ORIGINAL ARTICLE
Year : 2022 | Volume
: 11 | Issue : 1 | Page : 62--67
Evaluation of dental intern's satisfaction and self-competence in treating emergency cases during the first year of the coronavirus pandemic
Albraa B Alolayan1, Yaser A M Alsahafi2, Ahmed Ibrahim Hassan Ghibban3, Khuloud Mohammed Misbahammar Aljazaeri4, Shadia Abd-Elhameed Elsayed5,
1 Department of Oral Maxillofacial Surgery, Taibah University Dental College and Hospital, Medina, Saudi Arabia
2 Department of Preventive Dental Sciences, Taibah University Dental College and Hospital, Medina, Saudi Arabia
3 Department of Pediatric Dentistry, King Abdulaziz Medical City, National Guard Hospital, Jeddah, Saudi Arabia
4 Department of Oral Maxillofacial Surgery, Taibah University Dental College and Hospital; Preventive Dental Sciences, Taibah University Dental College and Hospital, Medina, Saudi Arabia
5 Department of Oral Maxillofacial Surgery, Taibah University Dental College and Hospital, Medina, Saudi Arabia; Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
Correspondence Address:
Shadia Abd-Elhameed Elsayed
Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, 344/41411, Almadinah Almunawwarrah, Saudi Arabia
Abstract
Background: The study aimed to identify the level of satisfaction and confidence of dental intern students in emergency care emergency room (ER) during COVID-19 Pandemic in order to determine factors that influence their satisfaction such as patient's age, gender, and ethnicity. Materials and Methods: A cross-sectional survey-based study was conducted at Al-Madinah Al-Munawwarah-Taibah University Dental-College and Hospital. The overall sample included in analysis was 105 dental interns with an average age of 24.7 years who were treating patients between July 2019 and August 2020 in emergency dental clinics at TUCDH. Results: The survey response rate was 100% and 51.4% of the participants felt comfortable and 80% felt confident on emergency days. However, male interns were significantly more comfortable and confident than females (P = 0.001 and 0.022 respectively). Endo-emergency constituted 77% of dental emergencies followed by surgery. 81.9% believe that age is the most challenging factor affecting their ER work, and most of them do not believe that patient's gender and ethnicity affect their performance. Stock shortages were the biggest challenge for their supervisor-led management. Conclusion: Majority of interns feel satisfied with their management of emergency cases during COVID-19 Pandemic with superior male significant meaning. More emergency training programs should be established in the educational dental curriculum to improve their satisfaction and confidence rate, especially for females during pandemics.
How to cite this article:
Alolayan AB, Alsahafi YA, Ghibban AI, Aljazaeri KM, Elsayed SA. Evaluation of dental intern's satisfaction and self-competence in treating emergency cases during the first year of the coronavirus pandemic.Saudi J Health Sci 2022;11:62-67
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How to cite this URL:
Alolayan AB, Alsahafi YA, Ghibban AI, Aljazaeri KM, Elsayed SA. Evaluation of dental intern's satisfaction and self-competence in treating emergency cases during the first year of the coronavirus pandemic. Saudi J Health Sci [serial online] 2022 [cited 2023 Jun 9 ];11:62-67
Available from: https://www.saudijhealthsci.org/text.asp?2022/11/1/62/344485 |
Full Text
Introduction
One of the most important services is the treatment of patients complaining of dental/oral pain in the daily emergency clinics.[1],[2],[3] Patients at these clinics are treated by dental interns who have been trained and educated at a high level for many years to address these clinical conditions.[4],[5] These clinics need knowledge and accuracy to identify the cause of pain and diagnose it properly to provide satisfactory treatment with great confidence.[6],[7],[8] There is no doubt that the Coronavirus crisis has affected all health workers, including internship students those who, unfortunately, have spent their internship at this time when the whole world is suffering from a deadly epidemic.[9],[10]
One of the most important aspects of developing high-standard treatment and care is addressing and evaluating the dental intern's confidence and satisfaction with the extent of the treatment provided which is important in developing and improving the outcomes of any educational program.[11],[12] The freshly graduated intern must be familiar with the basics of how to properly diagnose and provide appropriate treatment with high confidence and complete satisfaction.[13] Regardless of any other factor, all patients are equal without differentiation.[14]
The COVID-19 lockdown has had a significant influence on the oral healthcare system, particularly in the emergency department. Several tools are used to find out the extent of confidence and satisfaction of the doctor in treatment service.[15] Questionnaires are one of the ways to conduct this matter and to know the extent of satisfaction with oral health care.[16]
Many treatment services are provided by dental interns at the Taibah University College and Dental Hospital (TUCDH) in Almadinah Almunawwarah which is the only dental college in Al Madinah region in the Kingdom of Saudi Arabia that provides dental services to any patient free of charge on a daily basis. According to the review of the available literature in dental care, there are no studies done to link the satisfaction and confidence towards dental emergency treatment by intern prospective in the region during this crisis period.
