An assessment of online and offline blended teaching of Stomatology for non-stomatology medical students

An assessment of online and offline blended teaching of Stomatology for non-stomatology medical students | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article An assessment of online and offline blended teaching of Stomatology for non-stomatology medical students Jingyan Huang, Bo Yang, Guihong Yang, Honghao Zhang, Yeitian Gan, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6140068/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Introduction and aims: The COVID-19 pandemic accelerated the adoption of blended teaching models in medical education, highlighting their potential to address challenges in traditional pedagogy. This study evaluates the effectiveness of online and offline blended teaching for non-stomatology medical students in Stomatology, a critical yet often underrepresented discipline in medical curricula. Methods: A blended teaching approach was implemented, combining pre-recorded online lectures with interactive offline sessions. Pre-class surveys assessed students’ perceptions and readiness, while post-class evaluations, including theory tests and satisfaction questionnaires, measured learning outcomes and engagement. Results: The blended teaching model significantly enhanced classroom engagement, stimulated learning enthusiasm, and improved knowledge retention. Students receiving blended teaching demonstrated higher satisfaction and performance compared to those taught through traditional methods. Conclusions: The findings underscore the value of blended teaching in fostering interdisciplinary understanding and clinical competence in Stomatology. This study advocates for the broader application of blended teaching model in interdisciplinary Stomatology teaching to bridge gaps in oral-systemic health training and improve patient outcomes. online and offline blended teaching Stomatology non-stomatology medical students traditional teaching Figures Figure 1 Figure 2 Figure 3 Figure 4 1. Introduction Stomatology is a critical component of clinical medical education, as it fosters interdisciplinary understanding and equips future physicians with essential skills to address systemic health through oral manifestations. Studies demonstrate that over 90% of systemic diseases, including diabetes, cardiovascular conditions, and inflammatory bowel disease, present oral symptoms such as mucosal lesions or periodontal inflammation, necessitating early recognition by clinicians for timely intervention 1 – 4 . Furthermore, inadequate knowledge of oral health among medical students correlates with poor patient outcomes, particularly in diagnosing oral cancers or managing infections like infective endocarditis, where antibiotic prophylaxis during dental procedures significantly reduces cardiovascular risks 5 , 6 . The integration of oral-systemic health education also enhances interprofessional collaboration, as evidenced by improved clinical outcomes in multidisciplinary settings such as head and neck cancer management 7 – 11 . Additionally, gaps in medical curricula regarding oral emergencies, such as maxillofacial trauma or odontogenic infections, underscore the need for structured training to optimize emergency care 12 . Despite challenges in transitioning to virtual learning during the COVID-19 pandemic, blended educational models combining online and clinical practice have proven effective in reinforcing oral health competencies 13 , 14 . Thus, comprehensive Stomatology education not only bridges the gap between dental and systemic care but also cultivates a holistic clinical perspective, directly impacting patient safety and public health outcomes. Despite the recognized significance of stomatology in clinical education, achieving good teaching effects still poses a challenge because of insufficient emphasis on pedagogical innovation in interdisciplinary teaching. Traditional lecture-based approaches dominate dental curricula, often failing to promote interactive learning or address individual student needs 15 , 16 . Studies highlight that limited faculty training in modern educational strategies hinder dynamic teacher-student interactions, reducing opportunities for personalized feedback 17 , 18 . For instance, observational research reveals that lecturers relying on passive knowledge transmission struggle to engage students or adapt to diverse learning styles, exacerbating communication gaps 17 , 19 . Furthermore, while blended learning and simulation-based methods demonstrate efficacy in enhancing clinical competencies 20 , 21 , their adoption remains inconsistent due to institutional resistance, resource constraints, and insufficient faculty readiness 22 , 23 . Barriers such as inadequate interdisciplinary collaboration and rigid curricula further impede the integration of student-centered approaches like problem-based learning (PBL) and virtual reality 24 – 27 . Notably, stomatology students report dissatisfaction with traditional assessment-driven models that prioritize rote memorization over critical thinking, underscoring the need for pedagogical reforms 28 , 29 . These systemic inefficiencies highlight the urgency of re-evaluating educational frameworks to align with evolving clinical demands and learner expectations 30 , 31 . Addressing these gaps requires institutional commitment to faculty development, technological integration, and curricular flexibility to bridge communication divides and accelerate educational innovation. Historically, the COVID-19 pandemic has profoundly disrupted traditional educational frameworks, necessitating a rapid shift toward digital platforms to ensure continuity in medical and stomatology education. During the pandemic, strict social distancing measures led to significant reductions in clinical training opportunities and classroom-based instruction, as evidenced by a two-thirds decline in outpatient services and a 77% reduction in dental interns in tertiary hospitals 32 . This abrupt transition underscored the limitations of purely online education, such as reduced clinical skill acquisition and student engagement 33 , 34 . However, the crisis also accelerated the adoption of digital tools, including Zoom, Microsoft Teams, and AI-driven platforms like ChatGPT, which facilitated asynchronous learning, virtual simulations, and remote collaboration 35 – 37 . Studies demonstrated that blended models, such as semi-flipped classrooms (SFCs), which integrate pre-recorded online content with interactive offline sessions, outperformed traditional methods in both student performance and satisfaction 13 , 38 . For instance, SFCs enhanced knowledge retention in Stomatology and improved clinical reasoning through case-based discussions 38 . Despite challenges like internet connectivity issues and faculty unpreparedness for digital pedagogy 37 , the pandemic highlighted the necessity of hybrid approaches to balance flexibility, safety, and educational efficacy. These findings collectively emphasize that the integration of online and offline modalities, driven by pandemic exigencies and technological advancements, represents a sustainable evolution in medical education 13 , 33 , 39 . The current research aims to assess the effectiveness of online and offline blended teaching of Stomatology for non-stomatology medical students. To investigate this question, we implemented a full chain of reform measures. Before the class started, students’ perceptions of blended learning were investigated by online questionnaires, exploring their attitude, experience and suggestions about blended teaching. The teaching was transformed from traditional lectures to blended teaching, integrating lectures and online teaching. Additionally, class and extra learning materials on raining classroom were available to the experimental groups of students. At the end of the terms, overall impression and the effectiveness of the teaching was assessed by analysing the scores from online questionnaires given by students and theory test scores. 2. Methods 2.1 Study design Our study used the three following methods to collect data that would reflect perception, practice, and achievements of students in doing blended tasks through before- and after-class anonymous questionnaires. Before-class questionnaires were conducted to explore students’ learning interest, attitude, and platform media used in the context of blended learning. After-class, questionnaires were distributed to students undertaking different teaching modes to score the effectiveness of teaching, as subject effect evaluation of blended teaching. Besides, Eight-Year Program medical students from the different teaching modes submitted reviews and a teacher scored them for objective effect evaluation of the blended teaching. The research procedure is demonstrated in Fig. 1 . 2.2 Research participants The study involved three groups of second-year Clinical Medicine students at Sun Yat-sen University School of Medicine, focused on evaluating the effectiveness of a blended teaching mode for the “Stomatology” course. Online Teaching Groups(OT): comprised of 120 students who participated in the blended teaching mode during the 2021 academic year. Blended Teaching Group༈BT༉: comprised of 122 students who participated in the blended teaching mode during the 2022–2023 academic years. Control Group (Control): Included 172 students who completed the traditional teaching method in 2020. Additionally, students from the BT group were selected for before-class questionnaires to gain students’ general perception for offline, online and blended teaching approaches. 2.3 Effect evaluation of blended teaching method 2.3.1 Before-class questionnaire The questionnaire was designed to investigate students’ perception for blended teaching mode, focusing on the students’ preference and perspective on the advantages along with disadvantages of blended teaching. Questionnaires were distributed to the subjects by WJX.cn. Before class, the QR code of the questionnaire generated from WJX.cn was displayed to students from BT group who participated in the blended teaching mode, and the teacher explained the intention and purpose of the questionnaire. Course students voluntarily scanned the code to answer the questionnaire. Questions in the questionnaires were listed in Table 1 . The complete questionnaire can be referred to in Supplemental materials. Table 1 Questions included in the questionnaires Number Question stem Options 1 You prefer which teaching mode? A. Traditional teaching mode B. Online teaching mode C. Online and offline blended teaching mode 2 What problems do you think exist in the traditional teaching mode? A. no playback, it is easy to miss knowledge B. The spatiotemporal constraint C. Low efficiency and poor effect D. Content is closed and resources are scarce E. Low class participation F. It is not conducive to improving the ability of independent learning 3 What do you think are the advantages of online and offline blended teaching model? A. It can arouse the enthusiasm of learning B. It can strengthen the mastery of knowledge points C. It can improve the ability of independent learning D. Break through the limitation of traditional classroom and do not delay the learning progress 4 What do you think about the challenges of Online and Offline blended teaching model? A. The difficulty of the course increased, and the learning pressure increased B. Challenge of self-restraint C. Unable to reasonably arrange online learning time 5 What do you think about establishing a wechat group · A. Is conducive to timely communication between teachers and students B. Too much information causing interference C. Is very necessary 6 What do you think about getting class powerpoints after class A. Helps ease the study burden B. Very necessary Question 5 and 6 were scored according to five levels: strongly agree, agree, neutral, disagree and strongly disagree. The score ranged from 5–1. The higher score indicated the higher acceptance of the opinion. 