Educational videos as a teaching approach to enhance students’ practical skills in preclinical courses

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The use of video teaching material is increasingly popular and has been useful under Covid-19 teaching circumstances, where practical courses have been somewhat limited according to the pandemic situation. To our knowledge, this is the first study until now to evaluate video assisted teaching, regarding oral hygiene instructions, in dental education. Objective: The aim of this study was to investigate if high-quality educational videos could be a useful addition to the practical course of oral hygiene instructions in single or repetitive viewing and therefore be beneficial for improving students´ practical skills in performing oral hygiene instructions, including the perception of the students and their perceived security. Methods: 82 students form the 2 nd term of dental school were enrolled in this study and assigned to two groups. The students watched two videos showing the application of the bass toothbrushing method and the interdental brushing technique. Group 1 viewed the video only once, whereas Group 2 viewed the videos repeatedly every week on four consecutive weeks before seminar. By the end of the four weeks, the students were conducted to a practical test to evaluate the level of their obtained skills and filled out a questionnaire regarding their subjective experience of the educational videos. Conclusion: The results of this trial show that the students subjectively gained increased security in precision after watching the videos, whilst performing the required tasks. The students exhibited significant improvement in toothbrushing technique and applying the interdental brush after repetitive viewing of the videos compared to single viewing. There were no significant differences between groups regarding the assessment of the size of interdental spaces using a colorimetric probe. Dental students Education Toothbrush Bass technique Oral care Preventive dentistry e-learning Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction This study was conducted during the Covid-19 pandemic, when the performance of practical courses was a challenge and required adaptation of teaching methods to maintain the level of education and motivation among the students. Ensuring the safety of the teaching staff and students as SARS-CoV-2 is highly contagious, were priority, whilst ensuring a continuance of the required curriculum [ 1 ]. Teaching approaches with e-learning and the use of digital tools were implemented to a greater extent, than in previous years. According to one study, up to 82.5% students of the university have participated in distance learning in their medical school in the midst of COVID-19 pandemics [ 2 ]. In the United States, most of dental schools were limited to non- clinical activities and dental emergencies, postponing direct patient care [ 3 ]. E-learning has since gained in value, as an important alternative teaching method or complement to clinical courses [ 4 ]. Students worldwide are using various innovative technological tools as supplement to their face-to-face courses. E-learning refers to a technology-assisted learning system and is first described in 1998. The aim is to implement a customized, inter-active educational environment with various materials and technologies [ 5 ]. Video assisted coaching was recently introduced in general and dental medicine as a useful addition to practical seminars [ 6 – 9 ]. The videos have been a useful adjunct modality during pandemic restrictions and reduced patient contact. Oral hygiene instructions (OHI) are an important part of prevention and long-term success of treatment of oral health diseases, including caries, gingivitis and periodontitis [ 10 ]. Improving the awareness for oral health amongst dental students throughout the curriculum is of importance for patients’ oral health and prevention [ 11 ]. The right brushing technique is of great importance for preventing damage to gums and teeth whilst cleaning the surfaces of the teeth. The bass technique has been described as an effective and technique to clean the surfaces of the teeth [ 12 , 13 ]. Individual OHI consist, apart from the right toothbrush, of choosing the right interdental device and demonstrating the correct use to the patient. The interdental brush (IDB) is a useful and effective tool for removing the plaque from the interdental space [ 14 ]. The use of the IDB should be instructed to the patients correctly and in the adequate size, according to the interdental space diameter [ 15 ]. As of yet, however, there have been no investigations on digital oral hygiene training and education in undergraduate dental students. The objective of this study was to investigate if viewing of the educational videos would yield improvement in knowledge and perceived security regarding practical skills, thus if repetitive viewing would improve the precision and performance of OHI compared to a single viewing. The participants watched two instructional videos addressing a manual toothbrush technique and interdental cleaning once or multiple times. The study participants were asked to fulfil a questionnaire about their experience of the course and whether or not the videos have contributed to their knowledge or perceived security regarding bass method and interdental brushing. The dental students’ responses were scored using a five-point Likert scale [ 16 ]. After completion of the course, the correct technique of the bass method and interdental brushing, as well as the precision of choosing the right IDB for different interdental spaces were observed and evaluated by the examiners. Methods Study Design & Participants This study was conducted at the University Clinic of Dentistry of Vienna, Medical University of Vienna, from 26.04.2022 until 02.06.2022, in accordance with the Declaration of Helsinki. Ethical approval was obtained from the intra-university data protection commission and the clearing office of the Medical University of Vienna. The study was designed in cooperation with the Teaching Center of the Medical University of Vienna. The results of the test had no impact on the students' term assessment. A total of 82 first-year dental students participated in the study on a voluntary basis. Students were informed about the study-related objectives according to the protocol before the courses began. The medical administration office divided the students into eight groups based on their university curriculum schedule. The groups of students were then randomly assigned to two groups by drawing lots, consisting of group 1 (n = 40) and group 2 (n = 42). All students provided consent to participate in the research. The students were assigned a study participant number, which was only available to the study coordinator. Data from exams and questionnaires were collected and stored securely at the University Dental Clinic, accessible only to the examiners and study coordinator. Educational Video Development The educational videos were developed by SD, an experienced periodontologist and educator in this field, following thorough preparation. The videos demonstrated the correct use of OHI devices on a selected patient and were filmed and edited by a professional photographer. The video was filmed using the Canon 5D Mark III, a full-frame DSLR camera. It was set up to record in 1080p resolution. For post-production, the footage was edited using Adobe Premiere. Adobe Premiere was used to cut, arrange, and refine the footage, adding transitions, color grading, and audio adjustments to create a polished final video. Independent validation of the videos was conducted by additional specialists from the Department of Periodontology to ensure accuracy and effectiveness. The first video focused on the correct application of the Bass Technique and the position of the bristles for all tooth surfaces, recorded in high quality with additional visual and auditory information. The second video demonstrated the measurement of several interdental spaces with a calibrated probe and the correct technique of interdental brushing, with a duration of approximately three minutes. Both videos included audio descriptions explaining key points. Intervention Protocol During the first week, the students completed an oral hygiene practical course, learning the correct tooth brushing technique and interdental cleaning devices. These skills were practiced on themselves and their fellow students. The courses were held in dental chairs in small groups of up to four students per instructor. Following the practical course, students attended obligatory seminars where they viewed the instructional videos. Group 1 watched the videos only once, while Group 2 viewed the videos a total of four times, once per week over four consecutive weeks. The videos' total duration did not exceed 10 minutes, ensuring no reduction in available training time. Students received scientific articles on research about toothbrushes and interdental devices and additionally a handout from the introductory lecture on plaque control. Practical Testing & Evaluation After completing the seminars, students underwent a practical test on a plastic model, which was conducted by two experienced specialists. The practical test comprised two parts: Bass Technique Evaluation: Students demonstrated the Bass technique with a manual toothbrush (CURAPROX CS5460 Handzahnbürste ultra soft; Curaden, Kriens, Switzerland). Their technique was evaluated in the anterior and posterior jaw areas, focusing on the correct position, pressure, and movement of the brush and bristles. IDB Assessment: Students determined the adequate IDB size using a colometric Probe (IAP CURAPROX©; Curaden, Kriens, Switzerland). The calibrated probe suggested the suitable IDB size through a color code. The use of the IDB for two assigned interdental spaces was evaluated, emphasizing the correct size selection and application (CPS Prime/Perio Interdental Brush, Curaden, Kriens, Switzerland). Scoring Criteria were as following: The precision of the participants was categorized as correct (completely accurate technique), acceptable (improvable but not incorrect), or incorrect (completely wrong technique). The examiners were blinded to the group assignments and calibrated through assessment of the practical