Perceptions of Dental Undergraduates Towards Online Education During COVID-19: Assessment from India, Nepal and Sri Lanka

WhatsApp as a Tool in Blended Learning in Dental Education

Background and Objective

Dental education is unique, with clinical/practical learning much different from other professionals. In dentistry, students are exposed much earlier in their curriculum to patients, performing procedures under direct/indirect supervision. Hence, the present review attempted to assess the standing position of dentistry in blended learning worldwide.

Materials and Methods

E-learning modality was at its primitive stage as food for thought among educational task force committees, with only a handful of developed and developing countries equipped with it. During this pandemic, "WhatsApp" became a savior, as it was a widely used educational device among dental teachers and students. Furthermore, it was easily applicable in places where there was difficulty in obtaining regular internet bandwidth, especially in remote/rural areas. It is noteworthy that blended learning/e-learning, when complemented with the conventional teaching method, upskill critical thinking and problem-solving capabilities. Blended learning or virtual reality education should be made feasible without disparity, worldwide. Mind training, both students and staff in hybrid e-learning, is the need of the hour not only to keep pace with digitalized dentistry but to prepare the students to face real-world situations.

Conclusion

The sustainability of dental education should be rethought by dental schools with "Complimented Digital learning" wherever feasible, not only to cope with current trends but also to face unforeseen future challenges.

The impact of COVID-19 on medical students

Objective

The outbreak of COVID-19 has disrupted social order and placed a heavy burden on the healthcare system. The pandemic also has an unprecedented impact on medical students.

Methods

We searched PubMed for articles related to COVID-19 and medical students from January 2020 to December 2022. A total of 5358 studies were retrieved and after screening, 176 studies were finally included in this review.

Results

The impact of COVID-19 on medical students is widespread and profound. First reflected in the transformation of educational models. In the early days, education model quickly shifted from offline to online. In terms of clinical exposure, most students have been suspended from internships, while in some areas with staff shortages they have the opportunity to continue clinical work. Scientific research of medical students is also difficult to carry out due to COVID-19. The epidemic has also seriously damaged students' mental health, and this impact won't simply disappear with the improvement of the epidemic situation. The career intentions of medical students may also become firmer or change due to COVID-19. International medical electives have also been negatively affected by COVID-19 due to travel restriction. Even in the postpandemic era, with the gradual resumption of work, production and school, medical students are still affected in some ways by COVID-19.

Conclusion

The COVID-19 pandemic has had a profound impact on both the education of medical students and their personal development. Through COVID-19, we should reflect on what models of medical education should be developed in the future. Based on the experiences learned from COVID-19, we believe that a more flexible blended education model may be the most promising.

Online case-based learning in medical education: a scoping review

BACKGROUND

Case-Based Learning (CBL) in medical education is a teaching approach that engages students as learners through active learning in small, collaborative groups to solve cases from clinical patients. Due to the challenges afforded by the COVID-19 pandemic, small group learning such as CBL, transitioned quickly to include technology-enhanced learning to enable distance delivery, with little information on how to apply pedagogical frameworks and use learning theories to design and deliver online content.

METHODS

To extend understanding of online CBL a scoping review protocol following the PRISMA-ScR framework explored the literature that describes the use of online CBL application in medical education and the outcomes, perceptions, and learning theories. A literature search was conducted in January 2022 followed by a subsequent review in October 2022. After peer review using the PRESS guidelines, the CASP appraisal tool was used to assess the rigor of each study design.

RESULTS

The scoping review identified literature published between 2010 and 2022 (n = 13 articles), on online CBL in the field of medical education with 11 observational studies describing student and facilitator perceptions and two randomized controlled studies. Positive perceptions of online learning included a flexible work-life balance, connection with learners, and improved accessibility. Negative experiences of online CBL included poor internet access, a distracting learning environment, and loss of communication. In the studies that collected student performance data, results showed equivalent or improved outcomes compared to the control. The CASP appraisal tool highlighted the deficiencies in most study designs, lack of framework or learning theory, and poor reproducibility of the methods to answer the research questions.

