Effect of distance learning on the quality of life, anxiety and stress levels of dental students during the COVID-19 pandemic

Metaphorical perceptions of dental students toward dental education: a cross-sectional study from Türkiye

BACKGROUND

Understanding the complex, multifaceted, and often subconscious emotional and cognitive perspectives of undergraduate dental students regarding their education is crucial. Personality types and stress levels are believed to play a significant role in shaping these perceptions. Employing metaphors-using a familiar and concrete concept to explain an unfamiliar or abstract one-is an effective cognitive transfer technique for exploring students' views on dental education. This cross-sectional study aims to investigate dental students' perceptions of their education through metaphor analysis. Additionally, it aims to examine the relationship between students' personality types and stress levels, offering deeper insights into the factors influencing their educational experiences.

METHODS

This cross-sectional study included 1038 undergraduate dental students enrolled in faculties of dentistry at three universities in Türkiye during the 2023-2024 academic year. Data were collected via an electronic survey consisting of four sections. The first section gathered demographic information (gender, age, academic level, and occupational preference). In the second section, participants completed the sentence: "Dental education is similar to … because …" to illustrate their mental representations of dental education. The third section included the Perceived Stress Scale (PSS) to assess stress levels, while the fourth section comprised a personality inventory to determine personality types. All survey data were transferred to Excel for analysis. Metaphors were systematically evaluated, and the most representative ones were identified. Data analysis incorporated both qualitative (metaphor analysis and chi-square tests) and quantitative (linear regression) methods.

RESULTS

Metaphors were categorized into seven conceptual groups: 'master-apprentice training', 'challenging process-race', 'art-skill-creativity', 'patience-labor', 'union of differences', 'discipline-order-power', and 'unknowability-incomprehensibility-indispensability'. A significant gender difference was observed (p = 0.013): female students predominantly used metaphors in the 'patience-labor' category, while male students favored the 'art-skill-creativity' category. Academic year differences were also significant (p < 0.001), with advanced students more frequently using 'discipline-order-power' metaphors. Stress levels did not significantly differ among groups (p = 0.127), with 72.1% of participants reporting moderate stress, most commonly linked to the 'challenging process-race' category. The majority of participants (64.5%) exhibited a Type B personality. A statistically significant regression model was found between PSS scores and both age (p < 0.001) and personality type scores (p = 0.011).

CONCLUSION

This study highlights the influence of personality types and stress levels on dental students' perceptions of their education. Metaphor analysis proved to be an effective tool for identifying these perceptions. The most frequently reported category was 'challenging process-race'. A significant association was found between students' metaphorical categories and their gender and academic level. However, no significant relationships were observed between metaphor categories and occupational preference, stress levels, and personality types.

Managing Stress and Somatization Symptoms Among Students in Demanding Academic Healthcare Environments

INTRODUCTION

Stress is a common concern among healthcare students, due to the demands of their coursework and the elevated expectations they face. Especially among dentistry and nursing students, the phenomenon, although well-documented, covers psychosocial and physiological dimensions, with somatization symptoms being less explored. These manifestations are crucial to identify discipline-specific stressors and health impacts that can lead to targeted interventions for both disciplines.

AIM

This study investigates stress perceptions, somatization, and coping strategies among 271 nursing and dentistry students at the National and Kapodistrian University of Athens.

METHODOLOGY

An e-questionnaire was open for submissions during February and March 2024.

RESULTS

Females reported higher stress somatization (M = 10.22, SD = 5.23) than males (M = 7.94, SD = 6.14; Cohen's d = 0.412, p < 0.05). The interpretation of stress as "restlessness and psychological pressure" was more prevalent in dentistry students compared to nursing students. Moreover, nursing students who perceived stress as the "inability to manage unexpected or difficult situations, insecurity, panic" were more likely to experience stress somatization symptoms, while for dentistry students, stress somatization was related to "pressure to meet daily obligations/long-term goals". Physical symptoms for all students included chest discomfort, digestive issues, and headaches/nausea. Also, dentistry students reported more teeth clenching or grinding than nursing students. Short-term coping strategies included emotional balance, managing stressors, situation analysis, and breathing techniques. Long-term strategies involved distraction and entertainment, physical exercise, and patience. A higher willingness to seek coaching support correlated with higher stress somatization among dental students. Nursing students favored psychological support, while dentistry students suggested curriculum revision and improved infrastructure.

