntarily agreed to participate were randomly allocated into a control group of 33 and an intervention group of 34 students. Initially, the two groups undertook a pre-test to ensure the standardization of a scale regarding their existing academic knowledge of dental surgery forceps used for tooth extraction. Then the intervention group was provided with a mobile application (Dental Surgical Forceps application version 2.1.0.0), and 3 weeks later a post-test was given for both groups. The attitude of the students toward the effectiveness of mobile learning was as assessed by five-point Likert scale questionnaire. For comparison of the numerical parametric data, a T. test was used, while for non-parametric categorical data a Chi-Squire test was used, with level of statistical significant difference set at P-value of ≤0.05.

RESULTS

The response rate was 91% for the intervention group (31 out of 34 students completed the study), and 78% for the control group (26 out of 33 students completed the study). Statistical significant difference was observed between the pretest and post-test mean scores of the intervention group (P < 0.005), while the differences were not significant among the control group (P > 0.05). Regarding the attitude of the dental students, the mean scores of the sample indicate that the vast majority of the participants (93.5%) showed positive attitude regarding the effectiveness of mobile learning.

CONCLUSIONS

There is a marked difference in the students' scores regarding their knowledge of dental surgical forceps. The students showed positive attitude toward using the mobile application.

COVID-19 pandemic and the impact on dental education: discussing current and future perspectives

Due to the COVID-19 pandemic crisis, many dental schools and instructors are rethinking the way they teach and interact with students. New perspectives regarding a change in face-to-face activities, social isolation and the reformulation of clinical activities result in a transition toward e-learning and e-teaching processes. In this review, we discuss some favorable aspects and difficulties associated with virtual teaching and learning, searching for available tools and techniques as well as new perspectives.

Construct validity of script concordance testing: progression of scores from novices to experienced clinicians

OBJECTIVES

To investigate the construct validity of Script Concordance Testing (SCT) scores as a measure of the clinical reasoning ability of medical students and practising General Practitioners with different levels of clinical experience.

METHODS

Part I involved a cross-sectional study, where 105 medical students, 19 junior registrars and 13 experienced General Practitioners completed the same set of SCT questions, and their mean scores were compared using one-way ANOVA. In Part II, pooled and matched SCT scores for 5 cohorts of students (2012 to 2017) in Year 3 (N=584) and Year 4 (N=598) were retrospectively analysed for evidence of significant progression.

RESULTS

A significant main effect of clinical experience was observed [F_{(2, 136)}=6.215, p=0.003]. The mean SCT score for General Practitioners (M=70.39, SD=4.41, N=13) was significantly higher (p=0.011) than that of students (M = 64.90, SD = 6.30, N=105). Year 4 students (M=68.90, SD= 7.79, N=584) scored a significantly higher mean score [t₍₅₅₂₎=12.78, p<0.001] than Year 3 students (M = 64.03, SD=7.98, N=598).

CONCLUSIONS

The findings that candidate scores increased with increasing level of clinical experience add to current evidence in the international literature in support of the construct validity of Script Concordance Testing. Prospective longitudinal studies with larger sample sizes are recommended to further test and build confidence in the construct validity of SCT scores.