skills of 10 students with a mean percentage agreement of 77.78%. Questionnaire & Subjective Perception Participants completed a questionnaire specifically developed for this study to evaluate their subjective experience of the video viewing. The questionnaire comprised five questions using a 5-point Likert scale (strongly disagree, somewhat disagree, don’t know, somewhat agree, strongly agree) and was included in the supplementary material of this manuscript. The first four questions were identical for both groups, while the fifth question focused on either single or repeated video viewing. Students completed the questionnaire on a voluntary basis before the practical test. The questionnaire and the practical test were conducted independently. Statistical Analysis Statistical analysis was performed using SPSS version 27. A Mann-Whitney-U-Test (p < .05) was conducted to determine if repetitive video viewing led to significant improvements in observed precision and perceived security regarding practical skills, compared to single viewing. Normal distribution was tested using the Kolmogorov–Smirnov test (listwise and pairwise exclusion). The non-parametric Mann–Whitney-U-Test was used to compare differences between the two independent groups. The effect size was calculated to describe the magnitude of between-group differences. The study hypothesized that repetitive viewing of the videos would yield a significant improvement in observed precision and perceived security regarding practical skills. Results Practical Test Performance The practical exam consisted of two parts: the Bass technique with six components and interdental brushing with two components. Group 1 (single video viewing) differed significantly from Group 2 (repeated video viewing). Group 2 demonstrated significantly better results in observed precision regarding practical skills in both exam parts. Performance was evaluated by two experienced dental professionals as correct, acceptable, or incorrect. Observations included the movement of the brush, the applied pressure, and the quantity of brushing. The Bass technique assessment included evaluating the position, movement, and pressure of the brush and the angulation of the bristles. Statistically significant differences were observed between the groups. Students applied the technique to one anterior lingual and one anterior buccal localization of the jaw model, with similar results in both regions (Table 1). The most common mistakes were applying excessive pressure, incorrect brush placement, and improper movement (Figs. 1–5). Regarding the application of the IDB, Group 2 showed significantly higher precision compared to Group 1. There were no differences between groups in assessing the size of interdental spaces using a colorimetric probe. Both groups demonstrated similar mistakes during the IDB selection process, often choosing a smaller brush size than required. In the second test part, 14% of Group 1 students applied the IDB with correct movement and pressure, compared to 28% in Group 2. One participant was absent from the course, and her test results were therefore not included in the final results of the practical test, only of the questionnaire. Questionnaire Results The questionnaire evaluated participants’ perceived confidence in practical skills and their assessment of the videos’ usefulness. Group 2 reported significantly higher levels of perceived security in practical skills compared to Group 1 (Table 2). Notably, this increased confidence was accompanied by a measurable improvement in practical performance. Overall, participants expressed a positive impression of repeated video viewing, with 67% of Group 1 preferring to watch the videos before the second practical session and 81% of Group 2 stating that repeated viewing enhanced their knowledge. The results were consistent across all five questions. Visual Summary Table 1 presents a detailed comparison of practical test performance between Group 1 and Group 2, highlighting the significant differences in observed precision and practical skills. Table 2 summarizes the questionnaire results, showing higher perceived confidence in Group 1 but greater perceived knowledge enhancement in Group 2. Figures 1–5 illustrate common errors in the practical test and differences in technique precision between groups. Several questions during the examination were not marked as completed and as such have not been included in the analyses. Discussion This research investigated the effect of high-quality educational videos as an adjunct to hands-on OHI in preclinical dental courses. The present findings indicate that students who repeatedly engaged with these videos exhibited greater comprehension and precision in OHI approaches, enhanced demonstration abilities, and gained advantages from recurrent learning. The results of this study show that integrating such videos alongside conventional practical training can substantially enhance learning and possibly elevate patient education outcomes in dental studies. The main aim of the practical course for the students was to apprehend knowledge of instructing the bass technique and the correct choice and use of the IDB in order to prepare them for the upcoming clinical part of their studies. To the best of our knowledge, this investigation can be considered the first to evaluate the teaching effect of tooth brushing videos in undergraduate dental students. The correct choice of an oral hygiene device for the patient and adequate OHI are an important part of prevention in dentistry. The proper brushing technique is essential for maintaining the health of the gums and teeth while efficiently eliminating plaque. Forceful and/or incorrect brushing techniques might result in mechanical injury, leading to gum recession over time and abrasion of tooth surfaces. As previously demonstrated, manual toothbrushes with softer bristles may be safer for the soft tissues, whilst use of hard bristles may cause soft tissue trauma [ 17 ]. Gum recession exposes sensitive root surfaces, thereby heightening the risk of tooth sensitivity and decay. The IDB is an efficient instrument for plaque elimination in the interdental areas of individuals and should be appropriately introduced, shown, and sized according to the width of the interdental space in order to avoid trauma to the tissue [ 15 , 18 ]. Instructing on the proper method guarantees that patients maintain effective hygiene while minimizing potential injury to the oral structures. In the present investigation, the students used a calibrated colorimetric probe to measure the diameter access of the interdental spaces and practiced the previously demonstrated brushing movements for ensuring atraumatic use of the IDB. The individual OHI method for calibrated IDB is effective and acceptable for patients, encouraging the daily use of an adequate interdental device [ 19 ]. While the study highlights the benefits of educational videos in skill development, it does not assess their direct impact on patient safety. Instead, the findings emphasize the role of the videos as an effective learning tool to enhance students' practical abilities in oral hygiene instruction. The results of this study suggest that multiple viewings of the videos had a positive impact on the movement and applications of the oral hygiene devices. The angulation, pressure, and movement of the manual toothbrush exhibited by group 2, who watched the videos four times, were more precise compared to group 1, who watched the videos once. In addition, group 2 scored higher regarding the correct application of the IDBs, however, not in selecting the right size of the device with the calibrated probe. The practical skills in choosing the right IDB were similar in both groups. Selecting the correct size of the IDB presents a challenge for many dental students in order to consistently provide adequate patient instruction. In the subsequent clinical part of the dental curriculum, students are often inclined to settle for smaller IDBs in order not to hurt the gums of the patient, especially in areas of inflammation. Furthermore, the insertion of the calibrated probe and IDB is a process that requires a tactile measurement which improve with practical experience. Therefore, this is our understanding of why, in this particular task, watching the videos repeatedly did not significantly improve the performance of the students. Providing efficient practical experience for medical and dental students has been a challenge during the coronavirus pandemic, with the need to adapt and optimize education [ 20 ]. During our courses, we found that providing students with additional learning material and supplementary videos helped close the knowledge gap if attendance was not possible due to restrictions or illness at that time. The video-assisted teaching has been investigated previously in general medicine as an additional tool to enhance practical skills [ 7 , 8 ]. Studies on the utilization of videos as an instructional approach in dental education underscore their efficacy in improving both theoretical understanding and clinical competence. In the field of periodontology, educational videos significantly improve the real-time visualization of procedures during periodontal treatment compared to conventional observation and contribute to the enhancement of their psychomotor skills [ 21 , 22 ]. Research indicates that educational videos enhance knowledge acquisition, with animated videos markedly elevating test results [ 23 ]. Videos, particularly on platforms such as YouTube, are shown to be effective in educating clinical skills. Students who additionally watched YouTube videos in addition to their lectures exhibited superior performance in tasks such as tooth carving when compared to those who depended exclusively on notes [ 24 ]. As recently described, videos can successfully combine visual and audio elements to enhance engagement and learning outcomes [ 25 ]. Videos offer consistent training, are readily accessible for repeated viewing, and facilitate self-paced learning, rendering them a flexible and invaluable resource in dental teaching. Essential characteristics of good educational videos encompass concise and targeted content, superior visuals (such as animations and clear examples), interactivity (including quizzes or annotations), and information grounded in