Deliberate Error-Based Learning in Dental Radiography: An Educational Study

Objectives: We aimed to explore whether incorporating a deliberate error-based learning activity, adapted from error management training (EMT), could enhance undergraduate dental students' understanding of common intra-oral radiographic faults and their phantom-head imaging performance. Methods: This randomized two-arm educational study involved Year 2 dental undergraduates who completed pre- and post-intervention phantom-head imaging and a short multiple-choice test on radiographic errors. Students were allocated either to a brief, slide-based teaching session on imaging faults (conventional group) or to a hands-on activity in which they intentionally produced and corrected faulty images under supervision (EMT group). Main outcomes included MCQ scores, confidence ratings, overall imaging performance (percentage of maximum possible score), and distribution of diagnostic image quality categories. Two-sample t tests were used to check for inter-group differences in the change in the post-pre numerical scores. The Cochran-Mantel-Haenszel (CMH) linear-by-linear test was used to check for inter-group differences in the change in image distribution by diagnostic quality before and after the intervention. Results: Eighty-seven students contributed a total of 735 radiographs. Both groups showed improvements in MCQ scores and confidence within groups. Diagnostic acceptability of student radiographs was already high at baseline and remained so afterwards, with no significant differences between groups in MCQ gains, confidence changes, imaging scores, or shifts in diagnostic image quality distributions. Conclusions: Although the single, short EMT-style activity did not outperform conventional teaching on immediate outcomes, the study demonstrates that deliberate error-based learning is feasible in a pre-clinical radiography setting and well-received by students. The findings also help to clarify the circumstances under which EMT is most likely to yield benefits, suggesting that longer or more structured EMT sessions, particularly those involving metacognitive scaffolding or more challenging imaging scenarios, may be needed before performance differences can emerge.