Dental students’ perspective on the distance education system during COVID-19 pandemic: a cross-sectional study

Dental students’ perspective on the distance education system during COVID-19 pandemic: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Dental students’ perspective on the distance education system during COVID-19 pandemic: a cross-sectional study shaswata karmakar, Mehuli Kar, Delfin Lovelina Francis, saravanan sampoornam pape reddy, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5376940/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 02 Oct, 2025 Read the published version in BMC Medical Education → Version 1 posted 4 You are reading this latest preprint version Abstract Background The COVID-19 pandemic has wreaked havoc on education in a variety of settings, particularly medical and dental teaching institutes. During the pandemic, distance learning has become necessary to ensure that education continues. Objective The present study aims to analyze dental students’ perceptions of the transition of education from traditional to distance learning. Methods This was a cross-sectional study consisting of a 25-statement online questionnaire that was anonymously administered to students studying dentistry at Manipal Academy of Higher Education, Manipal, India. The data collected were analyzed statistically via chi-square test. Results A total of 713 out of 800 undergraduate dental students participated in the survey, resulting in an 89.12% response rate. A total of 73.9% of the students did not feel that it was easier to concentrate in online classes than in offline lectures, and 60.9% of the students felt that they could not learn the theoretical aspects adequately. Almost three-fourths of the students (73.9%) felt that lockdowns and distance education severely affected the quality of their dental education. A total of 86.4% of the students felt that a lack of patient exposure would affect their future dental practice. With respect to learning preferences, the majority of the students preferred a combination of traditional methods and online learning. Conclusion Despite these difficulties, dental students were able to adapt to the new distance learning education system. The COVID-19 pandemic taught not only the use of technology in education but also future learning strategies. Distance learning Dental education COVID-19 Medical education Technology Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction COVID-19, also known as coronavirus disease 2019 (COVID-19), has been recognized as a viral infection caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which created a public health crisis worldwide in late 2019 ( 1 ). Several measures have been taken to minimize the spread of contagion, including isolation, contact tracing, quarantine, social and physical distancing, hygiene measures and lockdown. Among these measures, social distancing has been the most widely used measure taken to protect people from the spread of the virus ( 1 ). The education system, being the backbone of a society as well as a country, was among the sectors that were severely affected by the pandemic. Medical education, specifically dental education, was no exception from being affected. Since social distancing was the need of the hour, the offline face-to-face classroom education system was interrupted worldwide. Learning in dentistry involves communication and treatment of patients through the oral cavity which is a reservoir for the COVID-19 virus. This exposes dental professionals to saliva, blood, and several other body fluids, which puts them at high risk of becoming infected as well as a source of viral spread to others ( 2 ). Moreover, droplet- and aerosol-generating dental treatment procedures, such as tooth preparation, ultrasonic scaling, and cavity preparation, are considered among the most effective modes of transmission of the virus in a dental clinical setting ( 3 ), ( 4 ). Therefore, restricting the teaching system to virtual mode and the treatment aspect to emergency-only care seems to be a realistic choice to prevent the spread of COVID-19( 4 ). Virtual learning can take the form of online theory and practical classes, assignments, and assessments. The rapid development of online teaching platforms and smart devices such as mobile devices, laptops, and tablets has provided convenient ways for students to attend classes and contact teachers ( 5 ). Students could continue to participate in live academic lectures in the web-based virtual environment, and they could also access these lectures whenever and wherever they needed them later. Virtual patients also aid dental students in developing clinical skills such as obtaining case histories, observing signs and symptoms, etc. ( 6 ). Various instruments, such as PowerPoint presentations, live or recorded lectures, video demonstrations, case scenarios, online whiteboards, and virtual models, have been used ( 7 ), ( 8 ). However, dentistry is a “professional artistry” by nature, as described by Robert Caplin et al. ( 9 ). The success of a dental treatment depends largely on the degree of skill the operator possesses. This “professional skill” is a combination