Dental and dental hygiene students' diagnostic accuracy in oral radiology: effect of diagnostic strategy and instructional method.

There has been much debate surrounding diagnostic strategies and the most appropriate training models for novices in oral radiology. It has been argued that an analytic approach, using a step-by-step analysis of the radiographic features of an abnormality, is ideal. Alternative research suggests that novices can successfully employ non-analytic reasoning. Many of these studies do not take instructional methodology into account. This study evaluated the effectiveness of non-analytic and analytic strategies in radiographic interpretation and explored the relationship between instructional methodology and diagnostic strategy. Second-year dental and dental hygiene students were taught four radiographic abnormalities using basic science instructions or a step-by-step algorithm. The students were tested on diagnostic accuracy and memory immediately after learning and one week later. A total of seventy-three students completed both immediate and delayed sessions and were included in the analysis. Students were randomly divided into two instructional conditions: one group provided a diagnostic hypothesis for the image and then identified specific features to support it, while the other group first identified features and then provided a diagnosis. Participants in the diagnosis-first condition (non-analytic reasoning) had higher diagnostic accuracy then those in the features-first condition (analytic reasoning), regardless of their learning condition. No main effect of learning condition or interaction with diagnostic strategy was observed. Educators should be mindful of the potential influence of analytic and non-analytic approaches on the effectiveness of the instructional method.

Integration of basic sciences and clinical sciences in oral radiology education for dental students.

Educational research suggests that cognitive processing in diagnostic radiology requires a solid foundation in the basic sciences and knowledge of the radiological changes associated with disease. Although it is generally assumed that dental students must acquire both sets of knowledge, little is known about the most effective way to teach them. Currently, the basic and clinical sciences are taught separately. This study was conducted to compare the diagnostic accuracy of students when taught basic sciences segregated or integrated with clinical features. Predoctoral dental students (n=51) were taught four confusable intrabony abnormalities using basic science descriptions integrated with the radiographic features or taught segregated from the radiographic features. The students were tested with diagnostic images, and memory tests were performed immediately after learning and one week later. On immediate and delayed testing, participants in the integrated basic science group outperformed those from the segregated group. A main effect of learning condition was found to be significant (p<0.05). The results of this study support the critical role of integrating biomedical knowledge in diagnostic radiology and shows that teaching basic sciences integrated with clinical features produces higher diagnostic accuracy in novices than teaching basic sciences segregated from clinical features.

The role of basic sciences in diagnostic oral radiology.

Although it is generally taken for granted that dental education must include both basic science and feature-based knowledge components, little is known about their relative roles in visual interpretation of radiographs. The objectives of this study were twofold. First, we sought to compare the educational efficacy of three learning strategies in diagnostic radiology: one that used basic scientific (pathophysiologic) information, one that used feature lists structured with an organizational tool, and one that used unstructured feature lists. Our second objective was to determine whether basic scientific information provides conceptual coherence or is merely a simple means for organizing feature-based knowledge. Predoctoral dental and undergraduate dental hygiene students (n=96) were randomly assigned into three groups (basic science, structured algorithm, and feature list) and were taught four confusable intrabony entities. The students completed diagnostic and memory tests immediately after learning and one week later, and these data were subjected to a 3x2 repeated measures ANOVA. For the diagnostic test, students in the basic science group outperformed those assigned to the feature list and structured algorithm groups on immediate and delayed testing (p<0.05). A main effect of learning condition was found to be significant. On the memory test, performance was similar across all three groups, and no significant effects were found. The results of this study support the critical role of basic scientific knowledge in diagnostic radiology. This study also refutes the organized learning theory and provides support for the conceptual coherence theory as a possible explanation for the process by which basic science aids in diagnosis.