DISCUSSION/CONCLUSIONS

Females exhibited higher stress somatization levels, with themes of insecurity and physical symptoms. Nursing students reported higher somatization linked to insecurity, while dental students associated stress with daily obligations and goals. The study highlights the need for improved support systems, flexible academic procedures, and better communication to address stress in healthcare academia.

Exploring the influence of learning modality preferences and COVID-19 infection experiences on depressive mood in Chinese students

The COVID-19 pandemic has significantly impacted the mental health of children and adolescents worldwide. While various factors contributing to this phenomenon have been explored, the role of learning style preferences remains underexamined. This cross-sectional study, conducted between October and November 2020, involved over 20,000 participants, including students from junior high school, senior high school, and undergraduate levels. Significant differences in depressive mood levels were observed among individuals with different learning modality preferences upon the return to traditional, in-person learning. Students with in-person learning preferences exhibited lower depression levels, while students with no preference for either learning style outperformed devotees of remote learning. The highest depression occurred among those endorsing neither learning mode. Importantly, the impact of these preferences on depressive moods was found to be moderated by COVID-19 infection experiences. The findings highlight the nuanced relationship between learning style preferences, COVID-19 infection experiences, and mental health outcomes among students. Acknowledging the moderating effect of infection experiences is crucial for developing targeted interventions and adapting pedagogical approaches post-pandemic. This study contributes valuable insights into the complex relationships shaping the mental well-being of students amidst educational disruptions caused by the pandemic.

The impact of the Khartoum war on dental education

The relentless conflict in Khartoum has severely crippled higher education, especially in specialized fields like dental education. The war has wreaked havoc on academic schedules, severely damaging infrastructure, and creating an atmosphere of pervasive uncertainty and stress for students and faculty alike. Academic continuity has been shattered, with courses and training programs facing frequent disruptions, leaving students struggling to complete their studies and gain essential practical experience. Faculty members, too, are under immense pressure, dealing with the dual burdens of maintaining educational standards and ensuring personal safety. This commentary delves into the devastating and far-reaching consequences of the ongoing conflict on dental education in Khartoum, highlighting the urgent need for comprehensive recovery and support strategies to restore this critical field.

Resilience and psychological factors among dentistry students who received face-to-face lectures during the COVID-19 pandemic

BACKGROUND

This research evaluated whether the relationships between factors of resilience, self-esteem, depression, and anxiety in dental students with changes in teaching and learning methods. We also studied the psychological impact of face-to-face lectures during the COVID-19 pandemic.

METHODS

This cross-sectional descriptive study used Google Forms to collect data with the Rosenberg Self-Esteem Scale (RSE), Connor-Davidson Risk Resilience Scale (CD-RISC), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI and BDI-II). An open-ended question was also asked about important learning difficulties.

RESULTS

The analysis revealed very high levels of resilience (30.23 ± 5.84), self-esteem in the normal range (29.08 ± 4.03), minimal depression levels (12.32 ± 8.05), and low anxiety levels (17.20 ± 12.41). There were no significant differences between sociodemographic variables ranges in regard to all psychological questionnaires. No high levels of depression and anxiety were found.

CONCLUSIONS

The levels were low compared to other studies in which online teaching was used, which is explained by the fact that the students retained adequate resilience and self-esteem thanks to being able to contact teachers and, above all, their own peers.

