{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:04:35Z","timestamp":1791911075610,"version":"4.3.4"},"reference-count":58,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100031572","name":"American Academy of Orofacial Pain","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100031572","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Clinical Research Services Faculty Grant Program"},{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","award":["R03DE034042"],"award-info":[{"award-number":["R03DE034042"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Predoctoral education in temporomandibular disorders (TMD) often provides limited opportunities for clinical exposure, which may hinder students\u2019 competence and confidence. This study aimed to assess the educational and behavioral impact of a TMD-specific virtual patient-based learning (VPBL) intervention on dental students\u2019 knowledge, behavioral intention for future practice, and confidence levels when integrated into a predoctoral TMD curriculum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy-seven third-year dental students at a large US predoctoral program participated in this prospective pre-post study. Initially, students received a 3-hour didactic TMD lecture by an orofacial pain specialist. One week later, they engaged in a 2-h faculty-moderated VPBL session incorporating educational videos and virtual patient cases based on Diagnostic Criteria for TMD. Participants completed assessments before and after the VPBL session, measuring TMD-related knowledge (10-item clinical-based questions), behavioral intention to incorporate TMD screening and management into practice (2 items), and confidence (validated 11-item questionnaire). Pre\/post changes were analyzed using paired t-tests, Wilcoxon signed-rank, and McNemar tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean knowledge scores improved from 4.1\u2009\u00b1\u20091.9 to 5.9\u2009\u00b1\u20091.9 (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001), with 41.6% increasing to 75.3% of participants achieving a 50% knowledge threshold (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). Confidence increased from 3.6\u2009\u00b1\u20091.9 to 6.2\u2009\u00b1\u20091.6 (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001), with the proportion of participants reaching 50% sufficient confidence growing from 20.8% to 72.7% (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). Improvements were also observed in behavioral intention to integrate TMD screening and management into future practice (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Integrating a TMD-specific VPBL intervention with didactic teaching was associated with short-term improvements in students\u2019 knowledge, confidence, and positive shifts in behavioral intention, supporting VPBL plausibility as an adjunct to predoctoral TMD education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>NCT07203456 (registration date: 09\/24\/2025).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12909-026-09388-0","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T09:44:28Z","timestamp":1778319868000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Integrating virtual patient-based learning into temporomandibular disorder education improves educational and behavioral outcomes"],"prefix":"10.1186","volume":"26","author":[{"given":"Linda","family":"Sangalli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Manning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidai","family":"Abdykarimova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Lok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Hawkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig S.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,9]]},"reference":[{"key":"9388_CR1","unstructured":"Klasser G, Romero-Reyes M. Orofacial pain guidelines for assessment, diagnosis, and management. 7th ed. Quintessence Publishing Co; 2023."},{"key":"9388_CR2","first-page":"1168","volume":"11","author":"CM Sawicki","year":"2024","unstructured":"Sawicki CM, Sangalli L. Pediatric dentists\u2019 practice patterns in the screening, diagnosis, and management of temporomandibular disorders. Child (Basel). 