2.3.2 Theoretical test At the end of the class, long term clinical medical students from the Control, OT and BT groups submitted reviews with a topic of the relationship between oral diseases and systemic diseases (20 points totally) in electric version as a theoretical test. Only Eight-Year Program medical students were incorporated into theoretical test to eliminate the intra-group difference in learning capacity and knowledge background. The submitted reviews were graded by the same teacher. 2.3.3 After-class questionnaire The questionnaire was designed to assess the effectiveness of blended teaching mode by satisfaction analysis from students about the courses. The questionnaire was focused on the students’ evaluation for the methods and effectiveness of the course. Questionnaires were distributed to the subjects by Educational Administration Evaluation System of Sun Yat-sen University at the end of class. Questionnaires were distributed to all the students from Online Teaching Groups, Blended Teaching Group and Control Group. The questionnaires include three groups of questions:1) Teaching content: The teaching is clearly organized, logically rigorous, easy to understand, clear the difficult points, highlight the key points, and reflect the new progress of the discipline. Correct use of foreign language vocabulary, foreign language pronunciation is accurate and clear. The language is standardized, vivid and smooth, and the expression ability is strong, which can attract the attention of students. Containing skilled, basic theory, basic knowledge teaching; 2) Teaching method: Teaching method is proper, pay attention to ability training and enlightening teaching. The teaching time is arranged reasonably and the rhythm is proper. Courseware production standard, handwriting clear, reasonable arrangement, detailed slightly appropriate. 3) Teaching effect: Pay attention to communication with students, arouse students' enthusiasm, active classroom atmosphere. Effective use of various teaching media. Each item was scored by the subjects. The maximum scores of each item were 55, 25 and 15 points. The overall impression scores were obtained by converting the sum of teaching content, method and effect sores to a hundred-mark system. The complete questionnaire can be referred to in Supplemental materials. 2.4 Implementation process of online and blended teaching 2.4.1 Blended teaching During the instructional period, the BT class educators embraced a hybrid teaching methodology. They crafted a detailed syllabus tailored for this blended approach and participated in an intensive training session dedicated to the rollout of this model. This preparatory training took place in the week preceding the educational intervention, aiming to shift the educators' focus towards a more integrated teaching style that emphasizes blended learning strategies over traditional, in-person teaching methods. The hybrid teaching framework employed in this research is structured around three key components: Initial Learning Phase: This stage leverages digital platforms such as Rain Classroom and WeChat groups for preliminary education. Students engage with case studies and undertake preparatory tasks, with their understanding assessed via self-evaluation quizzes. Interactive Classroom Sessions: The face-to-face component of the course is dedicated to fostering dialogue, addressing and distilling problems, clarifying doubts, and recapitulating essential concepts. This segment blends theory with practice, encouraging students to collaborate in small groups, typically comprising six to eight members, to enhance their learning experience. Post-Class Engagement: Following the classroom sessions, students continue their learning journey online. This includes delving into additional readings and completing coursework. In the course's second week, project guidelines are disseminated online. Throughout the project's duration, groups maintain online communication with their instructor to tackle any challenges. A week after the course concludes, students are expected to hand in their review assignments and respond to post-course surveys. 2.4.2 Online teaching The online teaching process was nearly the same with the blending teaching except for the offline classroom. The classes were given online containing communication and discussion, problem condensation, answering and solving doubts, and summarizing key points. Data analysis All statistical analyses were carried out using SPSS 26.0 software. Data in pre-class qualitative questionnaire was described as percentage. Data from after-class quantative questionnaire was presented as mean ± SD. The ANOVA test was used to determine if there was a significant difference between the groups. A P -value less than 0.05 was considered significant. Results The perception of students about blended teaching A total of 35 students from the BT group filled out the before-class questionnaires on the general perception for offline, online and blended teaching approaches, consisting of 12 males and 23 females. In regard of the teaching mode, nearly half, 51.43% of the students preferred traditional teaching mode despite the considered disadvantages (Fig. 2 A) including easily miss knowledge points (80%), spatiotemporal constraint (71.43%), low efficiency and poor effect (8.57%), closed content and scarce resources (5.71%), low class participation (11.43%) and inconduciveness to improving the ability of independent learning (5.71%). By comparision, 25.71% preferred blended teaching and 22.86% chose offline teaching as the preferred mode. It was believed that the most prominent advantage (74.29%) of the blended teaching was no delaying the learning progress by breaking through the limitation of traditional classroom. Additionally, the blended teaching was considered to promote the self-efficacy of students by arousing the enthusiasm of learning (22.86%) and improve the ability of independent learning (37.14%) (Fig. 2 B). However, challenges of blended teaching also exited, including challenge of self-restraint (77.14%), unable to reasonably arrange online learning time (42.86%) along with increased difficulty of the course and learning pressure (28.57%). The acceptability of online teaching media was also investigated. As a popular online communication media, the Weixin APP was considered essential for communication between teachers and students and no students disagreed its use except for too much information interference (8.57% of students deemed). Additionally, 88.57% of the subject students strongly agreed of the necessity of obtaining class powerpoints after class for ease of study burden. Comparison of theoretical test scores The theoretical test scores of students from OT and BT groups were significantly higher than the scores from the Control group ( P 0.05) (Fig. 3 ). Teaching effect of blended teaching marked by students According to the questionnaire survey, the blened-teaching group of students had a highest overall impression of teachers’ teaching among the 3 groups. Meanwhile, the scores given by the students in online group was slightly higher than the Control group. Nonetheless, there was no significant difference between the groups ( P > 0.05) (Fig. 4 A). In details, students in BT group agreed that the teacher could apply modern educational technology in teaching effectively. The teaching method scores from BT group were significantly higher than the Control and OT groups ( P 0.05). Similar trends applied to the scores for teaching methods and effects. Students from BT group believed that the course content was more closely related to basic theory and that the teacher focused more on the key points and explained the difficulties thoroughly (Fig. 4 C). At the end of the questionnaire, students from BT group marked significantly higher scores for the teaching effects than the other two groups ( P < 0.0001 Fig. 4 D). They thought that teachers pay adequate attention to communication with students, arouse students' enthusiasm and the classroom atmosphere was more active. Discussion Teaching Effectiveness The research findings demonstrate that both online (OT) and blended (BT) teaching modalities achieved significantly better theoretical test results compared to the conventional classroom (Control) approach, with no statistically significant difference between OT and BT groups. The blended teaching model showed particularly strong results in overall teaching evaluations, especially in the dimension of instructional methodology, indicating its effectiveness in enhancing students' theoretical knowledge and teaching satisfaction. Consistent with Regmi's finding that hybrid learning promotes student collaborative abilities, this study observed superior performance among BT group students in collaborative assessments such as group discussions and exploratory projects 40 . Although this study did not specifically examine innovative thinking, the results underscore the effectiveness of blended teaching in theoretical knowledge acquisition and comprehensive teaching evaluation, expanding the scope of related research. This investigation provides a unique perspective on cross-disciplinary teaching effectiveness by focusing on the teaching of Stomatology to non-stomatology students. The blended teaching model facilitates non-stomatology students' understanding and mastery of stomatological knowledge by leveraging online resources and offline interactive collaboration, representing an important complement to research on cross-disciplinary teaching effectiveness. Student Attitudes Despite the limitations of conventional teaching methods, nearly half of the students (51.43%) still preferred traditional classroom instruction. However, students acknowledged the advantages of blended teaching, including its flexibility in breaking time and space constraints (74.29%), enhancing learning motivation (22.86%), and improving self-directed learning skills (37.14%). They also identified challenges such as self-discipline requirements (77.14%) and difficulty in managing online learning time (42.86%). Similar to Qin's observation of teachers' evolving attitudes toward technology-mediated language teaching, students' attitudes toward blended teaching are complex and stage-dependent, influenced by factors such as teaching environment and technological familiarity 41 . Unlike previous studies focusing on instructors, this research targets student experiences, particularly in the context of cross-disciplinary education. Non-stomatology students, accustomed to their original disciplinary teaching methods, exhibit varied acceptance of the blended teaching model in this cross-disciplinary stomatology course. The study's comprehensive data collection provides precise directions for instructional improvement. Strengths and Challenges of Blended Teaching Blended teaching integrates the strengths of online and offline instruction. Online learning offers diverse resources and flexible learning schedules, promoting independent exploration, while offline sessions enhance face-to-face interactions, collaboration, and practical skills. In this study, blended teaching improved student performance in theoretical tests and collaborative assessments, while students recognized its role in knowledge acquisition and skill development. However, blended teaching presents challenges. Autonomous learning requires strong self-regulation to avoid distractions and maintain learning efficiency. Technical issues and poor time management can impede learning outcomes. As Zhang noted, challenges such as lagging pedagogical concepts and insufficient student proactivity may persist in blended teaching environments 42 . In cross-disciplinary contexts, blended teaching also faces knowledge integration difficulties. For non-stomatology students, online multimedia resources can aid comprehension of complex stomatological concepts, while offline discussions and practical exercises facilitate application of theoretical knowledge. Blended Teaching and Cross-Disciplinary Instruction In the context of teaching Stomatology to non-stomatology students, cross-disciplinary instruction offers unique advantages and challenges. It broadens students' knowledge horizons, fosters integrative thinking, and enhances their ability to address complex problems using multidisciplinary approaches. The collaborative nature of cross-disciplinary learning improves communication and teamwork skills. However, challenges include knowledge integration difficulties due to disciplinary differences, uneven resource allocation, and conflicting learning objectives. This study provides a novel perspective on cross-disciplinary teaching by analyzing its advantages and challenges in a stomatology course for non-stomatology students. Applicability for Non-Stomatology medical students The blended teaching model demonstrates applicability for non-stomatology students learning Stomatology Online resources, including animations and case studies, aid comprehension of complex concepts, while offline practical sessions enhance skill development. This approach helps students overcome disciplinary barriers, though limitations such as insufficient practical opportunities and differing cognitive frameworks persist. This study contributes to the literature by addressing the specific challenges faced by non-stomatology students in learning Stomatology and evaluating the suitability of blended teaching. Its comprehensive methodology, combining surveys and theoretical assessments, offers valuable insights for optimizing cross-disciplinary teaching practices. This study provides valuable insights for teaching practice, particularly in cross-disciplinary contexts. The findings suggest that blended teaching effectively enhances theoretical knowledge, collaboration, and student satisfaction by combining online flexibility with offline engagement. Educators should adopt this model to improve learning outcomes, especially for non-stomatology students in complex subjects like stomatology, while addressing challenges such as self-discipline and time management. Additionally, fostering collaborative activities and leveraging multimedia resources can further support cross-disciplinary instruction, helping students integrate knowledge across disciplines and develop practical skills. Conclusion In conclusion, this study aimed to assess the effectiveness of online and offline blended teaching of Stomatology for non-stomatology medical students. The results showed that the blended teaching model had a positive impact on student enthusiasm and classroom atmosphere, leading to better learning outcomes. Furthermore, the blended teaching model proved to be beneficial for students, allowing them to easily access course materials and improve their understanding of complex concepts. However, despite its advantages, the blended teaching model also presented some challenges, such as increased workload and difficulties in managing time effectively. Therefore, it is essential to address these challenges and develop strategies to optimize the blended teaching approach for non-stomatology medical students. Overall, this study highlights the essentiality of teaching mode reform in? cross-disciplinary teaching for medical undergraduates. Driven by pandemic exigencies and technological advancements, online and offline blended teaching mode was verified to enliven the classroom atmosphere, inspire studying enthusiasm, and achieve good learning effects in the learning of Stomatology for non-oral medical students. Abbreviations OT online teaching mode BT blended teaching mode. Declarations Ethics approval and consent to participate The need for ethics approval for the study was waived by the Medical Ethics Committee of the Hospital of Stomatology, Sun Yat-sen University (GHKQ-202503-K04-01). All methods were carried out in compliance with the Helsinki Declaration. Informed consent was shown along with the questionnaire before the survey. Consent for publication Not applicable. Availability of data and materials The transcripts/datasets analysed in current study are not publicly available due to the confidentiality of the data, but are available from the corresponding author on request. Competing Interests The authors declare no conflict of interest. Funding This work was financially supported by Undergraduate Education Quality and Reform Program of Guangdong Province in 2023. Authors' contributions Yan Wang (Funding acquisition: Equal) Jingyan Huang (Conceptualization: Equal; Funding acquisition: Equal; Investigation: Equal; Methodology: Equal; Project administration: Equal; Resources: Equal; Supervision: Equal; Validation: Equal; Writing – review & editing: Equal) Bo Yang (Investigation: Equal; Methodology: Equal; Writing – original draft: Lead) Guihong Yang (Writing – review & editing: Supporting) Honghao Zhang (Validation: Supporting; Visualization: Supporting) Yeitian Gan (Data curation: Supporting) Acknowledgements Not applicable. References Chatzopoulos GS, Jiang Z, Marka N, Wolff LF. Periodontal Disease, Tooth Loss, and Systemic Conditions: An Exploratory Study. Int Dent J. 2024;74(2):207-215. Byrd KM, Gulati AS. The "Gum-Gut" Axis in Inflammatory Bowel Diseases: A Hypothesis-Driven Review of Associations and Advances. Front Immunol. 2021;12:620124. Enteghad S, Shirban F, Nikbakht MH, Bagherniya M, Sahebkar A. Relationship Between Diabetes Mellitus and Periodontal/Peri-Implant Disease: A Contemporaneous Review. Int Dent J. 2024;74(3):426-445. Kaura Parbhakar K, Farmer JW, Quinonez C. The influence of living conditions and individual behaviors on the oral-systemic disease connection: a cross-sectional analysis. J Public Health Dent. 2022;82(2):220-228. Thornhill MH, Gibson TB, Yoon F, et al. Antibiotic Prophylaxis Against Infective Endocarditis Before Invasive Dental Procedures. J Am Coll Cardiol. 2022;80(11):1029-1041. Sperotto F, France K, Gobbo M, et al. Antibiotic Prophylaxis and Infective Endocarditis Incidence Following Invasive Dental Procedures: A Systematic Review and Meta-Analysis. JAMA Cardiol. 2024;9(7):599-610. Glossop S, Duffaydar H, Jones H, et al. Oral and maxillofacial surgery and dental health education in undergraduate medicine: a systematic review. Br J Oral Maxillofac Surg. 2024;62(10):882-888. Cernea CR, Leite AK, Muller BF, Matos LL. Multidisciplinary approach in head and neck cancer. Einstein (Sao Paulo). 2024;22(suppl 3):eEDS3. Jung K, Narwal M, Min SY, Keam B, Kang H. Squamous cell carcinoma of head and neck: what internists should know. Korean J Intern Med. 2020;35(5):1031-1044. Mody MD, Rocco JW, Yom SS, Haddad RI, Saba NF. Head and neck cancer. Lancet. 2021;398(10318):2289-2299. Taberna M, Gil Moncayo F, Jane-Salas E, et al. The Multidisciplinary Team (MDT) Approach and Quality of Care. Front Oncol. 2020;10:85. Sheth R, Smith RK, Lambert JS. Emergency Department Management of Maxillofacial Trauma. Emerg Med Pract. 2024;26(Suppl 10):1-33. Hong Y, Wu J, Wu J, et al. Semi-flipped classroom-based learning interventions in a traditional curriculum of oral medicine: students' perceptions and teaching achievements. BMC Med Educ. 2023;23(1):44. Subramanian T, Rowland KJ. Opportunities and Challenges in Medical Education During the COVID-19 Pandemic. Pediatr Ann. 2022;51(8):e319-e323. Trullàs JC, Blay C, Sarri E, Pujol R. Effectiveness of problem-based learning methodology in undergraduate medical education: a scoping review. BMC Med Educ. 2022;22(1):104. Preshaw PM, Ramseier CA, Loos BG, et al. Contemporary educational methods in periodontology. J Clin Periodontol. 2024;51 Suppl 27:117-192. Visioli S, Lodi G, Carrassi A, Zannini L. The role of observational research in improving faculty lecturing skills: A qualitative study in an Italian dental school. Med Teach. 2009;31(8):e362-369. Staines K. Oral medicine: the importance of a team-based approach. Br Dent J. 2024;236(4):227. Fedorchenko Y, Zimba O, Gulov MK, Yessirkepov M, Fedorchenko M. Medical Education Challenges in the Era of Internationalization and Digitization. J Korean Med Sci. 2024;39(39):e299. Ryan GV, Callaghan S, Rafferty A, Higgins MF, Mangina E, McAuliffe F. Learning Outcomes of Immersive Technologies in Health Care Student Education: Systematic Review of the Literature. J Med Internet Res. 2022;24(2):e30082. Elendu C, Amaechi DC, Okatta AU, et al. The impact of simulation-based training in medical education: A review. Medicine (Baltimore). 