Unraveling the core symptoms of mental health in senior grade three students- a network analysis

Background

Adolescence is not only an important transitional period of many developmental challenges, but also a high risk period for mental health problems. Psychotherapy is recommended for mental health problems in adolescents, but its effectiveness is not always satisfactory. One possible contributing factor may be the lack of clarity surrounding core symptoms.

Methods

In this study, we investigated the mental health status of senior grade three students, a group of adolescents facing college entrance exams, by the Middle School Student Mental Health Test (MHT) and analyzed the core symptoms by network analysis. This study was conducted through an online survey platform (www.xiaodongai.com) from 15 February 2023 to 28 March 2024. The subjects scanned a QR code with their mobile phone to receive the questionnaire.

Results

The mean age of these 625 students were 18.11 ± 2.90 years. There are 238 male participants and 387 female participants. 107 individuals scored above 56 (107/461, 23.2%), with individual scale scores over 8 up to over 60% of participating students. Notably, the top three prominent symptoms were "academic anxiety", "allergic tendency" and "somatic symptoms". However, upon conducting network analysis, it became evident that three strongest edges in this network were "somatic symptoms" and "impulsive tendency", "academic anxiety" and "social anxiety" as well as "social anxiety" and "Loneliness tendency". "somatic symptoms", "social anxiety" and "self-blame tendency" exerted the highest expected influence. This suggests that, statistically speaking, these three symptoms exhibited the strongest interconnections within the network.

Limitation

Cross-sectional analysis; Bias in self-reported variables.

Conclusion

These findings can deepen the knowledge of mental health among senior grade three students and provide some implications (i.e., targeting symptoms having highest expected influence) for clinical prevention and intervention to address the mental health needs of this particular group.

A comparison of online and face-to-face modalities in endodontic preclinical education: A retrospective study

PURPOSE

The aim of this study was to evaluate the competency of undergraduate students in following the principles of access cavity preparation and the radiographic quality of root canal filling in maxillary molar teeth in either online or face-to-face education courses during the novel coronavirus disease 2019 (COVID-19) pandemic.

METHODS

A total of 178 extracted maxillary molar teeth that underwent endodontic dental treatment by undergraduate students who completed the endodontic preclinical practice course online or face-to-face during the COVID-19 pandemic were retrospectively analyzed. A visual access cavity examination determined the form, width of the cavity, deroofing of the pulp chamber, and the presence of a perforation. Root canal fillings were examined radiographically on periapical radiographs for length, homogeneity, taper, and the presence of iatrogenic defects. Statistical analysis was performed using the chi-square test.

RESULTS

The incidence of incorrect form, wide cavities, and perforation was statistically higher in the online group than in the face-to-face group (p < 0.05). It was determined that root filling length and homogeneity were more successful in the face-to-face group (p < 0.05). When evaluated for iatrogenic errors, the presence of broken instruments was found to be significantly higher in the online group (p < 0.05). There was no significant difference between the groups in other iatrogenic errors and the taper of the root canal filling (p > 0.05).

CONCLUSION

The students who underwent face-to-face education were more successful in accessing cavity preparation and root canal fillings than the students who undertook online education.

Update of students' and lecturers' perspectives on online learning in dental education after a five-semester experience due to the SARS-CoV-2 (COVID-19) pandemic: insights for future curriculum reform

BACKGROUND

The coronavirus disease (COVID-19) pandemic has accelerated digital transformation in dental education, resulting in a shift from face-to-face teaching to online learning. While online learning could be a common strategy in various fields, the challenge for dental education is that it depends on the requirements of clinical experience to achieve competence in performing the dental treatment. This cross-sectional study aimed to analyse students' and lecturers' perceptions towards online learning after five semesters of experience using a questionnaire survey.

METHODS

Since the spring term of 2020, the theoretical part of the curriculum has been conducted in the form of online learning using a combination of synchronous and asynchronous formats. In the following semesters, more theoretical content was shifted back from online learning to face-to-face courses. Preclinical and clinical students enrolled in the dental curriculum during the spring term 2022 semester and all lecturers with at least one year of teaching experience in face-to-face and online learning formats were asked to fill out an online questionnaire regarding the aspects of handling, didactic benefit, motivation, and overall assessment.

