|Year : 2022 | Volume
| Issue : 1 | Page : 9-13
Are we ready for the pandemics: Analyzing indian dental institutions and their preparedness?
Department of Public Health Dentistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
|Date of Submission||21-Sep-2021|
|Date of Decision||18-Dec-2021|
|Date of Acceptance||19-Dec-2021|
|Date of Web Publication||06-Apr-2022|
Department of Public Health Dentistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi
Source of Support: None, Conflict of Interest: None
The COVID-19 pandemic experienced by the Indian subcontinent has been lethal compared to the pandemics of the past. The only lesson learned so far is the need to update our health-care infrastructure. However, besides this, there is also an urgent need to make long-term changes to the continuance of our dental educational system, which is important for the foundations of our mainstream health-care services. This article evaluates the impact of the COVID-19 pandemic on Indian dental education, taking into due consideration the difficulties and available resources. It also intends to recommend strategies and prepare for such scenarios in future. Recent advances in pedagogical innovations involving technology have provided many prospects, especially in the field of online platform learning, but the students/staff requires proficient learning to utilize it effectively. Furthermore, the foremost need is to develop and evaluate the most appropriate technology-based learning for the preclinical and clinical settings. Thus, the current pandemic has undeniably brought countless challenges but also gave the prospect to revolutionize future of Indian dental education.
Keywords: Dental institutions, dental students, higher education, pandemic, pedagogy
|How to cite this article:|
Verma A. Are we ready for the pandemics: Analyzing indian dental institutions and their preparedness?. J Dent Res Rev 2022;9:9-13
|How to cite this URL:|
Verma A. Are we ready for the pandemics: Analyzing indian dental institutions and their preparedness?. J Dent Res Rev [serial online] 2022 [cited 2022 Aug 10];9:9-13. Available from: https://www.jdrr.org/text.asp?2022/9/1/9/342700
| Background|| |
The world is struggling with a novel coronavirus-19 pandemic. The pandemic situation is not new to the world or the Indian subcontinent. The world, including India, has witnessed the three worst pandemics in the history of humankind, namely the Great plague (1720–1723), Asiatic cholera (1817–1824), and Spanish Flu (1918–1920). However, the burden of intensity and severity with which the coronavirus has impacted the world is beyond imagination. India has already witnessed the deadly first and the second wave and is presently on the verge of experiencing the third wave. The National COVID-19 Supermodel Committee has already predicted the third wave of COVID-19 by next February, once the newer Omicron variant starts replacing Delta as the dominant strain in India. The only answer yet for the prevention and containment of this disease is vaccination and following COVID-appropriate behavior.
Social distancing is the most important COVID-appropriate behavior to prevent the spread of this disease. The nationwide lockdown was announced by the Government of India (GOI) on March 23, 2020. Since then, all dental colleges/institutions deferred clinical teaching and adopted online teaching strategies. The premise for not allowing the students to attend the dental colleges/institutions is dual–students' safety may be jeopardized during clinical rotations putting them at risk of exposure to COVID-19-positive patients, and/or infected students may themselves become the portal of the spread of the disease. Furthermore, the preclinical training and discussions had to be suspended due to social distancing measures. This widespread pandemic has left a huge vacuum in conventional Indian dental education resulting in difficulties in ensuring the student's teaching, clinical experience/expertise, and competency skills.
Although few studies have focused on the COVID-19 pandemic impact in India and abroad focusing on the screening of patients, proper usage of personal protective equipment, and recently developed teledental consultations facilities in Indian dental institutions/colleges. However, none has focused on how to deliver clinical dental education in future, assuming there continues to be an infection risk for the foreseeable future. A comprehensive depiction of the COVID-19 impact on Indian dental education has not been reported yet. Hence, this article tries to analyze the preparedness of Indian dental schools, opportunities, and the challenges arisen among the pandemic.
| Preparedness of Indian Dental Institutions|| |
Dental education is a profession that demands close contact between the doctor and the patient. After more than 1.5 years of closure of dental colleges/institutions in India, we are still facing the pandemic and another test in terms of “unlock” which may become an initiating factor for the third wave.