research. Concerns over the accuracy of freely accessible web videos underscore the necessity for academic supervision and institutionally generated content [ 25 ]. A recent review centered on a comparative analysis of student performance and satisfaction regarding live versus video demonstrations, concluding that video-based learning notably enhances psychomotor skills and knowledge acquisition [ 26 ]. Effectively crafted videos continue to serve as a significant complement to conventional teaching techniques in dental education, enhancing engagement and learning results. In the present trial, both student groups have subjectively experienced a gain in precision, understanding, and practical skills through adjunct video presentation of the OHI, which was evaluated by means of a questionnaire. Traditional teaching methods can be a source of psychological distress, which may have a negative effect on the degree of psychological disorders, such as depression, anxiety, and burnout, among students [ 27 ]. According to a recent systematic review [ 28 ], the confidence of the students was reported to be higher after adjunctive teaching modalities. In diagnostic examinations, the medical students’ accuracy, confidence, and motivation to perform were shown to be improved with flexible e-learning videos [ 29 ]. Reduced stress levels among dental students have been reported when viewing videos during a fixed prosthodontic course [ 9 ]. The practical steps were shown in this study through videos and not a live demonstration. A previous study with students suggested that a well-designed videotaped demonstration was comparable to the teaching effect of a live demonstration [ 30 ]. The students, however, found preference in video demonstrations, considering it a better teaching tool, with the only disadvantage of not being able to ask questions and get immediate answers from an instructor. According to earlier research, live demonstrations were valued by dental students for real-time interaction and direct instructor feedback [ 26 ]. A randomized clinical trial investigated the impact of e-learning-assisted videos on preclinical skill competency levels in operative dentistry [ 31 ]. The students in the experimental group, which received a hybrid teaching modality, demonstrated a higher level of knowledge and skill competency than students who were only taught with traditional methods. An additional effect through video material is explained by the visualization of the procedure and enabling the students to recall the process and implement it in practice [ 30 ]. Regarding basic surgical skills among medical students, video-based teaching was shown to be as efficient as face-to-face teaching [ 32 ]. A study on undergraduate nursing students concluded that the use of an educational video on the puncture and heparinization of totally implantable access ports resulted in an increase of both cognitive and technological knowledge [ 33 ]. Additionally, high preference for video technology among dental students was indicated by one study [ 34 ]. The results of this trial support previous research that video-based learning is an effective tool for students in preclinical curriculum dental education, enhancing understanding and practical performance when utilized appropriately [ 35 ]. Students who watched the videos four times could demonstrate better performance in almost every exercise when compared to single viewing only, which could be of interest for future curriculum in terms of integrating repeated mandatory viewing before and during the courses. The study started four weeks before the practical test, and the group with repetitive viewing watched the video once per week. The other students watched the video once at the beginning of the month, so the time gap could have potentially influenced the learning outcome. It would be beneficial for students to voluntarily review the videos in post-practical sessions to reinforce learning and facilitate preparation for patient treatment. Additional dental procedures, including periodontal probing and scaling, tooth preparation, administration of local anesthesia, and execution of standard clinical examinations, could be illustrated through specialized short videos and incorporated into preclinical studies. For advanced students, revisiting the videos and extending the instructional duration to encompass communication skills and patient motivation would be advantageous. Alternative digital learning tools, including interactive simulation games, virtual reality technology, specialized e-learning platforms and mobile apps, could provide immersive, engaging, and adaptable learning experiences, improving educational outcomes and offering many chances for skill enhancement. Limitations This study had some limitations, that should be addressed. The short duration of the study with a lack of long-term follow-up of the students’ skills presents one limitation. For future studies, a long-term assessment of the learning effect would be of interest to evaluate this educational tool. Additionally, the students were unable to access the videos on personal preference, which was shown in previous studies to be an effective method [ 36 ]. This part of the study design was a conscious decision, since watching the same videos four times was not verifiable in a private setting. The study's findings indicate that short educational videos on oral hygiene instruction can enhance participants' knowledge, performance, and comprehension as a supplement to practical courses, however their relevance to complex dental procedures may be limited. Conclusion The viewing of high-quality short videos was shown to enhance students’ understanding and knowledge as an adjunct to practical courses. Repetitive viewing of educational videos seemed to be advantageous for students’ tooth brushing performance and interdental brushing technique when compared to skills after single viewing only. The students in group 2, who watched the videos four times, experienced a higher security regarding practical skills, compared to the group 1, who watched the videos only once. The data from this study suggest that multiple viewings of educational videos may help students achieve greater precision and a deeper understanding of oral hygiene instruction, potentially improving their ability to demonstrate these techniques in a clinical setting more accurately. For future adaptation of the dental curriculum, educational videos could be integrated as a mandatory part and additionally provided on demand throughout the student's courses for revisiting the apprehended knowledge and strengthening their clinical skills. Declarations Conflict of interest statement The authors declare that they have no conflict of interest. Author Contribution S.D., D.T. and M.L were involved in the student courses and exams. S.D. wrote the main manuscript text, J.G. prepared figures and tables. X.RF, A.M and A.H. reviewed the manuscript. Acknowledgement Our thanks go to all participants and colleagues who were involved in this study, and Mariano Nguyen for filming and editing the videos. We acknowledge Curaden, Switzerland for providing the materials for the student’s oral hygiene course. Data Availability Data is provided within the manuscript or supplementary information files References Sukumar S, Dracopoulos SA, Martin FE. Dental education in the time of SARS-CoV-2. Eur J Dent Educ. 2021 May;25(2):325-331 Al-Balas M, Al-Balas HI, Jaber HM, Obeidat K, Al-Balas H, Aborajooh EA, Al-Taher R, Al-Balas B. Distance learning in clinical medical education amid COVID-19 pandemic in Jordan: current situation, challenges, and perspectives. BMC Med Educ. 2020 Oct 2;20(1):341 Iyer P, Aziz K, Ojcius DM. Impact of COVID-19 on dental education in the United States. J Dent Educ. 2020 Jun;84(6):718-722. Naciri A, Radid M, Kharbach A, Chemsi G. 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Effect of a video on developing skills in undergraduate nursing students for the management of totally implantable central venous access ports. Nurse Educ Today. 2012 Aug;32(6):709-13. He K, Breitman L, Lee J, Van Doren E, Li A, Donoff RB. How US dental schools can better prepare their students to perform operative procedures. J Dent Educ. 2021 Apr;85(4):531-538. Schwarz G, Bleiner D, Günther D. On video lectures during remote teaching and beyond. Anal Bioanal Chem. 2022 May;414(11):3301-3309. Krumm IR, Miles MC, Clay A, Carlos Ii WG, Adamson R. Making Effective Educational Videos for Clinical Teaching. Chest. 2022 Mar;161(3):764-772. Tables Table 1. Comparison of group 1 and group 2 for Practical Test – Practical Exam in dental students (N=81) Median overall Group 1 (N=40) Control Group Group 2 (N=41) Test Group Mann-Whitney Question Median (mean) SD Median (mean) SD z P † Effect size 1.1 Position of the brush and angulation of the bristles (position: anterior buccal) 1 0 (0.60) 0.90 2 (1.51) 0.711 -4.375 0.000* -0.486 1.2 Correct pressure of the brush (position: anterior buccal) 2 2 (1.27) 0.877 2 (1.85) 0.478 -3.549 0.000* -0.394 1.3 Correct movement of the brush (position: anterior buccal) 2 2 (1.46) 0.682 2 (1.85) 0.432 -2.990 0.002* -0.339 1.4 Position of the brush and angulation of the bristles (position: anterior lingual) 2 1 (1.02) 0.947 2 (1.66) 0.617 -3.132 0.001* -0.348 1.5 Correct pressure of the brush (position: anterior lingual) 2 2 (1.38) 0.807 2 (1.80) 0.459 -2.684 0.004* -0.298 1.6 Correct movement of the brush (position: anterior lingual) 2 2 (1.65) 0.580 2 (1.93) 0.346 -2.905 0.003* -0.323 2.1 The assessment of 2 interdental spaces using an IAP CURAPROX© colorimetric probe (Nr. 1) 2 2 (1.25) 0.899 2 (1.37) 0.799 -0.474 0.323 -0.053 2.1 The assessment of 2 interdental spaces using an IAP CURAPROX© colorimetric probe (Nr. 2) 2 2 (1.41) 0.880 2 (1.33) 0.888 -0.500 0.339 -0.056 2.2 Correct application of the interdental brush 2 1 (1.15) 0.834 2 (1.76) 0.582 -3.690 0.000* -0.410 †Exact significance between group 1 and group 2 (one-sided), p < 0.05 Table 2. Comparison of group 1 and group 2 and for Self-Assessment in dental students (N=82) Median overall Group 1 (N=40) Control Group Group 2 (N=42) Test Group Mann-Whitney Question Median (mean) SD Median (mean) SD z P † Effect size Q1. The videos have contributed to a deepening of the learning content. 3 3 (2.85) 1.001 4 (3.43) 0.887 -3.027 0.001* -0.334 Q2. The videos made it easier to remember the practical parts. 