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Impact of Virtual Patient-Based Learning on Temporomandibular Disorder Knowledge Among Dental Students: A Pre-Post
Caroline M Sawicki1, Linda Sangalli2
1Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
Objectives:
Temporomandibular disorders (TMD) are common in dental practice, yet dental students report limited confidence and competence due to insufficient clinical exposure during predoctoral training. Virtual patient-based learning (VPBL) may enhance experiential learning; however, its impact on clinically relevant educational outcomes remains underexplored. This study evaluated whether a TMD-specific VPBL educational intervention improves dental students' diagnostic and management performance, self-perceived confidence, and knowledge.
Methods:
This quasi-experimental pre-post study included 83 fourth-year dental students at Adams School of Dentistry, University of North Carolina. Participants completed pre- and post-intervention assessments consisting of five Objective Structured Clinical Examination (OSCE)-style case scenarios evaluating TMD-related diagnostic and management skills. Between assessments, students reviewed 15 TMD virtual patient cases. Performance was scored using a predefined rubric across diagnostic accuracy, diagnostic reasoning, management appropriateness, justification for additional testing, and understanding of systemic/local factors influencing TMD (0-10 scale, 10 = "higher performance"). Secondary outcomes included confidence in 12 TMD-related skills (0-10 scale) and retrospective pre/post self-perceived knowledge (1-4 scale, 4 = "higher knowledge"). Changes were evaluated using paired t-tests and Wilcoxon signed-rank tests.
Results:
100% of the students completed both assessments. Overall performance improved significantly post-intervention (8.3 ± 1.4 vs. 9.4 ± 0.8, p < 0.001, effect size = 0.64), with gains observed across all domains (all p's < 0.05). Self-perceived knowledge increased significantly (2.6 ± 0.7 vs. 2.9 ± 0.6, p < 0.001, effect size = 0.70). Overall confidence in TMD-related skills was moderate (5.3 ± 1.7) and positively correlated with post-intervention knowledge (r = 0.70, p < 0.001).
Conclusions:
A TMD-specific VPBL educational intervention was associated with significant improvements in diagnostic and management performance and self-perceived knowledge, supporting its utility as an educational strategy to enhance TMD predoctoral curricula.
