Evaluation of a comprehensive clinical dentistry course at dental schools in Saudi Arabia

Haidar Al-Alawi; Mahdi Al-Shayeb; Abdulfatah Al-Jawad; Ali Al-Ali; Amr Mahrous

doi:10.4103/2348-2915.154635

ORIGINAL ARTICLE

Year : 2015 | Volume : 2 | Issue : 1 | Page : 5-9

Evaluation of a comprehensive clinical dentistry course at dental schools in Saudi Arabia

Haidar Al-Alawi¹, Mahdi Al-Shayeb², Abdulfatah Al-Jawad², Ali Al-Ali², Amr Mahrous¹
¹ Department of Substitutive Dental Sciences, College of Dentistry, University of Dammam, Dammam, Saudi Arabia
² Ministry of Health, Eastern Province, Saudi Arabia

Date of Web Publication

8-Apr-2015

Correspondence Address:
Haidar Al-Alawi
Department of Substitutive Dental Sciences, College of Dentistry, University of Dammam, Dammam
Saudi Arabia

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/2348-2915.154635

Abstract

Introduction: This study aimed to evaluate a Comprehensive Clinical Dentistry Course conducted at two dental schools in Saudi Arabia. Materials and Methods: This cross-sectional cohort study was conducted in two dental schools: King Saud University (KSU) and University of Dammam (UOD). The study subjects were students (42 UOD and 30 KSU), patients (32 UOD and 46 KSU), and faculty members (8 UOD and 7 KSU). Evaluations were collected using self-administered surveys. Results: The response rates were 72%, 78%, and 32% for students, patients, and faculty members, respectively. The students' evaluations demonstrated that case acceptance by supervisors was one of the difficulties facing 57.14% of UOD students compared to 30% of KSU students. The majority of faculty members (39%) were restorative specialists (25% UOD, 42.86% KSU). The overall evaluation of UOD faculty members was fair (50%) or good to very good (50%). For KSU faculty members, the overall evaluation was good (50%) or very good (50%). The mean age of the patients was 33.26 years. The level of education of the study subjects was either secondary school (43.6%) or university level (35.9%). Most of the study subjects knew about the program from their friends (57.7%). Approximately 96.1% of the study subjects were satisfied with the overall treatment of students. Discussion: The fundamental aim of the students was to have their cases accepted as early as possible to complete requirements on time. Conclusion: Dental students displayed relatively high psychological stress in relation to case acceptance by their supervisors. Demonstrating good attitude and quality treatment can increase the flow of patients.

Keywords: Comprehensive clinical dentistry, cross-sectional study, dental course evaluation, King Saud University, patient′s satisfaction, Saudi Arabia, University of Dammam

How to cite this article:
Al-Alawi H, Al-Shayeb M, Al-Jawad A, Al-Ali A, Mahrous A. Evaluation of a comprehensive clinical dentistry course at dental schools in Saudi Arabia. J Dent Res Rev 2015;2:5-9

How to cite this URL:
Al-Alawi H, Al-Shayeb M, Al-Jawad A, Al-Ali A, Mahrous A. Evaluation of a comprehensive clinical dentistry course at dental schools in Saudi Arabia. J Dent Res Rev [serial online] 2015 [cited 2023 Mar 27];2:5-9. Available from: https://www.jdrr.org/text.asp?2015/2/1/5/154635

Introduction

The evaluation of the teaching process in higher education began long ago in the US, UK, Australia, and other countries. ^[1] The literature shows that student evaluations of teaching are one of the most widely investigated topics in higher education research. ^[2],[3] The concept of student evaluations of teaching and debates about the merits of this process can be found as early as the 1920s. ^{[4],[5],[6],[7],[8]} Various factors have contributed to the current study of the relationship between student evaluations and performance improvement. A key trend that has been widely identified in the literature is the proliferation of quality initiatives that impinge on university teaching and elevate student feedback to a new level of importance in measuring and rewarding tertiary teaching performance. ^[9],[10]

The satisfaction of patients is a major factor in maintaining a high quality of health services. Assessments of patients' expectations and patients' feedback allow the best possible care to be provided. Furthermore, it is important to evaluate the quality of the care provided. Recent studies suggest that patient satisfaction, cooperation, and motivation are directly proportional. ^[11]

A Comprehensive Clinical Dentistry Course (CCDC) provides widely acknowledged benefits and has been implemented in several dental schools. ^{[12],[13],[14]} However, there is wide variation regarding the definition and application of comprehensive care. ^[15],[16] In Saudi Arabia, providing multidisciplinary dental treatment is one of the main goals the course. In addition, this course aims to expand students' clinical practice and knowledge. This course is part of the last year of the dental curriculum and consists of seminar and clinical sessions. Students are required to complete a number of comprehensive cases during the academic year rather than the traditional clinical requirements for discipline-specific guidelines.