2024;103(27):e38813. Ajjawi R, Barton KL, Dennis AA, Rees CE. Developing a national dental education research strategy: priorities, barriers and enablers. BMJ Open. 2017;7(3):e013129. Zheng B, Sun T. Self-Regulated Learning and Learning Outcomes in Undergraduate and Graduate Medical Education: A Meta-Analysis. Eval Health Prof. 2024:1632787241288849. Wang G, Tai B, Huang C, et al. Establishing a multidisciplinary PBL curriculum in the School of Stomatology at Wuhan University. J Dent Educ. 2008;72(5):610-615. Li Y, Ye H, Ye F, et al. The Current Situation and Future Prospects of Simulators in Dental Education. J Med Internet Res. 2021;23(4):e23635. Pang X, Li L, Liu X, Wang Y, Yang B. Application of Emerging Teaching Models in Dental Education: A Systematic Review and Meta-Analysis. International Dental Journal. 2024;74(6):1185-1196. Wu S, Gao L, Fu J, Zhao C, Wang P. The Application of Virtual Simulation Technology in Scaling and Root Planing Teaching. International Dental Journal. 2024;74(2):303-309. Marchan SM, Coldero LG, Smith WAJ. An evaluation of the relationship between clinical requirements and tests of competence in a competency-based curriculum in dentistry. BMC Med Educ. 2023;23(1):585. Xu X, Shi Z, Bos NA, Wu H. Student engagement and learning outcomes: an empirical study applying a four-dimensional framework. Med Educ Online. 2023;28(1):2268347. Holmboe ES, Yamazaki K, Hamstra SJ. The Evolution of Assessment: Thinking Longitudinally and Developmentally. Acad Med. 2020;95(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 59th Annual Research in Medical Education Presentations):S7-s9. Singh MK, Gullett HL, Thomas PA. Using Kern's 6-Step Approach to Integrate Health Systems Science Curricula Into Medical Education. Acad Med. 2021;96(9):1282-1290. Dong Q, Kuria A, Weng Y, Liu Y, Cao Y. Impacts of the COVID-19 epidemic on the department of stomatology in a tertiary hospital: A case study in the General Hospital of the Central Theater Command, Wuhan, China. Community Dent Oral Epidemiol. 2021;49(6):557-564. Hayat AA, Keshavarzi MH, Zare S, et al. Challenges and opportunities from the COVID-19 pandemic in medical education: a qualitative study. BMC Med Educ. 2021;21(1):247. Eleftheriou A, Rokou A, Argyriou C, Papanas N, Georgiadis GS. Web-based Medical Education During COVID-19 Lockdown: A Step Back or a Leap to the Future? Int J Low Extrem Wounds. 2022;21(3):272-274. Chan KY, Yuen TH, Co M. Using ChatGPT for medical education: the technical perspective. BMC Med Educ. 2025;25(1):201. Di Carvalho Melo L, Bastos Silveira B, Amorim Dos Santos J, et al. Dental education profile in COVID-19 pandemic: A scoping review. Eur J Dent Educ. 2023;27(2):252-261. Santos GNM, da Silva HEC, Leite AF, et al. The scope of dental education during COVID-19 pandemic: A systematic review. J Dent Educ. 2021;85(7):1287-1300. Wu S, Yang Z, Wu T, et al. Application of online learning combined with case-based discussion in oral medicine education. J Dent Educ. 2022;86(10):1399-1404. Guo MZ, Allen J, Sakumoto M, Pahwa A, Santhosh L. Reimagining Undergraduate Medical Education in a Post-COVID-19 Landscape. J Gen Intern Med. 2022;37(9):2297-2301. Regmi A, Mao X, Qi Q, Tang W, Yang K. Students’ perception and self-efficacy in blended learning of medical nutrition course: a mixed-method research. BMC Medical Education. 2024;24(1). Qin L, Ouyang X, Gao Y, Hennebry-Leung M. Emotional and Cognitive Dissonance of Teachers of Japanese as a Foreign Language Towards Technology-Mediated Language Teaching Curriculum: A Perezhivanie Perspective. The Asia-Pacific Education Researcher. 2024;33(4):889-900. Zhang J, Dai Y, Zhao F. Comparative Study on Online and Offline Teaching for Creative Idea Generation. Frontiers in Psychology. 2022;13. Additional Declarations No competing interests reported. Supplementary Files Supplementarymaterial.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 07 May, 2025 Reviewers agreed at journal 28 Apr, 2025 Reviewers invited by journal 17 Apr, 2025 Editor assigned by journal 08 Apr, 2025 Editor invited by journal 18 Mar, 2025 Submission checks completed at journal 13 Mar, 2025 First submitted to journal 13 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. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6140068","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":448981521,"identity":"d04b9572-6e0d-46ae-bee5-ee61c3c5718c","order_by":0,"name":"Jingyan Huang","email":"","orcid":"","institution":"Sun Yat-sen University, Hospital of Stomatology","correspondingAuthor":false,"prefix":"","firstName":"Jingyan","middleName":"","lastName":"Huang","suffix":""},{"id":448981522,"identity":"21a41b64-84f7-47c0-a264-12a33ef480a3","order_by":1,"name":"Bo Yang","email":"","orcid":"","institution":"Sun Yat-sen University, Hospital of Stomatology","correspondingAuthor":false,"prefix":"","firstName":"Bo","middleName":"","lastName":"Yang","suffix":""},{"id":448981523,"identity":"a84d1678-68f6-41b6-a037-77a3ed255fe9","order_by":2,"name":"Guihong Yang","email":"","orcid":"","institution":"Sun Yat-sen University, Hospital of Stomatology","correspondingAuthor":false,"prefix":"","firstName":"Guihong","middleName":"","lastName":"Yang","suffix":""},{"id":448981524,"identity":"f6cae4ee-a941-474c-8907-1040b6c8dc5b","order_by":3,"name":"Honghao Zhang","email":"","orcid":"","institution":"Sun Yat-sen University, Hospital of Stomatology","correspondingAuthor":false,"prefix":"","firstName":"Honghao","middleName":"","lastName":"Zhang","suffix":""},{"id":448981525,"identity":"ecbce3db-4034-4a1f-9ed9-ee0f6cb929d9","order_by":4,"name":"Yeitian Gan","email":"","orcid":"","institution":"Sun Yat-sen University, Hospital of Stomatology","correspondingAuthor":false,"prefix":"","firstName":"Yeitian","middleName":"","lastName":"Gan","suffix":""},{"id":448981526,"identity":"10473098-042c-4ca8-9353-55a12f00bee0","order_by":5,"name":"Yan Wang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABEElEQVRIiWNgGAWjYBADOX4gceABjMtDhBZjyQaglgRStCRuOAAkidJicPzs4dc8NXcSN187/BBoS13i/BkJjA/etjHIm+PSciYvzZrn2DPjbbfTDIBaDiduuJHAbDi3jcFwZwN2LWYHcsyMedgOy267nQDSciBxg0QCmzRvGwOQi0PL+TdALf8OM26enf4B5jD233i13Mgxfszbdlhxg3QOyBbmxIYbCWzM+LTY33hjxji377CxxO2cggMJBoeNN5x52Cw555yE4QYcWiT7c4w/vPl2WI5/dvrmDx8q6mTntycf/PCmzEYely1AwCaFiAUDBscGBsYGIEsCp3ogYP74A9ml+JSOglEwCkbByAQAwoBl69jseu8AAAAASUVORK5CYII=","orcid":"","institution":"Sun Yat-sen University, Hospital of Stomatology","correspondingAuthor":true,"prefix":"","firstName":"Yan","middleName":"","lastName":"Wang","suffix":""}],"badges":[],"createdAt":"2025-03-02 14:53:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6140068/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6140068/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82053078,"identity":"44ddbea3-4da0-4427-bbee-8946e9733951","added_by":"auto","created_at":"2025-05-06 10:09:20","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":80150,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThe research procedure\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6140068/v1/4453128769c376243107095a.jpg"},{"id":82051273,"identity":"1e93d904-dadb-40c5-95c8-5961e4e7558d","added_by":"auto","created_at":"2025-05-06 10:01:20","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":46961,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThe survey results on problems existing in the traditional teaching mode (A) and benefits of online and offline blended teaching model (B).\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6140068/v1/7e4e3595d8c36f12c802c32f.jpg"},{"id":82053923,"identity":"78e9303f-1059-4025-ae93-9af29a869df7","added_by":"auto","created_at":"2025-05-06 10:17:20","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":20420,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eComparison of theoretical test scores. \u003c/strong\u003eNs indicates no significance. **** \u003cem\u003ep\u003c/em\u003e\u0026lt;0.0001. ns indicates no significance.\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6140068/v1/018e3515380e9d06ee69df2f.jpg"},{"id":82051276,"identity":"057fed3c-986f-4387-8308-cd9c378d3c11","added_by":"auto","created_at":"2025-05-06 10:01:20","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":44567,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eComparison of scores for overall impression (A), teaching method (B), teaching content (C) and teaching effect (D). \u003c/strong\u003eNs indicates no significance. *\u003cem\u003ep\u003c/em\u003e\u0026lt;0.05.\u003c/p\u003e\n\u003cp\u003e**** \u003cem\u003ep\u003c/em\u003e\u0026lt;0.0001, ns indicates no significance.\u003c/p\u003e","description":"","filename":"4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6140068/v1/1b6a90b13b3287e77f5b1400.jpg"},{"id":82056321,"identity":"57f55010-6a54-4cab-ab11-95562383bdbe","added_by":"auto","created_at":"2025-05-06 10:33:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1163092,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6140068/v1/e102ac6f-7385-4c63-9035-ccc71705daa4.pdf"},{"id":82053076,"identity":"89e05950-5f60-45a5-a501-33bf301a0415","added_by":"auto","created_at":"2025-05-06 10:09:20","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":23716,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementarymaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-6140068/v1/e994684ffd7a34bcf5b3bc0a.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"An assessment of online and offline blended teaching of Stomatology for non-stomatology medical students","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eStomatology is a critical component of clinical medical education, as it fosters interdisciplinary understanding and equips future physicians with essential skills to address systemic health through oral manifestations. Studies demonstrate that over 90% of systemic diseases, including diabetes, cardiovascular conditions, and inflammatory bowel disease, present oral symptoms such as mucosal lesions or periodontal inflammation, necessitating early recognition by clinicians for timely intervention\u003csup\u003e\u003cspan additionalcitationids=\"CR2 CR3\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. Furthermore, inadequate knowledge of oral health among medical students correlates with poor patient outcomes, particularly in diagnosing oral cancers or managing infections like infective endocarditis, where antibiotic prophylaxis during dental procedures significantly reduces cardiovascular risks\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. The integration of oral-systemic health education also enhances interprofessional collaboration, as evidenced by improved clinical outcomes in multidisciplinary settings such as head and neck cancer management\u003csup\u003e\u003cspan additionalcitationids=\"CR8 CR9 CR10\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Additionally, gaps in medical curricula regarding oral emergencies, such as maxillofacial trauma or odontogenic infections, underscore the need for structured training to optimize emergency care\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. Despite challenges in transitioning to virtual learning during the COVID-19 pandemic, blended educational models combining online and clinical practice have proven effective in reinforcing oral health competencies\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Thus, comprehensive Stomatology education not only bridges the gap between dental and systemic care but also cultivates a holistic clinical perspective, directly impacting patient safety and public health outcomes.