Perception and academic challenges regarding dentistry among preclinical dental students: A cross-sectional comparative study

INTRODUCTION

A 1^st-year dental student is a mix of excitement, curiosity, and new challenges that shape a student’s early journey into dentistry. Students who want to pursue dentistry have no idea what the field is all about. As dentistry is an art and science, students are not only exposed to theoretical knowledge, but also to artistic preclinical skills, each of that is important for their adventure of expert evolution. 1^st-year dental students often face difficulties such as adapting to a vast curriculum, meeting the deadlines for submission, managing time efficiently, adapting to a new environment, and balancing academics with preclinical training, which they never expect.^[1] Also, learning a new language and culture and coming from diverse regions, poses a challenge. Students in the educational institutions come from various backgrounds and cultures, so their views and evaluations of the institution differ.^[2] Furthermore, due to their lack of admittance to medical school, 1^st-year dental students confront difficulties. Stress and a lack of prior exposure to hands-on techniques and other hurdles faced by them complicate their experience. 2^nd-year students have fewer issues than 1^st-year students because they have a better understanding and have learned coping mechanisms to manage stress after finishing their 1^st year. With experience, they also gain curiosity and self-assurance.

After going through these phases of challenges and excitement, I thought to do research on this topic, which might be of help to the preclinical students.

This study looks into whether these students knew what dentistry was about, the subjects involved, how technical and skill-based the field is, and how well they adjusted to the course and the challenges they encountered.

MATERIAL AND METHODS

RESULTS

As per Table 1, 39.1% of the students were relatively aware and 26% were fully aware of dental subjects (ρ = 0.041). A significant majority (62.1%) lacked prior knowledge of oral anatomy and histology (ρ< 0.001). However, most students (76.2%) expected subjects like anatomy, physiology, and biochemistry to be part of their curriculum (ρ< 0.001), indicating some alignment with their expectations.

Students acknowledged the importance of human anatomy in dentistry, with 80.4% agreeing on its relevance (ρ< 0.001). In addition, physiology and biochemistry were seen by 80.9% of students as closely related to their high school syllabus (ρ< 0.001), making them relatively easier to adapt to it. In contrast, 70.6% found oral anatomy and histology (ρ< 0.001) to have the least correlation with their prior education.

Practical work emerged as a significant challenge, with 73.2% observing peers excelling in preclinical tasks despite lacking prior experience (ρ< 0.001). This disparity affected the self-confidence of 51.1% of students (ρ< 0.001), who felt challenged by both practical and theoretical aspects. Furthermore, 43.8% admitted to doubting their decision to choose dentistry as a course (ρ < 0.001), reflecting the psychological stress experienced during the early stages of their education. 60.9% of students found interactions with seniors to be helpful in alleviating psychological stress (ρ < 0.001).

The results of the one-sample chi-square test shows the significant ρ -values (<0.05) across all questions, suggests strong differences in student opinions, shedding light on both positive experiences and areas of difficulty.

As per Table 2, most students (43.4%) agreed that physiology and biochemistry were easy to grasp, while a smaller percentage of 10.2% strongly agreed (ρ< 0.001). However, anatomy presented a notable challenge, with only 19.1% finding it easy to understand and a significant portion of 42.9% disagreeing (ρ< 0.001).

Practical skills and workload emerged as significant concerns. While most students (85.6%) acknowledged the artistic and essential nature of tooth carving (ρ < 0.001), a substantial proportion of 76.6% found preclinical Prosthodontics laborious (ρ< 0.001), and 42.1% considered submission of practical work taxing (ρ< 0.001). In addition, 57% of students believed that irregular attendance hindered their understanding of lecture topics (ρ< 0.001). Cultural adaptation and interpersonal challenges were also prominent. Nearly 42.6% of students reported difficulty settling into a new environment (ρ< 0.001), while 31.5% hesitated to interact with seniors (ρ< 0.001).

Chi-square test is used to see the association between responses and the year of study. If the ρ-value is <0.05 (χ²(df) = value, ρ < 0.05), the null hypothesis (there is no significant association between the year of study and the students’ responses to the given questions) is rejected, and it may conclude that there is a significant association. If the ρ -value is >0.05 (χ²(df) = value, ρ > 0.05), the null hypothesis is accepted, and it may conclude that no significant relationship exists.

The analysis in Supplementary Table 1 represents associations between the year of study (1^st Year and 2^nd Year BDS students) and their responses to various questions regarding dental education, subjects, and related experiences. Chi-square tests were conducted to assess these associations, with results including degrees of freedom and ρ -values. Most findings reveal no statistically significant differences between the two groups, indicating that perceptions and experiences are generally similar across the years, with a few notable exceptions.

