Integrating virtual patient-based learning into temporomandibular disorder education improves educational and behavioral outcomes

BACKGROUND: Predoctoral education in temporomandibular disorders (TMD) often provides limited opportunities for clinical exposure, which may hinder students' 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' knowledge, behavioral intention for future practice, and confidence levels when integrated into a predoctoral TMD curriculum. METHODS: 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. RESULTS: Mean knowledge scores improved from 4.1 ± 1.9 to 5.9 ± 1.9 (p<0.001), with 41.6% increasing to 75.3% of participants achieving a 50% knowledge threshold (p<0.001). Confidence increased from 3.6 ± 1.9 to 6.2 ± 1.6 (p<0.001), with the proportion of participants reaching 50% sufficient confidence growing from 20.8% to 72.7% (p<0.001). Improvements were also observed in behavioral intention to integrate TMD screening and management into future practice (p<0.001). CONCLUSIONS: Integrating a TMD-specific VPBL intervention with didactic teaching was associated with short-term improvements in students' knowledge, confidence, and positive shifts in behavioral intention, supporting VPBL plausibility as an adjunct to predoctoral TMD education. TRIAL REGISTRATION: NCT07203456 (registration date: 09/24/2025).