The present study aimed to recognize, explore the extent of the dental interns' satisfaction level and confidence in dental emergency treatment provided in the Dental College and Hospital at Taibah University in Madinah (TUCDH) during 1st year of COVID to determine factors affecting the quality and satisfaction rate like age, gender, and ethnicity of the patients and to correlate any gender effect of the dental interns on their evaluation.
Materials and Methods
Study design and setting
The study was conducted at TUCDH at Al-Madinah Al-Munawarah through designing a cross-sectional self-administered questionnaire survey research, following the ethical approval from the Taibah University. The investigation was carried out in accordance with the Declaration of Helsinki for Clinical Studies principles. The study population was a convenience sample included all male and female dental interns who were treating patients in emergency dental clinics at Taibah University Dental Collage and Hospital.
Inclusion criteria included all dental interns who provide ER treatment at TUCDH between July 2019 and August 2020. Any management of patients who complained of nonodontogenic pain or cases that need treatment not provided by the dental interns were excluded from the study.
Data collection
This questionnaire was directed to both genders of dental interns and it aimed to explore their level of satisfaction and obstacles that could impact their management of emergency cases. The survey was anonymous and took only 5–10 min to complete. The questionnaire composed of two parts. The first section was about general demographic details of the sample that included age, gender, and the marital status. The second part included questions concerning satisfaction and confidence toward dental emergency treatment and factors that could be associated with their quality of work and their satisfaction.
Review and analysis of the data collected were performed to identify factors that influence intern confidence in emergency situations and any associated factors that affect emergency care. Furthermore, the identification of the most emergency cases observed in our populations was determined.
Ethical considerations
The study proposal was approved from Taibah University College of Dentistry Research Ethics Committee (TUCD-REC/20200318/ALHGHIBBAN). Prior to the start of the study, all study participants signed an informed consent. The privacy and confidentiality of the participant were protected, as no patient identifiable features were included in the research. There were no potential risks, and participation to complete the questionnaire was voluntary.
Data analysis
Data entry and analyses were done using the Statistical Package for Social Sciences (SPSS) ver. 22 for Windows software (IBM SPSS Statistics IBM North America, 590 Madison Avenue, New York, NY, USA 10022. the United States). Descriptive statistics such as mean and standard deviation were performed for continuous variables as well as frequency and percentage for categorical variables. Inferential statistics were then conducted using Chi-square method for the analysis of associations. The statistical significance level was set to P < 0.05.
Results
The total sample included in this analysis was 105 dental interns with an average age of 24.7 years and range between 23 and 27 years of age. This is because they spend 6 years in the curriculum at the Taibah University, College of Dentistry. Male and female dental interns are relatively equal in number with 50.5% males and 49.5% females who spent their current year of internship at TUCDH in Al Madinah Almunawwarah [Table 1].{Table 1}
All interns respond to the survey with a response rate of 100%. 85.7% are single during internship. 51.4% of them felt comfortable and relaxed under emergency rooms (ERs) day schedule. However, 80% felt confident when dealing with ER case.
Most of the dental emergencies were endo-emergency (77.1%) followed by surgery (18.1%). Stock shortages were the biggest challenge to their management led by supervisor [Table 2] and [Table 3]. Male interns were more comfortable and confident at the day of emergency than female interns, the difference was a statistically significant (P = 0.0001 and P = 0.022 respectively) [Table 4].{Table 2}{Table 3}{Table 4}
Satisfaction rate ranged between 3/10 in 1.9% of the study sample to 10/10 in 12.4%. Noticeably, male satisfaction rates were starting at higher levels (6/10) than females (3/10). Male interns were more satisfied on emergency days than females (P = 0.006) [Figure 1].{Figure 1}
About 81.9% of subjects believed that the extreme age (too young and too old) was the most challenging factor influencing their ER practice, and most of them do not think that gender and ethnicity affect their work performance [Table 4]. Lack of materials especially PPE and Stock shortages (such as face shields, protective gowns, and N-95 masks) was the biggest challenge for their supervisor-led management.
