UNIVERSIDADE ESTADUAL PAULISTA
“JÚLIO DE MESQUITA FILHO”
Instituto de Ciência e Tecnologia
Campus de São José dos Campos
ORIGINAL ARTICLE DOI: https://doi.org/10.4322/bds.2023.e3768
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Braz Dent Sci 2023 July/Sept 26 (3): e3768
Evaluation of different teaching methodologies by assessing the
performance of dentistry students
Avaliação de diferentes metodologias de aprendizagem aferindo o desempenho de estudantes de odontologia
Milena Miranda Goulart GUIRADO1 , Rubens Nisie TANGO2 , Vanessa Ramos da SILVA1 ,
Vivian Silveira dos Santos BARDINI3 , Marianne SPALDING4 , Suzelei RODGHER5
1 - Universidade Estadual Paulista (Unesp), Instituto de Ciência e Tecnologia, Faculdade de Odontologia. São José dos Campos, SP, Brazil.
2 - Universidade Estadual Paulista (Unesp), Instituto de Ciência e Tecnologia, Faculdade de Odontologia, Departamento de Materiais Dentários
e Prótese Dentária. São José dos Campos, SP, Brazil.
3 - Universidade Estadual de Campinas, Engenharia de Transportes, Escola de Tecnologia. Limeira, SP, Brazil.
4 - Universidade Estadual Paulista (Unesp), Instituto de Ciências e Tecnologia, Faculdade de Odontologia, Departamento de Biociências e
Diagnóstico Bucal.
5 - Universidade Estadual Paulista (Unesp), Instituto de Ciência e Tecnologia, Departamento de Engenharia Ambiental. São José dos
Campos, SP, Brazil.
How to cite: Guirado MMG, Tango RN, Silva VR, Bardini VSS, Spalding M, Rodgher S. Evaluation of different teaching methodologies
by assessing the performance of dentistry students. Braz Dent Sci. 2023;26(3):e3768. https://doi.org/10.4322/bds.2023.e3768
ABSTRACT
Objective: The aim of this study was to compare the performance of day- and evening-class students in the
rst semester test of Dental Materials in the School of Dentistry at São José dos Campos - UNESP, who were
exposed to traditional lectures (TRAD) and Team-Based Learning (TBL). Material and Methods: The results
of Dental Materials rst semester test of students, from day and evening classes of 2016 were tabulated and
analyzed in this research. The groups formed for the execution of the methodology were randomized using the
individual global average of the previous year of the students, and the groups were composed of 6 to 7 members,
maintained throughout the course. During the correction of the tests, the subject of each question and the applied
methodology (TBL and TRAD) were identied. Responses of each question were graded separately according
to the subject for comparison between methodologies. A total of 88 tests were evaluated. The performance
was evaluated through a comparison of the average grade of each question, related to a specic learning
methodology. The data were submitted to t-test. Results: The students’ overall performance was similar when
both methodologies were compared. Students from day class presented higher grades with TBL whilst evening
class students presented better performance in questions with traditional lectures. Conclusion: Active learning
should be further implemented in Brazilian Dental Schools to change students’ habits aiming to improve their
personal and social skills besides of professional technical knowledge.
KEYWORDS
Educational activities; Dental Schools; Learning; Student evaluation; Higher education.
RESUMO
Objetivo: O objetivo deste estudo foi comparar o desempenho de alunos dos turnos diurno e noturno na prova do
primeiro semestre da Disciplina Materiais Dentários da Faculdade de Odontologia de São José dos Campos - UNESP,
expostos a aulas tradicionais (TRAD) e Aprendizagem Baseada em Equipe (TBL). Material e Métodos: Os resultados
da prova dos alunos, dos turnos diurno e noturno de 2016, foram tabulados e analisados. As turmas
utilizadas para a execução da pesquisa foram randomizadas utilizando-se a média global individual do ano
anterior dos alunos, sendo as turmas compostas de 6 a 7 integrantes, mantidas ao longo do curso. Durante
a correção das provas, foram identicados os assuntos de cada questão e a metodologia aplicada (TRAD e TBL).
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Guirado MMG et al.