CONCLUSION

This scoping review identified literature to describe the academic outcomes, and student and facilitator perceptions of online CBL in medical education. However, the CASP tool uncovered deficiencies in study descriptions and design leading to poor quality evidence in this area. The authors provide recommendations for frameworks and learning theories for the future implementation of online CBL.

The Dental Educational Environment of Online and Blended Learning during COVID-19, and the Impact on the Future of Dental Education

Blending face-to-face and online learning should create a focused environment that supports deep and meaningful teaching and learning that engages learners in a more active and collaborative educational experience. The present study aimed to evaluate students' online and blended learning educational environment self-perception at the Faculty of Dentistry, Kuwait University, during the COVID-19 pandemic.

METHODS

Undergraduate dental students who participated in blended learning with online lectures were invited to participate. The sample was a non-probability convenient sample, which included all clinical dental students invited to participate, who were enrolled in the fifth, sixth, and seventh (clinical year) years. All 69 students in these three clinical years were invited to participate. Electronic consent to participate and a self-administered questionnaire of two parts were completed. Part one of the questionnaire utilized the five subscales of the Dundee Ready Educational Environment Measure (DREEM) questionnaire; part two was developed in addition to evaluate the online teaching and learning subscales.

RESULTS

Descriptive statistics and analyses of variance were performed; Pearson correlations were made between the additional supplemental online teaching subscale and the original DREEM subscales. The mean students' perception of the teacher was high, followed by the academic self-perception and then the learning perception. Students' social self-perceptions had the lowest reported scores. Students' perceptions varied by year of education in all subscales except for the online domain. In comparing all domains (DREEM and the online component), graduating students (final year) had a more favorable perception than other students.

CONCLUSIONS

Within the limitations of the present study, online and blended learning were positively perceived, excluding the social self-perception and the perception that the online teaching time was not well used.

Psychological impact on dental students and professionals in a Lima population during COVID-19s wave: a study with predictive models

Peru was the country with the highest COVID-19 case fatality rate worldwide during second wave of infection, with dentists and pre-professional students being susceptible to infection due to clinical procedures they perform. This situation could have generated some kind of psychological disorder within this group. Therefore, the present study aimed to assess how COVID-19 pandemic affected this population group during second wave, in relation to depression, anxiety and stress. This observational and cross-sectional study in 368 Peruvian dentists (186 students and 182 professionals), was carried out during August to November 2021. The DASS-21 Scale was used to diagnose depression, anxiety and stress. For the statistical analysis, Pearson's chi-square test was used, in addition to a logit model using odds ratio (OR) to evaluate depression, anxiety and stress with the following factors: gender, age group, marital status, monthly family income, children, academic level, history of COVID-19, COVID-19 symptomatology, close relative with COVID-19, living with vulnerable people and work dedication. In addition, predictive models were constructed considering all possible significant causes. A significance level of p < 0.05 was considered. Dental students and professionals presented significant differences in levels of depression, anxiety and stress (p < 0.001, p = 0.022, p = 0.001; respectively). Male students were 56% less likely to develop stress (OR 0.44; CI 0.22–0.85) compared to females; while those unmarried were 81% less likely to develop stress (OR 0.19; CI 0.04–0.85). Likewise, those with children were 83% less likely to develop stress (OR 0.17; CI 0.06–0.52) and 65% less likely to develop depression (OR 0.35; CI 0.15–0.80). In addition, COVID-19 asymptomatics were 60% less likely to develop depression (OR 0.40; CI 0.17–0.92). However, having relatives with COVID-19 caused almost three times the probability of developing depression (OR 2.96; CI 1.29–6.79) and twice the probability of developing stress (OR 2.49; CI 1.07–5.78). As for dental professionals, it was noticed that those unmarried had almost three times the probability of developing stress (OR 2.93; CI 1.38–6.23); while those who only worked had twice the probability of developing stress (OR 2.37; CI 1.17–4.78). Dental students had a higher prevalence of depression, anxiety and stress. In addition, having children and being asymptomatic were protective predictors for depression, while being male, unmarried and having children were protective predictors for stress. However, having a relative with COVID-19 was a risk predictor for depression and stress. In professionals, only working and being unmarried were risk predictors for stress.

