An analysis of resilience in dental students using the Resilience Scale for Adults

Well-being of undergraduate dental students: Questionnaire design, findings and future directions

INTRODUCTION

The recent pandemic has highlighted the importance of addressing well-being in the overall health of students. There is a need for support systems within dental schools to help students demonstrate resilience, adapt to learning environments and thrive in their professional careers.

OBJECTIVES

The main aim of the study was to evaluate Bachelor of Dental Surgery (BDS) students' understanding and experience of well-being. The objectives were to create a suitable survey to assess students' well-being, investigate the factors affecting dental students' well-being and develop a student well-being action plan based on the analysis of the survey.

METHODS

A literature review was conducted to identify and critically assess existing measures of well-being in dental students. Four domains of well-being (emotional, physical, social, intellectual) relevant to dental students were identified. Through a comprehensive iterative process, a two-part survey was developed and tested, which measured individual experiences of well-being across the four domains and collected feedback on proposed initiatives to support student well-being. The survey was disseminated to all 452 dental students from Years 1 through 6, of which 71% (321) responded.

RESULTS

The survey revealed low levels of overall well-being among the dental student population, which worsened with increasing years of clinical study. Fear of failing exams presented the biggest challenge with regard to emotional well-being, while sleep deprivation and occupational health hazards most affected the physical well-being domain. Intellectual well-being was compromised by insufficient free time to pursue extracurricular interests and concerns about achieving the required skills. Despite a majority experiencing positive relationships with their peers and tutors, less than a fifth agreed that the Faculty of Dentistry 'supported my well-being as a dental student'.

CONCLUSION

As the first investigation of the well-being of dental students in Hong Kong, the key stressors identified were examinations, long schedules and the physical burden of dental work, which are consistent with international literature. The findings reveal students' needs and preferences for well-being initiatives which will be optimized in the implementation of student-centred curricular activities.

A cross-sectional study of academic success measures, grit, and resilience among US dental students

PURPOSE

This study explored themes previously identified as central to holistic professional school success, as related to traditional academic achievement, resilience, and grit measures.

METHODS

This cross-sectional study surveyed third- and fourth-year US dental students. Items addressed themes previously identified as central to professional school success, including need for cognition, patient ownership, collective orientation, grit, and resilience. Traditional academic metrics were also included. Statistical analyses comprised one-way analysis of variance (ANOVA), simple linear regression, and stepwise multiple regression procedures.

RESULTS

A total of 126 students participated (81% response rate). Collective orientation, need for cognition, patient ownership, and resilience did not significantly correlate with grade point average (GPA), whereas grit did, r = 0.29. Need for cognition and patient ownership combined significantly predicted grit with approximately 35% of variance explained. Approximately 25% of variance in resilience scores was accounted for by need for cognition, coupled with collective orientation. Grit and resilience significantly correlated, r = 0.59.

CONCLUSIONS

Grit significantly predicted both traditional and alternative metrics of success among dental students, particularly need for cognition and patient ownership. A high need for cognition is consistent among students who display both grit and resilience. Neither resilience nor the alternative measures of success predicted traditional academic metrics.

The six-domain well-being framework in oral health sciences: A pathway from theory to practice

OBJECTIVES

Well-being is a complex and multifaceted construct that has gained popularity in oral health sciences education. Maintaining students' well-being is essential for their academic performance and quality of life. While many definitions and frameworks of well-being exist, their applicability to oral health sciences education remains unknown. This study aimed to evaluate the applicability of the Feeney and Collins's framework of well-being to oral health sciences education by exploring students' perceptions and experiences in the University of British Columbia METHODS: An Interpretive Description approach was used to conduct semi-structured interviews with dental and dental hygiene students. Interviews were transcribed, and transcripts were coded and analyzed with guidance from Feeney and Collins's well-being and thriving framework using content analysis. Domains were inductively developed within and beyond the organizing categories of the chosen framework.

