A Learning Curve is Essential to Growth: Dental Education during Coronavirus Disease 2019.

Introduction: The Coronavirus disease 2019 (COVID-19) pandemic had a profound impact on normal dental education. The purpose of this study is to look at the influence of COVID-19 quarantine on dental graduates' readiness, as well as to look into the usefulness and limits of online education from the perspective of students. Materials and
Methods: A cross-sectional study was conducted among 1000 dental students of 18 dental colleges in Kerala from July 2021 to September 2021 using a self-reported closed-ended questionnaire and the information was coded, entered, and analyzed using the SPSS 20.0 version.
Results: A total of 88% of those who took the survey responded. Until the pandemic is over, a large majority of students (74.7%) prefer online lectures over classroom lectures. Only 46.1% of those who received online education felt confident enough to confront a patient.
Conclusion: Data showed that students partially appreciated the online system. According to the statistics, students did not believe that it could completely replace face-to-face clinical practice. Copyright:

INTRODUCTION

A highly infectious pneumonia began to spread in Wuhan, China, on December 12, 2019, and the WHO announced the novel Coronavirus disease 2019 (COVID-19) as the disease's causative pathogen in early January 2020.[1] COVID-19 has a much faster transmission speed, resulting in a global pandemic that has reached 100 countries and locations in a short period.[2]

Due to the high contagion rate and widespread infectivity, they declared the COVID-19 outbreak caused by the Severe Acute Respiratory Syndrome Coronavirus-2 a pandemic on March 11.[3] The first confirmed positive case in India was reported on January 30 in Thrissur, Kerala.[4]

The worldwide cessation of face-to-face didactic education has caused a disruption in student education from the primary level up to the level of professional training while most institutions are attempting to adapt to newer teaching and learning methods, a lack of precedent in these types of situations has placed an additional burden on institutions as well as students.[5]

The immediate impact of COVID-19 on the field of dental education was noticed quite early due to the significant impact of the pandemic, shortly after announcing the need for “social distancing” and reducing all contacts like teaching and training programs.[6]

Dentistry, unlike many other professions, is an amalgamation of three fundamental components: Theory, laboratory, and clinical practice; under this triage, a plethora of social programs, research projects, and interdisciplinary learning experiences are entwined. These interactions occur most frequently where teachers, students, and patients share more than just the school's infrastructure.[7]

The COVID-19 pandemic has disrupted many normal daily activities worldwide, including dental education and to combat the spread of COVID-19, schools and universities around the world have suspended face-to-face teaching and learning activities and have been encouraged to resume lectures via online platforms. Social gatherings, including those in educational institutions, are prohibited due to the risk of spreading COVID-19.[8]

Dentistry is a profession in which the doctor and dental staff work close to the patient's mouth.[9] There are numerous studies on dental students' positive attitudes and extensive use of e-learning methods, but there has been little research on their perceptions of the results of the pandemic on their clinical practical activity, learning motivation, and future impact on the dental profession.[10]

The purpose of this survey is aimed to study the effectiveness and challenges of online learning among dental students during 1½ years of the pandemic of COVID-19 in different dental colleges in Kerala conducted through a questionnaire survey.

MATERIALS AND METHODS

Study design

A cross-sectional study was conducted among dental students in Kerala from July 2021 to September 2021 using a self-reported closed-ended questionnaire consisting of twenty questions and was coordinated using survey heart https://surveyheart.com/form/613b8e21f9dd0e74515f3fcc.

Sample size and technique

A study was conducted among 1000 dental students from 18 dental colleges in Kerala, including both private and public institutions. The samples were chosen at random by emailing a survey heart link to dental students in Kerala.

Data collection

Since the study was conducted during the COVID 19 pandemic, it was decided to collect data via the internet using a survey heart form. The survey link was shared with the students via emails and WhatsApp groups from a registered state dental students association. A total of 1000 dental students from 18 dental colleges were chosen for the survey, of which 880 responded. Participants, after receiving and clicking the link, are automatically send to research material. The questions focused on the effectiveness and challenges of online dental education. There was no set deadline for completing the questionnaire. Only completed questionnaires were used in the report analysis. Some of the responses were coded as dichotomous variables, i.e., yes or no responses. Students of few dental colleges with their physical classes were excluded from the study.

Ethical consideration

The study participants were entirely voluntary. Anonymity was ensured, and no personal identification such as IP address and e-mail ID name were collected.

Statistical analysis

The information was coded, entered and analyzed using SPSS 20.0 version (IBM Corp, Armonk, NY, USA) descriptive statistic frequencies and percentages were utilized to sum up information.

RESULTS

A total of 1000 dental students were included in the study, 120 students did not respond. In all, 880 questionnaires were answered. The final sample size was 880 dental students with 88% response rate. The general characteristics are presented in Table 1. Majority of the participants belong to clinical year. Most of the participants preferred online classes over offline classes and 57.3% preferred zoom as their application during pandemic [Table 1].