Evaluation of different teaching methodologies by assessing the performance of dentistry students
Guirado MMG et al. Evaluation of different teaching methodologies by assessing
the performance of dentistry students
As respostas de cada questão foram graduadas separadamente de acordo com o assunto para comparação entre as
metodologias. Um total de 88 testes foi avaliado. O desempenho dos alunos foi avaliado por meio da comparação
da nota média de cada questão, relacionada a uma metodologia especíca de aprendizagem. Os dados foram
submetidos ao teste t. Resultados: O desempenho geral dos alunos foi semelhante quando comparadas as duas
metodologias. Os alunos do período diurno apresentaram notas mais altas no tratamento TBL, enquanto os
alunos do período noturno apresentaram melhor desempenho nas questões com aulas expositivas tradicionais.
Conclusão: A aprendizagem ativa deve ser mais implementada nos cursos de graduação em Odontologia,
no Brasil, para melhorar as habilidades pessoais e sociais dos alunos, além de aperfeiçoar o conhecimento técnico
prossional dos discentes.
PALAVRAS-CHAVE
Atividades educacionais; Faculdade de Odontologia; Aprendizagem; Avaliação do aluno; Ensino superior.
reection on the implications of the results of
scientic research in dental practice. In addition,
according to the National Curricular Guidelines
of the Undergraduate Course in Dentistry [9], the
pedagogical project should be built collectively,
centered on the student, and supported by the
teacher as a mediator of teaching-learning process.
It is important to adopt pedagogical concepts that
associate theory to practice, and active learning
can facilitate this process of “learning to learn”
It should also use methodologies which will
allow the active participation of students in this
process, the integration of knowledge of the basic
sciences with that of the clinical sciences, and the
establishment of scientic initiation programs as
a learning method [10].
Intrinsic motivation of students has shown
to be important for learning because it has
been associated to more effort spent on tasks
and activities and desire to learn [11-13].
In this sense, new teaching-learning methods
may enhance intrinsic motivation [14] and
facilitate their commitment [15,16]. According
to [4] the present century poses a great challenge
for the development of individual autonomy in
association with the collective. In this context,
it is education, through a critical, ethical, and
reflexive pedagogical practice, which should
trigger interdependence and transdisciplinary
approach in individuals. Building a critical
consciousness requires creative curiosity, and
in this process, students are active and aware
that reality is always changeable. Moreover, the
reexive thinking can only be induced by active,
dialogical, and participatory teaching-learning
methods, the modication of the programmatic
content of education and the use of techniques,
such as reduction and codification. It is only
with the development of dialogue that we can
overcome the anti-dialogue attitude, so present
in our cultural historical formation [17].
INTRODUCTION
Education is a very powerful instrument for
social change and transformation, and innovative
teaching practice is the only way to enhance
the quality of education [1]. Teaching activity
presupposes a ritual that involves the participants
in the process, learners, and teachers. In adult
education, this process should be built on the
premise that adults learn differently. Thus, it is
the teachers’ responsibility to equip themselves
with conceptual and practical-theoretical tools to
achieve their goals [2].
For a long time in the history of education,
the teacher was a content transmitter and the
student a reproducer - passive listener with
receptive attitude - without reexive thinking.
The traditional lectures with predominance of
oral exposure, predetermined and xed sequence
of contents, and repeated exercises focusing
memorization of the content can be easily found in
many 21st century higher education institutions.
It follows an extremely conservative paradigm, in
which the pursuit of highly specialized technical
efciency separates reason from feeling, body
from mind, and science from ethics [3,4].
The model of higher education affects
professionals’ skills [5,6], especially humanization,
which combined to the accelerated development
of digital technologies highlights the need for
transformation. The revision of teaching strategies
has become necessary because traditional
pedagogy, used in most educational institutions,
is proving to be insufcient to keep up with the
speed of progress in our society, thus dictating
new national curricular guidelines [7,8].
Higher education institutions have, among
their duties, to dispose and make educators
aware of the mission of teaching theoretical
content and to encourage students to develop
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Guirado MMG et al.
Evaluation of different teaching methodologies by assessing the performance of dentistry students
Guirado MMG et al. Evaluation of different teaching methodologies by assessing
the performance of dentistry students
Many active learning methods have been
described: problematization, problem-based
learning (PBL), team-based learning (TBL),
ipped classroom, seminars, critical experience
reports, socialization, round tables, thematic
debates, workshops, commented reading,
movies, musicals, dramatizations (role-play),
playful-pedagogical dynamics, and portfolio,
among others [18,19].
TBL, based on constructivism, places the
professor as a facilitator and promotes dialogue
and collaborative interactivity of students. Thus,
knowledge is aggregated and reconstructed in a
concrete and meaningful learning process [20].