The dental intern's marital status and age did not affect the degree of satisfaction or confidence in the evaluation of emergency care cases and did not statistically associate with any of the study variables.
Discussion
The internship year typically is full of excitement and enthusiasm, dental interns are interested in applying all what they know and practice more impulsively as after graduation so that a lot of research and successes make this year an enjoyable one that subsequently influences their career choice.[17],[18] Unfortunately, their graduation year was the Corona internship year.[1],[19]
The current study is important to understand dental interns' level of satisfaction and capacity to manage emergencies cases.[20],[21] Their confidence in treating various emergency scenarios that have occurred in various dental sub-specialties during the COVID-19 crisis will have a significant impact on their subsequent career choice.[22],[23]
The COVID-19 lockdown has had a significant influence on the oral healthcare system, particularly in the emergency department.[9],[10] At TUCDH, we are trying for the first time in Almadinah to study their level of satisfaction, causes of fear, and their most challenging emergencies during their internship year, which started in July 2019 and ended in August 2020. The study populations were a convenient sample of all registered male and female interns at Dental College and Hospital Clinics, which was founded in 2005 and is the only governmental dentistry school in Almadinah Almunawwarah that provides services to all residents and visitors from different nationalities who visit or stay in the holy city of Al Madinah.
TUCDH treats nearly 5000 patients each year, from different specialties including endodontics, prosthodontics, surgery, and pedodontics, all such services are free of charge. COVID 19 had an impact on patient visit rates and fewer patients have been treated this year since Madinah has been locked from March 2020 for 5 months, so only emergencies have been handled and after that Tele-dentistry was the only way for patients to interact with the clinics.[24] Upon graduation, dental interns can feel nervous during their 1st days of emergency rounds. It may be due to changes in the modification of their work calendar and mandatory working hours.[25],[26] Dental internship had more responsibility for tuition and sick leave, as well as other legislation and guidelines on institutional rules.[20],[27]
Because of the increasing caries rate and extraction in Almadinah patients,[28],[29] the most common emergency was endodontic emergencies (77.1%), followed by extraction of painful and highly decaying nonrestorable teeth (18.1%). This study's findings are consistent with those of others. In several Eastern Mediterranean nations, inflammatory or infectious oral disorders remain the most common emergency and urgent complaints among dental patients.[30]
The multiplicity of languages spoken by patients who joined the clinic is the most significant difficulty in Almadinah. Interns at Taibah serve patients who speak a variety of languages, including Arabic, English, Urdo, Malaysian, and Afghani. There are people of many races, cultures, and/or backgrounds. Patients have spoken Egyptian Arabic, Tunisian Arabic, Sudanese Arabic, Jordanian Arabic, Moroccan Arabic, and Algerian Arabic, among other dialects of the same language.[31] However, the management is not hampered by this difficulty. Patients are kindly handled and treated as is known about the Almadinah community, in addition to the existence of new generations who can express instructions to their parents.[32],[33],[34]
In the present survey, there was no difference between the numbers of female and male graduates, despite the fact that in other countries, males are far more prevalent in number.[3],[7] In contrast, globally, there is a rise in female dental students in comparison to the number of male dental students. Some progress has been made over the last few decades in increasing women's labor force participation and narrowing gender gaps, however, women still earn less than men, in our conservative societies.[22],[23]
The importance of supervision in the advancement of dental students' learning curves is critical, and a lack of mentoring in early dental careers has a negative impact on the discipline's quality.[3],[35],[36],[37] Mentor role modeling has both a negative and positive impact on the learner, with the negative impact being particularly dangerous.[36],[38] There is no previous analysis of the factors influencing internal satisfaction in our department so it is important to understand how factors affect the choice of practice and how this can affect future workforce. Patient's satisfaction with their intern dental service was not measured in the present study which needs further investigations.
Conclusion
We can conclude from the present study that almost most interns feel comfortable and satisfied with their management of emergency cases during crisis with superior significance of males. The age extreme of the emergency patient was the most obstacles in the management for both males and female interns.