\u003c/p\u003e \u003cp\u003eDespite the recognized significance of stomatology in clinical education, achieving good teaching effects still poses a challenge because of insufficient emphasis on pedagogical innovation in interdisciplinary teaching. Traditional lecture-based approaches dominate dental curricula, often failing to promote interactive learning or address individual student needs\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. Studies highlight that limited faculty training in modern educational strategies hinder dynamic teacher-student interactions, reducing opportunities for personalized feedback\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. For instance, observational research reveals that lecturers relying on passive knowledge transmission struggle to engage students or adapt to diverse learning styles, exacerbating communication gaps\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. Furthermore, while blended learning and simulation-based methods demonstrate efficacy in enhancing clinical competencies\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e, their adoption remains inconsistent due to institutional resistance, resource constraints, and insufficient faculty readiness\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. Barriers such as inadequate interdisciplinary collaboration and rigid curricula further impede the integration of student-centered approaches like problem-based learning (PBL) and virtual reality\u003csup\u003e\u003cspan additionalcitationids=\"CR25 CR26\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. Notably, stomatology students report dissatisfaction with traditional assessment-driven models that prioritize rote memorization over critical thinking, underscoring the need for pedagogical reforms\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e. These systemic inefficiencies highlight the urgency of re-evaluating educational frameworks to align with evolving clinical demands and learner expectations\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e,\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e. Addressing these gaps requires institutional commitment to faculty development, technological integration, and curricular flexibility to bridge communication divides and accelerate educational innovation.\u003c/p\u003e \u003cp\u003eHistorically, the COVID-19 pandemic has profoundly disrupted traditional educational frameworks, necessitating a rapid shift toward digital platforms to ensure continuity in medical and stomatology education. During the pandemic, strict social distancing measures led to significant reductions in clinical training opportunities and classroom-based instruction, as evidenced by a two-thirds decline in outpatient services and a 77% reduction in dental interns in tertiary hospitals\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e. This abrupt transition underscored the limitations of purely online education, such as reduced clinical skill acquisition and student engagement\u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e,\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e. However, the crisis also accelerated the adoption of digital tools, including Zoom, Microsoft Teams, and AI-driven platforms like ChatGPT, which facilitated asynchronous learning, virtual simulations, and remote collaboration\u003csup\u003e\u003cspan additionalcitationids=\"CR36\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e. Studies demonstrated that blended models, such as semi-flipped classrooms (SFCs), which integrate pre-recorded online content with interactive offline sessions, outperformed traditional methods in both student performance and satisfaction\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e. For instance, SFCs enhanced knowledge retention in Stomatology and improved clinical reasoning through case-based discussions\u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e. Despite challenges like internet connectivity issues and faculty unpreparedness for digital pedagogy\u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e, the pandemic highlighted the necessity of hybrid approaches to balance flexibility, safety, and educational efficacy. These findings collectively emphasize that the integration of online and offline modalities, driven by pandemic exigencies and technological advancements, represents a sustainable evolution in medical education\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e,\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe current research aims to assess the effectiveness of online and offline blended teaching of Stomatology for non-stomatology medical students. To investigate this question, we implemented a full chain of reform measures. Before the class started, students\u0026rsquo; perceptions of blended learning were investigated by online questionnaires, exploring their attitude, experience and suggestions about blended teaching. The teaching was transformed from traditional lectures to blended teaching, integrating lectures and online teaching. Additionally, class and extra learning materials on raining classroom were available to the experimental groups of students. At the end of the terms, overall impression and the effectiveness of the teaching was assessed by analysing the scores from online questionnaires given by students and theory test scores.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study design\u003c/h2\u003e \u003cp\u003eOur study used the three following methods to collect data that would reflect perception, practice, and achievements of students in doing blended tasks through before- and after-class anonymous questionnaires. Before-class questionnaires were conducted to explore students’ learning interest, attitude, and platform media used in the context of blended learning. After-class, questionnaires were distributed to students undertaking different teaching modes to score the effectiveness of teaching, as subject effect evaluation of blended teaching. Besides, Eight-Year Program medical students from the different teaching modes submitted reviews and a teacher scored them for objective effect evaluation of the blended teaching. The research procedure is demonstrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Research participants\u003c/h2\u003e \u003cp\u003eThe study involved three groups of second-year Clinical Medicine students at Sun Yat-sen University School of Medicine, focused on evaluating the effectiveness of a blended teaching mode for the “Stomatology” course. Online Teaching Groups(OT): comprised of 120 students who participated in the blended teaching mode during the 2021 academic year. Blended Teaching Group༈BT༉: comprised of 122 students who participated in the blended teaching mode during the 2022–2023 academic years. Control Group (Control): Included 172 students who completed the traditional teaching method in 2020. Additionally, students from the BT group were selected for before-class questionnaires to gain students’ general perception for offline, online and blended teaching approaches.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Effect evaluation of blended teaching method\u003c/h2\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e\u003cb\u003e2.3.1 Before-class questionnaire\u003c/b\u003e\u003c/h2\u003e \u003cp\u003eThe questionnaire was designed to investigate students’ perception for blended teaching mode, focusing on the students’ preference and perspective on the advantages along with disadvantages of blended teaching. Questionnaires were distributed to the subjects by WJX.cn. Before class, the QR code of the questionnaire generated from WJX.cn was displayed to students from BT group who participated in the blended teaching mode, and the teacher explained the intention and purpose of the questionnaire. Course students voluntarily scanned the code to answer the questionnaire. Questions in the questionnaires were listed in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The complete questionnaire can be referred to in Supplemental materials.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eQuestions included in the questionnaires\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuestion stem\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOptions\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYou prefer which teaching mode?\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eA. Traditional teaching mode\u003c/p\u003e \u003cp\u003eB. Online teaching mode\u003c/p\u003e \u003cp\u003eC. Online and offline blended teaching mode\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhat problems do you think exist in the traditional teaching mode?\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eA. no playback, it is easy to miss knowledge\u003c/p\u003e \u003cp\u003eB. The spatiotemporal constraint\u003c/p\u003e \u003cp\u003eC. Low efficiency and poor effect\u003c/p\u003e \u003cp\u003eD. Content is closed and resources are scarce\u003c/p\u003e \u003cp\u003eE. Low class participation\u003c/p\u003e \u003cp\u003eF. It is not conducive to improving the ability of independent learning\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhat do you think are the advantages of online and offline blended teaching model?\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eA. It can arouse the enthusiasm of learning\u003c/p\u003e \u003cp\u003eB. It can strengthen the mastery of knowledge points\u003c/p\u003e \u003cp\u003eC. It can improve the ability of independent learning\u003c/p\u003e \u003cp\u003eD. Break through the limitation of traditional classroom and do not delay the learning progress\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhat do you think about the challenges of Online and Offline blended teaching model?\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eA. The difficulty of the course increased, and the learning pressure increased\u003c/p\u003e \u003cp\u003eB. Challenge of self-restraint\u003c/p\u003e \u003cp\u003eC. Unable to reasonably arrange online learning time\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhat do you think about establishing a wechat group\u003c/p\u003e \u003cp\u003e·\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eA. Is conducive to timely communication between teachers and students\u003c/p\u003e \u003cp\u003eB. Too much information causing interference\u003c/p\u003e \u003cp\u003eC. Is very necessary\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhat do you think about getting class powerpoints after class\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eA. Helps ease the study burden\u003c/p\u003e \u003cp\u003eB. Very necessary\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e \u003cp\u003e\u003c/p\u003e \u003cp\u003eQuestion 5 and 6 were scored according to five levels: strongly agree, agree, neutral, disagree and strongly disagree. The score ranged from 5–1. The higher score indicated the higher acceptance of the opinion.