Studies from health science courses have shown
an overall improvement in student performance
who has classes in active format, using the TBL
method [21,22]. Studies have been reported the
TBL as a more efcient methodology compared to
traditional teaching in dentistry [23,24].
When faced with the increase in the number
of students, educators’ questions themselves
about the feasibility of maintaining its preferred
teaching technique, based on passive learning
or focus on based on group work and focused
on content application. Other doubts arise [25].
How not to prioritize the use of lectures? How to
stimulate motivation from the students? How to
ensure they arrive prepared for the study?
The aim of this study was to compare the
performance of day- and evening-class students
in the rst semester test of Dental Materials in the
School of Dentistry at São José dos Campos - UNESP,
who were exposed to traditional lectures and
TBL. The null hypothesis was that: there were no
differences between TBL to traditional lectures on
mean grades of test responses, and there were no
differences between class periods performance
regarding to teaching-learning method.
MATERIALS AND METHODS
The results of Dental Materials rst semester
test of second-year dental students, from day
and evening classes of 2016 were tabulated
and analyzed in this research - approved
by Research Ethics Committee - No. CAAE:
01908018.0.0000.0077. Teachers used TBL and
traditional lectures (TRAD) for both class periods,
alternating between them, i.e., a topic taught with
TBL in day class was addressed by TRAD in the
evening class and vice-versa.
The groups formed for the execution
of the methodology were randomized
using the individual global average of the
previous year (1 year) of the students, and
heterogeneous groups were composed of 6 to
7 members, combining students from different
performances.
Methodological care was taken to approach
the themes in a cross-sectional way during the
planning of the teaching plan and carrying out
the activities throughout the semester. The
assessment instrument was the same between
school periods, which consisted of 10 essay
questions, thus all students, from day and evening
classes, took the same type of test, however the
tests were different between the classes. The tests
were applied in the same day for both classes but
at different times, respecting the time the course
was offered. Thus, both classes were submitted
to similar temporal distance from classes to
evaluation.
The test, that consisted of ten questions,
from which the information on the identication
of the teaching strategy is contained in Table I.
The tests were prepared by a group of professors
(5, being 1 effective and 4 substitutes) of the
discipline, who graded the degree of difculty of
each question and ensure fairness between the
tests in the two school periods. All 10 questions
had the same weight in the nal grade of the
students’ test. The tests were part of the regular
evaluation of the discipline and the correctors had
access to the student’s identication.
Table I - Theme of each question and the methodology for each
class in both periods (day and evening class). Traditional lectures
(TRAD) and Team-Based Learning (TBL) methodology
Class topic Methodology
Alginate Day class TBL
Evening class TRAD
Acrylic resins 1 Day class TBL
Evening class TRAD
Acrylic resins 2 Day class TBL
Evening class TRAD
Elastomeric impression material Day class TRAD
Evening class TBL
Metal alloys Day class TRAD
Evening class TBL
Metal casting Day class TRAD
Evening class TBL
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Guirado MMG et al.
Evaluation of different teaching methodologies by assessing the performance of dentistry students
Guirado MMG et al. Evaluation of different teaching methodologies by assessing
the performance of dentistry students
The subjects of the questions were: impression
materials - alginate; acrylic resins (two questions);
elastomeric impression material; metal alloys and
casting (two questions). During the correction
of the tests, the subject of each question and
the applied methodology were identied. Each
question was valued from 0 to 10, thus facilitating
the scale for partial answers. Responses of each
question were graded separately according to the
subject for comparison between TBL and TRAD
(Table II). A total of 88 tests were evaluated,
50 from day classes, and 38 from evening classes.
The evaluation of the tests had a blueprint
for its correction in order to reduce subjectivity,
and the correction was guided by a template
formulated jointly by 2 professors (1 substitute
and 1 permanent), to minimize discrepancies.
The data were tabulated and submitted to
t-test (Excel MS, Microsoft). The average of each
question was compared by the method used in
the classes, as well as by comparing the averages
of the grades obtained in classes covered by TBL
and traditional lectures. Statistical analyses were
performed with a signicance level of 0.05.
RESULTS
The subject of questions, teaching methodology
in each class period, and the students’ performance
in each response, separately, are presented in
Table II. A low mean grade was observed for
the response of question #6 and #4 by day class
and evening class students, respectively, which
decreased the overall average for TBL method, as
well as for the response of question #6 by day class
that decreased the average for TRAD method.