One key observation is that the question on whether “anatomy is easy to grasp” showed a significant difference (χ²(df) = 4, ρ< 0.001). 1^st-year students were more likely to disagree or strongly disagree compared to 2^nd-year students, suggesting that 1^st-year students find anatomy more challenging. The perception that interaction with seniors helps psychologically was another area where a significant association was found (χ²(df) = 2, P = 0.046). 2^nd-year students were more likely to report that such interactions were beneficial. In contrast, questions on the relevance of subjects such as physiology and biochemistry to prior education(χ²(df) = 2, p = 0.648), the difficulty of preclinical work(χ²(df) = 3, ρ = 0.751), and the taxing nature of submissions(χ²(df) = 4, p = 0.126) did not yield significant associations.

DISCUSSION

The study involved focus groups with 1^st and 2^nd-year dental students to gather their insights and experiences. 2^nd-year students were part of the groups because they were old enough to understand what went wrong during the 1^st year, and their memory of the 1^st-year experience was still fresh.

The comparative analysis of 1^st and 2^nd-year students’ responses showed that 1^st-year students (p < 0.001) were more likely to disagree that anatomy was easy to grasp as compared to 2^nd year students. This difference may be attributed to the initial exposure and complexity of the subject, which likely eases with progression in the course and increased familiarity. First-year students often find difficulty in adjusting to a new academic environment, medical terminology, and new study methods as their transition to medical college. Adding to this, the complexity of visualizing three-dimensional structures of organs and their tissues, along with the vast amount of detailed information makes it difficult for many 1^st year students. Second year students have already had been through a year of college, which helped them develop better study strategies and effective ways to learn and retain information as they are more familiar with medical terminology and concepts. A similar study in Kerala, India, showed a decline in performance of dental students at the time of inception of the university, and as time progressed, the results of the students showed significant improvement,^[3] which supports our finding.

Another comparison showed that 2^nd-year students’ interaction with seniors helped them more psychologically (p = 0.046) than 1^st-year students. This finding highlights the importance of mentorship and peer guidance in easing psychological challenges, especially during the transition period in dental education. The freshmen were more likely to feel there were many obstacles when trying to get help for mental health compared to seniors and graduate students, according to the conclusion of research done in one Midwestern university in the United States.^[4] This is probably because 1^st-year students face more difficulty adjusting to a new environment and culture.

Both 1^st and 2^nd year, about 76.6% of students, agreed that preclinical prosthodontics was the most laborious work as it requires significant efforts and attention to detail in becoming skilled at the procedures and techniques. This uniformity across the years suggests that both 1^st year and 2^nd-year students face similar challenges and hold comparable views regarding the curriculum and workload. Overall, the study underscores the value of senior mentorship and the need for targeted support in mastering challenging subjects like anatomy, particularly for new entrants. This also hampered the self-confidence of 74.5% of students. Research was carried out by the University of Illinois at Chicago,^[5] where an active learning environment was introduced for 2^nd year dental students. This included meaningful clinical exposure with patients and the results showed improvement in students’ learning and performances.University of Florida College of Dentistry,^[6] did research which showed that using dental students as teachers for preclinical subjects like prosthodontics and occlusion could be a good way to support learning, providing student instructors with higher learning experiences, and supplementing the efforts of full-time faculty.

Many students found practical work to be both mentally and physically challenging, with 54% saying it was tough. Furthermore, 57% felt the college schedule was hard because the profession is rigorous, the curriculum includes a lot of lectures and preclinical classes, and spending long hours in confined spaces takes a toll on their physical and mental well-being. Another study has reported^[7] that the dental curriculum is guided by the Dental Council of India, which gives the colleges flexibility to include additional topics that address local health concerns or emerging global issues, helping students gain more relevant and meaningful learning experiences.

CONCLUSION

A significant association between the perception and challenges among 1^st and 2^nd-year students is observed in two aspects: grasping of anatomy and interaction with senior students. This indicated that both academic understanding and peer support varied across the two groups. The results of this study highlight the need for strategic curriculum planning and its correlation with 11^th and 12^th grade syllabus. This can help to bridge the gap and spark interest in students. Furthermore, the study underscores the importance of orientation programs to familiarize students with the dental curriculum, learning strategies, and academic expectations at an early stage. Seniors’ interaction with students by formal mentorship initiatives can help in guiding and mentoring them on effective study techniques, time management, and mastering their skills, which can overall help them psychologically.