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General introduction151acquire those advanced skills, a different approach of training may be preferred than methods proven to be effective and efficient to train other procedures in dentistry or medicine. When I started with this PhD-project, there were a limited number of scientific publications on methods of teaching Endodontology. It occurred to me that although we teach our students the importance of evidencebased practice, the way Endodontics is taught seemed, ironically, the most empirical. Around 2010, at the Academic Centre for Dentistry Amsterdam (ACTA) some curricular changes have been made, which included changes in methods of teaching Endodontology. This provided us with the opportunity to study those teaching methods. We studied the influence of methods of teaching on the performance of undergraduate students in Endodontics (chapter 2), and on their self-perceived competence and self-efficacy (chapter 3). To this end, to measure self-perceived competence and self-efficacy in Endodontics, we composed questionnaires. To get further insight in undergraduate students’ and novice dentists’ self-efficacy in Endodontics, a collaboration was established with Aarhus University (Aarhus, Denmark) (chapters 4 & 5). Self-efficacy is the major outcome measure in this thesis. As far as we know, we were the first who studied self-efficacy in relation to Endodontics. Selfefficacy is an important motivational construct, which predicts performance on work-related tasks (Gist & Mitchell 1992). A change in self-efficacy may lead to a change in performance, and in learning situations self-efficacy influences the degree of skill acquisition and retention (Gist & Mitchell 1992). Previous studies on education in Endodontics looked at confidence or self-confidence (Stewardson et al. 2003, Lynch et al. 2010, Tanalp et al. 2013, Murray & Chandler 2014), perception of confidence (Davey et al. 2015), confidence in practical skills (Manogue et al. 1999), feelings of preparedness (Manogue et al. 1999, Patel et al.2006), self-assessed competence (Karaharju-Suvanto et al. 2014), and perception of competence (Davey et al. 2015), but not at self-efficacy. Self-efficacy differs from both confidence and self-perceived competence. Confidence or self-confidence is much broader than self-efficacy. Self-efficacy focuses on abilities that are associated with behaviours (Oney & Oksuzoglu-Guven 2015). It is, for example, the belief that one can perform good quality root canal treatments in future situations. This is irrespective of whether one believes that a root canal treatment will solve the problem; whether it will prevent or heal apical periodontitis. Such outcome expectancy is, however, a constituent of confidence (Oney & Oksuzoglu-Guven Annemarie Baaij.indd 15 28-06-2023 12:26