The mean grade for each teaching method is
presented in Figure 1, which showed to be similar
to each other.
The comparison between student’s mean
grade in relation to the teaching method
and class period was showed in Figure 2.
Data followed normal distribution according
to Anderson Darling (p=0.12; α=0.05).
Teaching methodologies, TBL and TRAD, showed
to be similar for each class period (p = 0.409
and p = 0.114; t-test). Students from day class
presented higher grades with TBL whilst evening
class students presented better performance in
questions with traditional lectures.
Table II - The subject of each question, teaching methodology (TBL/ TRAD) in each class period, and the students’ performance in each response
Question Subject
Teaching methodology: Grades
DC EC
1 Alginate TBL: 8.58 TRAD: 7.91
2 Acrylic resin 1 TBL: 5.81 TRAD: 6.14
3 Acrylic resin 2 TBL: 8.42 TRAD: 6.11
4 Elastomeric impression material TRAD: 8.02 TBL: 3.54
5 Metal alloys TRAD: 6.98 TBL: 5.94
6 Metal casting TRAD: 2.58 TBL: 5.10
DC – day class, EC – evening class, TBL – Team based learning, TRAD – traditional lecture. Source: Prepared by the authors
Figure 1 - Mean grade (S.D.) for TBL – Team based learning and
TRAD – traditional method, similar to each other (p = 0.96; t-test).
Source: Prepared by the authors.
Figure 2 - Mean grade (S.D.) in relation to the teaching method
and class period. TBL – Team based learning and TRAD – traditional
method. Teaching methodology showed to be similar for each class
period (p = 0.409 and p = 0.114; t-test).
Source: Prepared by the authors.
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Evaluation of different teaching methodologies by assessing the performance of dentistry students
Guirado MMG et al. Evaluation of different teaching methodologies by assessing
the performance of dentistry students
DISCUSSION
Many teachers are changing the way they
teach, by replacing the traditional class in which
students often just listen, repeat, and occasionally
ask questions, with classes considered as more
dynamic. One of the main tasks of higher education
is to involve students in active learning [23].
This change is due to the inuence exerted by
national curricular guidelines that recommend
student-centered teaching strategies, in which the
pedagogical project is collectively constructed and
centered on the student as a subject of learning,
and the teacher plays the role of facilitator and
mediator of the teaching-learning process [8].
In this context, higher education institutions are
increasingly being encouraged to change the
way they teach, making teachers and students
learn from new networks of knowledge and
thus training professionals capable of dealing
with the social reality that will be found in
their professional life [3,25]. Consequently, the
professor should share information using different
approaches so that students can choose which are
better suited to their learning needs, and then
focus on out-of-class study [26-29]. However,
active learning is still new in many Brazilian
Dental Schools. Unfamiliarity of professors and
students to these teaching-learning methods has
impaired the implementation in daily classes,
being necessary to invest in training professors
in active learning methods [30-32].
The new methodological practices of teaching
need time for their adaptation and consolidation.
The classes of 2016 were the first ones to be
exposed to TBL in the course of Dental Materials.
The students’ overall performance was similar
when both methodologies (TBL and TRAD) were
compared. Thus, the rst null hypothesis that there
were no differences between TBL to traditional
lectures on mean grades of test responses was
accepted. However, it is necessary to emphasize
that this was considered the first contact of
the students with the active TBL methodology,
and since the period of establishment of this
methodology and the way students prepare for
classes improves with sequential sessions over
time, this average tends to rise. Moreover, the
students’ adaptation to the methods and the time
of use of the methodologies by the teachers also
determines their consolidation [30].
Implementing TBL or some other methodology
that has inverted classroom philosophy creates
space for concrete learning where students adopt
the role of cognitive learners to practice thinking
as a specialist within their eld [31], in a discipline
in which the theoretical content must be aligned
with the practical content, as is the case in the
dental materials discipline of the undergraduate
dentistry course. The development of this type
of methodology allows the student to create a
consistent reasoning of concepts at the time of
performing the practical activity. Team-based
learning approach increase dental students’
performance because students were provoked to
think and clarify problems rather than commonly
memorize accurate knowledge [33].
