The COVID-19 pandemic led to major changes worldwide, especially in social coexistence, as well as work and education. Especially in the field of medical and dental training, which due to their patient-centeredness are related to a high level of physical proximity, fast, alternative solutions had to be sought. An essential way to create infection-preventing distance was the introduction or expansion of digital teaching concepts. Almost all lecturers had to address this often new task .
The explosive nature of the topic and the concern of almost all lecturers at German universities caused the high number of participants in the present investigation. Although the survey was not based on personalized links or traceable participation, but on voluntary participation, with 101 participating lecturers, a relatively large field of participants could be registered compared to other lecturer surveys [18, 24].
The gender and age structure of the present study showed no significant differences between male and female participant numbers between certain age groups. In contrast, the results showed differences in the professional status of the participants. With over 50% of the participants (median 55.4%) the group of the senior physicians, senior physicians; senior consultants or directors are the most frequently represented group. This is not surprising in view of the fact that people in this position often have the predominant teaching performance and teaching responsibility and thus have the highest thematic interest in participating. As a result, most of the study participants were able to state that they had teaching experience of more than 10 years (51.5%).
With 51.5%, more than half of the respondents recorded a share of 25 and 50% in teaching, referred to their entire professional activity. 94.1% of those questioned also stated that more than 25% of their work was done outside of teaching. Clinical dental work beyond of teaching usually does not take place at home. Therefore, many lecturers are tied to one specific location. So at least 94.1% cannot fully exploit the advantages of digital teaching concepts . This restriction could be assumed to be the cause of the fact that only 13.9% of the respondents stated that they teach from home, while 83.1% of the study participants locate their teaching activities in the university (67.3% from the university's own office, 15.8% from classrooms such as lecture halls or conference rooms). In this regard other authors report similar results. Schlenz et al. identified share of 60.0% of the lecturers who gave lectures from the university's own office, while 2.9% used specially equipped conference rooms.18
Ebner et al.25 described a worldwide hype of digital teaching at universities, triggered by the pandemic. How much this trend has changed in the field of dental teaching was shown by the question of experience with online teaching. Although the acceptance, the usefulness and the effectiveness of digital learning formats have been described for decades [10, 12, 14–17, 26–28], only 24.8% of respondents said that they had offered digital teaching prior to pandemic. In addition, 64.4% of the participating lecturers had no previous experience. These results were in line with previous investigations . After the outbreak of the pandemic, more than 80% of the lecturers said they were doing online lectures (86.1%), online seminars (81.2%) and/or online bedside teaching (33.7%), which represented a sharp increase.
This rapid development in the implementation of digital content in the dental curriculum also harbors certain dangers. In spring 2020, COVID-19 caused considerable restrictions in dental teaching . The rapid changes in university teaching that became necessary as a result hit the universities and lecturers suddenly. As the present study shows, only 25.7% of the respondents were able to state that they had taken part in corresponding advanced training events on digital teaching by the time the pandemic broke out, and 36.6% of the respondents had dealt with the topic at least in self-study.
It can be assumed that, not least because of the lack of experience with digital teaching concepts until then, the selection of the teaching format was specified by the university for 62.4% of the participants. Against the background of countless digital possibilities in the field of teaching , this appears to be a sensible measure to create clear university structures. In addition, the license agreements represented a certain university restriction and focus on individual suppliers. Since a large number of students must be able to attend synchronous lectures, seminars and bedside teaching in digital formats, licenses are often unavoidable.
Although authors who examined the acceptance of digital teaching concepts on the part of students reported very high acceptance values, combined with the demand for more online teaching , this development was not clearly reflected on the part of the lecturers.
With 88.1% of the respondents, the vast majority indicated that classroom teaching was the preferred form of teaching, despite having had experience with digital teaching in the meantime. The reasons for this were certainly multilayered. For many lecturers, one reason could be the sudden need for digital offers combined with a lack of previous experience. This situation possibly led to excessive demands, at least temporarily. It should not be forgotten that digital teaching concepts also has disadvantages that are often described, such as eye fatigue from working on the screen and thus a decrease in receptivity  or a lack of motivation . Another decisive disadvantage of digital teaching concepts is the reduced interaction both between students and between students and lecturers . The selection of the teaching format suggests that this point is not insignificant on the lecturer side. Although formats in which discussed slides are used and which can be called up repeatedly, if necessary, with slight modifications, can be "recycled" again and again, the preferred teaching formats, regardless of the type of course, were the "live" formats such as Zoom, WebEx, Jitsi or BigBlueButton. These formats allow far more direct communication.