Recommendations
More emergency training programs during pandemics and times of crisis should be established in the dental curriculums to increase dental interns' satisfaction and confidence rate especially for females in treating patients of varying age groups.
Availability of data and materials
All data are available on request.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
| 1 | Abraham SB, Amini AM, Khorshed NE, Awad M. Quality of life of dentists. Eur J Dent 2018;12:111-5. |
| 2 | Ali S, Farooq I, Khan SQ, Moheet IA, Al-Jandan BA, Al-Khalifa KS. Self-reported anxiety of dental procedures among dental students and its relation to gender and level of education. J Taibah Univ Med Sci 2015;10:449-53. |
| 3 | Premadasa IG, Shehab D, Al-Jarallah KF, Thalib L. Frequency and confidence in performing clinical skills among medical interns in Kuwait. Med Teach 2008;30:e60-5. |
| 4 | Levin R. The correlation between dental practice management and clinical excellence. J Am Dent Assoc 2004;135:345-6. |
| 5 | Pascoe GC. Patient satisfaction in primary health care: A literature review and analysis. Eval Program Plann 1983;6:185-210. |
| 6 | Hashim R. Patient satisfaction with dental services at Ajman University, United Arab Emirates. East Mediterr Health J 2005;11:913-21. |
| 7 | Hoppe A, Persson E, Birgegård G. Medical interns' view of their undergraduate medical education in Uppsala: An alumnus study with clear attitude differences between women and men. Med Teach 2009;31:426-32. |
| 8 | Mensah C, Appietu ME, Asimah VK. Work-based social support and hospitality internship satisfaction. J Hosp Leis Sport Tour Educ 2020;27:100242. [doi: 10.1016/j.jhlste. 2020.100242]. |
| 9 | Elsayed SA, Abu-Hammad O, Lolayan AB, Althagafi N, Ayed Y, Eldeen YS, et al. Getting to know SARS-CoV-2: Towards a better understanding of the factors influencing transmission. Pesqui Bras Odontopediatria Clin Integr 2020;20:1-7. |
| 10 | Elsayed SA, Abu-Hammad O, Alolayan AB, Eldeen YS, Dar-Odeh N. Fallacies and facts around COVID-19: The multifaceted infection. Craniofac Surg 2020;31:e643-4. |
| 11 | Martins RC, Seijo MO, Ferreira EF, Paiva SM, Ribeiro Sobrinho AP. Dental students' perceptions about the endodontic treatments performed using NiTi rotary instruments and hand stainless steel files. Braz Dent J 2012;23:729-36. |
| 12 | Doumani M, Habib A, Alhababi A, Bashnakli A, Shamsy E, Nassani MZ. The internship dentists self confidence levels during root canal treatment procedures. Int J Dent Res 2017;5:121. |
| 13 | Tanalp J, Güven EP, Oktay I. Evaluation of dental students' perception and self-confidence levels regarding endodontic treatment. Eur J Dent 2013;7:218-24. |
| 14 | Kress GC Jr. Patient satisfaction with dental care. Dent Clin North Am 1988;32:791-802. |
| 15 | Mascarenhas AK. Patient satisfaction with the comprehensive care model of dental care delivery. J Dent Educ 2001;65:1266-71. |
| 16 | ArRejaie AS, Nawasrah AM, Khan SQ, Farooqi FA, Somali R, Al-Mudani WF. Patients' perception toward various dental treatments provided in the internship program. Saudi Med J 2014;35:1513-6. |
| 17 | Wang YF, Chiang MH, Lee YJ. The relationships amongst the intern anxiety, internship outcomes, and career commitment of hospitality college students. J Hosp Leis Sport Tour Educ 2014;15:86-93. |
| 18 | Stansbie P, Nash R, Chang S. Linking internships and classroom learning: A case study examination of hospitality and tourism management students. J Hosp Leis Sport Tour Educ 2016;19:19-29. |
| 19 | Hamid H, Khurshid Z, Adanir N, Zafar MS, Zohaib S. COVID-19 pandemic and role of human saliva as a testing biofluid in point-of-care technology. Eur J Dent 2020;14:S123-9. |
