Study on the effect of simulation-based case teaching method on the preclinical teaching of tooth defects restoration | BMC Medical Education

This study was a self before-and-after control study, conducted at Guanghua School of Stomatology, Sun Yat-sen University and received ethical approval from the Ethics Committee (the ethical approval NO. is KQEC-2024–08-01). The eligibility criteria of students include: 1. Undergraduate students majoring in stomatology; 2. Students have finished the theoretical course of dental prosthetics and the experimental course of dental defect restoration; 3. Students are physically and mentally healthy, can attend the full course. A total of 96 undergraduate dental students participated in this study, including 51 females and 45 males, aged 17 ~ 20 years, with an average of (18.23 ± 1.02) years. Written informed consent was taken from each participant prior to the start of the study.

In Guanghua School of Stomatology, Sun Yat-sen University, undergraduates have learned the basic principles of dental defect restoration, clinical operation process, problems and treatments after wearing dentures through 22 credit hours of LBL, and practically trained abutments preparation, impression making, temporary crown making and other practical operations through 52 credit hours of practical exercise before clinic.

This SCT class was arranged at the end of the term after all LBL and practical exercise. The aim of the SCT class was to improve the ability of students’ restoration decision, to promote the selection of optimal restoration plan and carrying out corresponding tooth preparation process, and to enhance the managements of intraoperative and postoperative problem and communication between dentists and patients. The flow chart of the SCT course was shown in Fig. 1.

Table of Contents

Before SCT class

We chose 2 cases of tooth defect restorations for this course. Case 1 was used for evaluating the effect of SCT course, and Case 2 was for classroom teaching of SCT course. The information and related questions of the 2 cases were shown in supplemental materials.

Before the class, the information of Case 1 and related questions (including diagnosis, feasible treatment plans, selection of restorations and materials, and treatments of postoperative problems, etc.) were provided to students to test the clinical critical thinking ability of students as the baseline of teaching effectiveness assessment (R1). The information of Case 2 was also provided to students for previewing and thinking independently.

In SCT class

Case-based group work

In SCT class, the medical information and images of clinical examination of Case 2 were provided again, with a teacher role playing as patient to simulate clinical scenario. Students gained the details of Case 2 by asking questions. In this process, the teacher only provided case-related information, but did not give any hints for case analysis.

Students were divided into 12 groups of 8 students each and discussed the feasible restoration plans of Case 2 in groups, then selected one plan (full crown, veneer or resin filling) to finish corresponding teeth preparation (if the selection was full crown or veneer) or restoration (if the selection was resin filling) on head model and recorded the pictures of operation process.

Subsequently, the representative of each group gave a report (including the feasible restoration plan, the reason of the choice of restoration plan and materials, the precautions for tooth preparation, the finished tooth preparation and prognosis of the restoration, ect.).

Defense and comments

After the students’ report, teachers asked questions about the restoration plans in the presentation, the group members answered. Then, the teacher commented and summarized about the treatment plan, the material selection and teeth preparation. Subsequently, teachers played roles to simulate the occurrence of post-treatment problems and the students dealt with these problems. Then, teachers summarized the post-treatment problem managements and dentist-patient communication.

Teachers recorded and marked the group work (scores of Case 2) of students in operating process, finished teeth preparation, oral presentation and defense, of which the full score was 20 points, 30 points, 35 points and 15 points respectively. The total score of the group work performance was 100 points.

A questionnaire survey of Case 2 was conducted using an online real-time collection APP called “wenjuanxing” ( at the end of SCT class. The questions of the questionnaire survey were shown in supplemental materials. Teachers can access the data in the background of the APP to gather feedback of SCT course from students as subjective evaluation of teaching effect.

After SCT class

After SCT, students answered the questions of Case 1 again, the scores were marked as R2. The comparison between the R1 and R2 was regarded as objective evaluation of teaching effect.

Data analysis

For assessing the effectiveness of SCT method, chi-square test was applied to compare R1 and R2. The results of questionnaire survey were also showed as bar graph. The difference was considered significant if the p-value was less than 0.05.

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