310 participants responded to the online questionnaire, yielding a response rate of 72%. The study sample was composed of 179 (57.7%) fourth year and 131 (42.3%) fifth year dental students. They were composed of 241 (77.7%) female and 69 (22.3%) male students.
Section 1: Impact on dental education. Students’ attitudes towards Online Learning
The educational impact of COVID-19 on 4th and 5th year dental students is shown in Table 1.
Question
|
Year
|
Strongly disagree %
|
Disagree
%
|
Agree
%
|
Strongly agree %
|
p value*
|
1
|
Do you feel that you missed educational experiences as a result of the lockdown?
|
4th
|
3.4
|
20.7
|
49.7
|
26.3
|
0.96
|
5th
|
3.8
|
18.3
|
51.1
|
26.7
|
Total
|
3.5
|
19.7
|
50.3
|
26.5
|
2
|
Do you think online assessment is a good method for evaluation?
|
4th
|
22.9
|
43.0
|
30.2
|
3.9
|
0.001
|
5th
|
13.0
|
30.5
|
50.4
|
6.1
|
Total
|
18.7
|
37.7
|
38.7
|
4.8
|
3
|
Do you think group discussion posted on E-learning such as clinical cases and scenarios had a positive value on your education?
|
4th
|
14.0
|
34.6
|
44.7
|
6.7
|
<0.001
|
5th
|
0.8
|
14.5
|
51.1
|
33.6
|
Total
|
8.4
|
26.1
|
47.4
|
18.1
|
4
|
Did this quarantine increase your collaboration with your colleagues?
|
4th
|
6.1
|
41.9
|
33.5
|
18.4
|
<0.001
|
5th
|
1.5
|
19.8
|
55.0
|
23.7
|
Total
|
4.2
|
32.6
|
42.6
|
20.6
|
5
|
Did you feel more engaged and motivated in following up with distant e-learning?
|
4th
|
19.6
|
39.1
|
30.2
|
11.2
|
0.049
|
5th
|
14.5
|
33.6
|
45.0
|
6.9
|
Total
|
17.4
|
36.8
|
36.5
|
9.4
|
6
|
Do you prefer online lectures compared to face to face theatre lectures?
|
4th
|
10.1
|
27.4
|
38.5
|
24.0
|
0.14
|
5th
|
4.6
|
22.1
|
48.1
|
25.2
|
Total
|
7.7
|
25.2
|
42.6
|
24.5
|
7
|
Do you feel comfortable with all this technology-based education?
|
4th
|
13.4
|
40.2
|
35.8
|
10.6
|
<0.001
|
5th
|
1.5
|
33.6
|
55.7
|
9.2
|
Total
|
8.4
|
37.4
|
44.2
|
10.0
|
*p value of Chi square test.
Table 1. Educational impact of COVID-19 on 4th and 5th year dental students.
The majority (76.8%) of the students, without significant effects of gender or year of study, agreed that they missed educational experiences as a result of the lockdown.
More than half (56.4%) of the students, particularly 4th year (65.9%) (p=0.001), feel that online assessment is not a good method for evaluation. Similarly, 54.2% of the students, particularly 4th year (58.7%) (p=0.049), feel less engaged and motivated in following-up with distant e-learning.
In contrast, higher percentage of the students (65.5%), particularly 5th year (84.7%) (p<0.001), think that group discussion posted on e-learning such as clinical cases scenarios had a positive value on their education. Similarly, higher percentage of the students (63.2%), particularly 5th year (78.7%) (p<0.001), think that the quarantine increased their collaboration with their colleagues. In addition, 67.1% of the students, without significant effects of gender or year of study, prefer online lectures compared to face to face theatre lectures. Significantly higher percentage of 5th year (64.9%) compared to 4th year dental students (46.4%) (p<0.001) feel comfortable with the technology-based education.
The experiences that were mostly affected by quarantine according to 4th and 5th year dental students are shown in Figure 1. Clinical training was the mostly affected experience reported by students (86.5%). Regular lectures were missed by a significantly higher percentage of 4th year students (p=0.008), while comprehensive case presentations were missed by higher percentage of 5th year students (p<0.001).
