Through the analysis of the questionnaire data, we found that this teaching experiment was effective in helping students gain an international perspective and improving their personal professional ability and team cooperation ability. The vast majority of respondents agreed or strongly agreed with these statements, and the proportion of disapproval/high disapproval was less than 8%.
Although the traditional teaching model in the past has a wide range of applications and low requirements for students' ability and the knowledge taught is relatively comprehensive, systematic and coherent, which is convenient for the systematic learning of basic knowledge, its disadvantages are also obvious and are not conducive to the cultivation of students' lifelong learning ability and innovative spirit. The TBL teaching model has become increasingly popular with students and teachers in recent years. Aliaa et al. introduced TBL into university curriculum education and found that TBL significantly improved teaching quality, as reflected in the improvement of student scores and satisfaction[9]. In traditional TBL teaching, the time for teachers to play their roles mainly focuses on the beginning and end of teaching, including task assignment and achievement evaluation. However, as individuals with rich knowledge and experience, their role has been greatly underestimated. A study showed that the average marginal effect of teaching + discussion on student performance is higher than discussion mode.. Therefore, on the premise of ensuring student-centeredness, the importance of teachers in TBL should be strengthened[10]. In this study, the students were divided into several groups to check the latest progress of the world's famous universities in this field on the different topics determined. Each group was assigned a teacher with experience studying abroad in the university to guide the process and help the students work in teams efficiently. Because of the relevant experience of studying abroad, the instructor could simplify the process of data collection and better grasp the cutting-edge trends of the university. In addition, the TBL teaching model solved the objective problem of the limited number of teachers with experience studying abroad in well-known universities and met the need for more students to receive personalized guidance. Because of the characteristics of the TBL teaching model, the survey results showed that both the control group and the experimental group believed that "TBL teaching is very important for all dental students". Furthermore, 88% of the students in the experimental group and 76% of the students in the control group agreed with the statement very much, and the students in the experimental group with TBL teaching experience agreed with it more. In addition, the results of the questionnaire showed that only 50% and 42% of the students in the control group superly agreed that the members communicated well and often provided useful feedback in recent group work. Nearly half of the students in the control group expressed concern about their recent gains in group work, which showed that the efficiency of group cooperation in control is low. In the experimental group, 86% and 80% of the students were very satisfied with the communication and feedback between the group members. This is mainly because the TBL teaching method can further enhance the interaction between teachers and students, effectively promote the learning atmosphere of students, increase their language expression opportunities in learning, improve their communication and communication skills, and further develop their team spirit. Through assistance and cooperation between team members and collective wisdom to solve the problems encountered in the learning process, students can change from passive acceptance of knowledge to active learning of knowledge, which not only stimulates their learning enthusiasm and interest but also effectively improves their learning cognitive ability to help them achieve the goal of improving the teaching effect.
Due to the wave of globalization, scientific research institutions, medical institutions and other exchanges and cooperation around the world are increasingly close, which virtually promotes the demand for medical professionals with high quality, high professional skills and international vision. Therefore, adopting an international curriculum of medical education to conduct teaching reform will help students understand and master the latest international knowledge dynamics of prosthodontics and track the international development trend to meet the requirements of the learning society for medical talent, promote the high-quality development of higher education, and enhance the international competitiveness of talent cultivation. In this study, not only is the Western "student-centered" TBL teaching mode adopted to fully mobilize students' awareness of autonomous learning, but the teachers assigned to each group, who had experience studying abroad in relevant universities, could convey the school's philosophy, teaching characteristics, and cultural differences to the group members during the guidance process and help the group members expand their international vision. In addition, during the TBL process, all members were required to use the original English version of materials and communicate fully in English, which greatly improved the foreign language ability of the students in the experimental group. At the end of the course, three-quarters of the students (76%) very much hoped to continue to participate in the international curriculum of medical education, and 78% of the students very much agreed that this course would help them understand the latest scientific research and clinical trends of prosthodontics. However, 98% of the students in the control group believed that the school should strive to create a stronger international atmosphere and provide students with opportunities to accept international education. At the same time, the results showed that the confidence of the students in the control group in scientific research and clinical practice was significantly weaker than that of the experimental group (P < 0.05). The results showed that the international curriculum of medical education integrated into teaching reform is beneficial for students to understand the latest scientific research and clinical progress in the world and can improve their communication ability with professionals and patients. This is similar to the results of some studies that indicate that students can improve abilities that were previously believed to only be improved by going abroad[11, 12]. The method of online contact with international peers was proposed by Ostbye and his colleagues in 1995, but only a few studies have reported this method so far[13–19]. For colleges and universities in low- and middle-income countries, it is difficult and unrealistic to seek the exchange and cooperation of well-known international peers. It is an alternative low-cost scheme to seek exchange with high-level talent with overseas experience in their own countries. To the best of our knowledge, this is the first time that this method of research has been reported.
According to previous research, we adopted the general competence field advocated by the widely accepted Accreditation Committee for Graduate Medical Education (ACGME) to evaluate the improvement of the individual abilities of medical students. These abilities are considered necessary to become an excellent doctor[20, 21]. The results showed that after nearly one year of course study, there was a significant difference in the improvement of personal ability between the two groups of students. Most of the students in the traditional group thought that they did not meet their expectations, and only 12% − 36% of the students were very supportive of the improvement of their abilities; in contrast, the experimental group thought that over one year of course teaching and clinical training, they had improved in various aspects. The proportion of students who felt very supported in various abilities was approximately twice that of the control group. This may be due to the TBL teaching mode adopted by the experimental group. The application of this teaching mode can greatly improve students' learning interest, promote their subjective initiative, and improve their abilities in literature review, medical record analysis, team cooperation, interpersonal communication and communication skills. Under the guidance of the teacher who collected medical record reports, research status and progress from a world-famous school on the topic and read a large number of relevant documents, the students' abilities related to consulting documents, professional knowledge, clinical diagnosis and treatment skills, and scientific research ability could be further improved. Therefore, the improvement of students' individual abilities in the experimental group was significantly higher than that in the control group, with the most obvious performance in the abilities of literature review and scientific research.