RESULTS

Students and lecturers rated the implementation of online learning as mostly positive, but pointed out that established 'face-to-face' learning could not be replaced. Moreover, the students reported personal benefits in terms of daily planning. Lecturers also benefitted as their experience increased in online teaching. For future curriculum, students demanded 49.5% (25.1) ((mean (standard deviation) of theoretical part in terms of online learning), while lecturers demanded only 34.1% (24.1).

CONCLUSIONS

Despite having no prior need for online learning, students and lecturers showed a positive perspective on online learning which should be considered in the implementation and planning of future dental education. However, in terms of practical training, it cannot replace face-to-face education in dentistry.

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.

Mental Health and Quality of Life among Dental Students during COVID-19 Pandemic: A Cross-Sectional Study

Students are particularly vulnerable from the mental health aspect, which was especially recognized during the COVID-19 pandemic. This study aimed to reveal the impact of COVID-19 on quality of life (QoL) and mental health among dental students. The study was conducted on a sample of 797 students (207 male and 592 female) with an average age of 21.7 ± 2.4, from the School of Dental Medicine, University of Belgrade. The measurements used in the study were the Demographic and Academic Questionnaire, Questionnaire about exposure to COVID-19, COVID-19-Impact on QoL Questionnaire (COV19-QoL), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire (PHQ-9). The mean total score for COV19-QoL was 2.9 ± 0.9, while the diagnostic criteria of GAD-7 and depression met 19.9% and 31.4% of students, respectively. There was a positive and strong correlation between QoL, anxiety, and depression. During COVID-19, predictors for lower perceptions of QoL were female gender and death of close relatives (p = 0.049, p = 0.005, respectively). At the same time, predictors for GAD were female gender, living in dormitories, and death of close relatives (p = 0.019, p = 0.011, p = 0.028, respectively), while for depression they were year of study, living with parents, and death of close relatives due to COVID-19 (p = 0.012, p = 0.008, p = 0.029, respectively). The study showed that students' QoL and mental health during the pandemic were at high risk.

The Association between COVID-19 Pandemic and the Quality of Life of Medical Students in Silesian Voivodeship, Poland

(1) Background: Since the COVID-19 pandemic spread rapidly in 2020, medical universities have been affected by a particular crisis. Due to the increased risk of SARS CoV-2 transmission, the authorities of medical faculties all over the world, including Poland, started to minimize direct contact between students. The objective of the paper is to identify and assess determinants of the quality of life among medical students in Poland before and during the COVID-19 pandemic. (2) Methods: We analyzed data obtained in a cross-sectional study performed among three groups of students tested in three consecutive research periods: period before the COVID-19 pandemic, the COVID-19 pandemic lockdown period and the COVID-19 pandemic period following lockdown. (3) Results: The total number of participants was 1098. We identified that the research period before the COVID-19 pandemic was the risk factor for lower quality of life in terms of the somatic and environmental domains. It was also confirmed that determinants such as poor financial situation, low frequency of physical activity and bad self-declared health status harmed the QoL scores in all domains. (4) Conclusions: The obtained results confirmed that better financial situation, higher physical activity and better self-declared health status were statistically significant factors improving the quality of life of first-year medical students in Poland. The findings of our study also showed that the declared somatic and environmental domains of QoL among medical students were better during the COVID-19 pandemic period. Our observations confirmed that the immediate implementation of e-learning could protect against the deterioration of mental health and quality of life in first-year medical students during possible future epidemic crises.

