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Evaluating and Developing Innovative Teaching Strategies for Fostering Image Reading Skills of Novices in Dental Education

Working groupMultiple Representations Lab
FundingLeibniz-WissenschaftsCampus "Cognitive Interfaces" Tübingen (WCT)
Project description

The ability to read medical images (e.g., panoramic X-rays) is an important skill required in dental medicine. Previous studies showed that reading X-rays is an error-prone process, with proficient performance requiring an extensive amount of practice. Despite its relevance, evidence-based methods for teaching medical image reading to novice students are lacking. This aspect was addressed by this project.

The project aimed at gathering insights on students’ information processing during (learning about) medical image reading in dental medicine and at designing novel teaching methods to support knowledge work. Within this project, different research questions were investigated in three research lines. In order to gain an insight into the effects of current teaching practice, research line 1 evaluated the regular radiology course with massed practice (a teaching method that involves massed learning of one type of material, such as radiographs). First results showed that students significantly improve their diagnostic competence through this radiology course and that they also changed their gaze behavior. In research line 2, the visual processing and diagnostic competence of the students of all semesters were recorded over three years in order to examine the development of visual expertise in cross-sectional and longitudinal terms. Based on previous research and findings from research lines 1 and 2, various training methods were developed and empirically tested. Students were encouraged to reflect on their own viewing behavior when viewing panoramic radiographs in order to get as close as possible to a complete visual coverage of a radiograph. In addition, further interventions aimed at strengthening students’ knowledge regarding the visual features of anomalies and the procedure for the diagnosis of panoramic radiographs. On the one hand, specific training sequences were used to contrast normal findings with findings for specific anomalies. On the other hand, the students watched videos in which experts explained how they proceed with the diagnosis of a panoramic radiograph and what they see on an image. In addition to these explanations, the eye movements of the experts were shown in the video. The aim is to improve the detection of anomalies in radiographs. In a final intervention, the students received feedback on their marked abnormal areas.


Dr. med. Dr. med. dent. Constanze Keutel, University Centre of Dentistry, Oral Medicine and Maxillofacial Surgery

Dr. med. dent. Fabian Huettig, University Centre of Dentistry, Oral Medicine and Maxillofacial Surgery

Prof. Dr. Enkelejda Kasneci, University of Tübingen


Eder, T. F., Richter, J., Scheiter, K., Huettig, F., & Keutel, C. (2021). Comparing radiographs with signaling improves anomaly detection of dental students: An eye‐tracking study. Applied Cognitive Psychology, 35, 909-923. Open Access

Eder, T. F., Richter, J., Scheiter, K., Keutel, C., Castner, N., Kasneci, E., & Huettig, F. (2021). How to support dental students in reading radiographs: effects of a gaze-based compare-and-contrast intervention. Advances in Health Sciences Education, 26(1), 159-181. Open Access

Castner, N., Appel, T., Eder, T., Richter, J., Scheiter, K., Keutel, C., Hüttig, F., Duchowski, A., & Kasneci, E. (2020). Pupil diameter differentiates expertise in dental radiography visual search. PLOS ONE, 15(5), e0223941. Open Access

Richter, J., Scheiter, K., Eder, T. F., Huettig, F., & Keutel, C. (2020). How massed practice improves visual expertise in reading panoramic radiographs in dental students: An eye tracking study. PLOS ONE, 15(12): e0243060. [Data] Open Access