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Preliminary Evaluation of a Dental Virtual Standardized Patient in Endodontic Clinical Reasoning and Decision-Making:
ZiYa Yuan1,2,3,4, Qian Zhu1,2,3,4, YingQi Ren1,2,3,4
1College of Stomatology, Chongqing Medical University, Chongqing, China.
Aim:
To develop and evaluate a dental virtual standardized patient (D-VSP) integrating natural-language intent recognition, a high-fidelity haptic simulator, and chairside visuals, to establish its face validity as a training tool for endodontic clinical reasoning and decision-making, and to examine its construct validity as a summative assessment instrument.
Methodology:
The D-VSP delivered a structured clinical workflow comprising six sections: history-taking, clinical examination, documentation, ancillary testing, diagnosis, and treatment planning. Dental students from the Stomatology College of Chongqing Medical University were classified into four pre-specified groups according to their self-reported clinical experience. All participants completed two virtual standardized patient cases: uncomplicated crown fracture (UCF) and symptomatic irreversible pulpitis (SIP). They then filled out two questionnaires assessing perceived usability and fidelity on 5-point Likert scales. Statistical analysis employed one-way analysis of variance or the Kruskal-Wallis test, with Bonferroni correction applied for multiple comparisons. The significance level was set at p < 0.05, and effect sizes were reported as eta-squared (η2).
Results:
A total of 149 students were recruited (data recovery rate: 96.64%). All groups rated the D-VSP highly for its usability and fidelity. SIP test scores differed significantly among the groups (H = 10.914, p = 0.012, η2 = 0.057). In addition, significant differences were found in the clinical examination section (H = 8.219, p = 0.042, η2 = 0.037) and the diagnosis section (H = 22.063, p < 0.001, η2 = 0.136) of the SIP test. For the UCF case, only the clinical examination section showed a significant difference (H = 8.496, p = 0.037, η2 = 0.039).
Conclusion:
This study established face and construct validity for the D-VSP, supporting its potential as a tool for teaching and assessing clinical reasoning in endodontics.