2024;11:1168.","journal-title":"Child (Basel)"},{"key":"9388_CR3","doi-asserted-by":"crossref","unstructured":"Sangalli L, Rayens W, Sawicki CM, Tuason D, Babiloni AH, Fricton J, et al. Higher confidence levels in temporomandibular disorders among predoctoral students with clinical patient exposure: a national-based cross-sectional study. Eur J Dent Educ. 2026;30(2):471\u201384.","DOI":"10.1111\/eje.13138"},{"key":"9388_CR4","doi-asserted-by":"crossref","unstructured":"Tuason D, Sawicki C, Fricton J, Prodoehl J, Palatinus S, Sangalli L. Comparison of different predoctoral educational modalities on knowledge levels in temporomandibular disorders: a national-based cross-sectional study. J Dent Educ; 2025.","DOI":"10.1002\/jdd.70000"},{"key":"9388_CR5","first-page":"547","volume":"31","author":"Z Qamar","year":"2022","unstructured":"Qamar Z, Alwahtani AH, Alshalawi H, Alsaif MA, Asiri AH, Almutairi SF. The level of self-perceived knowledge regarding temporo-mandibular disorders among the Saudi Arabian dental professionals working in dental institutes or universities vs. clinics or hospitals. Mymensingh Med J. 2022;31:547\u201352.","journal-title":"Mymensingh Med J"},{"key":"9388_CR6","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1002\/j.0022-0337.2014.78.10.tb05811.x","volume":"78","author":"AA Alonso","year":"2014","unstructured":"Alonso AA, Heima M, Lang LA, Teich ST. Dental students\u2019 perceived level of competence in orofacial pain. J Dent Educ. 2014;78:1379\u201387.","journal-title":"J Dent Educ"},{"key":"9388_CR7","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1111\/eje.12117","volume":"19","author":"Z Alsafi","year":"2015","unstructured":"Alsafi Z, Michelotti A, Ohrbach R, Nilner M, List T. Achieved competences in temporomandibular disorders\/orofa- cial pain: a comparison between two dental schools in Europe. Eur J Dent Educ. 2015;19:161\u20138.","journal-title":"Eur J Dent Educ"},{"key":"9388_CR8","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1002\/ejp.1283","volume":"23","author":"C Ziegeler","year":"2019","unstructured":"Ziegeler C, Wasilijeff K, May A. Nondental orofacial pain in dental practices \u2013 diagnosis, therapy and self- assessment of German dentists and dental students. Eur J Pain. 2019;23:66\u201371.","journal-title":"Eur J Pain"},{"key":"9388_CR9","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1080\/08869634.2020.1812816","volume":"41","author":"AK De Medeiros Tormes","year":"2023","unstructured":"De Medeiros Tormes AK, Lemos GA, Da Silva PLP, Forte FDS, De Sousa FB, Araujo DN, Batista AUD. Temporomandibular disorders: knowledge, competency, and attitudes of predoctoral dental students. Cranio. 2023;41:32\u201340.","journal-title":"Cranio"},{"key":"9388_CR10","doi-asserted-by":"publisher","first-page":"7886248","DOI":"10.1155\/2023\/7886248","volume":"2023","author":"X Xiong","year":"2023","unstructured":"Xiong X, Xiao C, Zhou X, Li X, Wang J, Yi Y. Knowledge and attitudes regarding temporomandibular disorders among postgraduate dental students and practicing dentists in western China: a questionnaire-based observational investigation. Pain Res Manag. 2023;2023:7886248.","journal-title":"Pain Res Manag"},{"key":"9388_CR11","first-page":"16","volume":"8","author":"J Durham","year":"2021","unstructured":"Durham J, Breckons M, Vale L, Shen J. DEEP study: modeling outcomes and costs of persistent orofacial pain. JDR Clin Trans Res. 2021;8:16\u201326.","journal-title":"JDR Clin Trans Res"},{"key":"9388_CR12","unstructured":"National Academies of Sciences, Engineer, and, Health M, and Medicine Division; Board on Health Care Services; Board on Health Sciences Policy; Committee on Temporomandibular Disorders (TMDs). : From Research Discoveries to Clinical Treatment. Temporomandibular Disorders: Priorities for ResearchCare. Yost O, Liverman CT, English R, Mackey S, Bond EC, editors. Washington (DC): National Academies Press (US); 2020. Available from: https:\/\/www.ncbinlmnihgov\/books\/NBK557987\/ Accessed 11 April 2024."},{"key":"9388_CR13","doi-asserted-by":"crossref","unstructured":"Sangalli L, Sawicki C, Fricton J, Haering HJ, Prodoehl J. Current status of temporomandibular disorders education in U.S. predoctoral dental curricula: a nationwide survey. Cranio. 2026;44(2):299\u2013310.","DOI":"10.1080\/08869634.2025.2505784"},{"key":"9388_CR14","doi-asserted-by":"publisher","first-page":"231","DOI":"10.14219\/jada.archive.2007.0142","volume":"138","author":"GD Klasser","year":"2007","unstructured":"Klasser GD, Greene C. Predoctoral teaching of temporomandibular disorders: a survey of U.S. and Canadian dental schools. J Am Dent Assoc. 