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.3.2 Theoretical test\u003c/h2\u003e \u003cp\u003eAt the end of the class, long term clinical medical students from the Control, OT and BT groups submitted reviews with a topic of the relationship between oral diseases and systemic diseases (20 points totally) in electric version as a theoretical test. Only Eight-Year Program medical students were incorporated into theoretical test to eliminate the intra-group difference in learning capacity and knowledge background. The submitted reviews were graded by the same teacher.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.3.3 After-class questionnaire\u003c/h2\u003e \u003cp\u003eThe questionnaire was designed to assess the effectiveness of blended teaching mode by satisfaction analysis from students about the courses. The questionnaire was focused on the students’ evaluation for the methods and effectiveness of the course. Questionnaires were distributed to the subjects by Educational Administration Evaluation System of Sun Yat-sen University at the end of class. Questionnaires were distributed to all the students from Online Teaching Groups, Blended Teaching Group and Control Group. The questionnaires include three groups of questions:1) Teaching content: The teaching is clearly organized, logically rigorous, easy to understand, clear the difficult points, highlight the key points, and reflect the new progress of the discipline. Correct use of foreign language vocabulary, foreign language pronunciation is accurate and clear. The language is standardized, vivid and smooth, and the expression ability is strong, which can attract the attention of students. Containing skilled, basic theory, basic knowledge teaching; 2) Teaching method: Teaching method is proper, pay attention to ability training and enlightening teaching. The teaching time is arranged reasonably and the rhythm is proper. Courseware production standard, handwriting clear, reasonable arrangement, detailed slightly appropriate. 3) Teaching effect: Pay attention to communication with students, arouse students' enthusiasm, active classroom atmosphere. Effective use of various teaching media. Each item was scored by the subjects. The maximum scores of each item were 55, 25 and 15 points. The overall impression scores were obtained by converting the sum of teaching content, method and effect sores to a hundred-mark system. The complete questionnaire can be referred to in Supplemental materials.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Implementation process of online and blended teaching\u003c/h2\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003e2.4.1 Blended teaching\u003c/h2\u003e \u003cp\u003eDuring the instructional period, the BT class educators embraced a hybrid teaching methodology. They crafted a detailed syllabus tailored for this blended approach and participated in an intensive training session dedicated to the rollout of this model. This preparatory training took place in the week preceding the educational intervention, aiming to shift the educators' focus towards a more integrated teaching style that emphasizes blended learning strategies over traditional, in-person teaching methods.\u003c/p\u003e \u003cp\u003eThe hybrid teaching framework employed in this research is structured around three key components:\u003c/p\u003e \u003cp\u003eInitial Learning Phase: This stage leverages digital platforms such as Rain Classroom and WeChat groups for preliminary education. Students engage with case studies and undertake preparatory tasks, with their understanding assessed via self-evaluation quizzes.\u003c/p\u003e \u003cp\u003eInteractive Classroom Sessions: The face-to-face component of the course is dedicated to fostering dialogue, addressing and distilling problems, clarifying doubts, and recapitulating essential concepts. This segment blends theory with practice, encouraging students to collaborate in small groups, typically comprising six to eight members, to enhance their learning experience.\u003c/p\u003e \u003cp\u003ePost-Class Engagement: Following the classroom sessions, students continue their learning journey online. This includes delving into additional readings and completing coursework. In the course's second week, project guidelines are disseminated online. Throughout the project's duration, groups maintain online communication with their instructor to tackle any challenges. A week after the course concludes, students are expected to hand in their review assignments and respond to post-course surveys.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e2.4.2 Online teaching\u003c/h2\u003e \u003cp\u003eThe online teaching process was nearly the same with the blending teaching except for the offline classroom. The classes were given online containing communication and discussion, problem condensation, answering and solving doubts, and summarizing key points.\u003c/p\u003e \u003cp\u003e \u003cb\u003eData analysis\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAll statistical analyses were carried out using SPSS 26.0 software. Data in pre-class qualitative questionnaire was described as percentage. Data from after-class quantative questionnaire was presented as mean ± SD. The ANOVA test was used to determine if there was a significant difference between the groups. A \u003cem\u003eP\u003c/em\u003e-value less than 0.05 was considered significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e \u003cb\u003eThe perception of students about blended teaching\u003c/b\u003e \u003c/p\u003e\u003cp\u003eA total of 35 students from the BT group filled out the before-class questionnaires on the general perception for offline, online and blended teaching approaches, consisting of 12 males and 23 females.\u003c/p\u003e\u003cp\u003eIn regard of the teaching mode, nearly half, 51.43% of the students preferred traditional teaching mode despite the considered disadvantages (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eA) including easily miss knowledge points (80%), spatiotemporal constraint (71.43%), low efficiency and poor effect (8.57%), closed content and scarce resources (5.71%), low class participation (11.43%) and inconduciveness to improving the ability of independent learning (5.71%).\u003c/p\u003e\u003cp\u003eBy comparision, 25.71% preferred blended teaching and 22.86% chose offline teaching as the preferred mode. It was believed that the most prominent advantage (74.29%) of the blended teaching was no delaying the learning progress by breaking through the limitation of traditional classroom. Additionally, the blended teaching was considered to promote the self-efficacy of students by arousing the enthusiasm of learning (22.86%) and improve the ability of independent learning (37.14%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eB). However, challenges of blended teaching also exited, including challenge of self-restraint (77.14%), unable to reasonably arrange online learning time (42.86%) along with increased difficulty of the course and learning pressure (28.57%).\u003c/p\u003e\u003cp\u003eThe acceptability of online teaching media was also investigated. As a popular online communication media, the Weixin APP was considered essential for communication between teachers and students and no students disagreed its use except for too much information interference (8.57% of students deemed). Additionally, 88.57% of the subject students strongly agreed of the necessity of obtaining class powerpoints after class for ease of study burden.\u003c/p\u003e\u003cp\u003e \u003cb\u003eComparison of theoretical test scores\u003c/b\u003e \u003c/p\u003e\u003cp\u003eThe theoretical test scores of students from OT and BT groups were significantly higher than the scores from the Control group (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.001). Nevertheless, there was no significant difference in the scores between OT and BT groups \u003cem\u003e(P\u003c/em\u003e \u0026gt; 0.05) (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e \u003cb\u003eTeaching effect of blended teaching marked by students\u003c/b\u003e \u003c/p\u003e\u003cp\u003eAccording to the questionnaire survey, the blened-teaching group of students had a highest overall impression of teachers’ teaching among the 3 groups. Meanwhile, the scores given by the students in online group was slightly higher than the Control group. Nonetheless, there was no significant difference between the groups (\u003cem\u003eP\u003c/em\u003e \u0026gt; 0.05) (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003eA).\u003c/p\u003e\u003cp\u003eIn details, students in BT group agreed that the teacher could apply modern educational technology in teaching effectively. The teaching method scores from BT group were significantly higher than the Control and OT groups (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.0001, Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003eB). There was no significant difference between Control and OT groups (\u003cem\u003eP\u003c/em\u003e \u0026gt; 0.05). Similar trends applied to the scores for teaching methods and effects. Students from BT group believed that the course content was more closely related to basic theory and that the teacher focused more on the key points and explained the difficulties thoroughly (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003eC). At the end of the questionnaire, students from BT group marked significantly higher scores for the teaching effects than the other two groups (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.0001 Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003eD). They thought that teachers pay adequate attention to communication with students, arouse students' enthusiasm and the classroom atmosphere was more active.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e \u003cb\u003eTeaching Effectiveness\u003c/b\u003e \u003c/p\u003e\u003cp\u003eThe research findings demonstrate that both online (OT) and blended (BT) teaching modalities achieved significantly better theoretical test results compared to the conventional classroom (Control) approach, with no statistically significant difference between OT and BT groups. The blended teaching model showed particularly strong results in overall teaching evaluations, especially in the dimension of instructional methodology, indicating its effectiveness in enhancing students' theoretical knowledge and teaching satisfaction.