Exploring the Application Capability of ChatGPT as an Instructor in Skills Education for Dental Medical Students: Randomized Controlled Trial

“In contrast, learners with higher spatial ability could activate preconstructed schemas based on 2D images, thus reducing the demand on working memory [20,44].”

“The trial protocol followed the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth; version 1.6.1) checklist (Multimedia Appendix 4) [31].”

“Instructional practitioners also need to incorporate Cognitive Load Theory [19,20] and the Control Value Theory of Achievement Emotions [21] into their instructional design; the former emphasizes minimizing the extraneous cognitive load, providing appropriate learning content for a given learner,…”

“Instructional practitioners also need to incorporate Cognitive Load Theory [19,20] and the Control Value Theory of Achievement Emotions [21] into their instructional design; the former emphasizes minimizing the extraneous cognitive load, providing appropriate learning content for a given learner,…”

“As an auxiliary tool in medical education, ChatGPT is currently considered a double-edged sword by many scholars [3,48].”

“A thematic analysis of interviews with higher education experts indicated that the personalized feedback and support provided by ChatGPT can assist students in setting and achieving goals, reflecting on their progress, and enhancing noncognitive skills such as motivation and self-efficacy [46,47].”

“On one hand, it may impede the development of students’ critical thinking and independent learning abilities and potentially encourage academic dishonesty [3,49-52].”

“Given the limited capacity of working memory to process information simultaneously, learners with lower spatial ability in the control group experienced cognitive load beyond their cognitive resources [20].”

“…the Control Value Theory of Achievement Emotions [21] into their instructional design; the former emphasizes minimizing the extraneous cognitive load, providing appropriate learning content for a given learner, and sparing sufficient working memory capacity for the germane cognitive load [22-26].”

“The latter highlights the importance of emotions which includes self-efficacy and motivation in academic achievements [27-29].”

“It uses advanced deep learning techniques to understand various cues and respond with contextually relevant and coherent language [4,5].”

“The latter highlights the importance of emotions which includes self-efficacy and motivation in academic achievements [27-29].”

“0 would be more advantageous in aiding skill instruction [55].”

“Before engaging in actual clinical practice, students typically undergo training in simulated environments using traditional dental mannequins [10], 3D-printed models [11,12], and virtual reality (VR) technologies [13,14].”

“On one hand, it may impede the development of students’ critical thinking and independent learning abilities and potentially encourage academic dishonesty [3,49-52].”

“In addition, ChatGPT provides real-time feedback and answers to student queries, thereby enhancing the efficiency of the learning process [34].”

“As an auxiliary tool in medical education, ChatGPT is currently considered a double-edged sword by many scholars [3,48].”

“Before engaging in actual clinical practice, students typically undergo training in simulated environments using traditional dental mannequins [10], 3D-printed models [11,12], and virtual reality (VR) technologies [13,14].”

“In the field of dental education, extant research indicates that ChatGPT demonstrates satisfactory performance across a range of dental assessment types [32,33].”

“Before engaging in actual clinical practice, students typically undergo training in simulated environments using traditional dental mannequins [10], 3D-printed models [11,12], and virtual reality (VR) technologies [13,14].”

“It uses advanced deep learning techniques to understand various cues and respond with contextually relevant and coherent language [4,5].”

“Before engaging in actual clinical practice, students typically undergo training in simulated environments using traditional dental mannequins [10], 3D-printed models [11,12], and virtual reality (VR) technologies [13,14].”

“…has some inherent limitation types, although ChatGPT is trained on big data, there is a possibility that the training data may be inherently biased or there may be errors in the training process, which leads to the accuracy and reliability of the information provided will also be affected [54].”

“Many studies have reported on the potential of ChatGPT for passing examinations [1], learning anatomy, and understanding emerging trends [6,7], making it an important tool in areas such as medical education.”

“In the field of dental education, extant research indicates that ChatGPT demonstrates satisfactory performance across a range of dental assessment types [32,33].”

“This hands-on approach allows students to apply theoretical knowledge to real cases [9].”

“Previous studies evaluating ChatGPT on Geographic Information Systems examinations demonstrated its capacity to achieve passing scores in spatial analysis, spatial statistics, and interpolation tasks [36].”

“A thematic analysis of interviews with higher education experts indicated that the personalized feedback and support provided by ChatGPT can assist students in setting and achieving goals, reflecting on their progress, and enhancing noncognitive skills such as motivation and self-efficacy [46,47].”

“Research has shown that ChatGPT can assist students in reviewing key concepts, reinforcing theoretical knowledge [1,15], and simulating clinical scenarios to enhance clinical reasoning [16].”

“In addition, given the limited working space in oral procedures, fine motor skills and high spatial ability are crucial for mastering technical skills [17,18].”

“…ability assessments, such as the mental rotations test, visualization of views test, and visualization of rotation test, have consistently shown that students with higher spatial aptitude achieve superior performance in endodontics [40], radiology [41], anatomy [42], and prosthodontics [43].”