2007;138:231\u20137.","journal-title":"J Am Dent Assoc"},{"key":"9388_CR15","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1053\/j.sodo.2024.04.008","volume":"30","author":"MT Galang-Boquiren","year":"2024","unstructured":"Galang-Boquiren MT, Katebi N, Hong C, Lipp M. Predoctoral orthodontic education in the United States: challenges and opportunities for generation Z learners. Semin Orthod. 2024;30:409\u201312.","journal-title":"Semin Orthod"},{"key":"9388_CR16","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.adaj.2020.05.002","volume":"151","author":"GM Heir","year":"2020","unstructured":"Heir GM. Orofacial pain, the 12th specialty: the necessity. J Am Dent Assoc. 2020;151:469\u201371.","journal-title":"J Am Dent Assoc"},{"key":"9388_CR17","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2025.12.021","author":"R Esposito","year":"2025","unstructured":"Esposito R, Sangalli L, Boggero IA, Kapos FP. Geographic and rural healthcare resource gaps in orofacial pain providers distribution across the United States. J Am Dent Assoc. 2025. https:\/\/doi.org\/10.1016\/j.adaj.2025.12.021.","journal-title":"J Am Dent Assoc"},{"key":"9388_CR18","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/j.adaj.2024.04.007","volume":"155","author":"GM Heir","year":"2024","unstructured":"Heir GM, Markman S, Schwartz AH, Patil AG. Access to care: is the specialty of orofacial pain underrecognized and underused? J Am Dent Assoc. 2024;155:465\u20139.","journal-title":"J Am Dent Assoc"},{"key":"9388_CR19","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1007\/s00784-020-03710-w","volume":"25","author":"LF Valesan","year":"2023","unstructured":"Valesan LF, Da-Cas C, Continu Reus J, Denardin ACS, Garanhani RR, Bonotto D, Januzzi E, et al. Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clin Oral Investig. 2023;25:441\u201353.","journal-title":"Clin Oral Investig"},{"key":"9388_CR20","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1111\/j.1600-0579.2010.00648.x","volume":"15","author":"DJ Sch\u00f6nwetter","year":"2011","unstructured":"Sch\u00f6nwetter DJ, Law D, Mazurat R, Sileikyte R, Nazarko O. Assessing graduating dental students\u2019 competencies: the impact of classroom, clinic and externships learning experiences. Eur J Dent Educ. 2011;15:142\u201352.","journal-title":"Eur J Dent Educ"},{"key":"9388_CR21","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.1002\/jdd.13906","volume":"89","author":"S Ojo","year":"2025","unstructured":"Ojo S, Sangalli L, Sawicki CM. Temporomandibular disorder education amongst pediatric dentistry and orthodontics postgraduate programs. J Dent Educ. 2025;89:1655\u201365.","journal-title":"J Dent Educ"},{"key":"9388_CR22","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1002\/jdd.12461","volume":"85","author":"YM Costa","year":"2021","unstructured":"Costa YM, De Koninck BP, Elsaraj SM, Exposto FG, Herrero Babiloni A, Kapos FP, Sharma S, Shimada A. Orofacial pain education in dentistry: a path to improving patient care and reducing the population burden of chronic pain. J Dent Educ. 2021;85:349\u201358.","journal-title":"J Dent Educ"},{"key":"9388_CR23","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1186\/s12909-022-03410-x","volume":"22","author":"R Plackett","year":"2022","unstructured":"Plackett R, Kassianos AP, Mylan S, Kambouri M, Raine R, Sheringham J. The effectiveness of using virtual patient educational tools to improve medical students\u2019 clinical reasoning skills: a systematic review. BMC Med Educ. 2022;22:365.","journal-title":"BMC Med Educ"},{"key":"9388_CR24","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1055\/s-0041-1731837","volume":"16","author":"R Moussa","year":"2022","unstructured":"Moussa R, Alghazaly A, Althagafi N, Eshky R, Borzangy S. Effectiveness of virtual reality and interactive simulators on dental education outcomes: systematic review. Eur J Dent. 2022;16:14\u201331.","journal-title":"Eur J Dent"},{"key":"9388_CR25","doi-asserted-by":"publisher","first-page":"6","DOI":"10.11607\/jop.1151","volume":"28","author":"E Schiffman","year":"2014","unstructured":"Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, International RDC\/TMD Consortium Network, International association for Dental Research; orofacial pain special interest group, et al. International Association for the Study of Pain. Diagnostic Criteria for Temporomandibular Disorders (DC\/TMD) for Clinical and Research Applications: recommendations of the International RDC\/TMD Consortium Network* and Orofacial Pain Special Interest Group\u2020. J Oral Facial Pain Headache. 