At the same time, the participants also evaluated the learning success of analog teaching as the greatest. On a scale from 0-100, the participants gave the analog lessons a median value of 82.0 for learning success, while digital, synchronous formats were rated significantly worse with a median value of 61.0. The participants rated the digital asynchronous teaching significantly worse.
The participants evaluated the differences in the interaction options with similar clarity, but even more clearly. Corresponding to the assessment of the learning success, the respondents see the greatest opportunities for interaction in the area of analog teaching (median 100.0). The opportunities for interaction with synchronous digital teaching (median 61.0) are seen as significantly worse. In asynchronous digital teaching, the lecturers see almost no opportunity for interaction (median 0.0).
Although a majority of the lecturers still prefer to use analog teaching and consider this to be more productive, the attitude towards online teaching has changed positively. While the respondents rated their attitudes towards online teaching on a scale of 0-100 with a median of 24.0, this improved during the pandemic to a median value of 50.0.
At the same time, however, in the relatively short period of the pandemic, the lecturers neither had the perceived knowledge of digital teaching concepts (before median 60.0 after 77.0) nor the perceived competence in the implementation of digital content (before median 68.0, After 69.0) significantly improved.
Surprisingly, the surveyed lecturers did not perceive any difference in the workload of their teaching activity between the workload before and during the pandemic. Although there was a tendency to describe additional effort before the pandemic, it was not statistically significant. When asked about the effort required to create individual teaching formats, a mixed picture emerges. While a significant additional effort is seen in the creation of lectures with digital formats (analog median 50.0, digital median 73.0), there is no significant difference between the creation of digital and analog formats when creating seminars and bedside teaching. This result could possibly be explained with the workflow of the various creation modes. While bedside teaching and seminars focus on working out certain issues in small groups, the lecturer takes the active part in lectures, while the students usually only receive the information . The second one is therefore better suited to be reproduced multiple times in asynchronous form. However, due to the storage of audio files, this requires more creation effort than digital lectures. The seminars or bedside-teaching, which are mostly offered as synchronous formats, differ little in terms of creation effort from their analog form.
When presenting the teaching units, on the other hand, the respondents see a significant additional effort both in the area of the lectures and in the area of the seminars. Only with bedside teaching a significant additional effort is seen in the analog form of learning.
When updating existing teaching units, however, this difference was small, so that no significant difference could be analyzed either in lectures (analog median 63.0, digital median 64.0) or in seminars (analog median 64.0, digital median 58.0).
Basically, the results clearly show how university dental teaching has changed since the pandemic. As already described in previous studies, the surveyed lecturers would like to continue online teaching after the pandemic . While the respondents in this study estimated the median proportion of their online teaching before the pandemic to be 4.8% (SD ± 11.44), they hope for a proportion of 40% (SD ± 25.8) in the future. The results suggest that female lecturers in particular are in favor of implementing more online teaching (male 30%, female 50%).
Due to its high proportion of crucial practical skills, dental training is not suitable for being fully taught in distance learning. However, the results show that there is a high level of willingness on the part of the lecturers to continue to design at least the theoretical part of the training digitally. At the same time, the participating lecturers point out the weaknesses of digital teaching in the area of interaction, which should be reduced as much as possible by choosing the appropriate format.
The present study had some limitations, on the one hand, in the composition of the field of participants and, on the other hand, in the circumstances in which the switch to digital teaching took place.
Since participation in this study was voluntary, a field of participants that was unevenly large between the various universities emerged. In order to take this fact into account, the present results must be viewed taking into account the weighting shown in Figure 1. Voluntary participation also means that only the more motivated employees preselectively declared themselves study participants.
Another limitation is the current situation under which the switch to digital teaching offers was mostly not voluntary. Here it would be advisable to collect the results again in further studies with a suitable interval. This would allow a realistic assessment of the attitudes towards digital teaching concepts on the part of the lecturers.
In summary, it can be stated that although the study participants offer significantly more digital teaching in times of the pandemic and have significantly positively changed their attitude towards online teaching, the learning success of analog teaching is rated highest. In the case of lectures in particular, the participating lecturers see a considerable amount of additional work involved in creating digital files. In general, the teachers at German universities are positive about the increased use of digital teaching and hope to be able to offer a far higher proportion of the teaching units digitally in the future.