The literature on evaluations of CCDC and the comparison of these courses between different dental colleges is limited. ^{[17],[18],[19]}

The aim of this study was to assess the current status of the CCDC and to determine the factors that contribute to the improvement of the outcomes of this course.

Materials and Methods

Study design

This was a cross-sectional cohort study.

Study subjects

Three surveys were administered: The first to dental students who had taken the CCDC, the second to faculty members who contributed to the teaching and clinical sections of the course, and the third to patients who completed the comprehensive treatment (finished phase 3 of treatment). All students, faculty members, and patients agreed to participate in this study, and informed consent was obtained.

Students, patients, and faculty members' evaluations of the CCDC were collected through self-administered surveys. The study was conducted in two dental schools in Saudi Arabia: King Saud University (KSU) (Riyadh, Saudi Arabia) and University of Dammam (UOD) (Dammam, Saudi Arabia). The study was conducted between March 2013 and June 2013.

Inclusion criteria

Faculty members who had attended the clinical sessions of the course
Students who had completed at least three comprehensive cases during the course, including recently graduated dentists (2 years earlier)
Dental interns who had recently completed the course
Patients who had completed phase 3 treatment or their entire treatment.

Exclusion criteria

Patients who had not completed treatment.

Data collection

In the faculty members' evaluations, demographic information, such as job rank, specialty, and affiliation, was collected through self-administered surveys. In addition, information was collected regarding the CCDC, such as years of participation, clarity of objectives, workload, organization, suitability of the session time, achievement of the outcomes, assessment of the reliability of the methods, the teaching environment, the difficulty of the referred cases, the grades' reflection of students' effort, satisfaction with treatment quality, students' understanding of comprehensive patient management, students' confidence, overall course evaluation, and willingness to participate in this course in the future.

In the students' evaluations, demographic information, such as gender, current occupation, age, marital status, university student stipend, and hometown, was collected. In addition, information was collected regarding the CCDC, such as the clarity of objectives, clarity of requirements, flow of patients, ability to find suitable patients, difficulty of the referred cases, case acceptance, time, workload, access to services, quality of services, availability of supervisors, support of supervisors, lecture quality and content, suitability of session time, satisfaction with treatment, clarity of students' evaluation criteria, grades' reflection of the students' effort, understanding of comprehensive patient care, physical and psychological stress, number of treated cases, course directors' personalities, personal facilities, and an overall course evaluation.

In the patient satisfaction survey, demographic information was collected, including age, gender, education level, occupation, income level, marital status, nationality, and language spoken. In addition, information was collected regarding the CCDC, such as how the patient learned of the program, scheduling the first appointment, treatment duration, number of appointments, duration of daily visits, and preference for attending morning or afternoon appointments. Other questions were asked regarding patient satisfaction, such as the clarity of the explanation and acceptance of the treatment plan, whether the patient's questions were answered, treatment alternatives provided, treatment completed on time, satisfaction with treatment by supervised students, and satisfaction with the treatment.

Finally, written recommendations were collected through open-ended questions from all candidates. Statistical analyses were performed using the SPSS (Statistical Package for the Social Sciences) data analysis software package SPSS Inc. Released 2009. PASW Statistics for Windows, Version 18.0 Chicago. A P < 0.05 was considered statistically significant.