2014;28:6\u201327.","journal-title":"J Oral Facial Pain Headache"},{"key":"9388_CR26","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1177\/0333102419893823","volume":"40","author":"International Classification of Orofacial Pain","year":"2020","unstructured":"International Classification of Orofacial Pain. st edition (ICOP). Cephalalgia. 2020;40:129\u2013221. 1.","journal-title":"Cephalalgia"},{"key":"9388_CR27","doi-asserted-by":"crossref","unstructured":"Sangalli L, Manning E, Miller CS, Fricton J, Lok B, Boggero IA. Testing an educational resource for implementation in temporomandibular disorders curriculum through a phase I define and refine study. J Dent Educ. 2026:90(1):117\u201327.","DOI":"10.1002\/jdd.13928"},{"key":"9388_CR28","doi-asserted-by":"publisher","DOI":"10.1002\/jdd.70032","author":"L Sangalli","year":"2025","unstructured":"Sangalli L, Manning E, Alessandri-Bonetti A, Mirfarsi S, Miller CS. Content validity assessment of a virtual patient-based learning platform for TMD education among orofacial pain experts. J Dent Educ. 2025. https:\/\/doi.org\/10.1002\/jdd.70032.","journal-title":"J Dent Educ"},{"key":"9388_CR29","unstructured":"TREND Statement Checklist. https:\/\/www.stackscdcgov\/view\/cdc\/149677 Accessed 31 Dec 2025."},{"key":"9388_CR30","doi-asserted-by":"publisher","first-page":"271","DOI":"10.11607\/ofph.3073","volume":"35","author":"H Chen","year":"2021","unstructured":"AAOP Committee on TMD Predoctoral Education, Chen H, Fricton J, Cohen J, Cowley T, Dhadwal S, Fillingim RB, et al. Temporomandibular disorders core curriculum for predoctoral dental education: recommendations from the American academy of orofacial pain. J Oral Facial Pain Headache. 2021;35:271\u20137.","journal-title":"J Oral Facial Pain Headache"},{"key":"9388_CR31","unstructured":"Commission on Dental Accreditation. Accreditation Standards For Dental Education Programs. https:\/\/www.codaadaorg\/-\/media\/project\/ada-organization\/ada\/coda\/files\/predoc_standardspdf?rev=20eabc229d4c4c24a2df5f65c5ea62c8&hash=B812B8A2FAF6D99F37703EE081B48E58 Accessed 18 April 2026."},{"key":"9388_CR32","doi-asserted-by":"publisher","unstructured":"Sangalli L, Manning E, Brzozowski-Sawicki P, Alabsy M, Palatinus S, Prodoehl J. Evaluating a predoctoral dental educational intervention for temporomandibular disorders: a prospective pre-post study. Eur J Dent Educ. 2026. https:\/\/doi.org\/10.1111\/eje.70118.","DOI":"10.1111\/eje.70118"},{"key":"9388_CR33","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1037\/hea0000161","volume":"34","author":"SM Czajkowski","year":"2015","unstructured":"Czajkowski SM, Powell L, Adler N, Naar-King S, Reynolds KD, Hunter CM, et al. From ideas to efficacy: the ORBIT model for developing behavioral treatments for chronic diseases. Health Psychol. 2015;34:971\u201382.","journal-title":"Health Psychol"},{"key":"9388_CR34","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1037\/hea0000665","volume":"37","author":"L Powell","year":"2018","unstructured":"Powell L, Appelhans B, Ventrelle J, Karavolos K, March M, Ong J, et al. Development of a lifestyle intervention for the metabolic syndrome: discovery through proof-of-concept. Health Psychol. 2018;37:929\u201339.","journal-title":"Health Psychol"},{"key":"9388_CR35","doi-asserted-by":"publisher","first-page":"11467","DOI":"10.15766\/mep_2374-8265.11467","volume":"20","author":"J Hawkins","year":"2024","unstructured":"Hawkins J, Cervero R, Durning SJ. Enhancing temporomandibular disorders education for initial care clinicians through interprofessional education. MedEdPORTAL. 2024;20:11467.","journal-title":"MedEdPORTAL"},{"key":"9388_CR36","doi-asserted-by":"publisher","unstructured":"Sawicki C, Sangalli L. Impact of virtual patient-based learning on temporomandibular disorder knowledge among dental students: a pre-post study. J Dent Educ. 2026. https:\/\/doi.org\/10.1002\/jdd.70232.","DOI":"10.1002\/jdd.70232"},{"issue":"1Suppl 1","key":"9388_CR37","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1080\/10810730.2013.829538","volume":"18","author":"CA Coleman","year":"2013","unstructured":"Coleman CA, Hudson S, Maine LL. Health literacy practices and educational competencies for health professionals: a consensus study. J Health Commun. 