E-Learning Satisfaction, Stress, Quality of Life, and Coping: A Cross-Sectional Study in Italian University Students a Year after the COVID-19 Pandemic Began

(1) Background: The objective was to investigate e-learning satisfaction in a sample of university students by evaluating quality of life, stress sociality, and coping. (2) Methods: This was an online survey involved 471 students attending the University of L′Aquila from June to July 2021. The primary goal was estimating the e-learning satisfaction as measured by the E-learning Satisfaction Scale, while the secondary outcomes were studying its relationship with demographic factors, the perception of quality of life, sociality, stress, and coping strategies using a hierarchical regression model. (3) Results: A total of 136 participants were males (29%); the mean age was 25 years. The results revealed that the satisfaction score was 30.6, and the mean stress level was 19.4. Students suffered psychologically and physically for 14 days a month. The sociality score was 36. With respect to coping strategies, students reported higher scores for “Acceptance” (6.0), “Active coping” (6.2), and “Planning” (6.4). E-learning satisfaction was significantly related to age and course attendance. It was positively associated with the social presence score and coping strategies such as self-blame and religion, while it was inversely related to stress and unhealthy days. (4) Conclusions: The students revealed a positive propensity to use e-learning despite the end of quarantine. Sociality, stress, quality of life, and coping seemed to play an important role in student′s e-learning satisfaction.

Effect of an endodontic e-learning application on students' performance during their first root canal treatment on real patients: a pilot study

BACKGROUND

E-learning has found its way into dental teaching in general and endodontic teaching in particular. The present study aimed to implement a newly developed multimedia learning application and assess its effect on students' first root canal treatment on real patients. With the COVID-19 outbreak, the application's performance was investigated during the pandemic.

METHODS

A total of 138 students in the initial clinical endodontic course participated in this study. The control group (n = 49) followed the traditional curriculum, including practice on artificial teeth and face-to-face teaching events. In addition to the traditional curriculum, test group 1 (n = 54) had access to an endodontic e-learning application containing videos demonstrating artificial teeth and patient cases. With the COVID-19 outbreak, test group 2 (n = 35) had no face-to-face teaching; however, endodontic patient treatments were included. The quality of students' first root canal treatment on real patients was compared using performance and radiographic assessment items. Statistical analysis was done using Kruskal-Wallis and chi-squared tests. Test groups received a questionnaire to assess the learning application. Test group 2 also completed a COVID-19-specific survey to measure students' perceptions of how the pandemic affected their endodontic education.

RESULTS

The results of endodontic treatments were significantly better for test group 1 (P < 0.001) and 2 (P < 0.001) than for the control group. Likewise, there were significantly fewer treatment errors in test group 1 (P < 0.001) and 2 (P < 0.001). No significant differences were found between test groups 1 and 2. Students of the test groups positively evaluated the e-learning application. Students of test group 2 expressed their fear of negative impacts on their course performance.

CONCLUSION

The e-learning application was well-received and seemed to improve endodontic education. The results imply that the quality of education may be maintained by implementing e-learning to compensate for face-to-face teaching. As no difference was found between online and face-to-face teaching, students' and lecturers' concerns that endodontic education is suffering because of the pandemic may be eased.

THE PROBLEM OF ANXIETY AMONG UKRAINIAN STUDENTS ON REMOTE LEARNING DURING COVID-19 PANDEMIC

OBJECTIVE

The aim: To explore the students' mental health in general and their anxiety in particular on remote learning during COVID-19 pandemic.

PATIENTS AND METHODS

Materials and methods: The study is based on the material of 112 respondents (85 females and 27 males), interviewed using The Depression, Anxiety and Stress scale-21 (DASS-21) and SAN - the test for emotional state.

RESULTS

Results: There are statistically significant differences between the samples of 1st and 2nd year students in terms of "depression" and "stress". The latter are more typical for second-year students. The article argues that, given the COVID-19 pandemic situation and the disruption of normal face-to-face learning, the true causes that determine the indicated trends deserve more extensive and comprehensive research.

CONCLUSION

Conclusions: It has been identified that the situation as a whole significantly affected the students' mental health in general and their anxiety level in particular.