“Previous studies also support this view [45].”

“…ability assessments, such as the mental rotations test, visualization of views test, and visualization of rotation test, have consistently shown that students with higher spatial aptitude achieve superior performance in endodontics [40], radiology [41], anatomy [42], and prosthodontics [43].”

“Many studies have reported on the potential of ChatGPT for passing examinations [1], learning anatomy, and understanding emerging trends [6,7], making it an important tool in areas such as medical education.”

“…ability assessments, such as the mental rotations test, visualization of views test, and visualization of rotation test, have consistently shown that students with higher spatial aptitude achieve superior performance in endodontics [40], radiology [41], anatomy [42], and prosthodontics [43].”

“A previous study applied this method to measure cognitive load differences between experts and students while examining dental radiographs [35].”

“Research has shown that ChatGPT can assist students in reviewing key concepts, reinforcing theoretical knowledge [1,15], and simulating clinical scenarios to enhance clinical reasoning [16].”

“5 have shown nascent potential in executing basic spatial queries [37].”

“It is capable of providing tailored assistance and feedback in response to the learner’s progress, offering technical guidance and confirmation of procedural steps [53].”

“…the Control Value Theory of Achievement Emotions [21] into their instructional design; the former emphasizes minimizing the extraneous cognitive load, providing appropriate learning content for a given learner, and sparing sufficient working memory capacity for the germane cognitive load [22-26].”

“The core of skills education is to enable students to master clinical skills, such as dental restoration, periodontal treatment, and surgical procedures, through hands-on practice [8].”

“Many studies have reported on the potential of ChatGPT for passing examinations [1], learning anatomy, and understanding emerging trends [6,7], making it an important tool in areas such as medical education.”

“Before engaging in actual clinical practice, students typically undergo training in simulated environments using traditional dental mannequins [10], 3D-printed models [11,12], and virtual reality (VR) technologies [13,14].”

“Previous research has demonstrated a significant yet modest positive correlation between spatial ability measured by the Purdue Spatial Visualization Test: Rotations and performance in dental anatomy assessments [39].”

“In addition, given the limited working space in oral procedures, fine motor skills and high spatial ability are crucial for mastering technical skills [17,18].”

“…ability assessments, such as the mental rotations test, visualization of views test, and visualization of rotation test, have consistently shown that students with higher spatial aptitude achieve superior performance in endodontics [40], radiology [41], anatomy [42], and prosthodontics [43].”

“…awareness of group allocation could plausibly influence student confidence through differential feedback, encouragement, and validation beyond the educational content itself; this concern did not apply to the 4 remaining studies, which used largely self-directed learning formats [47,68,70,80].”

“When used judiciously, these tools may also help manage cognitive load by offering immediate feedback and structured responses during self-directed learning [41].”

“In radiology, ChatGPT has shown promise in identifying anatomical landmarks, recognizing pathologies, supporting diagnostic reasoning, and interpreting imaging-related content [11, 14].”

“12,19 In addition, personalized AI-powered tools demonstrate potential to enhance clinical reasoning by aligning learning challenges with each student’s developing competence.”

“These interventions generally improved examination scores, diagnostic accuracy, or decision-making performance compared with conventional teaching methods [32, 35, 40, 44, 45, 49–52].”

“Furthermore, structured communication training using role-play and simulated patient interactions has been shown to improve practical communication competence beyond that achieved through supervised patient care alone [31, 32].”

“Previous studies have shown that GenAI, such as ChatGPT, has the potential to serve as an instructor for dental skills teaching [9].”

“Thus, AI in medical education presents a dual character [45-48], with its core value lying in assisting, rather than replacing, human educators.”

“Virtual-patient systems enabled repeated, risk-free practice and structured feedback for communication and clinical reasoning [24,26], while other AI-assisted educational approaches supported personalized explanations and knowledge acquisition [33,34].”

“Some studies have focused on chatbot-assisted learning as an educational intervention involving real dental students (3,5,6), whereas others have examined model performance on licensing or specialty examinations (10,11), or compared chatbot outputs against human respondents in more technical…”

“The remaining three trials 29 – 31 presented some concerns, mainly due to incompletely described randomization methods, lack of blinding, or partly subjective outcome measurement.”

“…AI and conversational agents (chatbot-based virtual patients) were more commonly associated with enhancements in affective outcomes including motivation, perceived competence, and satisfaction, with variable and predominantly subjective effects on cognitive skill development [7, 30–33 , 36].”

“A randomized controlled trial showed that dentistry students using GenAI support demonstrate improved operative skill performance and higher learning motivation compared to standard education techniques [81].”

“Most studies lacked pre-registered protocols [25, 31], suggesting a risk of selective outcome reporting.”

“Furthermore, two RCTs showed that ChatGPT’s role as a learning tool enhanced the performance of both dental and medical students for the lectures of clinical operative skills and orthopedics, respectively, compared to control groups (Huang et al., 2025; Gan et al., 2024).”