of ability, expertise and cleverness, which dictates the ultimate outcome of a dental treatment ( 9 ). Therefore, virtual methods of learning are of limited use in dental education, even though timely dissemination of information about COVID-19 by the Ministry of Health and the government has had a significant effect on knowledge and awareness ( 10 ), ( 11 ). Amir et al. evaluated the perspective of distance learning compared with that of classroom learning and concluded that most of the students agreed that learning combines both classroom and online modes( 12 ). However, contradictory results have also been reported in several studies. Sarialioglu et al. evaluated the perceptions and attitudes of dental students toward online distance learning and concluded that dental students were unhappy with the disruption of traditional patterns of education ( 13 ). The results from another study conducted by Di Giacomo revealed that most of the students were not satisfied with online distance learning, especially the preclinical and clinical aspects of the curriculum ( 14 ). To our knowledge, very few studies have investigated the attitudes and perspectives of Indian dental students toward changes in the education system due to the COVID-19 pandemic. Therefore, the aim of our study was to evaluate the perspective of dental students at an Indian university toward newly implemented distance learning. Materials and Methods First- to fourth-year undergraduate students studying professional Bachelor of Dental Surgery courses (BDS at the Manipal Academy of Higher Education (MAHE), Manipal, India, were the study participants. The study was conducted from January to December 2021. Students were informed about the study, and e-signed consent was obtained from them. This study was reported in compliance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. The study protocol was in accordance with the Helsinki Declaration and was reviewed and approved by the Institutional Ethical Committee (IEC no. 370/2021) as well as the Clinical Trial Registry of India (CTRI/2021/07/035258). The questionnaire was created via Google forms (Google LLC, California, USA). The questionnaire consists of 25 questions that include 5 sections (demographic details, acceptance, didactic learning, preclinical and clinical learning, and motivation). The response options for the questionnaire items represent a combination of ‘yes’ or ‘no’ responses and Likert-type scales (strongly disagree to strongly agree). Before the pandemic, the teaching method used in dentistry at MAHE was student-centered active blended learning. The teaching of theoretical aspects of the curriculum involves taking lecture classes face-to-face in the classroom via PowerPoint presentations, chalk and board presentations or a combination of them. Impartus web-based education tools (Impartus Innovations Private Limited, Bengaluru, India) were used to capture various lecture-based activities. Through this, students could access the lecture class, questions, learning objectives and syllabus of each course studied. For both preclinical and clinical aspects, question-based learning, outcome-based learning and collaborative learning approaches were used. For the clinical postings, the students were divided into small groups and were mentored by a subject teacher. Patients were given to the students to teach various clinical skills under the supervision of teaching faculties. Overall, the teaching system represented blended learning. Since the pandemic protocol mandated social distancing and work-from-home patterns in March 2020, the teaching system has shifted completely to distant learning. Lecture classes, doubt-clearing sessions, group discussions, and assessments were carried out via an online platform (Microsoft Teams, Microsoft LLC, USA). Preclinical and clinical portions of the syllabus in which psychomotor skills were required were substituted with video demonstrations and online simulation exercises. Statistical analysis: Descriptive statistics were computed, and analysis was performed using SPSS software version 28.0 (IBM LLC, Armonk, New York). The chi-square test was used for statistical analysis. P < 0.05 was considered statistically significant. Results Demographic data: Out of 800 undergraduate students who were studying dentistry at MAHE, Manipal, a total of 713 participants, comprising students in the 1st to 4th-year professional B.D.S., responded to and completed the questionnaire. This represented a response rate of 89.12%. The age of the students ranged from 17–25 years. The age-wise and study year-wise frequency distributions are presented in Fig. 1 and Fig. 2 . The students used mobile phones, laptops, tablets, or their combination to attend online classes (Fig. 3 ). Acceptance: The majority of the students (74.2%) had not been exposed to distance learning before this pandemic. They used laptops, mobiles, tablets, or combinations of these to attend classes. A total of 41.9% of the students felt that they were well-prepared for distance learning methods. One-fourth of the students (27.3%) did not have access to sufficient internet facilities. However, both online class timings and the