Trial reportEuropean journal of dental education : official journal of the Association for Dental Education in Europe2026
Choosing Wisely: Key Feature Examinations as a Powerful Approach to Foster Clinical Reasoning in Dental Education.
Trial report in European journal of dental education : official journal of the Association for Dental Education in Europe, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionClinical reasoning is considered a core skill for physicians, and its training should already be addressed in undergraduate medical education. At the University Medical Center Göttingen, students have been able to engage in formative key feature examinations since 2013. Recent studies have shown that these assessments can improve students' clinical reasoning skills. Such a teaching format was not previously existing in the study of dentistry. This study aims to evaluate the feasibility and efficacy of formative key feature examinations in dental education. MATERIALS AND
methodsIn this prospective, randomised, controlled, crossover study, fourth-year dental students participated in six weekly computer-based seminars in which complex dental patient cases were presented, and the underlying theoretical knowledge was taught. In alternate weeks, groups of students were invited to either read specially prepared text formats (control condition) or solve key feature cases (intervention) that covered the same theoretical content. Each case contained on average six key feature questions (items) referring to the diagnostic procedure and treatment of the patient presented.
resultsFeedback from the evaluation questionnaire indicated that dental key feature cases were generally well received. In addition, key feature cases can be successfully integrated into dental education in the form of e-seminars. Learning growth self-assessment of participants showed a significant improvement in the overall learning objectives. Iterative work with key feature cases was clearly associated with significantly greater improvements in exit and retention test scores compared to text-based learning.
conclusionRepeated formative key feature examinations can be effectively implemented in dental education and dental students' clinical reasoning skills can benefit from working on these cases. In addition, strengthening clinical reasoning skills in undergraduate dental education can help to avoid unnecessary dental interventions in future practice, as outlined in the Choosing Wisely recommendations.
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