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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 11  |  Issue : 3  |  Page : 133-137

Patient's acuity toward dental students' involvement in their surgical care in a tertiary dental institution


1 Post Graduate Student of Surendera Dental College and Research Institute, Rajasthan, India
2 Reader, Surendera Dental College and Research Institute, Rajasthan, India
3 Head of Department, Surendera Dental College and Research Institute, Rajasthan, India
4 Senior Lecturer, Surendera Dental College and Research Institute, Rajasthan, India

Date of Submission01-Jun-2020
Date of Acceptance20-Aug-2020
Date of Web Publication15-Oct-2020

Correspondence Address:
Dr. Thounaojam Leimaton
Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan
India
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DOI: 10.4103/srmjrds.srmjrds_45_20

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  Abstract 

Background: Dental students get the chance to experience real-life situations when they are in contact with patients, from whom they learn and enhance their knowledge. As the dental students' perceived professionalism, respect for patient privacy and confidence were significantly related to patients' acceptance of student participation in their care, these social competencies should be a priority in dental curricula. Aims: The aim was to investigate patients' perception regarding dental students' role in surgical treatment procedures. Settings and Design: A cross-sectional study was conducted on a randomly selected sample of 148 patients at our college in the department of oral surgery waiting room during the month of March 2019. Subjects and Methods: OpenEpi was used to determine sample size based on the average number of patients who attended the oral surgery department every day for 4 weeks in the month that proceeded data collection with the exclusion of weekend days. A self-administered questionnaire consisted of 17 close-ended questions to allow adult participants to answer and the guardians to answer on behalf of their children. The internal consistency of the questionnaire showed good reliability for participants during the pilot study (Cronbach's alpha: 0.86) and acceptable validity with intraclass correlation coefficient having value of 0.79. Statistical Analysis Used: Data were analyzed using IBM SPSS Statistics Windows, Version 20.0 for the generation of descriptive and inferential statistics. Results: It was found that 34.46% of the total participants did not want to allow dental student to watch them, whereas most of the participants (65.54%) would allow dental student to watch them while dental examination. A total of 86.49% believed that dental students should specifically obtain patient consent prior to becoming observers. It was observed that both genders preferred the similar gender dental student. Conclusion: The results showed that most of the surveyed patients had a positive perception of dental students as they accepted dental students' participation in their care.

Keywords: Dental student, Knowledge, Patient, Perception


How to cite this article:
Leimaton T, Batra M, Singh S, Aggarwal VP, Shukla S, Mangal P. Patient's acuity toward dental students' involvement in their surgical care in a tertiary dental institution. SRM J Res Dent Sci 2020;11:133-7

How to cite this URL:
Leimaton T, Batra M, Singh S, Aggarwal VP, Shukla S, Mangal P. Patient's acuity toward dental students' involvement in their surgical care in a tertiary dental institution. SRM J Res Dent Sci [serial online] 2020 [cited 2020 Dec 1];11:133-7. Available from: https://www.srmjrds.in/text.asp?2020/11/3/133/298262


  Introduction Top


A great part of education takes place in real situations. Dental students and trainee doctors get the chance to experience real-life situations when they are allowed to be in contact with patients, from whom they learn more and thus refine and enhance their knowledge.[1] Doctor and patients interaction can enhance connected and professional experience, along with good communication and clinical experience, paving the way for a better doctor–patient relationship in the future.[2]

The crux in medical education is clinical learning, without direct impact on the participants by way; of trainee interaction. Grassroots approach to modern medicine can be attributed entirely to patient sovereignty and informed consent the participant of the patient depends on many reasons but mostly inclined to their benevolence.[3] In medical education, the comfort of patients is also an essential consideration, both in terms of influencing patients' choices about whether to include students in their care, in addition to understand on ethical standpoint.

