The effectiveness of computer-aided learning in teaching orthodontics: A review of the literature

doi:10.1016/j.ajodo.2004.02.020

American Journal of Orthodontics and Dentofacial Orthopedics

Volume 127, Issue 5, May 2005, Pages 599-605

https://doi.org/10.1016/j.ajodo.2004.02.020 Get rights and content

Introduction: The purposes of this review were to evaluate the effectiveness of computer-aided learning (CAL) in orthodontic education, to make evidence-based recommendations for the use of CAL in orthodontics, and to develop guidelines for conducting comparative trials to evaluate CAL as a mode of learning in orthodontic education. Methods: Medline, the Cochrane Library Database, ERIC, CINAHL, LISA, Psycinfo, and IPA were searched for randomized controlled trials evaluating the effectiveness of CAL in orthodontics. Outcome measures included objectively measured posttest scores on mulitiple choice, written, or oral tests; performance on a clinical procedure or clinical interview; time spent on CAL programs to learn the material presented; and responses to questionnaires conveying participants’ attitudes toward various modes of learning. Results: Four randomized controlled trials comparing CAL with conventional teaching fulfilled the inclusion criteria and met the cutoff quality assessment checklist (QAC) score of ≥ 8. Each study was assessed for quality by 2 independent reviewers. The validity and strength of the selected studies were assessed by using a QAC for an educational intervention. Conclusions: The controlled trials of CAL in orthodontics that met our QAC cutoff score of 8 were split, with 2 showing that CAL enjoyed a significant advantage over conventional teaching, 1 showing no difference, and 1 showing that the conventional tutorial method was better. More high-quality trials evaluating the effectiveness of CAL in orthodontics are needed. CAL programs in orthodontics elicit mostly positive responses and attitudes from students toward learning.

Section snippets

Inclusion criteria

Criteria pertaining to the type of study, type of participants, and type of outcome measures were established for this review. Only randomized controlled trials or prospective controlled trials comparing CAL with another method of instruction were considered. Participants had to be homogenous undergraduate dental students or graduate students.

The outcome measures had to objectively measure posttest scores on multiple choice, written, or oral tests; performance on a clinical procedure or

Description of studies

The searches located 1332 articles, of which 56 appeared potentially relevant to the review and were retrieved. Only 33 of these articles were related to CAL in orthodontics; of these, letters, review articles, editorials, and articles merely describing the development of CAL programs without formal evaluation of their effectiveness were excluded without the need for quality assessment (Fig 1). Nine articles meeting the criteria for consideration in this review were formally assessed for

Level of evidence provided by the included studies

We sought to identify the best evidence available in the published literature evaluating the effectiveness of CAL in orthodontics by performing a systematic search of the literature and formally assessing the strength of the studies that met our predetermined inclusion criteria. Only 4 of the 1332 articles in the initial search met our inclusion criteria and QAC cutoff score. Although 2 excluded studies had fairly strong experimental designs,7, 9 they failed to administer a pretest before the

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By following the same protocol outlined in our previous systematic review of CAL in orthodontics and updating a search of the literature to include articles up to the fourth week of August 2007, the objectives of this review were to build on our previously published systematic review and provide contemporary information regarding CAL in orthodontics.3
Studies of computer-aided learning (CAL) in orthodontics have documented both objective and subjective outcomes; however, to date, no studies have attempted to correlate these 2 outcome measures.
The main objective outcome measured was performance on a written test covering material in the orthodontic diagnosis electronic tutorial (ODET) administered to 92 fourth-year undergraduate dental students. The main subjective outcome measured was a 12-statement questionnaire to elicit students' perception of the ODET and CAL as teaching modalities.
In the male and female subgroups, a statistically significant difference in mean lecture test scores favoring women (72.46%) over men (67.08%) was observed (P = 0.05). This difference was not observed for mean ODET test scores (P = 0.52). Although responses to the questionnaire were mostly positive, the students are not prepared to replace lectures with CAL tutorials. Responses showed that male students preferred self-instruction as a mode of learning more than female students did (P = 0.05). When linking objective and subjective outcomes, the mean ODET test score had a statistically significant (P = 0.025), but weak, positive correlation (r = 0.243) with self-reported time spent reviewing the ODET but not with any other statement in the questionnaire.
Despite a difference in lecture test scores between male and female students, there was no difference in mean ODET test scores between the 2 subgroups. This might be explained by sex differences: male students preferred self-instruction more than female students did. Improved performance on the ODET test was noted for students who reported longer times spent reviewing the tutorial. Because students are not prepared to replace lectures with CAL tutorials, from their perspective, the ODET should continue to be used with traditional modes of learning.
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^a: Graduate orthodontic resident

^b: Assistant professor, Discipline of Orthodontics

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Original articleThe effectiveness of computer-aided learning in teaching orthodontics: A review of the literature

Section snippets

Inclusion criteria

Description of studies

Level of evidence provided by the included studies

Comput Hum Behav

A meta-analysis of self-instruction in dental education

J Dent Educ

The effectiveness of computer-aided, self-instructional programs in dental educationa systematic review of the literature

J Dent Educ

Computer-aided learning in orthodonticsis there any out there?

J Orthod

Instructional multimedia programs for self-directed learning in undergraduate and postgraduate training in orthodontics

Eur J Dent Educ

The evaluation of three computer-assisted learning packages for general dental practitioners

Br Dent J

Computer-aided learning (CAL)an effective way to teach the index of orthodontic treatment need (IOTN)?

J Orthod

The acceptability of computer-aided instruction to the undergraduate

Br Dent J

An evaluation of a hypertext system for computer-assisted learning in orthodontics

Br J Orthod

A hypertext tutorial for teaching cephalometrics

Br J Orthod

A study into the effectiveness of a text-based computer-assisted learning program in comparison with seminar teaching of orthodontics

Eur J Dent Educ

Computer-assisted instruction in mixed dentition analysis

J Dent Educ

An assessment of computer-assisted learning in orthodontics

Br J Orthod

Original article
The effectiveness of computer-aided learning in teaching orthodontics: A review of the literature