A Cross-over Randomised Trial Comparing Two Teaching Methods
Condition: Educational Problems
Study type: Interventional

Summary: 
      The aim of the study aim to test the null hypothesis which states that there are no
      significant differences in knowledge retention and exam performance of dental undergraduate
      students in a Saudi Dental School using two different asynchronous teaching methods . The
      secondary aim is to analyse students' perceptions to the two teaching methods.
    

Detailed description: 
      Design: The trial was designed as a crossover clustered randomized trial whereby each group/
      cluster acted as their control for their learning performance and perception.

      Setting: College of Dentistry, Princes Sattam Bin Abdulaziz University, Riyadh, Saudi Arabia.

      Consents: The ethical approval was obtained from the Scientific Research Unit at the College
      of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh (ethical approval
      PSAU2020030). Written consent was obtained from students before commencing the trial.

      Participants: Fourth-year undergraduate dental students enrolled in the preclinical
      orthodontic course at Prince Sattam University were invited to participate in the study.
      Students who were registered in the course for the second time were excluded to lessen the
      bias associated with previous experience of orthodontic teaching. The sample size was based
      on the total number of students registered in the course at the time of the study.

      Randomization: Computer-generated randomization was performed to allocate participants to one
      of two groups. The sequence of random allocation was concealed from researchers who analyzed
      the results. Participants in the control group were taught through the virtual traditional
      learning method (VTL) using live-video streaming, while participants in the intervention
      group were taught through the virtual flipped learning method (VFL). VTL group included 16
      students, while the VFL group included 17 students. We use the term control group to refer to
      students who studied using the VTL format method across both periods. We also use the term
      intervention group to refer to students who studied using VFL format across both periods.

      Intervention: 4 lectures were delivered asynchronously using two different teaching methods
      as mentioned above. Participants in VFL had monitored remote access to the recorded lectures
      for one week, followed by 4 additional small group online discussion sessions. The students
      in both groups remotely attended all pre-recorded and live-video virtual lectures.

      Intervention implementation rounds The intervention was implemented in 3 consecutive weeks.
      The first lecture (L1: Adult Orthodontics) was taught in the first week. Before L1, all
      students were asked to complete a set of multiple-choice questions (MCQs) formative exam
      (i.e., pre-test). Following the pre-test, the lecture was delivered to participants of the
      VTL group using a passive online teaching format (live-video streaming). L1 was also recorded
      after obtaining verbal consent from the attendees. After the lecture was completed, students
      were asked to re-take the same pre-test exam and complete a questionnaire regarding the VTL
      experience.

      Within 24 hours following L1, participants of VFL had 7-day monitored remote access to the
      recorded lecture of L1, and they were taught using an active teaching model, referred to as
      the VFL model. Like the participants of the VTL group, participants of the VFL group were
      asked to complete the relevant pre-test.

      At the expiry of remote access to the recorded lecture, participants from VFL were invited to
      attend post-lecture discussion sessions. To enhance the effectiveness of post-lecture
      discussion, participants were randomly divided into two smaller subgroups, and the same
      lecturer facilitated the discussions for each group separately. At the end of each discussion
      session, participants were asked to re-take the pre-test of L1 and a complete questionnaire
      regarding their VFL experience.

      Following the small group's discussion session, participants of VFL were given a 30-minute
      break before the start of the second lecture related to the topic of Orthognathic Surgery
      (L2). However, the intervention was crossed over; hence, the cohort of VFL in week 1 acted as
      a control group while teaching L2 and vice versa. The same protocol of teaching models that
      were applied in week 1 was adopted.

      Participants of both groups were taught by the same instructor using the same materials,
      irrespective of the teaching methods. The lectures were delivered using the same presentation
      platform (PowerPoint, Microsoft Corp, Redmond, WA) and the same virtual learning platform
      (Zoom live-streaming software - Zoom Video Communications, Inc, San Jose, California, Version
      5.4.3). The duration of each lecture was 60 minutes, while the post-lecture discussion in the
      VFL design lasted 15 minutes. Learning outcomes were based on each lecture's learning
      objectives and outcomes that aligned with what is specified by the National Commission for
      Academic Accreditation and Assessment in Saudi Arabia.
    

Intervention name(s): Flipped classroom teaching method
Intervention type(s): Other
Intervention description(s): Participants will have 7 -day monitored remote access to a recorded lecture about orthodontic topic. At the expiry of remote access to the recorded lecture, participants from FG will be invited to attend post-lecture discussion sessions. To enhance the effectiveness of flipped classroom teaching method, the cohort of FG will be randomly, using computer generated randomisation, subdivided to two smaller groups in which each group will be consisted of half of the FG cohort. The same lecturer will moderate the discussions for each group separately.
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: The trial is designed as a cross-over clustered randomized trial (each group would be a cluster), so that each group will act as their own control for their learning performance and perception.
Masking: Single (Outcomes Assessor)
Primary purpose: Other
Keywords: Learning; Dental education; Teaching methods; Dental Students