Real-time interaction between students and real patients helps the students to connect the dots between clinical and theoretical knowledge.[4],[5] Dental students, trainees, and teachers fully support this teaching activity. Due to which the emphasis of patient participation is important for learning process, more over the interaction helps the students to better understand the diseases and use clinical reasoning to a wider approach.[4] As a result, in the medical education process, patients have an essential role. Therefore, interactions with real patients will always be the best resource in medical education.[6]

Understanding patient insights of having students involved in their clinical care is significant as they attempt to progress optimal models of care that incorporate training with the best likely experience for the patient.[7] Patient insights will be primarily constructed on individual knowledge or their nearby knowledge toward dental students; thus, this is measured a great way to assess dental undergraduate students' outlook. Studies had been conducted to know the feelings of the patients concerning dental students' involvement in their care.

However, evidence about the outcome of patient experience on dental undergraduate student' involvement such as the level of agreement and approval, is restricted. Earlier research has concentrated on the students of the medical field.[8],[9] A recent systemic review study reveals that students accounts of patients being cooperative but findings within one discipline of medicine may not be generalize able to others, and therefore may not be applicable to dental fraternity.[7]

The aim of the current study is to explore patients' acuity concerning about dental students' role in their surgical treatment procedures.


  Subjects and Methods Top


In this cross-sectional study, 148 patients were selected through random sampling at Surendera Dental College and Research Institute, Sri Ganganagar, in the department of oral surgery waiting room. While they were waiting their turn, all participants were asked to fill the anonymous written questionnaire. The study sample size was calculated by OpenEpi 2.3 (Developed by AG Dean, KM Sullivan and MM Soe) on the basis of the number of patients who had attended the oral surgery department every day for 4 weeks in this month; data collection was proceeded with exclusion of weekend days. The proposed patient's acuity toward dental students' involvement in their surgical care tool of the study was a simple self-administered questionnaire comprising of 14 close-ended questions for this study. The collection of data was done among the patients aged 12–60 years old who reported to Oral Surgery department for their surgical treatment during the time period of March, 2019. Adult participants completed the questionnaires and the guardians also completed to fill the answer on behalf of their children while they were waiting their turn. The proposal of the questionnaire was taken from the medical literature with slightly modified and some related questions were also added that serve the study purposes.[7] Questionnaires were circulated among participants in both Hindi and English language and incomplete questionnaires were excluded from the study.

Pretesting of the questionnaire was carried out among 10 participants to check its reliability and validity of the questionnaire. The internal consistency of the questionnaire showed good reliability for participants during the pilot study (Cronbach's alpha: 0.86) and acceptable validity with intraclass correlation coefficient with 95% confidence interval having value of 0.79. The ethical approval was obtained from the ethical committee of Surendera Dental College and Research Institute.

Under the guidance of statistician, collected data were tabulated in an Excel sheet. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp for the generation of inferential and descriptive statistics.


  Results Top


A total of one hundred and forty eight participants participated in the study. Among the total participants, 45 and 103 were males and females, respectively. During the survey, it was found that 51 (34.46%) of the total participants did not want to allow dental students to watch them, whereas most of the participants, 97 (65.54%) would allow dental student to watch them while dental examination. Among those who allowed dental students to examine, maximum were males (84.44%), and it was found to be statistically significant (P = 0.0013). 61.49% of participants allowed dental students to examine them. Majority of participants (93.24%) allowed if a dental student was examined with faculty supervising them [Table 1].
Table 1: Patients' perception about the role of dental students and residents in the clinic

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[Table 2] shows that majority of participants (97.30%) had been in contact with dental students during their visit/admission in the hospital. 77.7% of participants reported that dental students provided them useful information about their health problems. A total of 86.49% of patients believed that dental students should obtain their consent prior to becoming observers in the operating room. The gender-wise response to patient's views regarding experience with dental students was found to be statistically insignificant (P > 0.05).
Table 2: Views of patients' experience with dental students