surrounding environment were suitable for the majority of the students (84.3% and 73.2%, respectively) (Table 1). In terms of didactic learning, 73.9% of the students did not feel it was easier to concentrate in online classes than in offline lecture sessions, and 60.9% of the students felt that they could not learn the theoretical aspects adequately. More than half (57.4%) of the students reported that attending online classes was stressful. However, almost two-thirds of the students (69.3%) felt that they had ample opportunity to clear their doubts post e-lectures (Table 2 ). Table-1: Acceptance Questions Options F value % Apart from Covid-19 era, have you been exposed to distance e-learning before? No 529 74.2 Yes 184 25.8 Were you well prepared in advance for the distance e-learning methods? No 414 58.1 Yes 299 41.9 Were distance e-learning session timings suitable for you? No 112 15.7 Yes 601 84.3 Did you have access to sufficient internet facility to participate in online classes? No 195 27.3 Yes 518 72.7 Did you have a suitable environment around while you attended online classes? No 191 26.8 Yes 522 73.2 Table - 2: Didactic learning Questions Options f f- value % Online classes are stressful No 304 42.6 Yes 409 57.4 Do you feel easier to concentrate in online classes as compared to offline lecture sessions? No 527 73.9 Yes 186 26.1 Do you feel you have learnt the theoretical concepts adequately through distance e-learning? No 434 60.9 Yes 279 39.1 Do you feel online e-learning was a good option for understanding the theoretical part of your curriculum? No 413 57.9 Yes 300 42.1 Was there ample opportunity to clear your doubts during or post e-lectures? No 219 30.7 Yes 494 69.3 At the time of online learning, did you feel that you could ask questions regarding the topic or subject being taught, more often compared to that during classroom lectures? No 387 54.3 Yes 326 45.7 Preclinical and clinical learning: In total, 73.9% and 65.9% of the students had preclinical and clinical components in their curriculum, respectively. The majority of the students felt that they could not grasp the concepts adequately (74.6% and 82% for preclinical and clinical aspects, respectively). A total of 83.7% of the students felt that the case-based scenarios, demonstrations and resources used for teaching preclinical and clinical portions were not as effective as handling live patients (Table 3 ). Table - 3: Preclinical and clinical learning Questions Option f value % Did you have preclinical component(s) in your curriculum? No 186 26.1 Yes 527 73.9 If yes, do you feel you have grabbed the preclinical concepts and practices adequately through distance e-learning sessions? No 532 74.6 Yes 181 25.4 Did you have clinical component(s) in your curriculum? No 243 34.1 Yes 470 65.9 If yes, do you feel you have understood the clinical concepts and practices adequately through distance e-learning sessions? No 585 82 Yes 128 18 Do you feel the resources/demonstrations for teaching clinical/preclinical portions of the syllabus during e-learning process to be equally effective as handling the live patient? No 597 83.7 Yes 116 16.3 Table-4: Motivation Question Option f - value % Did you find the case-based scenarios used during online teaching beneficial to develop clinical skills? No 415 58.2 Yes 298 41.8 Do you think lack of patient exposure can affect your future dental practice? No 97 13.6 Yes 616 86.4 Does the implementation of the new distance education method motivate you to learn more? No 438 61.4 Yes 275 38.6 Do you wish distance e-learning sessions to continue post Covid-19 period instead of offline equivalents? No 483 65.8 Yes 230 34.2 Motivation: A total of 47.9% of the students strongly agreed that the lockdown severely affected their quality of education (Fig. 4 ). A total of 86.4% of the students felt that a lack of patient exposure would affect their future dental practice. A total of 61.4% of the students said that the newly implemented distance education system did not motivate them to learn more therefore, they did not want it to continue after the COVID-19 pandemic (65.8%) (Table 4). Discussion This cross-sectional study was conducted to evaluate dental students’ perceptions of and experience with the distance education system, which was implemented by MAHE Manipal, which is responsible for the COVID-19 pandemic. The first step taken by many dental educational institutions during the pandemic was to completely shut them down or restrict education and service delivery to emergencies only. When it was anticipated that the pandemic would last for a much longer period, the institutions started to implement new and different strategies to continue their education, research, and treatment activities with the lowest possible risk of infection for their students, patients, and staff. On the 11th of March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Originating in Wuhan Province in China, COVID-19 has spread to more than 200 countries worldwide( 15 ). As of December 2021, more than 90 million people have been affected, with more than 1.8 million deaths, and this number is increasing each day ( 16 ). India is a densely populated