3 3 (2.78) 1.097 3 (3.36) 0.727 -2.427 0.007* -0.268 Q3. The videos made it possible to increase the precision of the practical exercises. 3 2 (2.33) 1.047 3 (2.95) 0.936 -2.876 0.002* -0.318 Q4. The practical skills could be improved through the videos. 3 2 (2.42 1.035 3 (2.83) 0.853 -2.019 0.021* -0.223 Q 5.1 I would have liked to see the videos again before the second practical part. 3 3 (2.92 1.222 - - - - - Q 5.2 Repetitive viewing of the videos helped improve my knowledge. 3 - - 3 (3.10) 1.008 - - - †Significant difference between group 1 and group 2, p < 0.05 Additional Declarations No competing interests reported. Supplementary Files QuestionnaireGroup1.docx QuestionnaireGroup2.docx Cite Share Download PDF Status: Published Journal Publication published 02 Oct, 2025 Read the published version in BMC Medical Education → Version 1 posted Editorial decision: Revision requested 28 Apr, 2025 Reviews received at journal 23 Apr, 2025 Reviews received at journal 22 Apr, 2025 Reviewers agreed at journal 14 Apr, 2025 Reviews received at journal 14 Apr, 2025 Reviewers agreed at journal 13 Apr, 2025 Reviewers agreed at journal 07 Apr, 2025 Reviews received at journal 05 Apr, 2025 Reviewers agreed at journal 03 Apr, 2025 Reviewers agreed at journal 26 Mar, 2025 Reviewers agreed at journal 26 Mar, 2025 Reviewers invited by journal 26 Mar, 2025 Submission checks completed at journal 25 Mar, 2025 First submitted to journal 18 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Laky","email":"","orcid":"","institution":"Clinical Division of Periodontology, University Clinic of Dentistry, Medical University of Vienna","correspondingAuthor":false,"prefix":"","firstName":"Markus","middleName":"","lastName":"Laky","suffix":""},{"id":434426612,"identity":"948e003e-273a-42b0-b623-fd7b7527327f","order_by":2,"name":"Dino Tur","email":"","orcid":"","institution":"Clinical Division of Periodontology, University Clinic of Dentistry, Medical University of Vienna","correspondingAuthor":false,"prefix":"","firstName":"Dino","middleName":"","lastName":"Tur","suffix":""},{"id":434426614,"identity":"4c59fd52-9445-4fc7-b37d-5d80a43a8f0a","order_by":3,"name":"Julia Grundnig","email":"","orcid":"","institution":"Teaching Center, Medical University of Vienna","correspondingAuthor":false,"prefix":"","firstName":"Julia","middleName":"","lastName":"Grundnig","suffix":""},{"id":434426615,"identity":"49fbd4a3-acb6-4d66-8bd1-b6c9dfc5f99f","order_by":4,"name":"Xiaohui 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bristles\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5822344/v1/4e032cf4dc0b752a5a46ef20.png"},{"id":79351404,"identity":"4b5ade6c-5bdd-4f36-9d08-441991704295","added_by":"auto","created_at":"2025-03-27 10:28:21","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":27036,"visible":true,"origin":"","legend":"\u003cp\u003eThe differences in the practical test evaluation of dental students in group 1 and group 2 for correct pressure of the brush\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5822344/v1/3e447ddcbd225f0e76f0bdc8.png"},{"id":79353330,"identity":"de2dfa67-c419-408f-b7c3-20589a56d4c0","added_by":"auto","created_at":"2025-03-27 10:52:21","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":26629,"visible":true,"origin":"","legend":"\u003cp\u003eThe differences in the practical test evaluation of dental students in group 1 and group 2 for correct movement of the brush\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5822344/v1/b7aeee6c2f0d3fb1f1c509ae.png"},{"id":79352035,"identity":"25721ce3-166d-4b27-9803-0cfe211c4a01","added_by":"auto","created_at":"2025-03-27 10:36:21","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":27172,"visible":true,"origin":"","legend":"\u003cp\u003eThe differences in the practical test evaluation of dental students in group 1 and group 2 for correct assessment of two interdental spaces\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-5822344/v1/d73e11ec56716c33303de707.png"},{"id":79352040,"identity":"963288a9-677b-480e-a528-b8daebd97bff","added_by":"auto","created_at":"2025-03-27 10:36:21","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":23032,"visible":true,"origin":"","legend":"\u003cp\u003eThe differences in the practical test evaluation of dental students in group 1 and group 2 for correct application of the interdental brush\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-5822344/v1/5e5eeea50390e44cdad2df2d.png"},{"id":92884424,"identity":"561616df-09d2-4e2e-b6b0-a604ec0cedb8","added_by":"auto","created_at":"2025-10-06 16:12:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":815849,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5822344/v1/a800b0c5-92b3-4e72-b7ad-258bbde56d2b.pdf"},{"id":79351410,"identity":"bd045489-bdbb-4d8f-8c7c-916fb73fc1d5","added_by":"auto","created_at":"2025-03-27 10:28:21","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":20504,"visible":true,"origin":"","legend":"","description":"","filename":"QuestionnaireGroup1.docx","url":"https://assets-eu.researchsquare.com/files/rs-5822344/v1/36ab17b70473d57a33354eed.docx"},{"id":79352837,"identity":"ae100314-6335-40cf-9498-9af2851731b6","added_by":"auto","created_at":"2025-03-27 10:44:21","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":16971,"visible":true,"origin":"","legend":"","description":"","filename":"QuestionnaireGroup2.docx","url":"https://assets-eu.researchsquare.com/files/rs-5822344/v1/42d73b5d04c9dc278c97963a.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Educational videos as a teaching approach to enhance students’ practical skills in preclinical courses","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThis study was conducted during the Covid-19 pandemic, when the performance of practical courses was a challenge and required adaptation of teaching methods to maintain the level of education and motivation among the students. Ensuring the safety of the teaching staff and students as SARS-CoV-2 is highly contagious, were priority, whilst ensuring a continuance of the required curriculum [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Teaching approaches with e-learning and the use of digital tools were implemented to a greater extent, than in previous years. According to one study, up to 82.5% students of the university have participated in distance learning in their medical school in the midst of COVID-19 pandemics [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In the United States, most of dental schools were limited to non- clinical activities and dental emergencies, postponing direct patient care [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. E-learning has since gained in value, as an important alternative teaching method or complement to clinical courses [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Students worldwide are using various innovative technological tools as supplement to their face-to-face courses. E-learning refers to a technology-assisted learning system and is first described in 1998. The aim is to implement a customized, inter-active educational environment with various materials and technologies [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Video assisted coaching was recently introduced in general and dental medicine as a useful addition to practical seminars [\u003cspan additionalcitationids=\"CR7 CR8\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The videos have been a useful adjunct modality during pandemic restrictions and reduced patient contact.\u003c/p\u003e \u003cp\u003eOral hygiene instructions (OHI) are an important part of prevention and long-term success of treatment of oral health diseases, including caries, gingivitis and periodontitis [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Improving the awareness for oral health amongst dental students throughout the curriculum is of importance for patients\u0026rsquo; oral health and prevention [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The right brushing technique is of great importance for preventing damage to gums and teeth whilst cleaning the surfaces of the teeth. The bass technique has been described as an effective and technique to clean the surfaces of the teeth [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Individual OHI consist, apart from the right toothbrush, of choosing the right interdental device and demonstrating the correct use to the patient. The interdental brush (IDB) is a useful and effective tool for removing the plaque from the interdental space [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The use of the IDB should be instructed to the patients correctly and in the adequate size, according to the interdental space diameter [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs of yet, however, there have been no investigations on digital oral hygiene training and education in undergraduate dental students. The objective of this study was to investigate if viewing of the educational videos would yield improvement in knowledge and perceived security regarding practical skills, thus if repetitive viewing would improve the precision and performance of OHI compared to a single viewing. The participants watched two instructional videos addressing a manual toothbrush technique and interdental cleaning once or multiple times. The study participants were asked to fulfil a questionnaire about their experience of the course and whether or not the videos have contributed to their knowledge or perceived security regarding bass method and interdental brushing. The dental students\u0026rsquo; responses were scored using a five-point Likert scale [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. After completion of the course, the correct technique of the bass method and interdental brushing, as well as the precision of choosing the right IDB for different interdental spaces were observed and evaluated by the examiners.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy Design \u0026amp; Participants\u003c/p\u003e \u003cp\u003e This study was conducted at the University Clinic of Dentistry of Vienna, Medical University of Vienna, from 26.04.2022 until 02.06.2022, in accordance with the Declaration of Helsinki. Ethical approval was obtained from the intra-university data protection commission and the clearing office of the Medical University of Vienna. The study was designed in cooperation with the Teaching Center of the Medical University of Vienna. The results of the test had no impact on the students' term assessment.