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[Table 3] shows patients' acuity toward the training year of dental student involvement of dental students, gender, and level of co-operation. The overall sum of 77.78% of male participants and only 46.60% of females participants were comfortable with one dental student (P = 0.005). Both males and females agreed that the level of cooperation was affected by the general appearance and manner of students (P < 0.001). It was observed that both genders preferred the similar gender dental student.
Table 3: Patients acuity toward the training year of dental student, involvement of dental students, gender, and level of cooperation

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  Discussion Top


The present research was to assess the patients' insight toward the involvement of dental student during their surgical care. Only those participants were targeted who were about to undergo surgery and guardians on behalf of their children were about to undergo surgery to assurance that they would be honest, explicit, and communicative as much as possible about their perception and attitude.

To our knowledge, and as per the recent literature search, this is the first study to assess the patients' insight toward the involvement of dental student during their surgical care as previous studies were done among medical students. Therefore, comparisons of the present study results were done with the same studies done among medical students.

This questionnaire study was used to assess if there was any difference in patients' insight concerning about dental undergraduate students during their hospital course in different situations and levels starting from patients' first contact to dental students on taking history and examination up to being with them till the operating room. The result of our study has supported the studies that were done already in the previous medical field. Patients had a positive impact on attitude and acuity toward the involvement of dental students in their health care. Even if Vaughn et al.[9] have reported about the lack of clear defined cut points between the positive and the negative perceptions, others like Al Khatib T et al.[6] found that patients' satisfaction did not increase or decrease with the involvement of medical students by using two controlled groups for assessment. This positive perception was reliable with previous studies that performed in Saudi Arabia and other Middle East countries.[10],[11] As the outcome, they believe that taking history and examination for dental students' education were more effective. The study concluded that 94.6% participants thought that it was important for dental undergraduate students to be present in the operating room while performing surgery. A similar study performed by Ben Salah et al[12] has found that 90.2% of the patients permitted the presence of medical student in the operation theatre whereas only 57.7% of them permitted in the study conducted by Marwan et al.[13] Patients believed dental undergraduate students only observed during the surgeons while performing surgery in the operation theater, followed by minor procedure and a small proportion of patients assumed that undergraduates students were participated in the operation itself.

A total of 86.49% of participants believed that their consent should be obtained by dental undergraduate students prior to presenting in the operation room, even though all the participants were informed that they were in an academic teaching hospital. According to Santen et al.[14] findings, 90% of participants allowed undergraduate students to perform simple procedures with coherent explanation of their inexperience, whereas according to Marwan et al.,[13] 33.8% of participants only agreed to it.

A study conducted by Passaperuma et al.[15] revealed that participants were equally comfortable with both genders of medical students, but preferred female medical students in their studies. In a recent study, however, it was revealed that 80.58% of participants preferred female dental students. On the other hand, Mol et al.[8] found that 58% in Riyadh discovered their own gender preferences by the participant. Although it was noted, all the participants were happy to help.[12] Although no specific research has been done to determine the unpleasant experience of some, it can also be attributed to unprofessionalism, bad experience, miscommunication, or privacy related issues.

Dental education is vital to the improvement in this field; particularly, patients' insights of their connections with dental undergraduate students require more detailed estimation in further studies. The outcomes of the present research may be helpful to dental institutes in estimating their own patient–student relations. The important features of the aforementioned research were the consent taken from the participants of both gender's, as well as keeping in mind the subjective view of dental undergraduates regarding on the subjects like respect for patient confidentiality, students' perceived experience, and assurance, etc., which were not recorded in earlier research. The current research has few limitations like due to its nature of cross-sectional study, there might be possible for bias in reporting results. Additionally, potential bias may have been reported when dental undergraduate students filled the forms on behalf of the patients.


