Impacto de um modelo 3D da formação e progressão de lesões de cárie como objeto de aprendizagem no treinamento/ensino de alunos de graduação de diferentes contextos, na detecção de lesões de cárie utilizando o ICDAS: estudo multicêntrico controlado randomizado / Impact of a caries lesion formation and progression 3D model as a learning object in the training/teaching of undergraduate dental students from different contexts for the detection of caries lesions using the ICDAS: Multicenter controlled and randomized trial

O presente estudo teve como objetivo avaliar o impacto de um modelo 3D, sobre a formação e progressão de lesões de cárie como objeto de aprendizagem, no desempenho teórico/prático e grau de satisfação de alunos de graduação em odontologia de diferentes contextos, na detecção de lesões de cárie utilizando o ICDAS. Foi conduzido um estudo multicêntrico controlado randomizado envolvendo uma amostra por conveniência de alunos de graduação em odontologia de cinco instituições (1 nacional e 4 internacionais). Inicialmente, os alunos receberam uma aula teórica tradicional e responderam uma primeira avaliação teórica. Posteriormente, foram aleatoriamente alocados em dois grupos: 1) grupo teste: que recebeu uma aula teórica tradicional expositiva mais acesso ao modelo 3D e 2) grupo controle: que recebeu unicamente a aula teórica tradicional expositiva. Depois, os alunos do grupo controle saíram da sala e um vídeo de 6 minutos (modelo 3D) foi projetado. Após o vídeo os alunos do grupo controle regressaram à sala e ambos os grupos foram submetidos a uma avaliação teórico/prática com o propósito de avaliar o desempenho após a intervenção e grau de satisfação da atividade. Análises de regressão

linear e de Poisson multinível foram realizadas para analisar o impacto do objeto de aprendizagem no desempenho teórico-prático do aluno. Análises descritivas foram realizadas para avaliar o grau de satisfação do aluno. Um total de 307 alunos participou do estudo. Alunos que tiveram melhor desempenho na avaliação teórica inicial obtiveram melhores notas na média teórica final (OR=1,11; 95%IC=1,02-1,21). Alunos do grupo teste tiveram um melhor desempenho teórico em comparação com os do grupo controle (p=0,04), principalmente para questões relacionadas à correlação histológica do ICDAS com características clínicas dos diferentes estágios de progressão. Não houve diferença estatisticamente significante na avaliação prática entre grupos e, um alto nível de satisfação da atividade foi observado na amostra. Conclui-se que, a atividade avaliada teve um impacto satisfatório no desenvolvimento de competências teóricas relacionadas à detecção de lesões de cárie utilizando o ICDAS.

This study aimed at evaluating the impact of a 3D model as a learning object in the training/teaching and satisfaction degree of undergraduate dental students from different contexts for the detection of caries lesions using the ICDAS. A multicenter controlled randomized trial was conducted, involving a convenience sample of undergraduate dental students from five institutions (1 national and 4 international). Firstly, students attended a traditional theoretical lecture and answered a first theoretical test. Then, they were randomly allocated into two groups as follows: 1) test group: receiving the theoretical lecture and accessing the 3D model, and 2) control group: receiving the theoretical lecture only. Afterwards, control group students left the room and a 6-minute video was projected (3D model). Once the video had finished, control group students returned to the room and both groups were submitted to a theoretical/practical test to evaluate their performance after intervention as well as their satisfaction degree. Multilevel linear and Poisson regression analyses were done, to analyze

the learning object impact in the students´ theoretical/practical performance. Descriptive analyses were conducted to assess the students´ satisfaction degree. Three hundred and seven students participated. Those having a better performance in the initial theoretical test also had better grades in the final theoretical assessment (OR=1,11; 95%IC=1,02-1,21). Test group students had a better theoretical performance in comparison to control group ones (p=0,04), mainly in relation to questions regarding the ICDAS histological correlation with clinical features on each severity caries stage. There were no statistically significant differences regarding practical assessment between groups, and a high level of activity satisfaction was observed. In conclusion, the assessed activity had a satisfactory impact in the developing of theoretical skills in relation to the detection of caries lesions using the ICDAS.

Dental students' and lecturers' perception of the degree of difficulty of caries detection associated learning topics in Brazil / 보건의료교육평가

PURPOSE: It aimed to explore the degree of difficulty of caries-detection-associated-topics perceived by dental students and lecturers as pedagogical step in the development of learning objects for e-learning. METHODS: A convenience sample comprising ninety-eight subjects from different academic levels (undergraduate/graduate students and pediatric dentistry lecturers) participated. Two spreadsheets (isolated/relative) were created considering key topics in the caries detection process. The isolated evaluation intended to explore each topic in an isolated way, while the relative intended to classify, comparatively, the participants' perceived difficulty per topic. Afterwards, data were analyzed. All values on spreadsheets were combined obtaining the subject's final perception. Associations between the subjects' degree of the perceived difficulty and academic level were estimated. ANOVA was used to determine differences regarding the perception among evaluated topics in distinct groups. RESULTS: Caries histopathology and detection of proximal carious lesions were the topics perceived as the most difficult in the process of caries detection by both students and lecturers. Differentiation between an extrinsic pigmentation and a brown-spot (caries lesion) as well as differential diagnosis between caries and enamel developmental defects or non-carious lesions were considered as more difficult by undergraduates in comparison to graduates/lecturers (regression-coefficient=14.54; Standard Error=3.34; P<0.001 and 8.40, 3.31, and 0.01 respectively). CONCLUSION: Topics as histopathology and detection of proximal caries lesions were identified as the most difficult despite the academic level. However, some topics are differently perceived according to the group. These results are useful for developing pedagogical material, based on the students real learning needs/expectations.