\u003c/p\u003e \u003cp\u003eA total of 82 first-year dental students participated in the study on a voluntary basis. Students were informed about the study-related objectives according to the protocol before the courses began. The medical administration office divided the students into eight groups based on their university curriculum schedule. The groups of students were then randomly assigned to two groups by drawing lots, consisting of group 1 (n\u0026thinsp;=\u0026thinsp;40) and group 2 (n\u0026thinsp;=\u0026thinsp;42). All students provided consent to participate in the research. The students were assigned a study participant number, which was only available to the study coordinator. Data from exams and questionnaires were collected and stored securely at the University Dental Clinic, accessible only to the examiners and study coordinator.\u003c/p\u003e \u003cp\u003eEducational Video Development\u003c/p\u003e \u003cp\u003eThe educational videos were developed by SD, an experienced periodontologist and educator in this field, following thorough preparation. The videos demonstrated the correct use of OHI devices on a selected patient and were filmed and edited by a professional photographer. The video was filmed using the Canon 5D Mark III, a full-frame DSLR camera. It was set up to record in 1080p resolution. For post-production, the footage was edited using Adobe Premiere. Adobe Premiere was used to cut, arrange, and refine the footage, adding transitions, color grading, and audio adjustments to create a polished final video. Independent validation of the videos was conducted by additional specialists from the Department of Periodontology to ensure accuracy and effectiveness.\u003c/p\u003e \u003cp\u003eThe first video focused on the correct application of the Bass Technique and the position of the bristles for all tooth surfaces, recorded in high quality with additional visual and auditory information. The second video demonstrated the measurement of several interdental spaces with a calibrated probe and the correct technique of interdental brushing, with a duration of approximately three minutes. Both videos included audio descriptions explaining key points.\u003c/p\u003e \u003cp\u003eIntervention Protocol\u003c/p\u003e \u003cp\u003e During the first week, the students completed an oral hygiene practical course, learning the correct tooth brushing technique and interdental cleaning devices. These skills were practiced on themselves and their fellow students. The courses were held in dental chairs in small groups of up to four students per instructor.\u003c/p\u003e \u003cp\u003eFollowing the practical course, students attended obligatory seminars where they viewed the instructional videos. Group 1 watched the videos only once, while Group 2 viewed the videos a total of four times, once per week over four consecutive weeks. The videos' total duration did not exceed 10 minutes, ensuring no reduction in available training time. Students received scientific articles on research about toothbrushes and interdental devices and additionally a handout from the introductory lecture on plaque control.\u003c/p\u003e \u003cp\u003ePractical Testing \u0026amp; Evaluation\u003c/p\u003e \u003cp\u003eAfter completing the seminars, students underwent a practical test on a plastic model, which was conducted by two experienced specialists. The practical test comprised two parts:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eBass Technique Evaluation: Students demonstrated the Bass technique with a manual toothbrush (CURAPROX CS5460 Handzahnb\u0026uuml;rste ultra soft; Curaden, Kriens, Switzerland). Their technique was evaluated in the anterior and posterior jaw areas, focusing on the correct position, pressure, and movement of the brush and bristles.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eIDB Assessment: Students determined the adequate IDB size using a colometric Probe (IAP CURAPROX\u0026copy;; Curaden, Kriens, Switzerland). The calibrated probe suggested the suitable IDB size through a color code. The use of the IDB for two assigned interdental spaces was evaluated, emphasizing the correct size selection and application (CPS Prime/Perio Interdental Brush, Curaden, Kriens, Switzerland).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eScoring Criteria were as following: The precision of the participants was categorized as correct (completely accurate technique), acceptable (improvable but not incorrect), or incorrect (completely wrong technique). The examiners were blinded to the group assignments and calibrated through assessment of the practical skills of 10 students with a mean percentage agreement of 77.78%.\u003c/p\u003e \u003cp\u003eQuestionnaire \u0026amp; Subjective Perception\u003c/p\u003e \u003cp\u003eParticipants completed a questionnaire specifically developed for this study to evaluate their subjective experience of the video viewing. The questionnaire comprised five questions using a 5-point Likert scale (strongly disagree, somewhat disagree, don\u0026rsquo;t know, somewhat agree, strongly agree) and was included in the supplementary material of this manuscript. The first four questions were identical for both groups, while the fifth question focused on either single or repeated video viewing. Students completed the questionnaire on a voluntary basis before the practical test. The questionnaire and the practical test were conducted independently.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eStatistical analysis was performed using SPSS version 27. A Mann-Whitney-U-Test (p\u0026thinsp;\u0026lt;\u0026thinsp;.05) was conducted to determine if repetitive video viewing led to significant improvements in observed precision and perceived security regarding practical skills, compared to single viewing. Normal distribution was tested using the Kolmogorov\u0026ndash;Smirnov test (listwise and pairwise exclusion). The non-parametric Mann\u0026ndash;Whitney-U-Test was used to compare differences between the two independent groups. The effect size was calculated to describe the magnitude of between-group differences. The study hypothesized that repetitive viewing of the videos would yield a significant improvement in observed precision and perceived security regarding practical skills.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003ePractical Test Performance\u003c/p\u003e \u003cp\u003eThe practical exam consisted of two parts: the Bass technique with six components and interdental brushing with two components. Group 1 (single video viewing) differed significantly from Group 2 (repeated video viewing). Group 2 demonstrated significantly better results in observed precision regarding practical skills in both exam parts. Performance was evaluated by two experienced dental professionals as correct, acceptable, or incorrect. Observations included the movement of the brush, the applied pressure, and the quantity of brushing.\u003c/p\u003e \u003cp\u003eThe Bass technique assessment included evaluating the position, movement, and pressure of the brush and the angulation of the bristles. Statistically significant differences were observed between the groups. Students applied the technique to one anterior lingual and one anterior buccal localization of the jaw model, with similar results in both regions (Table\u0026nbsp;1). The most common mistakes were applying excessive pressure, incorrect brush placement, and improper movement (Figs.\u0026nbsp;1\u0026ndash;5).\u003c/p\u003e \u003cp\u003eRegarding the application of the IDB, Group 2 showed significantly higher precision compared to Group 1. There were no differences between groups in assessing the size of interdental spaces using a colorimetric probe. Both groups demonstrated similar mistakes during the IDB selection process, often choosing a smaller brush size than required. In the second test part, 14% of Group 1 students applied the IDB with correct movement and pressure, compared to 28% in Group 2.\u003c/p\u003e \u003cp\u003eOne participant was absent from the course, and her test results were therefore not included in the final results of the practical test, only of the questionnaire.\u003c/p\u003e \u003cp\u003eQuestionnaire Results\u003c/p\u003e \u003cp\u003eThe questionnaire evaluated participants\u0026rsquo; perceived confidence in practical skills and their assessment of the videos\u0026rsquo; usefulness. Group 2 reported significantly higher levels of perceived security in practical skills compared to Group 1 (Table\u0026nbsp;2). Notably, this increased confidence was accompanied by a measurable improvement in practical performance.\u003c/p\u003e \u003cp\u003eOverall, participants expressed a positive impression of repeated video viewing, with 67% of Group 1 preferring to watch the videos before the second practical session and 81% of Group 2 stating that repeated viewing enhanced their knowledge. The results were consistent across all five questions.\u003c/p\u003e \u003cp\u003eVisual Summary\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;1 presents a detailed comparison of practical test performance between Group 1 and Group 2, highlighting the significant differences in observed precision and practical skills. Table\u0026nbsp;2 summarizes the questionnaire results, showing higher perceived confidence in Group 1 but greater perceived knowledge enhancement in Group 2. Figures\u0026nbsp;1\u0026ndash;5 illustrate common errors in the practical test and differences in technique precision between groups. Several questions during the examination were not marked as completed and as such have not been included in the analyses.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis research investigated the effect of high-quality educational videos as an adjunct to hands-on OHI in preclinical dental courses. The present findings indicate that students who repeatedly engaged with these videos exhibited greater comprehension and precision in OHI approaches, enhanced demonstration abilities, and gained advantages from recurrent learning. The results of this study show that integrating such videos alongside conventional practical training can substantially enhance learning and possibly elevate patient education outcomes in dental studies. The main aim of the practical course for the students was to apprehend knowledge of instructing the bass technique and the correct choice and use of the IDB in order to prepare them for the upcoming clinical part of their studies. To the best of our knowledge, this investigation can be considered the first to evaluate the teaching effect of tooth brushing videos in undergraduate dental students.