Abstract
This study investigated the impact of visual thinking strategies (VTS), an art-based visual training method, on dental students' skills in radiographic interpretation, specifically evaluating root canal obturation. Despite the critical role of radiographic imaging in endodontic care, dental curricula typically assume observational skills rather than explicitly training them. A quasi-experimental mixed-methods design involved 90 third-year dental students, with 50 participating in structured VTS training sessions utilising selected artworks rich in visual details and interpretive complexity. The remaining 40 students served as a control group. Following VTS training, both groups assessed the quality of 198 periapical radiographs using a checklist-based scoring system aligned with the European Society of Endodontology guidelines. Ratings from an expert panel provided a consensus standard. Statistical analyses revealed that VTS-trained students produced radiographic assessments significantly closer to expert evaluations compared to untrained peers (median: trained group = 2.54; untrained group = 2.70; specialists = 2.50). Intraclass correlation coefficients showed substantial agreement between trained students and specialists (ICC = 0.878) versus lower agreement among untrained students (ICC = 0.799). Qualitative feedback indicated that VTS enhanced students' abilities to observe subtle details, interpret complex visual information, and consider multiple perspectives, reflecting improved visual diagnostic reasoning. However, some students expressed uncertainty regarding direct clinical applicability. These findings suggest that structured VTS training can meaningfully enhance observational and interpretive skills critical for radiographic assessment in dentistry, recommending further integration and evaluation of such art-based methods within dental education.