2013;18(1Suppl 1):82\u2013102.","journal-title":"J Health Commun"},{"key":"9388_CR38","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1080\/0142159X.2023.2197135","volume":"46","author":"H MacNeill","year":"2024","unstructured":"MacNeill H, Masters K, Nemethy K, Correia R. Online learning in health professions education. Part 1: teaching and learning in online environments: AMEE Guide 161. Med Teach. 2024;46:4\u201317.","journal-title":"Med Teach"},{"key":"9388_CR39","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.1186\/s12909-025-07507-x","volume":"5","author":"P Huang","year":"2025","unstructured":"Huang P, Miao W, Wang R, Yang F, Li X, Shen N. Innovative multimodal educational strategies: assessing the impact of integrative teaching methods on standardized neurology resident training. BMC Med Educ. 2025;5:1032.","journal-title":"BMC Med Educ"},{"key":"9388_CR40","doi-asserted-by":"crossref","unstructured":"Salari B, Amini M. The impact of different teaching methods on clinical reasoning and clinical decision-making of dentistry students: a systematic review. J Dent Educ. 2026;90(1);33\u201342.","DOI":"10.1002\/jdd.13930"},{"key":"9388_CR41","doi-asserted-by":"publisher","first-page":"2789","DOI":"10.1093\/pm\/pnab231","volume":"22","author":"R Bavarian","year":"2021","unstructured":"Bavarian R, Begasse de Dhaem O, Shaefer JR. Implementing virtual case-based learning in dental interprofessional education. Pain Med. 2021;22:2789\u201391.","journal-title":"Pain Med"},{"key":"9388_CR42","doi-asserted-by":"crossref","unstructured":"Fricton V, Larkin N, Sangalli L, Prodoehl J, Rayens WS, Fricton J. Confidence in diagnosing and treating temporomandibular disorders among dental students and faculty following implementation of the revised standards 2-24k: A cross-sectional study. Cranio. 2025:1\u201314.","DOI":"10.1080\/08869634.2025.2482265"},{"key":"9388_CR43","doi-asserted-by":"crossref","unstructured":"Gabbard T, Romanelli F. The accuracy of health professions students\u2019 self-assessments compared to objective measures of competence. Am J Pharm Educ. 2021;85(4):8405.","DOI":"10.5688\/ajpe8405"},{"key":"9388_CR44","doi-asserted-by":"publisher","first-page":"e094858","DOI":"10.1136\/bmjopen-2024-094858","volume":"14","author":"Y Pu","year":"2025","unstructured":"Pu Y, Xie H, Fu L, Zhang X, Long T, Su X, Feng X, Feng X. Self-efficacy as a mediator in the relationship between clinical learning environment and core nursing competence of intern nursing students: a multicentre cross-sectional study. BMJ Open. 2025;14:e094858.","journal-title":"BMJ Open"},{"key":"9388_CR45","doi-asserted-by":"publisher","unstructured":"Fan M, Hatfield ER, Sivakumar SK, Inglehart MR. Dental students\u2019 temporomandibular disorder-related education, knowledge, attitudes, and behavior. How do personal experiences matter? J Dent Educ. 2025. https:\/\/doi.org\/10.1002\/jdd.70008.","DOI":"10.1002\/jdd.70008"},{"key":"9388_CR46","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1111\/spc3.12265","volume":"10","author":"P Sheeran","year":"2016","unstructured":"Sheeran P, Webb T. The intention\u2013behavior gap. Soc Pers Psychol Compass. 2016;10:503\u201318.","journal-title":"Soc Pers Psychol Compass"},{"key":"9388_CR47","doi-asserted-by":"crossref","unstructured":"Sangalli L. Evolving progress in temporomandibular disorder education for predoctoral dental programs. Cranio. 2026;44(2):181\u20133.","DOI":"10.1080\/08869634.2025.2543482"},{"issue":"12","key":"9388_CR48","doi-asserted-by":"publisher","first-page":"1450","DOI":"10.1002\/j.0022-0337.2016.80.12.tb06232.x","volume":"80","author":"SS Adibi","year":"2016","unstructured":"Adibi SS, Kookal KK, Fishbeck NM, Thompson CR, Walji MF. Assessment of diagnosed temporomandibular disorders and orofacial pain conditions by predoctoral dental students: a pilot study. J Dent Educ. 2016;80(12):1450\u20136.","journal-title":"J Dent Educ"},{"key":"9388_CR49","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/1472-6831-12-26","volume":"12","author":"L Pimenta e Silva Machado","year":"2012","unstructured":"Pimenta e Silva Machado L, de Macedo Nery MB, de G\u00f3is Nery C, Leles CR. Profiling the clinical presentation of diagnostic characteristics of a sample of symptomatic TMD patients. BMC Oral Health. 