RESULTS

Thirty-one oral health sciences students participated in the study. Study data can largely be explained by the five well-being domains suggested by Feeney and Collins: physical, psychological, eudaimonic, subjective, and social. Spirituality and gratitude emerged as an additional domain that contributes to students' well-being. Interdomain relationships were observed. The social domain seemed to contribute to all other well-being domains; while the subjective domain seemed to be shaped by all other domains CONCLUSIONS: Feeney and Collins's framework seemed to be useful to understand and conceptualize well-being in oral health sciences education but needed to be expanded to include spirituality and gratitude. Further evidence is needed to explore the applicability of this framework in other health professional education disciplines.

Are we well? A post-pandemic snapshot of dental educator wellness, well-being, and fulfillment

INTRODUCTION

The COVID-19 pandemic brought unprecedented changes to oral care and dental education delivery. To date, the vast majority of studies focus on the impact COVID-19 had on the well-being and wellness of patients, practitioners, and students; however, limited literature addresses the pandemic's impact on dental educators.

PURPOSE

The aim of this study was to investigate the wellness, well-being, and fulfillment of dental educators in the years following the onset of the COVID-19 pandemic.

METHODS

Following Institutional Review Board approval, an anonymous electronic Qualtrics survey was emailed to full-time and adjunct faculty across five (5) dental education institutions in the US. Faculty self-reported on their wellness, general well-being, physical well-being, mental well-being, fulfillment, and work-life balance. Group differences were examined using analysis of variance and the Tukey-Kramer test for multiple comparisons at the p < 0.05 level.

RESULTS

The results revealed females and younger dental faculty members reported statistically significantly lower levels of wellness (F2, 123  = 11.16, p < 0.001, F3, 121  = 8.53, p < 0.001), physical (F2, 123  = 11.53, p < 0.001, F3, 121  = 5.54, p = 0.001) and mental well-being (F2, 123  = 12.49, p < 0.001, F3, 121  = 8.63, p < 0.001), fulfillment (F3, 121  = 5.01, p < 0.003), and higher levels of burnout (F2, 123  = 5.53, p = 0.005, F3, 121  = 4.85, p < 0.003). Those who expressed higher levels of burnout also had statistically lower mean well-being scores (F4, 119  = 10.54, p < 0.001). Females also reported a significantly lower work-life balance score compared to male respondents (F2, 121  = 10.37, p < 0.002).

CONCLUSION

Despite the social and environmental challenges faced over the last couple of years post-pandemic, dental educators demonstrate a quick ability to adapt, however, disproportional differences in gender and age groups were identified as being significantly correlated to dental educators' self-reports on wellness, well-being, and fulfillment. Insight into these variables can help inform strategies in the academic setting to help support and strengthen the academic workforce.

Understanding the Quality of Life and Its Related Factors in Orthodontics Postgraduate Students: A Mixed Methods Approach

This study analyzed the academic, sociodemographic, and labor conditions related to the quality of life (QOL) of orthodontics postgraduate students in Colombia. A mixed study (explanatory sequential design) was conducted. An online cross-sectional survey (n = 84; 64.3% females) was carried out with sociodemographic, academic, social support, health, labor, and QOL (WHOQOL-BREF) variables. Descriptive, bivariate analyses, and multivariate linear regression were performed. Focus groups (FGs) delved into aspects of relevance regarding QOL and determinants, through qualitative content analysis and triangulation of information. The median score in the four WHOQOL-BREF dimensions surpasses 50 points, with the highest score being in the psychological dimension (62.5 ± 16.7). According to the multivariate linear regression models, the variables significantly associated with QOL scores were playing sports, being married/living together, normal BMI, low social support, and medium/low socioeconomic status. The qualitative results explained the determinants of QOL in the personal, academic, and social dimensions of the participants. The discourses showed that the postgraduate course represents a resignification of their life, where their QOL is affected by the difficulties of their academic development, by the difficulty of reconciling the personal academic load with their affective, work, and social life, and by the stress they experience in their staff process. In conclusion, the participants' QOL was moderate and affected by different factors. The findings highlighted the importance of mental health promotion and well-being strategies in students of orthodontic postgraduate training programs in Colombia for improving QOL.

