Assessment of Knowledge and Perception Regarding ChatGPT Usage in Dental Students from North India

INTRODUCTION

Artificial intelligence comprises coded algorithms fed into a system, which may be useful to assist in psychology, academic writing, and space technology. Over the years, advancements in deep-learning technologies can be modelled to create human-like language, conduct question-answer, and sum-up written text.^[1]

The latest phenomenon is ChatGPT, which was launched in November 2022 and is powered by artificial intelligence. It mimics human responses and is used in content writing involving drafting of scientific research, probing datasets, and can be used to pass medical education. ChatGPT has shown potential in assessing the academic output of students by reviewing the academic grades of students.^[2] ChatGPT can be used for record-keeping.^[3] Language-learning models (LLMs) can be fed with text material, which can capitalize on text mining to fetch information from unstructured data, for example, free-text-notes from clinical practitioners.^[4] Thus, ChatGPT can be used to lessen the onus of record-keeping, which improves clinical workflow.^[4,5]

Artificial intelligence by means of ChatGPT has been deployed in dentistry in investigating dental caries identification by observing dental panoramic radiographs and X-rays, and even in classifying malocclusions, probing bony defects, and tracking periodontal disease.^[2,3] Thus, artificial intelligence could be comprehensively expanded in dental diagnosis.

Contemporary dental practice has also shown the usage of AI in evaluating CBCT images to identify tooth positioning and judge the strength of bone for osseointegration of dental implants.^[2] Presently, ChatGPT is free to use; however, over the period of time, other similar AIs may appear, and as people get familiar with them, their demand might increase, encouraging users to get acquainted with ChatGPT.^[3] The growing popularity related to ChatGPT usage poses ethical issues, for instance spread of misinformation because of inaccurate reporting and plagiarism issues arising during the drafting of manuscripts.^[4,5] There is controversy involving excessive overload of information obtained from ChatGPT, and concern associated with data authenticity, confidentiality, and privacy.^[5] Academic misrepresentation and copyright are other aspects concerning the usage of ChatGPT in the form of spurious research and ghost writing, which need to be considered seriously.^[4]

Chat GPT usage is said to be ambiguous. It seems the application of ChatGPT will bring about a change in healthcare and education, which garners attention to the ethical usage of ChatGPT. Amalgamating artificial intelligence with education advances research and results in interactive learning where learners actively cooperate.^[6] Nonetheless, reliance on ChatGPT can hinder creativity and perpetuate inability in problem-solving.^[7]

It is believed that if the learning environment for students is conducive and they sense positivity in learning, then students are willing to proactively learn new concepts and seek rationale in learning. In an educational setting, how students sense technological innovation like ChatGPT and their thoughts and familiarity with it, influences their keenness to use machine-learning technology in education.^[8]

There have been fewer studies in judging knowledge, attitude, and practice associated with ChatGPT among dental students,^[9,10] so our study intended to test knowledge and perception associated with ChatGPT in dental undergraduate students.

MATERIAL AND METHODS

The study was approved by the Institutional Ethical Committee bearing protocol number BDC/BHUD/12436 on 24^th November 2023. A Self-Administered online questionnaire designed on Google Survey form was disseminated via social media tools such as WhatsApp and Facebook to assess the feedback obtained from dental interns and dental students about their knowledge regarding ChatGPT in dentistry. The questionnaire was aimed at adhering to the CHERRIES Checklist for Reporting Results of Internet E-survey.^[11] The e-link of the study was https://docs.google.com/forms/d/e/1FAIpQLSdSAXVxpEsFG3gOsiLK10TQNoIMvPiVKs-0Ax37aT_zg_OZhQ/viewform?usp+sf_link shared with students using snowball sampling to maximum responses. The participation in the study was voluntary, and anonymity and confidentiality of responses was maintained. The Questionnaire comprised two parts

• 1st part obtained demographic information

• 2nd part assessed knowledge and perception about ChatGPT by using a closed-ended unstructured questionnaire based on a binary scale (yes and no).