\u003c/p\u003e\u003cp\u003eConsistent with Regmi's finding that hybrid learning promotes student collaborative abilities, this study observed superior performance among BT group students in collaborative assessments such as group discussions and exploratory projects\u003csup\u003e\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e. Although this study did not specifically examine innovative thinking, the results underscore the effectiveness of blended teaching in theoretical knowledge acquisition and comprehensive teaching evaluation, expanding the scope of related research.\u003c/p\u003e\u003cp\u003eThis investigation provides a unique perspective on cross-disciplinary teaching effectiveness by focusing on the teaching of Stomatology to non-stomatology students. The blended teaching model facilitates non-stomatology students' understanding and mastery of stomatological knowledge by leveraging online resources and offline interactive collaboration, representing an important complement to research on cross-disciplinary teaching effectiveness.\u003c/p\u003e\u003cp\u003e \u003cb\u003eStudent Attitudes\u003c/b\u003e \u003c/p\u003e\u003cp\u003eDespite the limitations of conventional teaching methods, nearly half of the students (51.43%) still preferred traditional classroom instruction. However, students acknowledged the advantages of blended teaching, including its flexibility in breaking time and space constraints (74.29%), enhancing learning motivation (22.86%), and improving self-directed learning skills (37.14%). They also identified challenges such as self-discipline requirements (77.14%) and difficulty in managing online learning time (42.86%).\u003c/p\u003e\u003cp\u003eSimilar to Qin's observation of teachers' evolving attitudes toward technology-mediated language teaching, students' attitudes toward blended teaching are complex and stage-dependent, influenced by factors such as teaching environment and technological familiarity\u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e. Unlike previous studies focusing on instructors, this research targets student experiences, particularly in the context of cross-disciplinary education. Non-stomatology students, accustomed to their original disciplinary teaching methods, exhibit varied acceptance of the blended teaching model in this cross-disciplinary stomatology course. The study's comprehensive data collection provides precise directions for instructional improvement.\u003c/p\u003e\u003cp\u003e \u003cb\u003eStrengths and Challenges of Blended Teaching\u003c/b\u003e \u003c/p\u003e\u003cp\u003eBlended teaching integrates the strengths of online and offline instruction. Online learning offers diverse resources and flexible learning schedules, promoting independent exploration, while offline sessions enhance face-to-face interactions, collaboration, and practical skills. In this study, blended teaching improved student performance in theoretical tests and collaborative assessments, while students recognized its role in knowledge acquisition and skill development.\u003c/p\u003e\u003cp\u003eHowever, blended teaching presents challenges. Autonomous learning requires strong self-regulation to avoid distractions and maintain learning efficiency. Technical issues and poor time management can impede learning outcomes. As Zhang noted, challenges such as lagging pedagogical concepts and insufficient student proactivity may persist in blended teaching environments\u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e. In cross-disciplinary contexts, blended teaching also faces knowledge integration difficulties. For non-stomatology students, online multimedia resources can aid comprehension of complex stomatological concepts, while offline discussions and practical exercises facilitate application of theoretical knowledge.\u003c/p\u003e\u003cp\u003e \u003cb\u003eBlended Teaching and Cross-Disciplinary Instruction\u003c/b\u003e \u003c/p\u003e\u003cp\u003eIn the context of teaching Stomatology to non-stomatology students, cross-disciplinary instruction offers unique advantages and challenges. It broadens students' knowledge horizons, fosters integrative thinking, and enhances their ability to address complex problems using multidisciplinary approaches. The collaborative nature of cross-disciplinary learning improves communication and teamwork skills.\u003c/p\u003e\u003cp\u003eHowever, challenges include knowledge integration difficulties due to disciplinary differences, uneven resource allocation, and conflicting learning objectives. This study provides a novel perspective on cross-disciplinary teaching by analyzing its advantages and challenges in a stomatology course for non-stomatology students.\u003c/p\u003e\u003cp\u003e \u003cb\u003eApplicability for Non-Stomatology medical students\u003c/b\u003e \u003c/p\u003e\u003cp\u003eThe blended teaching model demonstrates applicability for non-stomatology students learning Stomatology Online resources, including animations and case studies, aid comprehension of complex concepts, while offline practical sessions enhance skill development. This approach helps students overcome disciplinary barriers, though limitations such as insufficient practical opportunities and differing cognitive frameworks persist.\u003c/p\u003e\u003cp\u003eThis study contributes to the literature by addressing the specific challenges faced by non-stomatology students in learning Stomatology and evaluating the suitability of blended teaching. Its comprehensive methodology, combining surveys and theoretical assessments, offers valuable insights for optimizing cross-disciplinary teaching practices.\u003c/p\u003e\u003cp\u003eThis study provides valuable insights for teaching practice, particularly in cross-disciplinary contexts. The findings suggest that blended teaching effectively enhances theoretical knowledge, collaboration, and student satisfaction by combining online flexibility with offline engagement. Educators should adopt this model to improve learning outcomes, especially for non-stomatology students in complex subjects like stomatology, while addressing challenges such as self-discipline and time management. Additionally, fostering collaborative activities and leveraging multimedia resources can further support cross-disciplinary instruction, helping students integrate knowledge across disciplines and develop practical skills.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, this study aimed to assess the effectiveness of online and offline blended teaching of Stomatology for non-stomatology medical students. The results showed that the blended teaching model had a positive impact on student enthusiasm and classroom atmosphere, leading to better learning outcomes. Furthermore, the blended teaching model proved to be beneficial for students, allowing them to easily access course materials and improve their understanding of complex concepts.\u003c/p\u003e\u003cp\u003eHowever, despite its advantages, the blended teaching model also presented some challenges, such as increased workload and difficulties in managing time effectively. Therefore, it is essential to address these challenges and develop strategies to optimize the blended teaching approach for non-stomatology medical students.\u003c/p\u003e\u003cp\u003eOverall, this study highlights the essentiality of teaching mode reform in? cross-disciplinary teaching for medical undergraduates. Driven by pandemic exigencies and technological advancements, online and offline blended teaching mode was verified to enliven the classroom atmosphere, inspire studying enthusiasm, and achieve good learning effects in the learning of Stomatology for non-oral medical students.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eonline teaching mode\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eblended teaching mode.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe need for ethics approval for the study was waived by the Medical Ethics Committee of the Hospital of Stomatology, Sun Yat-sen University (GHKQ-202503-K04-01). All methods were carried out in compliance with the Helsinki Declaration. Informed consent was shown along with the questionnaire before the survey.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe transcripts/datasets analysed in current study are not publicly available due to the confidentiality of the data, but are available from the corresponding author on request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was financially supported by Undergraduate Education Quality and Reform Program of Guangdong Province in 2023.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYan Wang (Funding acquisition: Equal)\u003c/p\u003e\n\u003cp\u003eJingyan Huang (Conceptualization: Equal; Funding acquisition: Equal; Investigation:\u003c/p\u003e\n\u003cp\u003eEqual; Methodology: Equal; Project administration: Equal; Resources: Equal;\u003c/p\u003e\n\u003cp\u003eSupervision: Equal; Validation: Equal; Writing – review \u0026amp; editing: Equal)\u003c/p\u003e\n\u003cp\u003eBo Yang (Investigation: Equal; Methodology: Equal; Writing – original draft: Lead)\u003c/p\u003e\n\u003cp\u003eGuihong Yang (Writing – review \u0026amp; editing: Supporting)\u003c/p\u003e\n\u003cp\u003eHonghao Zhang (Validation: Supporting; Visualization: Supporting)\u003c/p\u003e\n\u003cp\u003eYeitian Gan (Data curation: Supporting)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eChatzopoulos GS, Jiang Z, Marka N, Wolff LF. Periodontal Disease, Tooth Loss, and Systemic Conditions: An Exploratory Study. \u003cem\u003eInt Dent J. \u003c/em\u003e2024;74(2):207-215.\u003c/li\u003e\n\u003cli\u003eByrd KM, Gulati AS. The \u0026quot;Gum-Gut\u0026quot; Axis in Inflammatory Bowel Diseases: A Hypothesis-Driven Review of Associations and Advances. \u003cem\u003eFront Immunol. \u003c/em\u003e2021;12:620124.\u003c/li\u003e\n\u003cli\u003eEnteghad S, Shirban F, Nikbakht MH, Bagherniya M, Sahebkar A. Relationship Between Diabetes Mellitus and Periodontal/Peri-Implant Disease: A Contemporaneous Review. \u003cem\u003eInt Dent J. \u003c/em\u003e2024;74(3):426-445.\u003c/li\u003e\n\u003cli\u003eKaura Parbhakar K, Farmer JW, Quinonez C. The influence of living conditions and individual behaviors on the oral-systemic disease connection: a cross-sectional analysis. \u003cem\u003eJ Public Health Dent. \u003c/em\u003e2022;82(2):220-228.\u003c/li\u003e\n\u003cli\u003eThornhill MH, Gibson TB, Yoon F, et al. Antibiotic Prophylaxis Against Infective Endocarditis Before Invasive Dental Procedures. \u003cem\u003eJ Am Coll Cardiol. \u003c/em\u003e2022;80(11):1029-1041.\u003c/li\u003e\n\u003cli\u003eSperotto F, France K, Gobbo M, et al. Antibiotic Prophylaxis and Infective Endocarditis Incidence Following Invasive Dental Procedures: A Systematic Review and Meta-Analysis. \u003cem\u003eJAMA Cardiol. \u003c/em\u003e2024;9(7):599-610.\u003c/li\u003e\n\u003cli\u003eGlossop S, Duffaydar H, Jones H, et al. Oral and maxillofacial surgery and dental health education in undergraduate medicine: a systematic review. \u003cem\u003eBr J Oral Maxillofac Surg. \u003c/em\u003e2024;62(10):882-888.\u003c/li\u003e\n\u003cli\u003eCernea CR, Leite AK, Muller BF, Matos LL. Multidisciplinary approach in head and neck cancer. \u003cem\u003eEinstein (Sao Paulo). \u003c/em\u003e2024;22(suppl 3):eEDS3.