A comparative analysis of dental education in China and Japan based on the four-component instructional design (4C/ID) model.

Background: Balancing cognitive load and clinical psychomotor skills within a limited curriculum time remains a core challenge in dental education. Faced with new healthcare demands driven by an aging population, dental education systems in both China and Japan require essential reforms. While current cross-national comparative studies mainly focus on macro-policy levels, introducing an objective educational model helps systematically analyze the core logical differences in micro-level pedagogical implementation and cognitive load management strategies. This study aims to examine differences in the distribution of 4C/ID components across Chinese and Japanese dental curricula, the localized strategies each country employs to refine cognitive load in dental education, and the feasibility of using the 4C/ID model as a retrospective curricular diagnostic tool to guide dental education reform. Objective: This study used a retrospective comparative case study design, analyzing comprehensive undergraduate syllabi and clinical practicum documents from Zhejiang Chinese Medical University (ZCMU, China) and Okayama University (OU, Japan). Using the Four-Component Instructional Design (4C/ID) model, all courses were mapped into four categories: authentic learning tasks (C1, clinical practice or simulation), supportive information (C2, subclassified into C2a: dental-specific theory and C2b: general/medical theory), procedural information (C3, instructor demonstrations), and part-task practice (C4, skill repetition). By combining semantic frequency analysis with the review of key pedagogical cases, this study assessed the instructional priorities of both countries. Results: Both curricula prioritize authentic learning tasks (C1) as a foundational means to foster professional competency, but differ in their structural approaches to modulating students' cognitive load. Relying on a broad medical foundation, ZCMU front-loads general medical theory (C2b: 19.9%) while delaying dental-specific theory (C2a: 10.9%), concentrates clinical immersion in the last year (C1: 61.0%), and has limited skill training (C3+C4: 8.2%). In contrast, OU (C1: 39.7%) exhibits a longitudinal integration of C2a (15.9%) and C2b (24.3%) throughout the program, while dedicating considerably more hours to demonstrations and skill repetition (C3+C4: 20.1%). Conclusion: Analyzing the curriculum with the 4C/ID model offers valuable empirical insights that inform global dental education reform. To address the comorbidity challenges of a super-aged society, future dental reforms might incorporate lessons from Japanese and Chinese experiences by combining detailed theoretical scaffolding (C2) with comprehensive medical diagnostic reasoning to potentially manage cognitive load. Additionally, utilizing advanced digital simulation technology to initially separate procedural information (C3) and part-task practice (C4) from authentic learning tasks (C1) may offer a practical method to balance theoretical understanding with the development of complex psychomotor skills.