\u003c/p\u003e \u003cp\u003eThe correct choice of an oral hygiene device for the patient and adequate OHI are an important part of prevention in dentistry. The proper brushing technique is essential for maintaining the health of the gums and teeth while efficiently eliminating plaque. Forceful and/or incorrect brushing techniques might result in mechanical injury, leading to gum recession over time and abrasion of tooth surfaces. As previously demonstrated, manual toothbrushes with softer bristles may be safer for the soft tissues, whilst use of hard bristles may cause soft tissue trauma [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Gum recession exposes sensitive root surfaces, thereby heightening the risk of tooth sensitivity and decay. The IDB is an efficient instrument for plaque elimination in the interdental areas of individuals and should be appropriately introduced, shown, and sized according to the width of the interdental space in order to avoid trauma to the tissue [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Instructing on the proper method guarantees that patients maintain effective hygiene while minimizing potential injury to the oral structures. In the present investigation, the students used a calibrated colorimetric probe to measure the diameter access of the interdental spaces and practiced the previously demonstrated brushing movements for ensuring atraumatic use of the IDB. The individual OHI method for calibrated IDB is effective and acceptable for patients, encouraging the daily use of an adequate interdental device [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. While the study highlights the benefits of educational videos in skill development, it does not assess their direct impact on patient safety. Instead, the findings emphasize the role of the videos as an effective learning tool to enhance students' practical abilities in oral hygiene instruction.\u003c/p\u003e \u003cp\u003e The results of this study suggest that multiple viewings of the videos had a positive impact on the movement and applications of the oral hygiene devices. The angulation, pressure, and movement of the manual toothbrush exhibited by group 2, who watched the videos four times, were more precise compared to group 1, who watched the videos once. In addition, group 2 scored higher regarding the correct application of the IDBs, however, not in selecting the right size of the device with the calibrated probe. The practical skills in choosing the right IDB were similar in both groups. Selecting the correct size of the IDB presents a challenge for many dental students in order to consistently provide adequate patient instruction. In the subsequent clinical part of the dental curriculum, students are often inclined to settle for smaller IDBs in order not to hurt the gums of the patient, especially in areas of inflammation. Furthermore, the insertion of the calibrated probe and IDB is a process that requires a tactile measurement which improve with practical experience. Therefore, this is our understanding of why, in this particular task, watching the videos repeatedly did not significantly improve the performance of the students.\u003c/p\u003e \u003cp\u003eProviding efficient practical experience for medical and dental students has been a challenge during the coronavirus pandemic, with the need to adapt and optimize education [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. During our courses, we found that providing students with additional learning material and supplementary videos helped close the knowledge gap if attendance was not possible due to restrictions or illness at that time. The video-assisted teaching has been investigated previously in general medicine as an additional tool to enhance practical skills [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Studies on the utilization of videos as an instructional approach in dental education underscore their efficacy in improving both theoretical understanding and clinical competence. In the field of periodontology, educational videos significantly improve the real-time visualization of procedures during periodontal treatment compared to conventional observation and contribute to the enhancement of their psychomotor skills [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Research indicates that educational videos enhance knowledge acquisition, with animated videos markedly elevating test results [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Videos, particularly on platforms such as YouTube, are shown to be effective in educating clinical skills. Students who additionally watched YouTube videos in addition to their lectures exhibited superior performance in tasks such as tooth carving when compared to those who depended exclusively on notes [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. As recently described, videos can successfully combine visual and audio elements to enhance engagement and learning outcomes [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Videos offer consistent training, are readily accessible for repeated viewing, and facilitate self-paced learning, rendering them a flexible and invaluable resource in dental teaching. Essential characteristics of good educational videos encompass concise and targeted content, superior visuals (such as animations and clear examples), interactivity (including quizzes or annotations), and information grounded in research. Concerns over the accuracy of freely accessible web videos underscore the necessity for academic supervision and institutionally generated content [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. A recent review centered on a comparative analysis of student performance and satisfaction regarding live versus video demonstrations, concluding that video-based learning notably enhances psychomotor skills and knowledge acquisition [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Effectively crafted videos continue to serve as a significant complement to conventional teaching techniques in dental education, enhancing engagement and learning results.\u003c/p\u003e \u003cp\u003eIn the present trial, both student groups have subjectively experienced a gain in precision, understanding, and practical skills through adjunct video presentation of the OHI, which was evaluated by means of a questionnaire. Traditional teaching methods can be a source of psychological distress, which may have a negative effect on the degree of psychological disorders, such as depression, anxiety, and burnout, among students [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. According to a recent systematic review [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], the confidence of the students was reported to be higher after adjunctive teaching modalities. In diagnostic examinations, the medical students\u0026rsquo; accuracy, confidence, and motivation to perform were shown to be improved with flexible e-learning videos [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Reduced stress levels among dental students have been reported when viewing videos during a fixed prosthodontic course [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe practical steps were shown in this study through videos and not a live demonstration. A previous study with students suggested that a well-designed videotaped demonstration was comparable to the teaching effect of a live demonstration [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. The students, however, found preference in video demonstrations, considering it a better teaching tool, with the only disadvantage of not being able to ask questions and get immediate answers from an instructor. According to earlier research, live demonstrations were valued by dental students for real-time interaction and direct instructor feedback [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. A randomized clinical trial investigated the impact of e-learning-assisted videos on preclinical skill competency levels in operative dentistry [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. The students in the experimental group, which received a hybrid teaching modality, demonstrated a higher level of knowledge and skill competency than students who were only taught with traditional methods. An additional effect through video material is explained by the visualization of the procedure and enabling the students to recall the process and implement it in practice [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Regarding basic surgical skills among medical students, video-based teaching was shown to be as efficient as face-to-face teaching [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. A study on undergraduate nursing students concluded that the use of an educational video on the puncture and heparinization of totally implantable access ports resulted in an increase of both cognitive and technological knowledge [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Additionally, high preference for video technology among dental students was indicated by one study [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe results of this trial support previous research that video-based learning is an effective tool for students in preclinical curriculum dental education, enhancing understanding and practical performance when utilized appropriately [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Students who watched the videos four times could demonstrate better performance in almost every exercise when compared to single viewing only, which could be of interest for future curriculum in terms of integrating repeated mandatory viewing before and during the courses. The study started four weeks before the practical test, and the group with repetitive viewing watched the video once per week. The other students watched the video once at the beginning of the month, so the time gap could have potentially influenced the learning outcome. It would be beneficial for students to voluntarily review the videos in post-practical sessions to reinforce learning and facilitate preparation for patient treatment. Additional dental procedures, including periodontal probing and scaling, tooth preparation, administration of local anesthesia, and execution of standard clinical examinations, could be illustrated through specialized short videos and incorporated into preclinical studies. For advanced students, revisiting the videos and extending the instructional duration to encompass communication skills and patient motivation would be advantageous. Alternative digital learning tools, including interactive simulation games, virtual reality technology, specialized e-learning platforms and mobile apps, could provide immersive, engaging, and adaptable learning experiences, improving educational outcomes and offering many chances for skill enhancement.