2012;12:26.","journal-title":"BMC Oral Health"},{"key":"9388_CR50","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.oooo.2023.02.001","volume":"136","author":"K Patel","year":"2023","unstructured":"Patel K, Eley KA, Cascarini L, Watt-Smith S, Larkin M, Lloyd T, et al. Temporomandibular disorders-review of evidence-based management and a proposed multidisciplinary care pathway. Oral Surg Oral Med Oral Pathol Oral Radiol. 2023;136:54\u201369.","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"9388_CR51","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/j.1365-2923.2009.03547.x","volume":"44","author":"WC Mcgaghie","year":"2010","unstructured":"Mcgaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation-based medical education research: 2003\u2013 2009. Med Educ. 2010;44:50\u201363.","journal-title":"Med Educ"},{"issue":"Suppl 1","key":"9388_CR52","first-page":"1040","volume":"85","author":"Y Abe","year":"2020","unstructured":"Abe Y, Boyer B, Padilla M, Clark GT. Clinical skills evaluation and examination center: From demos to competence validation. J Dent Educ. 2020;85(Suppl 1):1040\u20132.","journal-title":"J Dent Educ"},{"key":"9388_CR53","doi-asserted-by":"publisher","unstructured":"Rodrigues-Pereira P, Dias-Calcas MAP, Moreira M\u00e9lo A, Melchior MO, Gaspar Ribeiro L, Pazin-Filho A, et al. Generative artificial intelligence-driven clinical case simulation in temporomandibular disorder education: ChatGPT versus real patients. J Dent Educ. 2025. https:\/\/doi.org\/10.1002\/jdd.70104.","DOI":"10.1002\/jdd.70104"},{"key":"9388_CR54","doi-asserted-by":"publisher","first-page":"e14676","DOI":"10.2196\/14676","volume":"21","author":"AA Kononowicz","year":"2019","unstructured":"Kononowicz AA, Woodham LA, Edelbring S, Stathakarou N, Davies D, Saxena N, et al. Virtual patient simulations in health professions education: systematic review and meta-analysis by the digital health education collaboration. J Med Internet Res. 2019;21:e14676.","journal-title":"J Med Internet Res"},{"key":"9388_CR55","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1177\/0022034516653743","volume":"95","author":"G Slade","year":"2016","unstructured":"Slade G, Ohrbach R, Greenspan J, Fillingim R, Bair E, Sanders A, et al. Painful temporomandibular disorder: decade of discovery from OPPERA studies. J Dent Res. 2016;95:1084\u201392.","journal-title":"J Dent Res"},{"key":"9388_CR56","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s12909-017-1116-8","volume":"18","author":"S Aoun Bahous","year":"2018","unstructured":"Aoun Bahous S, Salameh P, Salloum A, Salameh W, Park YS, Tekian A. Voluntary vs. compulsory student evaluation of clerkships: effect on validity and potential bias. BMC Med Educ. 2018;18:9.","journal-title":"BMC Med Educ"},{"key":"9388_CR57","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1111\/j.1467-9280.2006.01693.x","volume":"17","author":"H Roediger","year":"2006","unstructured":"Roediger H, Karpicke J. Test-enhanced learning: taking memory tests improves long-term retention. Psychol Sci. 2006;17:249\u201355.","journal-title":"Psychol Sci"},{"key":"9388_CR58","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/1471-2288-7-30","volume":"7","author":"R McCarney","year":"2007","unstructured":"McCarney R, Warner J, Iliffe S, van Haselen R, Griffin M, Fisher P. The hawthorne effect: a randomised, controlled trial. BMC Med Res Methodol. 2007;7:30.","journal-title":"BMC Med Res Methodol"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-026-09388-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-09388-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-09388-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:08:15Z","timestamp":1783033695000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12909-026-09388-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,9]]},"references-count":58,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["9388"],"URL":"https:\/\/doi.org\/10.1186\/s12909-026-09388-0","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,9]]},"assertion":[{"value":"23 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was deemed exempt by the Institutional Review Board (IRB) of Midwestern University (IRB-25-0306, 04 June 2025). Informed consent was obtained from all participants in compliance with IRB-approved exempt research procedures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1063"}}