Results

The response rates were 72%, 78%, and 32% for students (UOD 84% and KSU 60%), patients (UOD 64% and KSU 92%), and faculty members (UOD 32% and KSU 32%), respectively. The students' evaluations showed that the mean age of the study subjects was 23.94 years (23.90 UOD, 24.00 KSU), ranging from 21 to 27 years. Most of the study subjects were male (98.61%). Approximately 62.5% of the study subjects were students enrolled in the course at the time of the study, and the rest were recently graduating dentists. Most of the subjects (66.67% average, 71.43% UOD, 60% KSU) reported that university students' stipends were not sufficient. Case acceptance by supervisors was one of the most common difficulties; 57.14% of UOD students and 30% of KSU students reported poor and fair case acceptance by supervisors (P = 0.014) [Figure 1]. Students' reports of poor ease of access to a support lab differed significantly between the two schools (P = 0.028) (61.90% of UOD students compared to 26.67% of KSU students) [Figure 2]. The development of clinical planning skills was good or excellent for 69.04% of UOD students compared to 30% of KSU students (P = 0.005) [Figure 3]. Students' communication skills improved for 78.57% of UOD students and 50% of KSU students (P = 0.007) [Figure 4]. There were statistically significant differences in the relationship between case acceptance and psychological stress (P = 0.023).

Figure 1: Ease of case acceptance by the supervisors for University of Dammam and King Saud University (P = 0.014)

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Figure 2: Ease of access to the support lab for University of Dammam and King Saud University (P = 0.028)

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Figure 3: Benefit of the Comprehensive Clinical Dentistry Course in clinical planning for University of Dammam and King Saud University (P = 0.005)

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Figure 4: Benefit of the Comprehensive Clinical Dentistry Course in communication for University of Dammam and King Saud University (P = 0.007)

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Examining the faculty evaluations, we found that 37.5% of the supervisors were assistant professors (37.5% UOD, 42.86% KSU). In addition, 39% of the supervisors specialized in restorative dentistry (25% UOD, 42.86% KSU) [Figure 5]. The mean number of years in practice was 3.13 (2.50 years at UOD and 3.71 years at KSU). The overall evaluation of the CCDC was fair for 50% of UOD faculty members. In contrast, KSU faculty members' overall evaluation was either good (50%) or very good (50%) [Figure 6].

Figure 5: Faculty members' specialties

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Figure 6: Faculty members' overall evaluation of the Comprehensive Clinical Dentistry Course

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The mean age of the patients was 33.26 years (35.69 at UOD, 31.57 at KSU), ranging from 16 to 75 years, and 73.1% of the patients were male. The patients' level of education was either secondary school (43.6%) or university level (35.9%). The majority of the patients (88%) were employed or students. The income level was between 1000 and 10000 SR for 66.2% of subjects and below 5000 SR for 35.3% of the patients. There was no statistically significant difference in marital status (60.3% married and 39.7% single). Saudi nationality was the most common (64.1%), although 35.9% of the subjects were non-Saudi. Most of the subjects were Arabic-language speakers (89.7%). Most of the study subjects (78.2%) knew about the program from either a friend or a treating dentist (57.7% friends, 20.5% dentists). The booking of the first appointment was easy for 82.1% of the study subjects. The average number of appointments was 2 appointments per week for 53.8% of the subjects. The daily appointment duration was normal for 79.5% of the subjects. There was no statistically significant difference in the patients' preference for morning or afternoon appointments (P = 0.207, 55.1% morning appointments, 41.0% afternoon appointments). Approximately 97.3% of the study subjects were satisfied with the treatment by supervised students as well as with the overall treatment they received (96.1% of patients).

Discussion

Most of the students were male (98.61%) because all the UOD students who took this course were male. We found that 66.67% (71.43% UOD, 60% KSU) of the students thought that the stipend was not sufficient. Most of the students paid for external labs to obtain better-quality work in a shorter period of time. The flow of patients was much higher in KSU than in UOD. The long history of providing dental care in KSU might contribute to the ease of case acceptance by the supervisors.

There were statistically significant differences in the relationship between case acceptance and psychological stress (P = 0.023). The fundamental aim of the students was to have their cases accepted as early as possible to complete requirements on time. The patients' poor adherence to appointments affected the psychological status of the students.

Approximately 57.7% of the patients knew about the program from their friends, demonstrating that a good attitude and quality treatment can increase the flow of patients.

Approximately 88% of patients were either students or employed, which contradicts the belief that unemployed patients are the best candidates for treatment in this type, of course. In addition, although employed patients have less free time than unemployed patients, employed patients follow their own daily schedules, providing a greater likelihood of adherence to the treatment schedule.

