Test-enhanced learning and its effect on comprehension and diagnostic accuracy.

CONTEXT: In health professions education, tests have traditionally been used to assess the skills and knowledge of learners. More recently, research in psychology and education has shown that tests can also be used to enhance student memory; a phenomenon called the 'testing effect'. Much of the research in this domain has focused on enhancing rote memory of simple facts, and not on the deeper comprehension and application of complex theoretical knowledge necessary to diagnose and manage patients. The purpose of this study was to examine the effects of testing on students' comprehension of the basic science mechanisms and diagnostic accuracy. METHODS: Undergraduate dental and dental hygiene students (n = 112) were taught the radiographic features and pathophysiology underlying four intrabony abnormalities. Participants were divided into two groups: the test-enhanced (TE) condition and the study (ST) condition. Following the learning phase, the TE condition group completed an interventional test that tested the basic science mechanisms and the ST condition group was given additional study passages without being tested. Participants in both groups then completed a diagnostic test and a memory test immediately after the learning phase and 1 week later. RESULTS: A main effect of testing condition was found. The participants in the TE condition group outperformed those in the ST condition group on immediate and delayed testing. Unlike the diagnostic test, the memory test showed no difference between the groups. CONCLUSION: The inclusion of the basic science test appears to have improved the students' understanding of the underlying disease mechanisms learned and also improved their performance on a test of diagnostic accuracy.

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.

Technique acquisition in the use of two thermoplasticized root filling methods by inexperienced dental students: a microcomputed tomography analysis.

INTRODUCTION: Limited endodontic experiences in dental schools suggest the need for easy-to-learn techniques. Therefore, two simplified root filling methods were assessed for adequacy and expediency when performed by inexperienced students. METHODS: Eight students were trained (45-minute lecture and 90-minute practice) in use of ProTaper Obturators (PTO) and System-B/Calamus (SBC). They subsequently filled the root canals in two extracted, single-rooted teeth per method (n = 32). Canals were preshaped and prefitted with obturators and master cones. The volume of root-filling voids determined by microcomputed tomography imaging in 1-mm increments, time to complete fillings, and students' responses in questionnaires were analyzed (independent-sample t test and Mann-Whitney U test). RESULTS: PTO had a significantly smaller void volume in the apical 6 mm of canals (P < 0.001), required significantly shorter time (P < 0.001), and was perceived as easier to learn and use but less likely to be favored after graduation than SBC. CONCLUSION: These results suggested that the PTO root filling method was particularly suitable for teaching when endodontic experiences available for students are limited.

Visual field magnification and touch perception when exploring surfaces with the index finger and a rigid instrument.

OBJECTIVE: The aim of this project was to compare texture discrimination when both touch and vision were perturbed. BACKGROUND: Texture discrimination is important in the workplace. How textures are identified with the finger and with instruments when vision is magnified with lenses or video cameras is unclear. METHOD: Sandpaper was explored with the index finger or a metal instrument (hemostat), using normal or magnified vision. The forces generated during exploration were measured, and participants rated surface roughness. RESULTS: With the finger, the perception of roughness was unaffected with magnification; with the instrument, magnified surfaces were perceived as rougher (p < .05). Forces during finger exploration were unaffected by magnification; forces with the instrument increased under magnification (p < .05). CONCLUSION: Visual characteristics of the working field can influence the exploration and perception of materials. With the finger, mechanoreceptors that directly detect textures are activated, and with the instrument, receptors sensitive to vibrations are stimulated. APPLICATION: The higher forces produced when using instruments under magnification could lead to material damage. Attenuated perception of texture when exploring with tools may lead to difficulty in accurate touch perception. This could create problems in industrial tasks such as grading wool or identifying surface imperfections on manufactured materials, as well as in clinical settings such as dentistry or surgery in which instruments are used during tissue identification.