An important duty for the administration of dental colleges/institutions is to protect the health of students, faculty, as well as patients while keeping track of the changing environment, local or national policies, and at the same time, ensuring that there is continuity in the education of the students. Although the Dental Council of India (DCI) has laid down the uniform guidelines for the Indian dental institutions in managing academics during the current crisis, clinical teachings, i.e., when to resume hands-on experience, has been left at the discretion of local agencies' policies and recommendations, extent of spread of infection, and availability of faculty, and other resources.
Classically, dental education is mainly composed of three parts: lectures/problem-based learning (PBL), simulation laboratory courses, and clinical skill training., The COVID-19 pandemic has collapsed the conventional four-walled face-to-face teaching methodology of the entire Indian educational system. Within short notice, as per the guidelines received from the University Grants Commission (UGC) and Ministry of Human Resource Development under the GOI classroom-based teaching is suspended since lockdown and the entire methodology of the dental education system in our country came to a standstill, unprepared to teach clinical skills, and left with the exploration of e-learning modalities to continue dental education during lockdown due to the COVID pandemic.
Mostly, all Indian dental schools have adopted the online teaching methodology of the participants as a measure of social distancing with different systems available such as Google Classroom, Zoom meeting, Google Meet, Skype, and so on for online learning.
| Opportunities for Indian Dental Education|| |
The COVID-19 pandemic has opened a panorama of technology to be explored by the faculty and students in our country. The present generation is the age of globalization and digitization where everything and anything is just at the click of a mouse and our present generation can easily adapt to digital features. Although the mode of lecture delivery as PowerPoint presentations was already in place but switching on to online lecture for delivery as well as for attending lectures was an adaptation that has been made by both teachers and students. Both the students and also the teachers familiarized themselves with advanced information technology pieces of training which were held in many institutions. Earlier, the students were supposed to be more tech-friendly in comparison to the senior faculty, but the pandemic has surely helped in minimizing the so-called generation gap and formalizing the shift from auditoriums to online.
Many studies have concluded that online education is well accepted by the students as well as the faculties in India and abroad.,,,,, Online formats offered numerous advantages such as easy access to educational material to students at their convenience, increased retention rates, saving time, and being in their preferred environments. The relevant material could also be disseminated to as many students as possible since lectures were available online. This system can also solve the problem of the shortage of teaching staff in rural and remote dental institutions in India and this e-material can be collectively shared among different schools in different countries. Thus, the online content can lay future foundation for the development of the main courses for the core dental competency of students in different countries worldwide.
Many countries have developed and are currently using modern digital techniques such as simulators, educational videos illustrating clinical steps, virtual case discussions, digital impressions, easy-to-use virtual reality (VR) haptic devices as a substitution for clinical training.,, Online clinical-teaching technologies such as virtual patient interactions are also being tried in medicine and similar tools/strategies could benefit dentistry. Hence, the options are continually evolving which still need to be explored and adapted in India. Various available tools and possible strategies that may be used for continuing dental education in such a crisis are enlisted in [Table 1] and [Table 2], respectively.
|Table 1: Available tools and platforms to continue dental education among the COVID-19 pandemic|
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|Table 2: Possible strategies to continue dental education for different groups among the COVID-19 pandemic|
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Although small active group discussions were already in place to encourage critical thinking. Similar case-based discussions and preclinical exercises on the concept of PBL can also be circulated as videos with quiz-based questions. To enhance online clinical teaching, videos depicting clinical demonstrations can also be created by faculty. Although creating such kind of live demonstration videos can be time-consuming, one of the best options is to share such resources with other institutions through a universal online portal that can be developed by any statutory bodies such as the DCI where such material can be readily accessed by the dental students.
Since hands-on clinical practical experience is of utmost importance in the curricula of dental schools and is affected the worst as most of the teaching institutions are either closed or only running the emergency outpatient departments. This window is a good opportunity for the educational authorities and dental fraternity to invest in reevaluating their concept of competency-based education, incorporating variations of distance learning permanently in the curricula, building innovative systems and investing in haptic technology, and evolving online modules for their courses to minimize the disruption of dental education.,
| Challenges of Dental Education in India: The Digital Immigrant Issues|| |
Although the educational transition has already occurred in Indian dental institutions addressing lecture/PBL and simulation laboratory courses to some extent, the clinical skill training has been completely halted without any supplement/substitute.