RESULTS

A total of 281 responses were obtained, in which the mean age of participants was 23±1.5 years. Among the respondents, 21.7% were 1^st year students, 17.1% were 2^nd year students, 13.9% were 3^rd year students, 27% were final-year students, and 20.3% were internship students. Around 90.8% of students were aware of ChatGPT and wanted dental students to be trained for using ChatGPT. Irrespective of gender, half of the subjects felt ChatGPT was misleading to dental community. Around 86.1% observed integration of ChatGPT with dental education will turn out to be economical. Approximately 88.6% regarded ChatGPT a good tool in understanding dental concepts and 65.5% perceived ChatGPT utilization in preventing and treating dental disease. Dismally, one-third participants considered ChatGPT to not be useful in preventing and treating dental disease and perpical lesions. Nevertheless, 61.6% noted ChatGPT’s usefulness in detecting and treating malocclusions and three-fourth (79.6%) marked ChatGPT as being resourceful in screening dental images for planning dental treatments. Four-fifth (83.6%) noted ChatGPT can be effectively applied in teledentistry, and two-third (66.7%) related ChatGPT with implant treatment. ChatGPT was viewed for use in record-keeping by 77.6% participants, which would reduce the cumbersome process of manual record-keeping. Around two-three observed (70.1%) that ChatGPT could simulate human intellect and be applied ethically in decision making.

One-fifth (20%) of female students were not aware of ChatGPT in comparison with their male counterparts. One-third (36.3%) of female students thought ChatGPT may not be useful in preventing and treating dental disease, and similarly, one-third of female students (32.4%) considered ChatGPT to not be useful in identifying dental restoration. Regardless of gender, 33% of participants recognized that ChatGPT would not be useful to identify periapical lesions and treat malocclusion. Despite gender variance, not more than 20% of participants viewed ChatGPT as ineffective in dental imaging, and 33% overlooked ChatGPT GPT ineffectual in implant success. Less than one-fifth (20%) of male subjects perceived that ChatGPT could not be integrated into tele dentistry, with a similar observation in 14.8% of female subjects. Additionally, 23.6% of female subjects considered that ChatGPT is not able to enhance workflow, with a non-significant association with male counterparts. One-third subjects, irrespective of their gender, perceived that ChatGPT could not imitate human intellect. However, slightly more than one-third, regardless of gender, raised doubts regarding the ethical usage of ChatGPT in decision-making.

DISCUSSION

In the above study, it was observed that four-fifths of students had the urge to apply ChatGPT in dental education and were evoked with emotion, considered ChatGPT a good tool in understanding dental concepts, which was consistent with existing literature.^[8] Four-fifths expressed that ChatGPT is economical, since virtual simulations are cost-effective when weighed against traditional and haptic simulations.^[13] Two-thirds of students perceived that ChatGPT would enhance learning by diagnosing and identifying dental caries and periapical lesions, which was slightly less than in contrast to a similar study involving dental undergraduates.^[9] The utility of ChatGPT in preventing and treating dental disease was also observed among dental students, and this coincided with a previous study testing ChatGPT’s effectiveness in the context of the dental public health domain.^[14] Predominantly, respondents viewed Chat GPT usage in dental imaging since AI systems can be used to process and analyze CBCT images, which would aid in better diagnosis of dental treatment.^[15]

Three-fourths of respondents held the perspective of using an AI system in tele-dentistry. This has been possible in recent times when telemonitoring is eagerly being considered in developing countries because of its effective monitoring demonstrated in children and adolescents to avert possible appliance damage in Pierre Robin Syndrome subjects.^[16] Three-fourths had the prospect of ChatGPT simulating human intellect, which was recognizable given its capability to decode human voice into text language, which would further help in academic writing and would be beneficial to non-English speaker in transcribing their ideas.^[7] Although two-thirds considered that ChatGPT can be applied ethically in decision making, it would be immature to believe that researchers exercise restraint in overreliance on ChatGPT; there are apprehensions about the privacy of data and ethical dilemmas surrounding ChatGPT.^[7] Students felt that ChatGPT was effective in reducing treatment burden, given its scope in focusing dental and medical care through speech, text, and voice assimilation, which would lower the time for diagnosis and help in record-keeping.^[5] Roughly half of the participants noted Chat GPT could mislead the dental community by spreading false information, and this observation matched with a study where plagiarism and academic fraud were detected using ChatGPT.^[17]

It is conspicuous from the study that the majority of students possessed knowledge about ChatGPT and were willing to embrace AI in dentistry. ChatGPT was considered a useful tool in understanding dental concepts, for instance explanation of dental procedures through 3D visualization, which would be useful in refining the knowledge of dental students.^[3] ChatGPT was also useful in engaging real-time conversations supporting tele-dentistry carried out from any place, and would save the time of physical consultation when treating patients with minor dental ailments.^[4] However, dependence on ChatGPT could hinder professional development since dental training involves patient interaction, and the profession demands dentists to be sympathetic and gentle.^[18]

CONCLUSION

ChatGPT role in dentistry cannot be overruled given the immense potential of artificial intelligence in dentistry. Dentists can integrate ChatGPT in clinical practice, however diligence and caution is required from ethical perspective