Table 1

Distribution of participants according to their preferences regarding online education

Questions	Options	Percentage
Year of academics	Preclinical year	296 (33.7)
	Clinical year	584 (66.3)
Application preferred	Zoom	504 (57.3)
	Microsoft teams	124 (14.1)
	Google meet	197 (22.4)
	Any other	55 (6.2)
Which one do you prefer till the pandemic ends?	Online classes	657 (74.7)
	Reopening of classes	223 (25.3)

The educational impact was measured using 12 questions with multiple options. About 41.9% preferred online lectures over face-to-face theater lectures. About 33.5% took part in online classes passionately. Only 12.7% reported lack of device for learning online. Of which 71.4% had confronted network issues. About 62.5% perceived stress during online classes. 37.6% felt more engaged and encouraged in coping up with distant e learning. During COVID-19, 54.2% of participants felt that they lost educational experience due to lockdown 53.2% felt that they missed interaction with their colleagues. About 57.3% feels satisfied with all the new e learning. About 78.8% obtained adequate support from family for attending online classes. 85.9% felt that they were able to obtain enough communication with their lecturers. About 63.3% felt online examinations as a good method for academic assessment [Table 2].

Table 2

Perspectives of students toward online learning

Questions	Yes (%)	No (%)
Do you prefer online lectures compared to theatre lectures?	368 (41.9)	512 (58.1)
Do you attend online classes enthusiastically?	294 (33.5)	586 (66.5)
Have you encountered any network issue?	628 (71.4)	252 (28.6)
Do you have access to a device for learning online?	768 (87.3)	112 (12.7)
Do you feel stressed out during online classes?	550 (62.5)	330 (37.5)
Do you feel more engaged and motivated in following up with distant e learning?	331 (37.6)	549 (62.4)
Do you feel that you missed educational experience as a result of lockdown?	476 (54.2)	404 (45.8)
Did the online classes decrease the interaction with your colleagues?	468 (53.2)	412 (46.8)
Do you feel comfortable with all these technology based education?	504 (57.3)	376 (42.7)
Do you receive enough support from family for attending online classes?	693 (78.8)	187 (21.2)
Does the online session provide platform for interaction with lecturers?	755 (85.9)	125 (14.1)
Do you find online assessment as a good method of evaluation?	557 (63.3)	323 (36.7)

The self-perceived preparedness related to cognition, communication, and professional skills were recorded by five questions with multiple options. About 32.8% considered classes effective through online education. 77.5% felt deprived of practical session due to online education. Only 46.1% have confidence to face a patient. 62.3% have confidence in skills acquired through online education and 27.8% have confidence in starting independent practice with the current knowledge acquired through online education [Table 3].

Table 3

Self perceived preparedness related to cognition, communication, and professional skills

Questions	Agree (%)	Disagree (%)
Do you consider that both theory and practical session equally effective through online education?	288 (32.8)	592 (67.2)
Did you feel any loss in practical sessions?	688 (77.5)	192 (22.5)
Do you have confidence to face a patient?	405 (46.1)	475 (53.9)
Do you have confidence in skills acquired through online education?	548 (62.3)	332 (37.7)
Do you have confidence in starting independent practice with the current knowledge acquired through online education?	245 (27.8)	635 (72.2)

DISCUSSION

The study's purpose was to investigate the difficulties and impacts of the COVID-19 pandemic on dental education. The closing of schools and colleges had a major effect on the education of students. Dental colleges are using many platforms to cover the syllabus, but they are failing to provide practical clinical learning.

About 41.9% of participants preferred online lectures during the COVID pandemic, which is in line with a study conducted by Aditi and Jayalakshmi in Chennai.[11] As per the findings of the study, 62.5% felt stressed out due to the online classes, which is in contrast with the study conducted by Iosif et al. in Bucharest.[12]

About 63.3% of students agreed that online examinations were a good method of evaluation which is in contrast with the study conducted by Kassab et al. in Bahrain.[13]

Only 27.8% of the candidates responded that they have the courage to start an independent practice with the knowledge acquired through online classes, which is in line with a study conducted by Hattar et al. in Jordan.[14]

About 32.8% found the effectiveness of sessions conducted through online education, which is in contrast with the study conducted by Ilser et al. in New York.[15] About 78.8% received enough support from their families to attend the online classes, which is similar to a study conducted by Chang et al. in China.[16] A majority of the candidates, about 77.8%, missed the practical sessions, which is in line with a study conducted by Varvara et al. in Italy.[17] About 57.3% felt comfortable with all the technology based education, which is in line with a study conducted by Al Taweel FB in Italy.[18] About 54.2% of the students missed the educational experience due to the new method of e-learning, which is similar to the study conducted by Cheng et al. in China.[19]

About 53.2% of the respondents missed their interactions with the colleagues, which is in line with the study conducted by Machado RA in Brazil.[20]

Limitations

There are fewer constraints in this study. Due to the danger of infection, the research was unable to undertake face-to-face interviews. Students who did not check their e-mail on a routine basis and were preoccupied with personal matters chose not to respond to the questionnaire sent through email.

CONCLUSION

Dental schools have investigated using online teaching methods to theoretically train their students and give basic practical information about the operations they would experience once the schools are open. While dental procedures require practice before a student can deal with patients, these precautions will guarantee that they are confident in their ability to preserve their knowledge and abilities while restricted at home. However, institutions must consider the numerous flaws and issues that come with such teaching and learning techniques and strive to reduce them as much as feasible. Dental institutions must review and reprioritize their patient-care strategy.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.