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5
Braz Dent Sci 2023 July/Sept;26 (3): e3819
Toniolo J et al.
Usefulness and satisfaction of a digital learning tool for caries detection using ICDAS
Toniolo J et al.
Usefulness and satisfaction of a digital learning tool for caries
detection using ICDAS
was using the DLT as blended learning, so
it has the function of an extra-class activity
for undergraduate dental students to train
their diagnostic abilities. Frehywot et al. [16]
evaluated several studies comparing blended
learning with traditional approaches and found
that blended learning yielded either promising
results or no statistically signicant difference
in outcomes between the different modalities.
This evaluation also indicated that blended
learning is effective for conveying medical
knowledge and developing practical competences,
for example, detecting caries lesions and scoring
them. We opted for releasing certicates only
after the user responded to the satisfaction
questionnaire as a way of stimulating them to
respond to it. As reported by others [17], it is
easier to motivate learners to gain knowledge
than to contribute to a research study. It could
be speculated that many undergraduate dental
students who used the DLT were encouraged
by their professors to use it as an extra-class
activity, and therefore, their professors may
have asked them to submit the nal certicate
as conrmation of accomplishment.
Rocha et al. (2021) [18] compared
different teaching methodologies for the
training of radiographic detection of proximal
carious lesions. The authors observed that
students preferred active or a hybrid (blended)
methodology, reporting to be easy to learn,
making themselves feel more confident in
performing the trained diagnosis. A study
conducted by Maatuk et al. (2021) [19] stated
that students agreed that e-learning is useful and
helped them to be condent and improved their
academic standards. However, they reported
to be worried that this fact could decrease the
workload for teaching staff and could raise the
pressure on students. These ndings are similar
to ours, since students found that our DLT
helped them on learning, gave them immediate
results and t their needs.
We consider the 34% of evasion rate
moderate. This may be due to the length of
the tool, which was comprised of 60 questions
that were previously tested in the controlled
environments [13,14]. Also, the user interface
factor scored the lowest in our satisfaction
questionnaire (79.2%). It is important to state
that both previously published studies using the
DLT [13,14] were conducted in a controlled
setting, so all users who participated in the
study had to nish their training. In the present
investigation conducted in a non-controlled
setting, since 1574 people who visited the site
did not feel motivated to start the DLT, it could
be suggested the need to invest a greater effort
in better design and in a more attractive layout.
The users of the present DLT averaged
15 minutes and 14 seconds to complete the
tool; this represents the average time a user was
actively interacting with the site, responding to
the questions, reading feedback, and checking the
ICDAS table. This was expected, as it is known
that the average student has an attention span
between 10 and 20 minutes [18]. Users that
nished the tool had great interest in doing so,
as they would return even after taking a break.
We may also infer that a shorter DLT might have
a lower evasion rate. Reducing the number of
questions should be considered, however this
could be risky, as the learning efcacy of this
DLT has been assessed by two studies [13,14],
using the same number of pictures and the exact
number and format of questions.
E-learning tools have their limitations.
To assess the activity status of a caries lesion,
three factors need to be considered when a
carious lesion is examined visually and gently
probed: plaque accumulation, visual appearance
(opacity), and tactile feeling (roughness) [7].
In this context, activity assessments would be
hardly possible using any DLT.
According to traffic data of the website
compiled by Google Analytics, access to the tool
peaked in the beginning of quarantine in Brazil
due to the Covid-19 pandemic. On March 11,
2020, the World Health Organization (WHO)
declared the coronavirus (COVID-19) outbreak a
global pandemic. In the period of only a month
after the beginning of quarantine in Brazil we
had 96 new users, which represents 30% of the
number of users of a whole semester in 2019.
The DLT to complement the ICDAS training
that is available online had greater reception
and interest from the public than expected.
We conclude that this DLT, in the present
format, is mostly useful for teaching ICDAS in
dental schools as a tool for blended learning.
This exploratory study has opened our eyes
to usability issues we could not perceive in
previous controlled studies. In this manner, we
can continue to improve this DLT to better t
e-learners’ needs and hopes.