| 20 | Abdelsalam M, Rodriguez TE, Brallier L. Student and faculty satisfaction with their dental curriculum in a dental college in Saudi Arabia. Int J Dent 2020;2020:6839717. |
| 21 | Ocampo AC, Reyes ML, Chen Y, Restubog SL, Chih YY, Chua-Garcia L, et al. The role of internship participation and conscientiousness in developing career adaptability: A five-wave growth mixture model analysis. J Vocat Behav 2020;120:103426. |
| 22 | Abu-Hammad S, Elsayed SA, Nourwali I, Abu-Hammad O, Sghaireen M, Abouzaid BH, et al. Influence of gender on career expectations of oral and maxillofacial surgeons. J Craniomaxillofac Surg 2020;48:458-62. |
| 23 | Dar-Odeh N, Elsayed SA, Nourwali I, Ryalat S, Al-Shayyab MH, Abu-Hammad O. Social factors as career obstacles for female oral and maxillofacial surgeons in three Middle Eastern countries. Int J Oral Maxillofac Surg 2019;48:1504-8. |
| 24 | Dar-Odeh N, Elsayed S, Babkair H, Abu-Hammad S, Althagafi N, Bahabri R, et al. What the dental practitioner needs to know about pharmaco-therapeutic modalities of COVID-19 treatment: A review. J Dent Sci 2021;16:806-16. |
| 25 | Aherne D, Farrant K, Hickey L, Hickey E, McGrath L, McGrath D. Mindfulness based stress reduction for medical students: Optimising student satisfaction and engagement. BMC Med Educ 2016;16:209. |
| 26 | Almaymuni AD, Alamri AA, Alnefaie MN. Knowledge and perception on surgical and invasive procedure protocols among final year medical students and interns in a university affiliated hospital in Jeddah. Egypt J Hosp Med 2017;69:3077-82. |
| 27 | Niemi-Murola L, Helenius I, Turunen J, Remes V. Graduating medical students and emergency procedure skill teaching in Finland – Does a clinical skills centre make the difference? Med Teach 2007;29:821-6. |
| 28 | Elsayed SA, Ayed Y, Alolayan AB, Farghal LM, Kassim S. Radiographic evaluation and determination of hypercementosis patterns in Al-Madinah Al-Munawwarah, Saudi Arabia: A retrospective cross-sectional study. Niger J Clin Pract 2019;22:957-60. |
| 29 | Elsayed SA, Althagafi N, Bahabri R, Alshanqiti MM, Alrehaili AM, Alahmadi AS. Retrospective radiographic survey of unconventional ectopic impacted teeth in Al-Madinah Al-Munawwarah, Saudi Arabia. Open Access Maced J Med Sci 2020;8:203-8. |
| 30 | Meisha DE, Alsolami AM, Alharbi GM. Social determinants of seeking emergency and routine dental care in Saudi Arabia during the COVID-19 pandemic. BMC Oral Health 2021;21:212. |
| 31 | Alhamami M. Makkah is the ultimate multilingual phenomenon. Int J Islam Thought 2018;14:60-71. |
| 32 | Elsayed SA, Alolayan AB, Alahmadi A, Kassim S. Revisited maxillary sinus pneumatization narrative of observation in Al-Madinah Al-Munawwarah, Saudi Arabia: A retrospective cross-sectional study. Saudi Dent J 2019;31:212-8. |
| 33 | Zaki H, Alolayan AB, Ahmed WM, Alabdeen EZ, Elsayed SA. Minimally invasive technique for removal of a mandibular radicular cyst: A case report. Enviro Dent J 2021;03:13-6. |
| 34 | Elsayed S, Alolayan A, Farghal L, Ayed Y. Generalised hypercementosis in a young female seeking extraction: Revision and update of surgical technique. J Coll Physicians Surg Pak 2019;29:1111-3. |
| 35 | Shi XC, Gordon S. Organizational support versus supervisor support: The impact on hospitality managers' psychological contract and work engagement. Int J Hosp Manag 2019;87:102374. |
| 36 | Shah S, Halai T, Patel J, Sproat C. Perceived confidence and experience in oral surgery among final year undergraduate students in a UK dental school. Br Dent J 2018;224:177-82. |
| 37 | Pedro JD. Induction into the workplace: The impact of internships. J Vocat Behav 1984;25:80-95. |
| 38 | Narayanana VK, Olk PM, Fukami CV. Determinants of internship effectiveness: An exploratory model. Acad Manag Learn Educ 2010;9:61-80. |
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