Online Learning during the COVID-19 Pandemic: Dental Students' Perspective and Impact on Academic Performance, One Institution Experience

Background: The COVID-19 pandemic caused all universities in Malaysia to switch to online learning, including for dental education. The effect of this switch has yet to be assessed. Thus, this study aimed to assess International Islamic University Malaysia (IIUM) dental students’ perspectives on the implementation of online learning during the COVID-19 pandemic and its impact on academic performance. Methods: Cross-sectional and retrospective methods were used. The handling, didactic benefits, motivation, and challenges of online learning were assessed via an online questionnaire, and academic performance was assessed by comparing professional exam scores pre- and post-online learning. Results: Among the 249 IIUM dental student respondents, a positive response was recorded for the management of online learning, despite a few challenges in the area of didactic benefits and motivation. A significant improvement (p-value < 0.05) was observed in examination scores in oral biology, microbiology, and pharmacology, while dental material and GMGS showed declines in performance. Other subjects showed no significant difference (p-value > 0.05) in mean scores before and after online learning. Conclusion: Generally, students had a positive response towards online learning management, despite facing some challenges. Based on the analysis of examination results, only two subjects in Year 2 and Year 3 were negatively affected by online learning during the pandemic.

Stress among dental students transitioning from remote learning to clinical training during coronavirus disease 2019 pandemic: A qualitative study

OBJECTIVES

To identify dental students' perceptions of stress over returning to in-person clinical training after remote learning required from the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

This was a qualitative observational study. The sample was composed of undergraduate students (n = 47) in the final year of São Paulo State University, School of Dentistry, Araraquara program. The data were collected using a questionnaire created in Google Forms. The data was analyzed using the discourse of the collective subject technique.

RESULTS

More than half of the students (63.8%) reported experiencing stress in the transition from remote learning to clinical training. According to the students, the main causes of this stress were fear of COVID-19 infection or contamination (31.5%) and insecurity in their clinical treatment skills after having gone so long without training (25.5%). Half of the students surveyed (51.1%) exhibited at least one stress-related symptom. For most of the students (70.2%), remote learning was insufficient to prepare them for returning to in-person clinical activities. Performing laboratory pre-clinical activities prior to clinical training was the suggestion most frequently cited by the students (25.5%), as a way to avoid some of the stress associated with their return to in-person learning. The main coping strategies adopted by the students upon their return to in-person learning were making the most of their clinical training, planning cases, and studying relevant topics before treating patients (48.9%).

CONCLUSION

The dental students perceived high levels of stress during the transition from remote learning to clinical training.

Knowledge deficit and fear of COVID-19 among higher education students during the first wave of the pandemic and implications for public health: a multi-country cross-sectional survey

BACKGROUND

Public health measures such as physical distancing and distance learning have been implemented during the COVID-19 pandemic. COVID-19 related knowledge deficit can increase fear that leads to negative mental health and COVID-19, especially among adolescents. Therefore, our study aimed to assess COVID-19 related knowledge deficit and its association with fear among higher education (HE) students during the first wave of COVID-19.

METHODS

A cross-sectional survey, COVID-19 International Students Well-being Study (C-19 ISWS) was conducted in 133 Higher Education Institutions (HEIs) in 26 countries between April 27 and July 7, 2020. A stratified convenience sampling technique was used. Descriptive, bivariate, mixed-effect logistic regression analyses were conducted using R software.