Recommendations

Students' maintenance of an excellent attitude with patients is reflected in the flow of patients, as indicated by the finding that 57.7% of the study subjects knew about the program from their friends. Reliable methods and criteria should be implemented for case acceptance by supervisors to reduce students' stress related to case acceptance.

Limitations

A limited number of local and international studies regarding a CCDC were one of the limitations that we faced while conducting this study. In addition, a number of patients, students, and faculty members were not willing to participate. The small number of subjects limited the ability to perform a stratified analysis. Finally, we were limited by time constraints because we conducted this research as a requirement for the internship program.

Conclusions

Dental students displayed relatively high psychological stress in relation to case acceptance by their supervisors. Most of the patients treated in this course knew about this course from their friends, which highlights the fact that a good attitude and treatment can increase the flow of patients. The majority of the supervisors were restorative specialists.

Acknowledgments

We would like to extend our gratitude to our KSU colleagues for providing valuable support while conducting this study.

References

1.	Braskamp L, Brandenberg D, Ory J. Evaluating Teaching Effectiveness: A Practical Guide. Beverly Hills, CA: Sage Publications; 1984.
2.	Al-Sowygh ZH. Academic distress, perceived stress and coping strategies among dental students in Saudi Arabia. Saudi Dent J 2013;25:97-105.
3.	Tu MG, Yu CH, Wu LT, Li TC, Kwan CY. Dental and medical students' perspectives on early exposure to PBL in Taiwan. J Dent Educ 2012;76:746-51.
4.	D'Apollonia S, Abrami P. Navigating student ratings of instructions. Am Psychol 1997;52:1198-208.
5.	McKeachie W. Research on college teaching. The historical background. J Educ Psychol 1990;82:189-200.
6.	Millman J. Handbook of Teacher Evaluation. Beverley Hills, CA: Sage Publications; 1981.
7.	Menges RJ, Mathis BC. Key Resources on Teaching, Learning, Curriculum, and Faculty Development: A Guide to the Higher Education Literature. San Francisco: Jossey-Bass Publishers; 1988.
8.	Smock HR, Crooks TJ. A plan for the comprehensive evaluation of college teaching. J Higher Educ 1973;44:577-86.
9.	Arthur L. From performativity to professionalism: Lecturers' responses to student feedback. Teach Higher Educ 2009;14:441-54.
10.	Moore S, Kuol N. Students evaluating teachers: Exploring the importance of faculty reaction to feedback on teaching. Teach Higher Educ 2005;10:57-73.
11.	Locker D, Dunt D. Theoretical and methodological issues in sociological studies of consumer satisfaction with medical care. Soc Sci Med 1978;12:283-92. [PUBMED]
12.	Formicola AJ, Myers R, Hasler JF, Peterson M, Dodge W, Bailit HL, et al. Evolution of dental school clinics as patient care delivery centers. J Dent Educ 2008;72 2 Suppl: 110-27.
13.	Holmes DC, Trombly RM, Garcia LT, Kluender RL, Keith CR. Student productivity in a comprehensive care program without numeric requirements. J Dent Educ 2000;64:745-54.
14.	Johnson G. A comprehensive care clinic in Swedish dental undergraduate education: 3-year report. Eur J Dent Educ 1999;3:148-52.
15.	Bohannan HM. Operating outpatient clinics in 1990. J Dent Educ 1984;48 6 Suppl: 50-6.
16.	Evangelidis-Sakellson V. Student productivity under requirement and comprehensive care systems. J Dent Educ 1999;63:407-13.
17.	Blalock JS, Callan RS, Lazarchik DA, Frank Caughman W, Looney S. Restorative dentistry productivity of senior students engaged in comprehensive care. J Dent Educ 2012;76:1615-22.
18.	Adibi SS, Chaluparambil J, Chambers SK, Estes K, Valenza JA, Walji MF. Assessing the delivery of comprehensive care at a dental school. Tex Dent J 2012;129:1267-75.
19.	Park SE, Timothé P, Nalliah R, Karimbux NY, Howell TH. A case completion curriculum for clinical dental education: Replacing numerical requirements with patient-based comprehensive care. J Dent Educ 2011;75:1411-6.