Baxmann Martin, Kárpáti Krisztina, Baráth Zoltán
Department of Orthodontics, Faculty of Education and Research, DTMD University, 9516, Wiltz, Luxembourg.
Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, University of Szeged, Szeged, 6720, Hungary.
BMC Med Educ. 2025 May 20;25(1):736. doi: 10.1186/s12909-025-07361-x.
Orthodontic postgraduate education plays a critical role in developing clinical competence, yet substantial variability exists in how programs structure, deliver, and assess clinical knowledge. This systematic review aimed to evaluate the content and delivery of clinical knowledge in orthodontic postgraduate programs and their reported impact on trainee competence. The review followed PRISMA 2020 guidelines and a pre-specified protocol. A comprehensive search was conducted across PubMed, Cochrane Library, ERIC, and CINAHL for studies published between January 2000 and December 2024. Gray literature and reference lists were also screened. Eligible studies included randomized controlled trials, cohort studies, and cross-sectional studies involving postgraduate orthodontic students or educators, with interventions related to instructional strategies or clinical knowledge delivery. Qualitative studies and those focused solely on undergraduate or continuing education were excluded. Following duplicate removal, 104 records were screened, and 30 studies met the inclusion criteria after full-text assessment. Study selection and data extraction were performed independently by two reviewers, with discrepancies resolved by a third. Risk of bias was assessed using the Newcastle-Ottawa Scale, and quality of evidence was evaluated using the GRADE framework. Due to heterogeneity in study design and outcome measures, a narrative synthesis was conducted. Instructional strategies included didactic lectures, problem-based learning, scenario-based simulations, digital learning platforms, and structured assessments such as Mini-CEX and OSCE. Feedback-oriented and interactive methods were consistently associated with improvements in clinical reasoning, procedural skills, and learner confidence. However, substantial variability existed in assessment formats and feedback implementation across institutions. Newcastle-Ottawa scores indicated generally strong selection and outcome measurement, though comparability was often limited. GRADE assessments showed most studies were of moderate quality due to inconsistency or imprecision. These findings highlight the need for harmonized, evidence-based frameworks to guide the delivery and assessment of clinical knowledge in orthodontic postgraduate education, while allowing for flexibility based on institutional context. Efforts to standardize assessment strategies and integrate technology-enhanced learning may support improved competence development across diverse programs.
正畸研究生教育在培养临床能力方面起着关键作用，但各项目在临床知识的构建、传授和评估方式上存在很大差异。本系统评价旨在评估正畸研究生项目中临床知识的内容和传授方式及其对学员能力的影响。该评价遵循PRISMA 2020指南和预先指定的方案。对PubMed、Cochrane图书馆、教育资源信息中心（ERIC）和护理学与健康领域数据库（CINAHL）进行了全面检索，以查找2000年1月至2024年12月期间发表的研究。还筛选了灰色文献和参考文献列表。符合条件的研究包括随机对照试验、队列研究和横断面研究，涉及正畸研究生或教育工作者，干预措施与教学策略或临床知识传授有关。定性研究以及仅关注本科教育或继续教育的研究被排除。在去除重复记录后，筛选了104条记录，经过全文评估，30项研究符合纳入标准。两名评审员独立进行研究选择和数据提取，如有分歧由第三名评审员解决。使用纽卡斯尔-渥太华量表评估偏倚风险，使用GRADE框架评估证据质量。由于研究设计和结果测量的异质性，进行了叙述性综合分析。教学策略包括讲授式讲座、基于问题的学习、基于情景的模拟、数字学习平台以及结构化评估，如迷你临床演练评估（Mini-CEX）和客观结构化临床考试（OSCE）。以反馈为导向的互动方法始终与临床推理、操作技能和学习者信心的提高相关。然而，各机构在评估形式和反馈实施方面存在很大差异。纽卡斯尔-渥太华评分表明，总体而言，选择和结果测量较为可靠，但可比性往往有限。GRADE评估显示，由于不一致或不精确，大多数研究质量中等。这些发现凸显了需要统一的、基于证据的框架来指导正畸研究生教育中临床知识的传授和评估，同时允许根据机构背景进行灵活调整。标准化评估策略和整合技术增强学习的努力可能有助于不同项目提高能力培养水平。