\u003c/p\u003e\n\u003ch3\u003eLimitations\u003c/h3\u003e\n\u003cp\u003eThis study had some limitations, that should be addressed. The short duration of the study with a lack of long-term follow-up of the students\u0026rsquo; skills presents one limitation. For future studies, a long-term assessment of the learning effect would be of interest to evaluate this educational tool. Additionally, the students were unable to access the videos on personal preference, which was shown in previous studies to be an effective method [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. This part of the study design was a conscious decision, since watching the same videos four times was not verifiable in a private setting. The study's findings indicate that short educational videos on oral hygiene instruction can enhance participants' knowledge, performance, and comprehension as a supplement to practical courses, however their relevance to complex dental procedures may be limited.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe viewing of high-quality short videos was shown to enhance students\u0026rsquo; understanding and knowledge as an adjunct to practical courses. Repetitive viewing of educational videos seemed to be advantageous for students\u0026rsquo; tooth brushing performance and interdental brushing technique when compared to skills after single viewing only. The students in group 2, who watched the videos four times, experienced a higher security regarding practical skills, compared to the group 1, who watched the videos only once. The data from this study suggest that multiple viewings of educational videos may help students achieve greater precision and a deeper understanding of oral hygiene instruction, potentially improving their ability to demonstrate these techniques in a clinical setting more accurately. For future adaptation of the dental curriculum, educational videos could be integrated as a mandatory part and additionally provided on demand throughout the student's courses for revisiting the apprehended knowledge and strengthening their clinical skills.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eConflict of interest statement\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no conflict of interest.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eS.D., D.T. and M.L were involved in the student courses and exams. S.D. wrote the main manuscript text, J.G. prepared figures and tables. X.RF, A.M and A.H. reviewed the manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003e Our thanks go to all participants and colleagues who were involved in this study, and Mariano Nguyen for filming and editing the videos. We acknowledge Curaden, Switzerland for providing the materials for the student\u0026rsquo;s oral hygiene course.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData is provided within the manuscript or supplementary information files\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eSukumar S, Dracopoulos SA, Martin FE. Dental education in the time of SARS-CoV-2. Eur J Dent Educ. 2021 May;25(2):325-331\u003c/li\u003e\n \u003cli\u003eAl-Balas M, Al-Balas HI, Jaber HM, Obeidat K, Al-Balas H, Aborajooh EA, Al-Taher R, Al-Balas B. Distance learning in clinical medical education amid COVID-19 pandemic in Jordan: current situation, challenges, and perspectives. BMC Med Educ. 2020 Oct 2;20(1):341\u003c/li\u003e\n \u003cli\u003eIyer P, Aziz K, Ojcius DM. Impact of COVID-19 on dental education in the United States. J Dent Educ. 2020 Jun;84(6):718-722.\u003c/li\u003e\n \u003cli\u003eNaciri A, Radid M, Kharbach A, Chemsi G. 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Perceptions of medical students towards and effectiveness of online surgical curriculum: a systematic review. BMC Med Educ. 2021 Nov 11;21(1):571.\u003c/li\u003e\n \u003cli\u003eShikino K, Rosu CA, Yokokawa D, Suzuki S, Hirota Y, Nishiya K, Ikusaka M. Flexible e-learning video approach to improve fundus examination skills for medical students: a mixed-methods study. BMC Med Educ. 2021 Aug 13;21(1):428.\u003c/li\u003e\n \u003cli\u003eThilakumara, I.P., Jayasinghe, R.M., Rasnayaka, S.K., Jayasinghe, V.P. and Abeysundara, S. (2018), Effectiveness of Procedural Video Versus Live Demonstrations in Teaching Laboratory Techniques to Dental Students. Journal of Dental Education, 82: 898-904.\u003c/li\u003e\n \u003cli\u003eIqbal A, Ganji KK, Khattak O, Shrivastava D, Srivastava KC, Arjumand B, AlSharari T, Alqahtani AMA, Hamza MO, AbdelrahmanDafaalla AAEG. Enhancement of Skill Competencies in Operative Dentistry Using Procedure-Specific Educational Videos (E-Learning Tools) Post-COVID-19 Era-A Randomized Controlled Trial. Int J Environ Res Public Health. 2022 Mar 31;19(7):4135.\u003c/li\u003e\n \u003cli\u003eCo M, Chung PH, Chu KM. Online teaching of basic surgical skills to medical students during the COVID-19 pandemic: a case-control study. Surg Today. 2021 Aug;51(8):1404-1409.\u003c/li\u003e\n \u003cli\u003eCardoso AF, Moreli L, Braga FT, Vasques CI, Santos CB, Carvalho EC. Effect of a video on developing skills in undergraduate nursing students for the management of totally implantable central venous access ports. Nurse Educ Today. 2012 Aug;32(6):709-13.\u003c/li\u003e\n \u003cli\u003eHe K, Breitman L, Lee J, Van Doren E, Li A, Donoff RB. How US dental schools can better prepare their students to perform operative procedures. J Dent Educ. 2021 Apr;85(4):531-538.\u003c/li\u003e\n \u003cli\u003eSchwarz G, Bleiner D, G\u0026uuml;nther D. On video lectures during remote teaching and beyond. Anal Bioanal Chem. 2022 May;414(11):3301-3309.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eKrumm IR, Miles MC, Clay A, Carlos Ii WG, Adamson R. Making Effective Educational Videos for Clinical Teaching. Chest. 2022 Mar;161(3):764-772.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Comparison of group 1 and group 2 for Practical Test \u0026ndash; Practical Exam in dental students (N=81)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"1011\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 61px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian overall\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 184px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup 1 (N=40)\u003cbr\u003e\u0026nbsp;Control Group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup 2 (N=41)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTest Group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMann-Whitney\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuestion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian (mean)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian (mean)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ez\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e1.1 Position of the brush and angulation of the bristles (position: anterior buccal)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0 (0.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e2 (1.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.711\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-4.375\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.486\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e1.2 Correct pressure of the brush (position: anterior buccal)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e2 (1.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.877\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e2 (1.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.478\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-3.549\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.394\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e1.3 Correct movement of the brush (position: anterior buccal)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e2 (1.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.682\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e2 (1.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.432\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-2.990\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.002*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.339\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e1.4 Position of the brush and angulation of the bristles (position: anterior lingual)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e1 (1.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.947\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e2 (1.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.617\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-3.132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.348\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e1.5 Correct pressure of the brush (position: anterior lingual)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e2 (1.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.807\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e2 (1.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.459\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-2.684\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.004*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.298\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e1.6 Correct movement of the brush (position: anterior lingual)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e2 (1.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.580\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e2 (1.