Accepted for/Published in: JMIR Human Factors
Date Submitted: May 5, 2026
Date Accepted: Aug 13, 2026
Development and Initial Usability Evaluation of SSEndoSim, a Free Mobile Endodontic Diagnostic Simulator: A Cross-Sectional Study
ABSTRACT
Background:
Endodontic diagnostic accuracy among undergraduate dental students is variable. No freely accessible mobile simulation tool existed integrating the AAE dual-diagnosis requirement, the ESE criterion, and structured automated feedback within a single deployable application.
Objective:
This paper describes the development of EndoSim which is a free, open-access mobile web-based endodontic diagnosis simulator and reports the findings of a usability and educational acceptability evaluation
Methods:
EndoSim presents clinical vignettes requiring simultaneous pulpal and periapical diagnosis, investigation sequencing, treatment selection, and confidence rating, with an automated 17-point scoring rubric and five-component structured feedback. Usability was assessed using the System Usability Scale (SUS) and a five-item acceptability scale among 33 final-year BDS students at LUMHS, Jamshoro, Pakistan (April 2026). Descriptive statistics were computed using Python 3.11
Results:
Mean SUS score was 75.30 (SD 14.72; 95% CI 70.28–80.33; median 80.0), graded Good/Acceptable. A total of 23 of 33 participants (69.7%) met the acceptable usability threshold (≥68). Overall educational acceptability was high (mean 4.62/5.00); highest-rated items were automated feedback value (EA2: mean 4.76, SD 0.50) and peer recommendation intention (EA4: mean 4.76, SD 0.44).
Conclusions:
EndoSim achieved acceptable usability and high educational acceptability in a resource-constrained dental education setting. Freely available at https://tinyurl.com/ssendosim, it is the first mobile simulator integrating dual-diagnosis, and structured automated feedback.
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