{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T03:37:43Z","timestamp":1777261063156,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Dental Education"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the diagnostic accuracy, satisfaction and self\u2010confidence of dental students when classifying dental caries lesions using simulation\u2010based experience and photographs, and to examine whether the sequence of these interventions influences diagnostic performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A randomised crossover study was conducted with 37 second\u2010year undergraduate dental students. Participants were assigned to one of two intervention sequences: Photograph\u2013Simulation\u2010based Experience (P\u2013SBE) or Simulation\u2010based Experience\u2013Photograph (SBE\u2013P). Each student completed four diagnostic attempts, two with photographs and two with simulation\u2010based experience, using the Nyvad criteria. Diagnostic accuracy was assessed using the area under the receiver operating characteristic curve (AUC) and pairwise discriminative accuracy (pAUC). Satisfaction and self\u2010confidence in learning were measured using the National League for Nursing Satisfaction and Self\u2010Confidence in Learning Questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Simulation\u2010based experience demonstrated higher diagnostic accuracy than photographs in both sequences. In the P\u2013SBE sequence, AUC increased from 79.7 (95% CI: 77.2\u201382.3) in the first photograph\u2010based attempt to 93.2 (95% CI: 91.6\u201394.9) in the second simulation\u2010based attempt. In the SBE\u2013P sequence, AUC was also higher in the second simulation\u2010based attempt, reaching 89.9 (95% CI: 88.1\u201391.7). Students also reported greater satisfaction, higher self\u2010confidence and a more positive overall perception of simulation\u2010based experience (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Simulation\u2010based experience yielded higher diagnostic accuracy than photographs in this Nyvad\u2010based educational context. The highest overall performance was observed when photographs preceded simulation\u2010based experience, supporting the progressive and complementary use of both approaches in undergraduate cariology teaching. Simulation\u2010based experience was also perceived as enhancing satisfaction and self\u2010confidence in learning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eje.70173","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T03:15:34Z","timestamp":1777259734000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Accuracy, Satisfaction and Self\u2010Confidence of Dental Students When Classifying Dental Caries Lesions Using Simulation\u2010Based Experience and Photographs: A Randomised Crossover Study of Intervention Sequence"],"prefix":"10.1111","author":[{"given":"Susana","family":"Calle\u2010Molina","sequence":"first","affiliation":[{"name":"School of Dentistry CES University  Medell\u00edn Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2293-0431","authenticated-orcid":false,"given":"Diego Fernando","family":"Rojas\u2010Gualdr\u00f3n","sequence":"additional","affiliation":[{"name":"School of Medicine CES University  Medell\u00edn Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Isabel","family":"Arango\u2010Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"School of Dentistry CES University  Medell\u00edn Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu\u00eds Fernando","family":"V\u00e9lez","sequence":"additional","affiliation":[{"name":"School of Dentistry CES University  Medell\u00edn Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5950-5634","authenticated-orcid":false,"given":"Aline Leite","family":"de Farias","sequence":"additional","affiliation":[{"name":"School of Dentistry CES University  Medell\u00edn Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2621-2231","authenticated-orcid":false,"given":"Manuel","family":"Restrepo","sequence":"additional","affiliation":[{"name":"School of Dentistry CES University  Medell\u00edn Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000503309"},{"key":"e_1_2_11_3_1","volume-title":"Global Oral Health Status Report: Towards Universal Health Coverage for Oral Health by 2030","author":"World Health Organization","year":"2022"},{"key":"e_1_2_11_4_1","first-page":"418","volume-title":"Dental Caries: The Disease and Its Clinical Management","author":"Fejerskov O.","year":"2025"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000550238"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.identj.2024.08.010"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752\u20107325.2002.tb03446.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12641"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000016526"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000239755"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1590\/1807\u20103107bor\u20102023.vol37.0120"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/eje.12092"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000329730"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2025.105737"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jdd.12962"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/qshc.2004.009878"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0000000000000150"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784\u2010021\u201004248\u20100"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909\u2010016\u20100759\u20101"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/154405910308200208"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1159\/000480522"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472\u20106920\u20105\u20101"},{"key":"e_1_2_11_23_1","first-page":"266","volume-title":"Simulation in Nursing Education: From Conceptualization to Evaluation","author":"Jeffries P. 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