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.346\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-2.905\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.003*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.323\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e2.1 The assessment of 2 interdental spaces using an IAP CURAPROX\u0026copy; colorimetric probe (Nr. 1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e2 (1.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.899\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e2 (1.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.799\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-0.474\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.323\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.053\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e2.1 The assessment of 2 interdental spaces using an IAP CURAPROX\u0026copy; colorimetric probe (Nr. 2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e2 (1.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.880\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e2 (1.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.888\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-0.500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.339\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e2.2 Correct application of the interdental brush\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e1 (1.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.834\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e2 (1.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.582\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-3.690\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.410\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026dagger;Exact significance between group 1 and group 2 (one-sided), \u003cem\u003ep\u003c/em\u003e \u0026lt;\u0026thinsp;0.05\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Comparison of group 1 and group 2 and for Self-Assessment in dental students (N=82)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"1011\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 61px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian overall\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 184px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup 1 (N=40)\u003cbr\u003e\u0026nbsp;Control Group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup 2 (N=42)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTest Group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMann-Whitney\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuestion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian (mean)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian (mean)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ez\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003eQ1. The videos have contributed to a deepening of the learning content.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e3 (2.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e1.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e4 (3.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.887\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-3.027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.334\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 295px;\"\u003e\n \u003cp\u003eQ2. The videos made it easier to remember the practical parts.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e3 (2.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e1.097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e3 (3.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.727\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-2.427\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.007*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.268\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 295px;\"\u003e\n \u003cp\u003eQ3. The videos made it possible to increase the precision of the practical exercises.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e2 (2.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e1.047\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e3 (2.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.936\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-2.876\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.002*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.318\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 295px;\"\u003e\n \u003cp\u003eQ4. The practical skills could be improved through the videos.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e2 (2.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e1.035\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e3 (2.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.853\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-2.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e0.021*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-0.223\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003eQ 5.1 I would have liked to see the videos again before the second practical part.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e3 (2.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e1.222\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 295px;\"\u003e\n \u003cp\u003eQ 5.2 Repetitive viewing of the videos helped improve my knowledge.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e3 (3.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e1.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 100px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026dagger;Significant difference between group 1 and group 2, \u003cem\u003ep\u003c/em\u003e \u0026lt;\u0026thinsp;0.05\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Dental students, Education, Toothbrush, Bass technique, Oral care, Preventive dentistry, e-learning","lastPublishedDoi":"10.21203/rs.3.rs-5822344/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5822344/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction:\u003c/strong\u003e In the education of dental students, practical seminars are of great importance for obtaining necessary skills and ensuring patient safety. The use of video teaching material is increasingly popular and has been useful under Covid-19 teaching circumstances, where practical courses have been somewhat limited according to the pandemic situation. To our knowledge, this is the first study until now to evaluate video assisted teaching, regarding oral hygiene instructions, in dental education.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e The aim of this study was to investigate if high-quality educational videos could be a useful addition to the practical course of oral hygiene instructions in single or repetitive viewing and therefore be beneficial for improving students´ practical skills in performing oral hygiene instructions, including the perception of the students and their perceived security.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e 82 students form the 2\u003csup\u003end\u003c/sup\u003e term of dental school were enrolled in this study and assigned to two groups. The students watched two videos showing the application of the bass toothbrushing method and the interdental brushing technique. Group 1 viewed the video only once, whereas Group 2 viewed the videos repeatedly every week on four consecutive weeks before seminar. By the end of the four weeks, the students were conducted to a practical test to evaluate the level of their obtained skills and filled out a questionnaire regarding their subjective experience of the educational videos.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThe results of this trial show that the students subjectively gained increased security in precision after watching the videos, whilst performing the required tasks. The students exhibited significant improvement in toothbrushing technique and applying the interdental brush after repetitive viewing of the videos compared to single viewing. There were no significant differences between groups regarding the assessment of the size of interdental spaces using a colorimetric probe.\u003c/p\u003e","manuscriptTitle":"Educational videos as a teaching approach to enhance students’ practical skills in preclinical courses","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-27 10:28:17","doi":"10.21203/rs.3.rs-5822344/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-04-28T05:08:47+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-23T09:28:45+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-22T17:52:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"130460709731680789126093906493196012211","date":"2025-04-14T07:30:44+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-14T06:10:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"230721381829742049655545175149564269334","date":"2025-04-13T16:52:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"68322870270845053682233358730594932762","date":"2025-04-08T01:52:44+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-05T04:59:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"60856967052384301250708428443438261517","date":"2025-04-03T21:27:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"126970950961532895611661648292975115345","date":"2025-03-26T16:31:31+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"198293310065095911243799769461759851638","date":"2025-03-26T09:49:39+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-03-26T05:43:55+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-25T13:18:49+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-03-18T16:19:54+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2b0b88b0-2970-406a-aa68-96783537b703","owner":[],"postedDate":"March 27th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-10-06T16:09:06+00:00","versionOfRecord":{"articleIdentity":"rs-5822344","link":"https://doi.org/10.1186/s12909-025-07807-2","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2025-10-02 15:57:41","publishedOnDateReadable":"October 2nd, 2025"},"versionCreatedAt":"2025-03-27 10:28:17","video":"","vorDoi":"10.1186/s12909-025-07807-2","vorDoiUrl":"https://doi.org/10.1186/s12909-025-07807-2","workflowStages":[]},"version":"v1","identity":"rs-5822344","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5822344","identity":"rs-5822344","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}