Impact of Holistic Versus Step-by-Step Curriculum on Technical Competency and Self-Confidence in Preclinical...

This study aimed to compare the effects of two different curriculum sequencing models-holistic and step-by-step-on the technical competency and self-confidence of undergraduate dental students in preclinical endodontic education.

A total of 120 second-year dental students in the 2023-2024 academic year were divided into two groups for the preclinical endodontic course. Group A followed a holistic curriculum, completing all stages of root canal treatment on each tooth group before moving to the next. Group B followed a step-by-step curriculum, performing each treatment stage sequentially across all tooth groups. At the end of the preclinical training, self-confidence was assessed using a five-point Likert scale questionnaire, and technical competency was evaluated through standardized rubrics applied to endodontic treatments on single- and multi-rooted extracted teeth. Statistical analyses included the Pearson chi-square, Fisher's exact, Mann-Whitney U, and Kendall's Tau correlation tests, with significance set at p < 0.05.

The only significant difference in self-confidence between groups was found in posterior rubber dam application, with Group B reporting higher confidence (p < 0.05). Also, Group B achieved significantly higher scores in cavity preparation for multi-rooted teeth and root canal obturation for both single- and multi-rooted teeth (p < 0.05). A low but significant positive correlation was found between self-confidence and performance in multi-rooted cavity preparation (p = 0.049).

The step-by-step curriculum led to superior technical competency in complex procedures, while self-confidence levels remained similar between the two groups. These findings suggest that the step-by-step curriculum may better support early skill acquisition in preclinical endodontics, while perceived confidence does not necessarily reflect actual competence.