\u003c/li\u003e\n\u003cli\u003eJung K, Narwal M, Min SY, Keam B, Kang H. Squamous cell carcinoma of head and neck: what internists should know. \u003cem\u003eKorean J Intern Med. \u003c/em\u003e2020;35(5):1031-1044.\u003c/li\u003e\n\u003cli\u003eMody MD, Rocco JW, Yom SS, Haddad RI, Saba NF. Head and neck cancer. \u003cem\u003eLancet. \u003c/em\u003e2021;398(10318):2289-2299.\u003c/li\u003e\n\u003cli\u003eTaberna M, Gil Moncayo F, Jane-Salas E, et al. The Multidisciplinary Team (MDT) Approach and Quality of Care. \u003cem\u003eFront Oncol. \u003c/em\u003e2020;10:85.\u003c/li\u003e\n\u003cli\u003eSheth R, Smith RK, Lambert JS. Emergency Department Management of Maxillofacial Trauma. \u003cem\u003eEmerg Med Pract. \u003c/em\u003e2024;26(Suppl 10):1-33.\u003c/li\u003e\n\u003cli\u003eHong Y, Wu J, Wu J, et al. Semi-flipped classroom-based learning interventions in a traditional curriculum of oral medicine: students\u0026apos; perceptions and teaching achievements. \u003cem\u003eBMC Med Educ. \u003c/em\u003e2023;23(1):44.\u003c/li\u003e\n\u003cli\u003eSubramanian T, Rowland KJ. Opportunities and Challenges in Medical Education During the COVID-19 Pandemic. \u003cem\u003ePediatr Ann. \u003c/em\u003e2022;51(8):e319-e323.\u003c/li\u003e\n\u003cli\u003eTrull\u0026agrave;s JC, Blay C, Sarri E, Pujol R. Effectiveness of problem-based learning methodology in undergraduate medical education: a scoping review. \u003cem\u003eBMC Med Educ. \u003c/em\u003e2022;22(1):104.\u003c/li\u003e\n\u003cli\u003ePreshaw PM, Ramseier CA, Loos BG, et al. Contemporary educational methods in periodontology. \u003cem\u003eJ Clin Periodontol. \u003c/em\u003e2024;51 Suppl 27:117-192.\u003c/li\u003e\n\u003cli\u003eVisioli S, Lodi G, Carrassi A, Zannini L. The role of observational research in improving faculty lecturing skills: A qualitative study in an Italian dental school. \u003cem\u003eMed Teach. \u003c/em\u003e2009;31(8):e362-369.\u003c/li\u003e\n\u003cli\u003eStaines K. Oral medicine: the importance of a team-based approach. \u003cem\u003eBr Dent J. \u003c/em\u003e2024;236(4):227.\u003c/li\u003e\n\u003cli\u003eFedorchenko Y, Zimba O, Gulov MK, Yessirkepov M, Fedorchenko M. Medical Education Challenges in the Era of Internationalization and Digitization. \u003cem\u003eJ Korean Med Sci. \u003c/em\u003e2024;39(39):e299.\u003c/li\u003e\n\u003cli\u003eRyan GV, Callaghan S, Rafferty A, Higgins MF, Mangina E, McAuliffe F. Learning Outcomes of Immersive Technologies in Health Care Student Education: Systematic Review of the Literature. \u003cem\u003eJ Med Internet Res. \u003c/em\u003e2022;24(2):e30082.\u003c/li\u003e\n\u003cli\u003eElendu C, Amaechi DC, Okatta AU, et al. The impact of simulation-based training in medical education: A review. \u003cem\u003eMedicine (Baltimore). \u003c/em\u003e2024;103(27):e38813.\u003c/li\u003e\n\u003cli\u003eAjjawi R, Barton KL, Dennis AA, Rees CE. Developing a national dental education research strategy: priorities, barriers and enablers. \u003cem\u003eBMJ Open. \u003c/em\u003e2017;7(3):e013129.\u003c/li\u003e\n\u003cli\u003eZheng B, Sun T. Self-Regulated Learning and Learning Outcomes in Undergraduate and Graduate Medical Education: A Meta-Analysis. \u003cem\u003eEval Health Prof. \u003c/em\u003e2024:1632787241288849.\u003c/li\u003e\n\u003cli\u003eWang G, Tai B, Huang C, et al. Establishing a multidisciplinary PBL curriculum in the School of Stomatology at Wuhan University. \u003cem\u003eJ Dent Educ. \u003c/em\u003e2008;72(5):610-615.\u003c/li\u003e\n\u003cli\u003eLi Y, Ye H, Ye F, et al. The Current Situation and Future Prospects of Simulators in Dental Education. \u003cem\u003eJ Med Internet Res. \u003c/em\u003e2021;23(4):e23635.\u003c/li\u003e\n\u003cli\u003ePang X, Li L, Liu X, Wang Y, Yang B. Application of Emerging Teaching Models in Dental Education: A Systematic Review and Meta-Analysis. \u003cem\u003eInternational Dental Journal. \u003c/em\u003e2024;74(6):1185-1196.\u003c/li\u003e\n\u003cli\u003eWu S, Gao L, Fu J, Zhao C, Wang P. The Application of Virtual Simulation Technology in Scaling and Root Planing Teaching. \u003cem\u003eInternational Dental Journal. \u003c/em\u003e2024;74(2):303-309.\u003c/li\u003e\n\u003cli\u003eMarchan SM, Coldero LG, Smith WAJ. An evaluation of the relationship between clinical requirements and tests of competence in a competency-based curriculum in dentistry. \u003cem\u003eBMC Med Educ. \u003c/em\u003e2023;23(1):585.\u003c/li\u003e\n\u003cli\u003eXu X, Shi Z, Bos NA, Wu H. Student engagement and learning outcomes: an empirical study applying a four-dimensional framework. \u003cem\u003eMed Educ Online. \u003c/em\u003e2023;28(1):2268347.\u003c/li\u003e\n\u003cli\u003eHolmboe ES, Yamazaki K, Hamstra SJ. The Evolution of Assessment: Thinking Longitudinally and Developmentally. \u003cem\u003eAcad Med. \u003c/em\u003e2020;95(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 59th Annual Research in Medical Education Presentations):S7-s9.\u003c/li\u003e\n\u003cli\u003eSingh MK, Gullett HL, Thomas PA. Using Kern\u0026apos;s 6-Step Approach to Integrate Health Systems Science Curricula Into Medical Education. \u003cem\u003eAcad Med. \u003c/em\u003e2021;96(9):1282-1290.\u003c/li\u003e\n\u003cli\u003eDong Q, Kuria A, Weng Y, Liu Y, Cao Y. Impacts of the COVID-19 epidemic on the department of stomatology in a tertiary hospital: A case study in the General Hospital of the Central Theater Command, Wuhan, China. \u003cem\u003eCommunity Dent Oral Epidemiol. \u003c/em\u003e2021;49(6):557-564.\u003c/li\u003e\n\u003cli\u003eHayat AA, Keshavarzi MH, Zare S, et al. Challenges and opportunities from the COVID-19 pandemic in medical education: a qualitative study. \u003cem\u003eBMC Med Educ. \u003c/em\u003e2021;21(1):247.\u003c/li\u003e\n\u003cli\u003eEleftheriou A, Rokou A, Argyriou C, Papanas N, Georgiadis GS. Web-based Medical Education During COVID-19 Lockdown: A Step Back or a Leap to the Future? \u003cem\u003eInt J Low Extrem Wounds. \u003c/em\u003e2022;21(3):272-274.\u003c/li\u003e\n\u003cli\u003eChan KY, Yuen TH, Co M. Using ChatGPT for medical education: the technical perspective. \u003cem\u003eBMC Med Educ. \u003c/em\u003e2025;25(1):201.\u003c/li\u003e\n\u003cli\u003eDi Carvalho Melo L, Bastos Silveira B, Amorim Dos Santos J, et al. Dental education profile in COVID-19 pandemic: A scoping review. \u003cem\u003eEur J Dent Educ. \u003c/em\u003e2023;27(2):252-261.\u003c/li\u003e\n\u003cli\u003eSantos GNM, da Silva HEC, Leite AF, et al. The scope of dental education during COVID-19 pandemic: A systematic review. \u003cem\u003eJ Dent Educ. \u003c/em\u003e2021;85(7):1287-1300.\u003c/li\u003e\n\u003cli\u003eWu S, Yang Z, Wu T, et al. Application of online learning combined with case-based discussion in oral medicine education. \u003cem\u003eJ Dent Educ. \u003c/em\u003e2022;86(10):1399-1404.\u003c/li\u003e\n\u003cli\u003eGuo MZ, Allen J, Sakumoto M, Pahwa A, Santhosh L. Reimagining Undergraduate Medical Education in a Post-COVID-19 Landscape. \u003cem\u003eJ Gen Intern Med. \u003c/em\u003e2022;37(9):2297-2301.\u003c/li\u003e\n\u003cli\u003eRegmi A, Mao X, Qi Q, Tang W, Yang K. Students\u0026rsquo; perception and self-efficacy in blended learning of medical nutrition course: a mixed-method research. \u003cem\u003eBMC Medical Education. \u003c/em\u003e2024;24(1).\u003c/li\u003e\n\u003cli\u003eQin L, Ouyang X, Gao Y, Hennebry-Leung M. Emotional and Cognitive Dissonance of Teachers of Japanese as a Foreign Language Towards Technology-Mediated Language Teaching Curriculum: A Perezhivanie Perspective. \u003cem\u003eThe Asia-Pacific Education Researcher. \u003c/em\u003e2024;33(4):889-900.\u003c/li\u003e\n\u003cli\u003eZhang J, Dai Y, Zhao F. Comparative Study on Online and Offline Teaching for Creative Idea Generation. \u003cem\u003eFrontiers in Psychology. \u003c/em\u003e2022;13.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"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":"online and offline blended teaching, Stomatology, non-stomatology, medical students, traditional teaching","lastPublishedDoi":"10.21203/rs.3.rs-6140068/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6140068/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction and aims:\u003c/h2\u003e \u003cp\u003eThe COVID-19 pandemic accelerated the adoption of blended teaching models in medical education, highlighting their potential to address challenges in traditional pedagogy. This study evaluates the effectiveness of online and offline blended teaching for non-stomatology medical students in Stomatology, a critical yet often underrepresented discipline in medical curricula.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eA blended teaching approach was implemented, combining pre-recorded online lectures with interactive offline sessions. Pre-class surveys assessed students\u0026rsquo; perceptions and readiness, while post-class evaluations, including theory tests and satisfaction questionnaires, measured learning outcomes and engagement.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eThe blended teaching model significantly enhanced classroom engagement, stimulated learning enthusiasm, and improved knowledge retention. Students receiving blended teaching demonstrated higher satisfaction and performance compared to those taught through traditional methods.\u003c/p\u003e\u003ch2\u003eConclusions:\u003c/h2\u003e \u003cp\u003eThe findings underscore the value of blended teaching in fostering interdisciplinary understanding and clinical competence in Stomatology. This study advocates for the broader application of blended teaching model in interdisciplinary Stomatology teaching to bridge gaps in oral-systemic health training and improve patient outcomes.\u003c/p\u003e","manuscriptTitle":"An assessment of online and offline blended teaching of Stomatology for non-stomatology medical students","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-06 10:01:15","doi":"10.21203/rs.3.rs-6140068/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-05-07T10:58:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"122959889235517083971833663922512178379","date":"2025-04-28T09:07:20+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-17T18:05:54+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-08T17:18:37+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-03-18T09:09:56+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-13T10:25:20+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-03-13T10:24:09+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":"fc880f0f-0f0d-4ca9-b897-0988c93fd715","owner":[],"postedDate":"May 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-05-06T10:01:15+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-06 10:01:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6140068","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6140068","identity":"rs-6140068","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}