The confidence gap: Between objective skill gains and subjective self-efficacy in digital cephalometric training

Despite the increasing integration of digital technologies into dental education, the pedagogical value of digital cephalometric training remains unclear. This training may also influence professional self-confidence. This study evaluated a digital cephalometric training model and explored the determinants of student self-assessment.

In this quasi-experimental study, students identified 20 landmarks before and after training, using digital cephalometric software. After training, students completed a 6-dimensional questionnaire using a 5-point Likert scale. Paired t tests were used to compare pretraining and posttraining accuracy, and Pearson's correlation and multiple linear regression were used to examine associations among the dimensions and predictors of self-assessment.

Digital training significantly improved the accuracy of all 20 landmarks, with the greatest gains for traditionally difficult points (eg, nasion and pterygomaxillary fissure). Students valued instant feedback, autonomous learning, and a blended digital-traditional model. Despite objective skill improvements, a confidence gap emerged: self-assessment scores were relatively low, and regression analysis showed that self-assessed confidence was not predicted by positive digital learning experiences but by endorsement of the value of traditional methods in fostering professional thinking.

Digital cephalometric training effectively enhanced landmark identification skills relevant to orthodontic diagnosis; however, educators must address the disconnect between objective competence and subjective confidence. Integrating new technologies with foundational professional values using traditional approaches may better support students' professional confidence.