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 Table of Contents  
Year : 2021  |  Volume : 33  |  Issue : 1  |  Page : 12-15

Whatsapp as an E-learning tool of dental radiograph interpretation among dental undergraduates - A pilot study

Department of Oral Medicine and Radiology, KAHERs KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India

Date of Submission24-Sep-2020
Date of Decision04-Feb-2021
Date of Acceptance08-Feb-2021
Date of Web Publication26-Mar-2021

Correspondence Address:
Dr. Anjana Bagewadi
Professor, Oral Medicine and Radiology, KLE VK Institute of Dental Sciences, Nehru Nagar, Belagavi - 590 010, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jiaomr.jiaomr_195_20

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Background: The number of smartphone users and social media has increased exponentially. The applications have been used for teaching, learning, and assessment. WhatsApp allows sharing of images with multiple users and is a great platform for discussions. Hence, it was decided to teach interpretation of intra-oral periapical radiographs (IOPA) for dental undergraduates. Aim: The study aimed to know the perception and acceptability for WhatsApp as an e-learning tool for learning IOPA radiograph interpretation. Methodology: Seventy-five third year students of Bachelor of Dental Surgery participated in the study. They were further grouped into smaller groups, containing 7-8 students in one batch. Every student made and posted five IOPAs images with interpretation in the WhatsApp group. The next day, the facilitator clarified the doubts. At the end of the posting, students answered a questionnaire with a 4-point Likert scale of 10 items. The analysis was done manually by calculating aggregate percentages of responses. Results: 98.6% of students felt WhatsApp facilitates group discussion and provides the flexibility of time. 96% of students agreed that it encourages participation. 89% felt it helped them clear doubts. Conclusion: All the students participated enthusiastically. They could learn at their convenient time and without the fear of face-to-face interaction. Hence, WhatsApp can be an adjunct teaching methodology for interpretation of IOPA.

Keywords: E-learning, Mobile learning, WhatsApp, IOPA (Intra-oral periapical radiograph), blended learning, social media learning

How to cite this article:
Bagewadi A. Whatsapp as an E-learning tool of dental radiograph interpretation among dental undergraduates - A pilot study. J Indian Acad Oral Med Radiol 2021;33:12-5

How to cite this URL:
Bagewadi A. Whatsapp as an E-learning tool of dental radiograph interpretation among dental undergraduates - A pilot study. J Indian Acad Oral Med Radiol [serial online] 2021 [cited 2022 Sep 25];33:12-5. Available from: https://www.jiaomr.in/text.asp?2021/33/1/12/312202

   Introduction Top

The use of smartphones and WhatsApp has increased exponentially.[1] WhatsApp is a convenient and widely accepted instant messaging service.[2],[3],[4]. It allows sharing various forms of media and group discussions and hence facilitates learning.[5],[6],[7],[8],[9],[10] It provides flexibility, ensures student engagement, supports and strengthens lifelong learning.[11],[12],[13] The application of taking pictures and storage aids learners revisit anytime, anywhere for better understanding.[8],[14],[15]

Intra-oral periapical (IOPA) radiograph making and interpretation begin in third year clinics.[16] In the initial phase, the students find difficulty in interpretation because of minute findings and incompetency.

A literature search revealed the use of WhatsApp to teach histopathological slides[17] and oral radiology.[8] As our campus has free WIFI, and students possessed smartphones and used WhatsApp, it was planned to teach interpretation of IOPA and know the perception and acceptability of WhatsApp as an e-learning tool.

   Methodology Top

This is a descriptive cross-sectional pilot study conducted at a recognized and reputed Dental Institute. This study conformed to ethical guidelines of the 1975 Declaration of Helsinki and was approved by the Institutional Research and Ethics committee of a dental institute bearing no 1262 dated 18/7/2019. The Methodology is explained in Flow Chart .

Sample size

Sample size was based on formula n = Z2S2/d2, std deviation of 2.5 (Reference Shital S, et al.) with acceptable error of 0.6 P value of 0.05 at Zα = 1.96 at 5% level of significance. 4× (2.5)2/(0.5)2 = 100, 4× (2.5 × 2.5)/(0.6)2 = 70. The required sample size was 70 since there were 75 students, all were included in the study.

Inclusion criteria

All students having a smartphone and using the WhatsApp version from or upgraded version and giving consent to be part of the study.

Exclusion criteria

Students not having a smartphone and not using WhatsApp and didn't give consent to be part of the study.

Study population

IOPA making and interpretation is a routine training program in 3rd year BDS first-term clinical posting of Oral Medicine and Radiology. This batch of students fulfilled the inclusion criteria and hence were included in the pilot study.

IOPA radiograph making and interpretation is part of routine training in the Oral Medicine and Radiology posting. All were informed and oriented about steps in learning radiographic interpretation using mobile technology. All the students attended a didactic lecture on radiograph making, processing, and interpretation as a part of a regular theory class scheduled in a lecture hall. This would give them knowledge on the process of making and interpreting radiographs. The next part of the study was conducted in the first-term posting of the Department of Oral Medicine and Radiology of 15 days. Students participated in a total of 10 batches comprising of seven students (five batches) and eight students (five batches) students posting- wise. WhatsApp group of students and facilitator were created batch- wise. Instruction on the method of WhatsApp learning was explained. The study period was 6 months beginning from orientation, lecture, and completion of all batches of clinical postings. The IOPA radiographs included for interpretation in the study were limited to caries, periapical pathosis, and periodontal problems.