Despite there were no differences, higher
mean grades were achieved with different
teaching-learning methodology in different
class periods. Day class students presented
superior performance with TBL while evening
class students achieved higher mean grades
with traditional lectures. Therefore, the second
null hypothesis that there were no differences
between class periods performance regarding to
teaching-learning method was rejected. In Brazil,
double shift is often a reality for students of
evening classes, where work and study are
reconciled [34]. It could have reduced the
available time for out-of-class study jeopardizing
the performance of students in TBL classes and
consequently, in the questions related to these
subjects.
TBL, besides other collaborative active
learning methods, creates space for concrete
learning. Students can develop technical
professional knowledge skills to solve increasingly
challenging problems [31]. In this scenario, one
of the drawbacks of the present study was that
students’ individual contribution to the group was
not assessed [35]. Collaborative active methods
also allow students to develop/enhance their
emotional intelligence [36], which showed to be
important because of its inuence on students’
learning behavior [37]. According to some
authors [38,39] motivation can be divided into
intrinsic, which involves the inherent satisfaction
produced by acquiring new science knowledge,
and in extrinsic motivation, which involves
learning science as a means to a concrete end [40].
Two scales were introduced to the classical scale
termed extrinsic motivation, i.e., grade motivation,
related to short-term goals, and career motivation,
related to long-term goals [39], which more clearly
target the objectives that students perceive to be
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Evaluation of different teaching methodologies by assessing the performance of dentistry students
Guirado MMG et al. Evaluation of different teaching methodologies by assessing
the performance of dentistry students
important at this stage of their education [41].
According to Twenge (2013) [42], allowing
generation Z workers small career leaps, such as
acting as a preceptor for students, can help to install
and cultivate condence. This principle can also
work for generation Z undergraduate students.
Thus, group study could be important when
considered as a space for peer-instruction
teaching and learning.
The results of this research corroborate
previous studies that have demonstrated that
TBL method is a promising way to teaching
in dentistry course [43-45]. The complexity
of subjects also showed to influence on the
effectiveness of teaching-learning method and
consequent students’ performance. However,
it was considered that active learning methods
can be successfully implemented. It should be
emphasized that time is a fundamental factor
for the long-term success of active learning
methods [31]. Further studies about in-class
daily practice in Brazilian Dental Schools
involving active learning should be performed
to increase data and exchange of experiences
focusing improvement of teaching learning
process in Dentistry.
One limitation of this study is that no courses
is yet being fully offered using TBL as a teaching
strategy at the university where the research was
carried out; so, it would be interesting a comparison
between different teaching methodology for
classes that had completed the entire course
in the TBL or traditional method in each term.
Thus, there is an open subject for further studies.
CONCLUSIONS
Based on the results, the following conclusions
were made:
- general performance of students was similar
when comparing TBL to traditional lectures;
- TBL was more effective in day class.
On contrary, traditional lectures were more
effective in evening class;
- the complexity of subject presented an
important role in students’ performance.
Active learning should be further implemented
in Brazilian Dental Schools to change students’
habits aiming to improve their personal and social
skills besides of professional technical knowledge.
Author’s Contributions
MMGG: Conceptualization, Methodology,
Formal Analysis, Investigation, Writing – Original
Draft Preparation, Writing – Review & Editing.
RNT: Conceptualization, Methodology, Formal
Analysis, Investigation, Writing – Original
Draft Preparation, Writing – Review & Editing.
VRS: Conceptualization, Methodology, Formal
Analysis, Investigation, Writing – Original
Draft Preparation. VSSB: Conceptualization,
Methodology, Formal Analysis, Investigation,
Writing – Original Draft Preparation, Writing
– Review & Editing. MS: Conceptualization,
Methodology, Formal Analysis, Investigation.
SR: Conceptualization, Methodology, Formal
Analysis, Investigation, Writing – Original Draft
Preparation, Writing – Review & Editing.
Conict of Interest
The authors declare no conict of interest.
Funding
This research received no external funding.
Regulatory Statement
This study was conducted in accordance with
all the provisions of the local human subjects
oversight committee guidelines and policies of
Research Ethics Committee of ICT/CSJC – UNESP.
The approval code for this study is: CAEE
01908018.0.0000.0077.
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Suzelei Rodgher
(Corresponding address)
Universidade Estadual Paulista (Unesp), Instituto de Ciência e Tecnologia,
Departamento de Engenharia Ambiental. São José dos Campos, SP, Brazil.
Email: suzelei.rodgher@unesp.br
Date submitted: 2023 Jan 01
Accepted submission: 2023 June 13