Impact of resilience and environmental stress on burnout of students in public and private dental schools in Western Saudi Arabia

Background

Dental students' burnout has been repeatedly reported in the literature; however, there is little information about the contributing factors in different contexts and settings.

Aims

This study aimed to investigate the correlation between burnout among undergraduate dental students and sociodemographic (specifically gender), psychological (resilience), and structural factors (dental environment stress).

Subjects and Methods

An online cross-sectional survey questionnaire was distributed among a convenience sample of 500 undergraduate Saudi dental students. The survey included questions about sociodemographic factors (gender, level of education, academic achievement, type of school [public or private], and living arrangements). The study also included items that allowed assessment of students' burnout using the Maslach Burnout Inventory (MBI) and assessment of student environmental stress and resilience using the Dental Environment Stress Scale (DESS) and the Brief Resilience Scale (BRS). Descriptive statistics, univariate, and linear regression analyses were performed.

Results

The response rate was 67% (male = 119, female = 216). Univariable analysis showed that gender, level of education, and DESS and BRS scores correlated significantly (P <.05) with MBI scores. Adjusted multiple linear regression lends further support to that the MBI scores negatively correlated with the BRS score but positively correlated with the DESS score (β = -0.29, P <.001; β = 0.44, P <.001, respectively).

Conclusions

Within the limitations of this study, the findings demonstrated that increases in resilience correlated significantly with decreases in burnout and increases in environmental stress correlated significantly with increases in burnout among dental students. However, gender had no influence on burnout.

Students' resilience and mental health in the dental curriculum

OBJECTIVES

Dental education is perceived as a source of students' psychological and occupational stress. Resilience has been proposed as a protective factor that may support students' in managing that stress. The objectives of this study were twofold: to map the mental health and well-being content in the curriculum of the Faculty of Dentistry (FoD) at the University of British Columbia (UBC) and to investigate factors influencing resilience levels amongst dental students at UBC.

METHODS

The curricular database and website of UBC's FoD were used to gather information on mental health content. A survey with the Connor-Davidson 10-Item Resilience Scale was distributed to dental students at UBC (N = 289). Students' de-identified demographic data were also collected.

RESULTS

Two main mental health and well-being curricular components were identified: one didactic session on stress management and one interactive workshop on resilience. The response rate for the survey was 68.2%. Students who did not receive any mental health content (2020/21 year 1 students) had higher resilience scores (p = .043) when compared to students who received both components (2019/20 year 1 students and 2018/19 year 2 students). The multiple regression analysis highlighted North American/European ethnic origins as a predictor for higher resilience levels (p = .008).

CONCLUSIONS

The results of this study showed that ethnic origins and major life events, such as the pandemic, influenced resilience. Curricular activities promoting resilience seemed to not necessarily impact students' resilience. Further longitudinal studies are needed to assess the curricular and non-curricular activities influence over dental students' well-being.

A cross-sectional study investigating mental health and resilience among pre-doctoral students at a US dental school

PURPOSE/OBJECTIVES

This study explored key mental health measures as self-reported by pre-doctoral dental students enrolled in all four years of dental school and their relationships with a year in school and resilience.

METHODS

This study utilized archival data from the National Collegiate Health Assessment (NCHA) survey administered in Fall 2020. This instrument is a compilation of validated measures assessing a broad spectrum of health-related behaviors, including nutrition, substance use, social relationships, and mental health. The mental health measures explored in this study included validated scales assessing mental distress, suicide behavior risk, psychological well-being, and resilience.

RESULTS

Students in all 4 years of dental school completed the survey (62% response rate). Most students reported high resilience, positive psychological well-being, and moderate mental distress, with mental health challenges spiking in the D2 and D3 years. Resilience emerged as a protective factor for student mental health. Years in school did not retain a significant impact on mental health when controlling for resilience.