According to 4th and 5th year dental students, the dental subspecialties most negatively affected by quarantine are shown in Figure 2. Conservative dentistry (73.2%) followed by prosthodontics (69.4%) were the two most negatively affected subspecialties while orthodontics (18.4%) and oral diagnosis (21.0%) were the two least negatively affected subspecialties. Pediatric dentistry (p=0.002) was reported to be negatively affected by higher percentage of 5th year students, while oral surgery (p=0.033), periodontics (p<0.001), orthodontics (p<0.001), and oral diagnosis (p<0.001) were reported to be negatively affected by higher percentage of 4th year students.
Section 2: Preparedness related to cognition, communication, and professional skills
The mean total preparedness score (TPS) for the 131 participants 5th year students was 24.4 (SD ±4.7) with a range of 5 to 34. The mean TPS was not significantly affected by gender of the participants (p>0.05).
The responses of the students to the 17 indicators of preparedness related to cognition, communication, and professional skills are shown in Table 2. Generally, students showed a total or most of time preparedness related to majority of attributes and professional skills. However, a significant percentage of students find difficulty in evaluating new dental materials using evidence-based approach (47.3%) and in having sufficient evidence-based knowledge of scientific principles to support their dental practice. In addition, around 10% of students do not reflect on their clinical practice in order to address their learning needs.
Skill
|
No experience %
|
Mostly
%
|
Always
%
|
1
|
I evaluate new dental materials/products using evidence-based approach.
|
47.3
|
38.9
|
13.7
|
2
|
I have sufficient evidence-based knowledge of scientific principles to support my practice.
|
19.1
|
66.4
|
14.5
|
3
|
I reflect on my clinical practice in order to address my learning needs.
|
9.9
|
50.4
|
39.7
|
4
|
I can manage patient’s expectations for their treatment.
|
7.6
|
61.1
|
31.3
|
5
|
I am able to refer patients with complex treatment needs.
|
6.9
|
30.5
|
62.6
|
6
|
I feel comfortable asking for help from supervisor/colleague if needed.
|
6.9
|
46.6
|
46.6
|
7
|
I maintain accurate records of my clinical notes.
|
4.6
|
50.4
|
45
|
8
|
I restrict my relations with my patients to a professional level.
|
4.6
|
43.5
|
51.9
|
9
|
I take responsibility for my continuing professional development.
|
3.8
|
33.6
|
62.6
|
10
|
I take appropriate measures to protect patient confidentiality.
|
3.8
|
22.9
|
73.3
|
11
|
I can communicate potential procedural risks to my patients.
|
3.1
|
47.3
|
49.6
|
12
|
I can obtain informed consent from my patients.
|
2.3
|
31.3
|
66.4
|
13
|
I can motivate my patients to maintain good oral/general health.
|
1.5
|
55
|
43.5
|
14
|
I am aware of my legal responsibilities as a dental professional.
|
0.8
|
31.3
|
67.9
|
15
|
I recognize my personal limitations in clinical practice.
|
0.8
|
39.7
|
59.5
|
16
|
I can communicate appropriately with my colleagues.
|
0.8
|
26.7
|
72.5
|
17
|
I can communicate effectively with my patients.
|
0
|
35.9
|
64.1
|
Table 2. Preparedness related to cognition, communication, professional skills of 5th year dental students arranged in descending order with regards to “No experience”
General Practice readiness
As shown in Table 3, nearly one-third of 5th year students are not sure of their confidence in the skills acquired before graduation and nearly two-thirds of them prefer to be mentored or indirectly supervised following graduation. In addition, only 28.2% have confidence in starting an independent practice after graduation and, therefore, the majority prefer to have a well-structured year of residence with proper training after graduation.
Question
|
No
%
|
Unsure
%
|
Yes
%
|
1
|
Do you have confidence in the skills acquired before graduation?
|
3.8
|
35.1
|
61.1
|
2
|
Do you prefer to be mentored or indirectly supervised following graduation?
|
11.5
|
24.4
|
64.1
|
3
|
Do you have confidence in starting an independent practice after graduation?
|
27.5
|
44.3
|
28.2
|
4
|
Do you have preference for a well-structured year of residence, with proper training?
|
3.1
|
10.7
|
86.3
|
Table 3. Practice readiness of 5th year dental students