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Generative Artificial Intelligence-Driven Clinical Case Simulation in Temporomandibular Disorder Education: ChatGPT
Paula Rodrigues-Pereira1, Maria Amália Pereira Dias-Calças1, Alex Moreira Mélo1
1Departamento de Odontologia Restauradora, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo (FORP/USP), Ribeirão Preto, São Paulo, Brazil.
Background:
Temporomandibular disorders (TMDs) and orofacial pain (OFP) demand advanced diagnostic and clinical reasoning skills in dental education. Traditional simulations with real patients face limitations in availability and standardization. Generative artificial intelligence (GAI), such as ChatGPT-3.5, has emerged as a potential tool for clinical training.
Methods:
This blinded, cross-sectional, crossover study involved 30 undergraduate dental students, each completing two simulated cases: one with ChatGPT-3.5 and one with standardized real patients. Cases were developed and validated by TMD/OFP specialists via the Delphi method and incorporated into the AI through structured prompts. Quantitative parameters (such as responses, word count, follow-up questions, reformulations, and diagnostic accuracy) and qualitative aspects (such as empathy, clarity, and relevant information) were analyzed.
Results:
GAI simulations provided higher information density (231 vs.167 relevant units; p < 0.001) and clearer reasoning flow. Students interacting with real patients asked more follow-up questions (p = 0.004) and required more reformulations (p = 0.011), indicating more adaptive communication. Diagnostic accuracy did not differ significantly (p > 0.05). Relevant information correlated positively with diagnostic accuracy (r = 0.484; p = 0.007), whereas total word count correlated negatively (r = -0.386; p = 0.035).
Conclusions:
ChatGPT-3.5 matched real patient simulations in diagnostic reasoning for TMD/OFP. Combining GAI's scalability and standardization with real patient variability may optimize clinical competency training.