CONCLUSIONS

Resilience is important in bolstering dental students' mental health. Dental students' mental health challenges increased during the D2 and D3 years. Dental educators may positively influence student well-being by taking measures that foster resilience at the beginning of and midway through dental school.

A scoping review and evaluation of instruments used to measure resilience among post-secondary students

As mental health problems continue to increase among post-secondary populations, the need to develop effective initiatives designed to bolster students' resilience has increasingly been identified as a priority. Therefore, access to valid tools with which to measure the efficacy of these interventions is imperative. To date, a comprehensive assessment of existing instruments used to evaluate the construct of resilience among post-secondary student populations has not been conducted. The purpose of this study was to fill this gap by conducting a scoping review of literature detailing the use of resilience instruments and evaluating their quality based on suitability for use in the post-secondary setting and associated psychometric evidence. We identified a total of 78 records published between 2010 and 2022, extracting a total of 12 instruments. Using detailed criteria frameworks, each instrument was assessed in terms of suitability and quality of associated psychometric evidence for validity and reliability. The results of our study suggest that many of the instruments currently being used to assess resilience among post-secondary students may not be appropriate. The majority of the instruments included in our review were developed for use among general adult populations and not specifically designed for use in the post-secondary setting. Most instruments did not assess resilience in a comprehensive, holistic matter that addressed the ability to bounce back from adversity by drawing upon psychological, social, cultural, and environmental resources, as defined by recent research. Further, no instruments included in our review had published evidence in support of a complete psychometric analysis. The results of our evaluation suggest that the Connor-Davidson Resilience Scale (CD-RISC) is the most suitable instrument for measuring resilience among post-secondary populations due to its suitability, comprehensive assessment of the construct of resilience, and demonstrably strong psychometric properties for both the 25- and 10-item versions of the tool.

Relação entre Perfil, Hábitos, Vivências Acadêmicas e Resiliência de Universitários

Resumo A falta de recursos para lidar com situações desafiadoras pode dificultar o ajuste do estudante à universidade e aumentar o risco de fracasso acadêmico. Pensando nisso, o objetivo deste estudo foi verificar se há relação entre o perfil, os hábitos de vida, as vivências acadêmicas e a resiliência de graduandos das áreas da saúde e Psicologia. Trata-se de um estudo transversal e inferencial. Participaram 361 graduandos dos cursos de Biomedicina, Educação Física, Enfermagem, Farmácia, Fisioterapia, Medicina, Nutrição, Terapia Ocupacional e Psicologia, matriculados em três instituições federais de Ensino Superior do interior de Minas Gerais. Utilizou-se um questionário sociodemográfico e de hábitos de vida, a Escala de Resiliência e o Questionário de Vivências Acadêmicas - versão reduzida -, respondidos de forma on-line pelos universitários, bem como análises descritivas e correlacionais. Os resultados mostraram resiliência média para a maioria dos universitários e boa adaptação ao contexto universitário, além de relações entre a resiliência e o período cursado, estar em psicoterapia, avaliar positivamente a própria saúde e todas as dimensões das vivências acadêmicas. Conclui-se que a resiliência é uma capacidade importante para enfrentar as demandas da graduação e que é possível desenvolvê-la, especialmente durante o começo da graduação e com a adoção de intervenções focadas no autoconhecimento, na autoeficácia e em boas estratégias de enfrentamento. Desenvolver a resiliência nos estudantes pode colaborar para a promoção da saúde desta população e a redução da evasão no Ensino Superior.

Dental faculty well-being amid COVID-19 in fall 2020: A multi-site measure of burnout, loneliness, and resilience

PURPOSE/OBJECTIVES

This study aimed to understand the impact of the COVID-19 pandemic on dental school faculty's self-reported burnout, loneliness, and resilience.

