Utilising a web-based e-learning platform for orthodontic case analysis training: a randomised controlled trial

Abstract

In orthodontic case analysis, structured clinical reasoning is required to achieve a diagnosis and establish a treatment decision. In this randomised controlled trial, a web-based training app was compared with conventional analogue case planning in undergraduate dental students. Twenty-eight undergraduate dental students from RWTH Aachen University were randomised to either a digital training group, using the web-based app Orthotrainer, or an analogue training group, performing conventional case analyses with physical models and printed diagnostic records. After a baseline knowledge and online readiness assessment, both groups completed two standardised training sessions. Following the sessions, the ease of use was assessed using the System Usability Scale and the User Experience Questionnaire. The final analogue module exam tested knowledge transfer. Additionally, 27 orthodontic educators from four university orthodontic departments were surveyed regarding analogue correction practices. Baseline orthodontic knowledge was comparable between groups (analogue: M = 13.07 ± 3.15 vs digital: M = 12.86 ± 2.41, p = 0.842). Both groups demonstrated significant performance improvement across training sessions separated by three weeks, ß = 8.31, 95% CI [2.66, 13.96], p = 0.005, without overall group differences. Exploratory subarea analyses revealed analogue superiority in extraoral assessment (b = 23.37, 95% CI [7.31, 39.42], p < 0.001), digital advantage in radiographic evaluation (b = -17.34, 95% CI [-33.40, -1.29], p = 0.002) and no difference in the model analysis. There were no differences between the groups in the final module exam. The usability assessment yielded a mean SUS score of M = 78.89 ± 14.11 for digital training (compared to the analogue training, M = 40.30 ± 11.19, p < 0.001), while students rated the UEQ for the digital version higher in the dimensions of pragmatic, hedonic quality and overall quality (all p < 0.001). Among 27 surveyed educators, analogue correction was rated time-intensive, with preference for digitalisation. The Orthotrainer web application delivered diagnostic performance equivalent to that of conventional analogue training, proving particularly effective in radiographic analysis. Higher usability and user experience ratings support its integration into routine teaching. These findings suggest that structured digital tools can support the development of diagnostic reasoning and serve as a valuable addition to traditional orthodontic education.