  Conclusion Top


The majority of the surveyed participants are accepted the participation of dental students' in their care as they have a positive insight of dental students, even though the majority of surveyed participants favored that the doctor should be positively present with their students while performing these interactions. As the dental undergraduate students' perceived experience, respect for patient confidentiality and assurance were significantly related to patients' acceptance for participation of student in their care, these social abilities should be a main concerned in dental curricula. This may consecutively encourage patients to be more accepting of the involvement of dental students in their care.


  Acknowledgment Top


We also acknowledge the assistance of Dr. Deeksha Gijwani, Dr. Joram Mesum, Dr. Topie Nyodu for their cooperation.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Alwathnani S, Abbas M. Patients' attitudes toward presence of trainee physicians during consultation at PHCS Riyadh, Saudi Arabia. Univer J Manag 2018;6:141-7.  Back to cited text no. 1
    
2.
British Medical Association, Medical Education Subcommittee: Role of the Patient in Medical Education. British Medical Association; 2008.  Back to cited text no. 2
    
3.
Chipp E, Stoneley S, Cooper K. Clinical placements for medical students: Factors affecting patients' involvement in medical education. Med Teach 2004;26:114-9.  Back to cited text no. 3
    
4.
Diemers AD, Dolmans DH, Verwijnen MG, Heineman E, Scherpbier AJ. Students' opinions about the effects of preclinical patient contacts on their learning. Adv Health Sci Educ Theory Pract 2008;13:633-47.  Back to cited text no. 4
    
5.
Hemphill RR, Santen SA, Rountree CB, Szmit AR. Patients' understanding of the roles of interns, residents, and attending physicians in the emergency department. Acad Emerg Med 1999;6:339-44.  Back to cited text no. 5
    
6.
Al-Khatib T, Othman SB, El-Deek B. Patients' Perception toward medical students' involvement in their surgical care: Single center study. Educ Res Int 2016;2: 1-8.  Back to cited text no. 6
    
7.
Bentley SA, Trevaskis JE, Woods CA, Guest D, Watt KG. Impact of supervised student optometry consultations on the patient experience. Clin Exp Optom 2018;101:288-96.  Back to cited text no. 7
    
8.
Mol SS, Peelen JH, Kuyvenhoven MM. Patients' views on student participation in general practice consultations: A comprehensive review. Med Teach 2011;33:e397-400.  Back to cited text no. 8
    
9.
Vaughn JL, Rickborn LR, Davis JA. Patients' attitudes toward medical student participation across specialties: A systematic review. Teach Learn Med 2015;27:245-53.  Back to cited text no. 9
    
10.
Abdulghani HM, Al-Rukban MO, Ahmad SS. Patient attitudes towards medical students in Riyadh, Saudi Arabia. Educ Health (Abingdon) 2008;21:69.  Back to cited text no. 10
    
11.
Sayed-Hassan RM, Bashour HN, Koudsi AY. Patient attitudes towards medical students at Damascus University teaching hospitals. BMC Med Educ 2012;12:13.  Back to cited text no. 11
    
12.
Ben Salah A, El Mhamdi S, Bouanene I, Sriha A, Soltani M. Patients' attitude towards bedside teaching in Tunisia. Int J Med Educ 2015;6:201-7.  Back to cited text no. 12
    
13.
Marwan Y, Al-Saddique M, Hassan A, Karim J, Al-Saleh M. Are medical students accepted by patients in teaching hospitals? Med Educ Online 2012;17(1):1-13.  Back to cited text no. 13
    
14.
Santen SA, Hemphill RR, Spanier CM, Fletcher ND. Sorry, it's my first time!' Will patients consent to medical students learning procedures? Med Educ 2005;39:365-69.  Back to cited text no. 14
    
15.
Passaperuma K, Higgins J, Power S, Taylor T. Do patients' comfort levels and attitudes regarding medical student involvement vary across specialties? Med Teach 2008;30:48-54.  Back to cited text no. 15
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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Abstract
Introduction
Subjects and Methods
Results
Discussion
Conclusion
Acknowledgment
References
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