METHODS

A 34-item questionnaire composed of three previously validated scales - adapted Copenhagen Burnout Inventory, the brief resilience scale, and a short loneliness scale - and demographic information was sent by email to dental school faculty in four dental schools across the US during the sixth and seventh months of the COVID-19 pandemic.

RESULTS

Two-hundred sixteen (19.63%) of faculty invited to participate completed the survey. On a scale of five, with five indicating extreme burnout and one indicating no burnout, the average personal burnout was 2.7 (SD = 0.83), and work-related burnout (WRB) was 2.8 (SD = 0.83). Personal and WRB decreased with increasing age. WRB was significantly higher among full-time faculty, females, and those living alone. Faculty who lived alone experienced more loneliness than those who lived with others. Resilience was not a statistically significant difference across demographic groups. Regarding the impact of COVID-19 pandemic on their burnout, loneliness, and resilience on a scale ranging from "Never" (scored as 1) to "A great deal" (scored as 5), the average response for burnout was 3.3 (SD = 1.01), loneliness was 2.6 (SD = 1.10), and resilience was 2.8 (SD = 0.99).

CONCLUSION(S)

While self-reported burnout and resilience scores did not show a significant increase during the pandemic, the rates of burnout and loneliness remain higher than the public. Dental education has real challenges and opportunities to explore individual and organizational interventions to combat burnout and loneliness and enhance resilience among faculty.

Mental health and wellness in Canadian dental schools: Findings from a national study

OBJECTIVES

To survey the mental health and wellbeing content in the curricula, services, and activities of the 10 Canadian dental schools, and to explore the specifics of this area in the Faculty of Dentistry (FoD) at The University of British Columbia (UBC).

METHODS

An electronic survey consisted of four major categories: curricular activities and services, structural approaches, infrastructural approaches, and evaluation methods, was distributed to all Canadian dental schools. A situational analysis was conducted at UBC's FoD via document appraisal and key informants' exploratory interviews.

RESULTS

Eight dental schools responded to the survey showing that didactic sessions being the pedagogical method to deliver resilience content. None of the responding schools reported formally evaluating their mental health content. Through situational analysis, a relational map that identified four major areas contributing to students' mental health at UBC's FoD was generated which includes four major aspects: (1) curricular content on mental health, (2) informal wellbeing and mental health networks, (3) protective, and (4) risk factors influencing students' mental health.

CONCLUSIONS

As this study described the mental health and wellbeing activities, services, and curricular content across multiple Canadian dental schools, the diverse approaches each school adopted and how personal and professional aspects of students' lives being attempted to be addressed are a critical starting point to engage educators in dentistry. The situational analysis outcome, where a detailed description of the mental health situation at UBC's FoD, can be used to guide in-depth studies of the area of wellbeing at other dental schools.

COVID-19 and Dental and Dental Hygiene Students' Career Plans

OBJECTIVE

The aims of this study were to investigate whether dental and dental hygiene students' career plans postgraduation were affected by the coronavirus disease 2019 (COVID-19) pandemic and to examine wellness and readiness for clinical practice among students who reported a change in career plans.

METHODS

An anonymous online REDCap survey was developed and emailed to 436 dental and dental hygiene students at a US dental school. The survey consisted of 81 questions that covered demographics, career plans postgraduation, and readiness and wellness measures. An open-ended question assessing how students' career plans have changed during the pandemic was also included.

RESULTS

A total of 252 students completed the survey, of whom 11.5% reported that their plans for future dental practice have changed since the COVID-19 outbreak. Students who reported a change to their career plans had significantly higher mean perceived stress (20.1 vs. 16.3; P = 0.003) and anxiety (9.2 vs. 6.2; P = 0.004) scores and lower mean resilience (18.9 vs. 20.9; P = 0.01) scores than those who reported no change to their career plans. Concerns were raised regarding the limited employment opportunities, long-term stability of the dental profession, and the interruptions to clinical education and licensure examinations consequent to the pandemic.

