Kognitive Prozesse bei der initialen Diagnosefindung und Therapieplanung in der Kieferorthop die [Cognitive processes in inital diagnosis and treatment planning in orthodontics]

[english] Introduction: The investigation of diagnostic processes in dentistry and particularly in orthodontics is an often neglected subject of research. This study investigates cognitive processes at initial diagnosis and during treatment planning in orthodontics. We differentiated between various levels of experience: dentists without special training, assistants and specialist dentists. The aim was to identify cognitive processes and use this information for the improvement of education. Methods: A case vignette (complete, evaluated diagnostic record of a patient with patient’s history, clinical findings, study model, cephalogram, panoramic x-ray, photographs) was presented to 17 test persons (5 dentists, 5 assistants and 7 specialist dentists). With the help of think-aloud protocols, statements were systematised and quantified to enable statistical analysis. Results: The cognitive process is a complex and variable interaction of different processes. Reduction to a single known cognitive model was not possible. At a high cognitive load, there were no significant differences between groups for processing, but significant differences were found in the order in which the diagnostic records were considered. With increasing experience, less information (15%) was considered. The study model takes up a substantial proportion of diagnosis and treatment planning in terms of time (>30%) and content. Discussion: The initial orthodontic diagnosis and treatment planning is a highly individual process. An integrated model of analytical and non-analytical approaches can be adopted for orthodontics. Target for the improvement of education should be stricter systematics and reduction of the cognitive load. To build individual strategies it may also be helpful to incorporate more case-based exercises. [german] Einführung: Die Untersuchung diagnostischer Prozesse nach kognitiven Gesichtspunkten ist speziell in der Zahnmedizin und Kieferorthop die bisher wenig betrachtet worden. In dieser Studie werden die kognitiven Prozesse bei der initialen Diagnostik und Therapieplanung in der Kieferorthop die untersucht. Es wurden verschiedene Erfahrungslevel von Zahn rzten ohne spezielle Ausbildung, Weiterbildungsassistenten und Fachzahn rzten differenziert. Ziel war es, die gedanklichen Prozesse zu erkennen und Konsequenzen für eine Verbesserung der Ausbildung abzuleiten. Methode: Eine Fallvignette (komplette, ausgewertete diagnostische Unterlagen eines Patienten mit Anamnese, klinischem Befund, Studienmodell, Fernr ntgenseitbild, Orthopantomogramm, Fotos) wurde 17 Probanden (5 Z