country, and COVID-19 is a highly transmissible disease. Therefore, avoidance of crowding and physical distancing was mandatory to minimize the spread of the infection, especially in a country such as India, which is at even greater risk for rapid spread of infection. The United States Occupational Safety and Health Administration (US-OSHA) categorized dental treatments as very high risk due to several factors such as aerosol generation and exposure to saliva and blood( 12 ). Amid a pandemic, the greatest challenge for teachers in dental colleges was to decrease the spread of COVID-19 infection without the interruption of dental education. Distant learning methods have therefore been adopted by almost all universities worldwide( 17 ). During this period, MAHE, Manipal used various learning methods, such as lecture-based education (LBE), group learning (GL), problem-based education (PBE), and case-scenario-based learning (CSL). LBE focuses mainly on didactic learning, which consists of factual knowledge delivery on a particular topic. In GL, the students are divided into small groups, topics are discussed, assignments are given, and online tests are performed. PBE is the application of theoretical knowledge for the solution of practical problems. This approach was used mainly for preclinical exercises. The CSL was prepared to simulate clinical cases. In this method, students are given the history and other clinical findings of a patient. The students were then asked to apply their basic knowledge of the disease and assess the scenario, to accurately diagnose the condition and plan a line of treatment. In the present study, concerning the theoretical aspects of the curriculum, students expressed several advantages of online classes, such as convenient timing of the classes, convenience of attending classes from any place, ease of understanding, and no fear of missing classes, as they are recorded and saved for future reference (Fig. 5 ). This, in turn, reduced the necessity of conducting revision classes on very important topics. The majority of the students also agreed that they had ample opportunity to clear their doubts after the lecture session and that they could ask questions regarding the topic taught more often than they had during classroom lectures. However, almost two-thirds of the students felt a lack of concentration in online classes compared with offline face-to-face lectures. This might be due to the lack of an appropriate environment for studying at a location that is distant from the teaching institute. In a review, Dhawan et al. discussed the drawbacks associated with online teaching and concluded that online teaching was not an alternative but rather a necessity during a pandemic ( 18 ). Distance learning was more challenging in terms of the preclinical and clinical aspects of the curriculum. Despite these drawbacks, enormous efforts have been made to overcome these challenges. Several online tutorial programs were organized by the university to guide the faculty members in various online activities. E-modules were used to teach the students about practicing hands-on and various stimulating exercises for their clinical skills at home. However, the majority of the students felt that the preclinical and clinical aspects of the curriculum could be learned better via a face-to-face learning approach than from a distant approach. Dentistry is an occupation whose core element is work based upon the mastery of a complex body of knowledge and skills ( 19 ). The efficacy of dental treatments depends on the skill of the operator, which can be defined as practical knowledge in combination with ability, cleverness and expertise. Hence, dentistry is more of an art than a science ( 19 ). These skills could not be completely learned without exposure to preclinical models and patients, which might be the reason that the students were dissatisfied with distance learning. Our findings are in line with those of several other reviewed studies ( 20 ), ( 21 ). However, the results of our study revealed mixed perceptions and attitudes toward online education during the COVID-19 pandemic. The negative feedback by the students might be due to mental stress created by several factors, such as staying at home suddenly, not being able to meet their peers, lockdown, isolation and back-to-back lecture classes ( 22 ). To date, there is no gold-standard approach to address such a pandemic situation. All the teaching methods implemented were on a trial-and-error basis. Although many students were satisfied with distance learning, they presented a predominantly negative perspective on the implementation of complete distance learning. The results of our present study showed that the face-to-face system was preferred by the students and that they did not want the distance learning system to continue for a long period of time. Their opinions, such as “lack of patient exposure would affect our future dental practice” and “implementation of the new distance learning method does not motivate us to learn more,” proved the same. Our results are consistent with those of a recent study performed by Noor et al., who concluded that e-learning can be