On day one of the posting, students participated in small group discussions with trained staff in charge/facilitator on IOPA radiograph making and received demonstration. They were taught the interpretation of IOPA in a structured format. Students were also demonstrated to take pictures of the IOPAs against the light of the X-ray viewer. From day 2 onwards to the 14th day, students made radiographs on patients allotted with caries, periapical pathosis, and periodontal problems. All the students shared these IOPA radiograph images for the interpretation in their respective WhatsApp groups. All the WhatsApp group students had to participate mandatorily in interpretation of the radiograph in a format provided. The students could post interpretation conveniently till the next day morning. On average, seven to eight IOPAs were interpreted daily.

The students could revisit the radiographs as many times as possible and add new relevant information on the interpretation of IOPAs posted. They could access additional e-sources for better understanding and interpretation. They could post their doubts too. The next day, the facilitator/staff in charge through a group discussion clarified doubts and the findings. This was done for 1 h daily. The findings posted were checked for consistent answers. Inconsistent findings were considered doubts and were clarified. This process continued till all students in the batch completed making 5 IOPAs each and posting for discussion. A total number of 35–40 radiographs were discussed during the posting.

At the end of this posting, the student had to answer a modified pretested questionnaire with a 4-point Likert scale with close-ended 10 items to know their perception of the use of WhatsApp as a learning tool for dental radiographs [Table 1].[15] Four senior faculty of the department of Oral Medicine and Radiology checked the validity. Ten interns answered the questionnaires for reliability. The Cronbach's alpha value of the questionnaire was 0.86. Analysis of responses was done manually by calculating aggregate percentages of responses [Table 1].
Table 1: Questions and responses in aggregate percentage

Click here to view

   Results Top

All the students (100%) participated in the survey. 98.6% of students felt WhatsApp facilitates group discussion and provides the flexibility of time. 96% of students agreed that it encourages the participation of students who may not participate in face-to-face interaction. They felt it was interesting and eased the way of learning compared to face-to-face. It helps clear doubts and helped build on information with continuous interaction with the facilitator and colleagues. 85% of students felt the facility of searching for additional information through the internet facilitated the learning. This also allowed students to self-assess their level of knowledge.

   Discussion Top

All the students participated enthusiastically. It was highly accepted as every student possessed a smartphone and the campus has free WIFI. The learning content was through visual and text, hence students' higher-order comprehension of critical thinking and analyzing developed. Student engagement was observed by WhatsApp messages in structured format posted on the group. This was consistent with the findings by Cheston et al.[18] The encouragement to do additional search for interpretation and diagnosis would also help them to be a self-directed learner. Some of the students were benefitted from peer inputs. This is a convenient method of learning.[19],[20],[21],[22] They could revisit the images at their leisure and discuss with batchmates outside the classroom and during clinical hours. The participation of shy and non-confident students was also observed. The record of participation and post would aid the teacher to assess the students. This method could be used for formative assessment during day-to-day discussions.[23],[24],[25] Every batch of students could get knowledge and understanding of 35–40 radiographs in a single posting when compared to 5 IOPAs made by self in traditional method. This method of learning saved faculty and student time and as most of the observations especially the minute and fine details were done outside clinic time. More time was available for discussion and doubts were clarified benefitting all. Monitoring all students' participation was possible with 7–8 students per batch. Peer learning and team learning were observed as the participants read interpretations posted by all in the group. WhatsApp learning can be used for small group learning effectively and also as an adjunct training method with conventional method. Our results are consistent with findings of Lohitashwa et al.[26] and Raiman et al.[15]

The observations of staff in charge/facilitator were all students participated in interpretation. WhatsApp learning provided every student an opportunity to view all radiographs unlike the conventional method. Students got adequate and convenient time to view the radiograph as the image was saved in the WhatsApp group. The facility of magnifying/zooming helped them view and understand the minute details clearly, for example, initial caries, break in the continuity of lamina dura, and bone loss. This method of learning saved a lot of time during clinical posting.

The limitation of the study was that the current study was conducted on a smaller sample. Objective assessment was not done to know the gain from this method, as a study by Amry et al., says WhatsApp facilitated only superficial learning.[27] The present study did not assess the amount of time spent by students and whether WhatsApp learning has any negative aspects, for example, distraction.[28] Another drawback of this study is that it was conducted for only one term of one academic year of students. Further studies should be undertaken with a larger group of students in different academic years.

Limitations and future prospects

Further research on the effectiveness of this instructional methodology should be taken up. A structured program can be prepared for this method of blended/adjunct learning to benefit the students at large.

   Conclusion Top

Most of the students have smartphones and use of WhatsApp has become an integral part of student's daily life. Implementing WhatsApp learning of IOPA radiographic interpretation was easy and acceptable to all students. Students who remained absent also benefitted from this methodology of learning. Thus, WhatsApp can be used as an adjunct teaching methodology in dental radiology. However, WhatsApp teaching can also be extended to teach communication skills, examination, by sharing videos and group discussion. Hence sharing of educational information and learning by facilitating can be achieved.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

   References Top

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[PUBMED]  [Full text]  
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