Abstract / Summary
Background: The purpose of the study was to explore the impact of a think-aloud (TA) pedagogical approach on the enhancement of clinical reasoning skills through the use of think-aloud recordings. Methods: Fifth-year dentistry students who provided written informed consent for participation were included in this study. During phase 1 (TA1), the expert recorded five think-aloud videos verbalizing his thoughts to analyze the clinical data and devise treatment options. Ten students completed a knowledge assessment test and recorded their own think-aloud recordings for each case, resulting in 50 verbal transcripts. Subsequently, they accessed think-aloud recordings of the expert through Moodle. During the second phase (TA2), an identical protocol was implemented for both students and the expert with five new cases, resulting in the production of 55 additional verbal transcripts. The agreement of student and expert thoughts as recorded by the transcripts was evaluated through quantitative analysis, which employed Cohen’s kappa and Wilcoxon signed rank statistical tests. Qualitative thematic analysis was employed to investigate the convergence of thinking tendencies over time. R version 4.5.2 was used for the statistical analysis and for generating the word clouds. Results: The percentage of agreement between students and the expert increased for pre-treatment considerations [43.07% (TA1) to 79.4% (TA2)] and perceived challenges [60.76% (TA1) to 62.94% (TA2)], whereas it declined for treatment options [63.07% (TA1) to 44.70% (TA2)]. The Cohen’s kappa values for agreement did not exhibit a statistically significant increase (V = 13, p = 0.16). The number of major congruent themes between the students and the expert doubled following exposure to the expert recordings. The number of shared terms in the transcripts increased from 65 (TA1) to 90 (TA2). Conclusions: This exploratory investigation identified different patterns of student–expert agreement. Agreement increased for pre-treatment considerations, remained relatively stable for anticipated challenges, and decreased for treatment options. Longitudinal studies with a larger sample size are recommended to study these trends. Think-aloud recordings warrant further investigation as a potential educational resource to enhance clinical reasoning.