In India, there is a huge gap between the infrastructural facilities between various government and private dental colleges/institutions. There are also no uniform standards in the digital tools applied to dental education in India. Conventionally for the simulation laboratory course, after a demonstration by the teacher, the students are required to practice on the simulation models. This basic infrastructural facility of simulation models is still very limited in number. Even though several studies have indicated that personal instruction and feedback from faculty cannot be replaced by simulator training and feedback,,, but when the world is exploring the use of modern digital or VR techniques as an alternative to simulation laboratory models, Indian dental colleges/institutions are still not ignorant for the use/importance of such simulation models or the use of VR techniques. The current information technology facilities are not good enough in most Indian dental colleges/institutions and to uplift, the e-technology for developing/implementing the various modern digital tools and applications has financial implications that may require industry collaborations.
Therefore, the undergraduate and postgraduate curriculum in India has taken a back seat and the focus has shifted to evaluate the students' competency from the practical to purely theoretical skills due to the lack of facilities and resources for developing the e-practical learning modalities. However, the question arises is the current online learning is as effective as conventional classroom-based teaching. This pandemic has raised the need to analyze the preparedness of students graduating dental students, especially in terms of their clinical competency skills during the COVID-19 period.
Despite the good acceptance of online teaching as a modality,,,, among dental students, there are many difficulties to overcome in India. Nonreliable Internet access created a struggle among students to participate in digital learning; social isolation due to home learning; reduced interaction/discussions with friends/peers; increased dependence on the online world and a scuffle to delineate boundaries between work and home. The majority of the Indian population stays in rural areas where there is limited access to the 3G/4G networks. Many students have moved to their hometown due to lockdown and closure of the dental schools and are unable to have access even for the remote online lectures. This has widened the existing gap between those from privileged and disadvantaged backgrounds in India. Few students belonging to a low socio-economic background face the challenge of having access to computers/laptops. Moreover, many senior faculties and students still find themselves in the learning curve of “digital immigrants issues.” One of the prime reasons for the lack of good faculty input in online dental education is the lack of drive of educational institutions in India to create good training programs for their faculty and their students., The emphasis is added on evolving and deploying online lecture content rather than creating a supplement for clinical skills to enhance their competency levels.
Furthermore, the focus needs to be made on the formative assessment module of the students. As of now, our country's professional examination is governed by the DCI. The mode of conduction of examination is offline and is variable subject to the conditions prevailing in the particular region and the guidelines issued by the GOI (No. DE-14-ACADEMIC [MDS]-2021/474 dated May 21, 2021). This approach has led to the delay in the starting of the new academic year for dental students. Although the pattern of the online examination, which was tested in India by various other professional bodies such as the UGC had its shortfalls. To overcome the challenge of cheating and timely uploading the answer sheets, few countries such as the USA have developed a LockDown Browser and are using the same for conducting timely online student examinations., India can also develop a specific examination browser so that the sanity of examination can be maintained by removing the chances of cheating as well as providing ease of directly submitting the examination sheets without uploading and being dependent on online networks.
| Conclusion|| |
The World Health Organization and epidemiology experts say that the COVID-19 pandemic will always remain and “new normal” will prevail. Even after this COVID-19 pandemic, the world needs to be prepared for another pandemic which is quite certain in the near future. As educators and professionals, we must create a “hybrid educational approach” in dental curricula to address this situation.
The current “teaching transition time” should be utilized to define new standards, elucidate learning contents, outline to what scope conservative workflows can be taught, and what can be transformed online. Furthermore, there is a necessity to create accepted digital standards of education among the different dental institutions/universities within our country.
Hence, the need of the hour is to develop a digitalized dental education system to suit different situations and explore new technological tools for the continuance of professional dental education in our country without any delays as the seed for a paradigm shift has already been sown.
This study is a review article and is limited to the analysis of available data from published studies, so ethical approval was exempted.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Swetha G, Anantha Eashwar VM, Gopalakrishnan S. Epidemics and pandemics in India throughout history: A review article. Indian J Public Health Res Dev 2019;10:1570.
Rose S. Medical student education in the time of COVID- 19. JAMA 2020;323:2131-2.
Sahi PK, Mishra D, Singh T. Medical education amid the COVID-19 pandemic. Indian Pediatr 2020;57:652-7.
