Evaluating the effectiveness of problem-based learning combined with six thinking hats in oral pathology education

In Oral Pathology, traditional slide-based teaching methods often focus on passive observation which may not completely ignite the pathology resident's critical thinking and diagnostic capabilities. Hence we designed and evaluated a modified teaching method which was integrating Problem-Based Learning (PBL) with Six Thinking Hats (STH) methodology in enhancing diagnostic skills in the assessment of diagnostically challenging cases.

A cohort of n = 15 Oral Pathology residents were included for the study. Their diagnostic accuracy, critical thinking, and knowledge retention were assessed through traditional slide-based teaching and a PBL integrated with STH approach. The PBL-STH framework engaged residents in a multi-perspective analysis of clinical data, histopathological features, and immunohistochemical markers (e.g., CD20, CD138), using structured group discussions based on the six thinking hats to foster collaborative decision-making.

Diagnostic accuracy significantly improved with the PBL-STH method, with 86.6% of residents accurately diagnosing DLBCL compared to 40% in traditional teaching. Critical thinking and risk analysis were markedly higher with PBL-STH (93.3% vs. 30%), and peer collaboration was observed in all PBL-STH sessions. Additionally, knowledge retention after two weeks was better among residents trained with the PBL-STH approach (90% vs. 55%), and overall satisfaction was significantly higher (93% vs. 50%).

The PBL integrated with STH approach offers substantial benefits over traditional teaching methods, improving diagnostic accuracy, critical thinking, engagement, and knowledge retention in Oral Pathology. This innovative methodology encourages deeper analysis and collaboration, proving to be a highly effective educational tool for complex diagnostic cases especially in oral pathology which is the backbone for treatment, follow up, prognosis and quality of life of patients Also, implementation of PBL-STH in medical and dental curricula could enhance clinical reasoning and diagnostic skills across specialties.