CONCLUSIONS

A comprehensive effort inclusive of adeptly designed clinical and curriculum experiences paired with wellness interventions and support tailored to students is needed. These measures need to support trainees across varying years in training and resilience levels to be effective for dental and dental hygiene students as they approach their future career intentions in the dental profession. Additional longitudinal research is needed to assess if change in career intentions during the COVID-19 pandemic corresponds with actual change postpandemic and affects the dental profession.

KNOWLEDGE TRANSFER STATEMENT

This study explores the potential short-term change in career intentions of dental hygiene and dental students during the COVID-19 pandemic. Findings can inform workforce planning as well as interventions developed and implemented by academic dental institutions to support student wellness during unexpected and prolonged emergency situations.

A descriptive pilot study of the immediate impacts of COVID-19 on dental and dental hygiene students' readiness and wellness

BACKGROUND

The ongoing novel coronavirus disease 2019 (COVID-19) pandemic has impacted dental students training across the U.S. academic dental institutions by moving classroom instruction to an online modality, limiting patient care, canceling external rotations, and rescheduling of licensure examinations.

OBJECTIVE

The aim of this study was to assess the immediate impacts of COVID-19 on students' readiness to enter clinical practice or residency and its association with well-being (anxiety, perceived stress, coping and social support, and resilience).

METHODS

An online REDCap survey was distributed to 407 D1-D4 year dental students and 29 DH3-DH4 year dental hygiene students enrolled at a U.S. dental school. The survey consisted of readiness and wellness measures as well as socio-demographic variables.

RESULTS

Overall response rate was 58% (N = 252) ranging from 40% among D4 students to 72% among D1 students. About half (55%) of the respondents were White, a third (34%) Asians and 5% were African Americans. Ninety-two percent were non-Hispanics while 62% were female. Overall mean (SD) anxiety score was 6.5 (5.3) and 26% of respondents reported moderate or severe levels of anxiety. Anxiety score differed significantly by gender with females reporting higher anxiety levels, mean (SD) = 7.3 (5.5) versus 5.2 (4.7) for males; P = 0.002). Furthermore, mean anxiety score differed significantly among the dental school classes, ranging from 5.5 (5.3) among D2 students to 11.8 (6.2) in DH4 students (P = 0.02).

CONCLUSION

Academic dental institutions need to be responsive to the heightened anxiety and uncertainly levels of students and provide responsive training and support to mitigate its effects.

The Protective Role of Resilience in Emotional Exhaustion Among Dental Students at Clinical Levels

Purpose

The epidemic of burnout among dental students has been repeatedly documented. This study aimed to assess burnout, specifically emotional exhaustion (EE), and examined the impact of protective and risk psychological factors for EE among clinical-level dental students in Saudi Arabia (SA).

Methods

A cross-sectional study was conducted, using a convenience sample of undergraduate dental students who were recruited from five separate dental schools. A self-administered questionnaire was distributed to 500 students to obtain socio-demographic data and to assess the students’ psychological characteristics (Maslach Burnout Inventory EE subscale, Dental Environment Stress Scale [DES] and Brief Resilience Scale [BRS]). Descriptive, bivariate and multivariable logistic regression analyses were performed.

Results

Of 272 respondents, 53% reported high EE. Adjusted multivariable logistic regression modelling demonstrated that students who reported higher BRS scores were significantly less likely to report high EE (adjusted odds ratio [AOR]=0.79, 95% CI=0.70–0.89, p<0.001). However, females were more than twice as likely as males to report high EE (AOR=2.27, 95% CI=1.14–4.61, p=0.024). In addition, students who reported higher DES scores also reported high EE (AOR=1.10, 95% CI=1.07–1.12, p<0.001).

Conclusion

The findings suggest that resilience is a protective factor against high EE, after adjusting for key characteristics. There is a need for a preventive programme that addresses EE, taking into consideration other unexplored underlying factors.