Deery C. The COVID-19 pandemic: Implications for dental education. Evid Based Dent 2020;21:46-7.
Iyer P, Aziz K, Ojcius DM. Impact of COVID-19 on dental education in the United States. J Dent Educ 2020;84:718-22.
Chang JY, Wang LH, Lin TC, Cheng FC, Chiang CP. Comparison of learning effectiveness between the physical classroom and online learning for dental education during the COVID-19 pandemic. J Dent Sci 2021;16:1281-9.
Chang TY, Hong G, Paganelli C, Phantumvanit P, Chang WJ, Shieh YS, et al
. Innovation of dental education during COVID-19 pandemic. J Dent Sci 2021;16:15-20.
Kumar PM, Gottumukkala SN, Ramesh KS, Bharath TS, Penmetsa GS, Kumar CN. Effect of e-learning methods on dental education: An observational study. J Educ Health Promot 2020;9:235.
Shrivastava KJ, Nahar R, Parlani S, Murthy VJ. A cross-sectional virtual survey to evaluate the outcome of online dental education system among undergraduate dental students across India amid COVID-19 pandemic. Eur J Dent Educ 2022;26:123-30. doi:10.1111/eje.12679. Epub 2021 Mar 12.. Available from: https://doi. Org/10.1111/eje. 12679
. [Last accessed on 2021 Dec 18].
Hattar S, AlHadidi A, Sawair FA, Alraheam IA, El-Ma'aita A, Wahab FK. Impact of COVID-19 pandemic on dental education: Online experience and practice expectations among dental students at the University of Jordan. BMC Med Educ 2021;21:151.
Gupta A, Shrestha RM, Shrestha S, Acharya A, Pandey N. Perception of BDS students of Kathmandu University on online learning during COVID-19 pandemic. Orthod J Nepal 2020;10:20-8.
Joda T, Lenherr P, Dedem P, Kovaltschuk I, Bragger U, Zitzmann NU. Time efficiency, difficulty, and operator's preference comparing digital and conventional implant impressions: A randomized controlled trial. Clin Oral Implants Res 2017;28:1318-23.
Zitzmann NU, Kovaltschuk I, Lenherr P, Dedem P, Joda T. Dental students' perceptions of digital and conventional impression techniques: A randomized controlled trial. J Dent Educ 2017;81:1227-32.
Zitzmann NU, Matthisson L, Ohla H, Joda T. Digital undergraduate education in dentistry: A systematic review. Int J Environ Res Public Health 2020;17:3269.
Van Doren EJ, Lee JE, Breitman LS, Chutinan S, Ohyama H. Students' perceptions on dental education in the wake of the COVID-19 pandemic. Dent Educ 2020;10.1002/jdd.12300. doi: 10.1002/jdd.12300. Online ahead of print. Available from: https://doi.org/10.1002/jdd0.12300
. [Last accessed on 2021 Dec 18].
Kozarovska A, Larsson C. Implementation of a digital preparation validation tool in dental skills laboratory training. Eur J Dent Educ 2018;22:115-21.
Quinn F, Keogh P, McDonald A, Hussey D. A study comparing the effectiveness of conventional training and virtual reality simulation in the skills acquisition of junior dental students. Eur J Dent Educ 2003;7:164-9.
Ren Q, Wang Y, Zheng Q, Ye L, Zhou XD, Zhang LL. Survey of student attitudes towards digital simulation technologies at a dental school in China. Eur J Dent Educ 2017;21:180-6.
Al-Azzam N, Elsalem L, Gombedza F. A cross-sectional study to determine factors affecting dental and medical students' preference for virtual learning during the COVID-19 outbreak. Heliyon 2020;6:e05704.
Bawa P. Retention in online courses: Exploring issues and solutions – A literature review. SAGE Open 2016;6:1-11. [doi: 10.1177/2158244015621777].
Advisory on holding UG and PG Examination-2021 by the Dental Colleges/Universities and to appoint External Examiner, Circular No. DE. - 14-ACADEMIC(MDS)-2021/474. New Delhi: Dental Council of India (DCI); dated 21 May 2021. Available from: https://www.dciindia.gov.in/Admin/NewsArchives/L.No.%20474.PDF
. [Last accessed on 2021 Dec 18].
[Table 1], [Table 2]