RESULTS

Out of 127,362 respondents, 72.1% were female, and 76.5% did not report a previous history of confirmed COVID-19. The majority of those without the previous infection 81,645 (83.7%) were from 21 European countries while the rest 15,850 (16.3%) were from 5 non-European countries. The most frequent correct response to COVID-19 related knowledge questions among respondents was having the virus without having symptoms (94.3%). Compared to participants with good knowledge, the odds of being afraid of acquiring SARS-COV-2 infection among those with poor knowledge was 1.05 (95%CI:1.03,1.08) and the odds of being afraid of contracting severe COVID-19 was 1.36 (95%CI:1.31,1.40).

CONCLUSION

COVID-19 related knowledge was independently associated with both fear of acquiring SARS-COV-2 infection as well as contracting severe COVID-19. Our findings will serve as a basis for public health response for both the current and similar future pandemics by highlighting the need for addressing the COVID-19 knowledge deficit to fight the infodemic and prevent negative mental health outcomes.

Social media use and mental health during the COVID-19 pandemic in young adults: a meta-analysis of 14 cross-sectional studies

Background

Public isolated due to the early quarantine regarding coronavirus disease 2019 (COVID-19) increasingly used more social media platforms. Contradictory claims regarding the effect of social media use on mental health needs to be resolved. The purpose of the study was to summarise the association between the time spent on social media platform during the COVID-19 quarantine and mental health outcomes (i.e., anxiety and depression).

Methods

Studies were screened from the PubMed, Embase, and Cochrane Library databases. Regarding eligibility criteria, studies conducted after the declaration of the pandemic, studies that measured mental health symptoms with validated tools, and studies that presented quantitative results were eligible. The studies after retrieval evaluated the association between time spent on social media platform and mental health outcomes (i.e. anxiety and depression). The pooled estimates of retrieved studies were summarised in odds ratios (ORs). Data analyses included a random-effect model and an assessment of inter-study heterogeneity. Quality assessment was conducted by two independent researchers using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). This meta-analysis review was registered in PROSPERO (https://www.crd.york.ac.uk/PROSPERO/, registration No CRD42021260223, 15 June 2021).

Results

Fourteen studies were included. The increase in the time spent using social media platforms were associated with anxiety symptoms in overall studies (pooled OR = 1.55, 95% CI: 1.30–1.85), and the heterogeneity between studies was mild (I² = 26.77%). Similarly, the increase in social media use time was also associated with depressive symptoms (pooled OR = 1.43, 95% CI: 1.30–1.85), and the heterogeneity between studies was moderate (I² = 67.16%). For sensitivity analysis, the results of analysis including only the “High quality” studies after quality assessment were similar to those of the overall study with low heterogeneity (anxiety: pooled OR = 1.45, 95% CI: 1.21–1.96, I² = 0.00%; depression: pooled OR = 1.42, 95% CI: 0.69–2.90, I² = 0.00%).

Conclusions

The analysis demonstrated that the excessive time spent on social media platform was associated with a greater likelihood of having symptoms of anxiety and depression.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13409-0.

The Psychological Impacts of COVID-19 Pandemic among Emerging Adults: An Observational Cross-Sectional Study

(1) Background: COVID-19 has had psychological impacts, particularly anxiety, depression, anger, and suicidal ideation, on the world’s populace, including young persons who were prone to mental health disorders even before the pandemic. We described the psychological impacts of COVID-19 among emerging adults aged 18–30 years in Saudi Arabia. (2) Methods: A cross-sectional survey was done among a randomly sampled population in Saudi Arabia between July 2020 and May 2021 using the DSM-5 Self-rated Level 1 Cross-Cutting Symptom Measure and Ask Suicide Questionnaire. Logistic regression was used to assess participant characteristics associated with reporting symptoms of mental disorders under each of the 13 domains that would warrant further investigation. (3) Results: Approximately, 91% of participants experienced different mental health symptoms; these participants are more likely to be young, female students, those who had a history of being diagnosed with a mental disorder, and those diagnosed or treated for COVID-19. (4) Conclusion: This study strongly showed an increased prevalence of mental health symptoms among young persons during the COVID-19 pandemic. Addressing the mental health burden among young persons in time using simple, self-administered screening tools linked to interventions will prevent dire consequences in the future.