accepted only partially and not as a single method of education in dentistry ( 23 ). Therefore, with all the technological advancements, the education system in the future should be directed toward a hybrid method, i.e., in-person and clinical training should be combined with virtual education ( 24 ). The results of our survey can help take steps to manage the crisis and minimize its impact on the dental education system. This would also help institutions be better prepared for similar disruptions in the future. Conclusion Despite these challenges, dental students were able to adapt to the new learning methods of distance learning. Within the limitations of the study, it could be concluded that distance learning can only be an adjunct to conventional methods, especially in dentistry. Blended learning via hybrid methods, i.e., the use of both virtual platforms and face-to-face teaching, is the method of choice for dental education to ensure the quality of education and to be updated with technological advances. 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Cite Share Download PDF Status: Published Journal Publication published 02 Oct, 2025 Read the published version in BMC Medical Education → Version 1 posted Editorial decision: Revision requested 14 Nov, 2024 Editor assigned by journal 10 Nov, 2024 Submission checks completed at journal 10 Nov, 2024 First submitted to journal 02 Nov, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5376940","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":378078395,"identity":"dada146f-7b27-4fb5-9d17-4fd9a079a83d","order_by":0,"name":"shaswata karmakar","email":"data:image/png;base64,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","orcid":"","institution":"Department of Periodontology, Manipal College of dental Sciences Manipal, Manipal Academy of Higher Education, India","correspondingAuthor":true,"prefix":"","firstName":"shaswata","middleName":"","lastName":"karmakar","suffix":""},{"id":378078396,"identity":"c86b81b6-76e3-4dfa-a8b7-e67c7d3c166d","order_by":1,"name":"Mehuli Kar","email":"","orcid":"","institution":"Manipal College of dental Sciences Manipal, Manipal Academy of Higher Education, India, India","correspondingAuthor":false,"prefix":"","firstName":"Mehuli","middleName":"","lastName":"Kar","suffix":""},{"id":378078397,"identity":"d1b14b25-55c3-4a11-b52c-ef58d5ae9a2a","order_by":2,"name":"Delfin Lovelina Francis","email":"","orcid":"","institution":"Department of Public Health Dentistry, Saveetha Dental College and Hospital","correspondingAuthor":false,"prefix":"","firstName":"Delfin","middleName":"Lovelina","lastName":"Francis","suffix":""},{"id":378078398,"identity":"3c7f7099-35f0-4ad7-a532-ec7ad4b1a2a5","order_by":3,"name":"saravanan sampoornam pape reddy","email":"","orcid":"","institution":"Army Dental Centre (Research and Referral)","correspondingAuthor":false,"prefix":"","firstName":"saravanan","middleName":"sampoornam pape","lastName":"reddy","suffix":""},{"id":378078399,"identity":"d01fe6f1-5e19-4237-a141-97bb8d9b4f12","order_by":4,"name":"baishakhi modak","email":"","orcid":"","institution":"Manipal College of dental Sciences Manipal, Manipal Academy of Higher Education, India, India","correspondingAuthor":false,"prefix":"","firstName":"baishakhi","middleName":"","lastName":"modak","suffix":""}],"badges":[],"createdAt":"2024-11-02 07:38:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5376940/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5376940/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-025-07906-0","type":"published","date":"2025-10-02T15:57:18+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":71544081,"identity":"2a075b37-9dad-426c-a135-505c1b28ff1a","added_by":"auto","created_at":"2024-12-16 14:54:39","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":41804,"visible":true,"origin":"","legend":"\u003cp\u003eAgewise frequency distribution of the study participants\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-5376940/v1/79a0c3b9ae73ebc43f52d9a0.png"},{"id":71544624,"identity":"a96112b7-734b-462b-b7c4-ef30ced74f0d","added_by":"auto","created_at":"2024-12-16 15:02:39","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":47214,"visible":true,"origin":"","legend":"\u003cp\u003eStudy yearwise frequency distribution of the study participants\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-5376940/v1/449bb60e8f5641e220023bd2.png"},{"id":71544084,"identity":"31ef3da1-91d9-4e00-a897-418919a79de5","added_by":"auto","created_at":"2024-12-16 14:54:39","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":74465,"visible":true,"origin":"","legend":"\u003cp\u003eFrequency distribution of the devicesused by the participants to attend online classes during the lockdown period\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-5376940/v1/7cd9ca0b44b7c5807fba26e8.png"},{"id":71544083,"identity":"c0dca3c9-0d03-4be9-a91a-ee11cab8625c","added_by":"auto","created_at":"2024-12-16 14:54:39","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":170689,"visible":true,"origin":"","legend":"\u003cp\u003eParticipants’ agreement with the quality of education during the COVID-19 lockdown period\u003c/p\u003e","description":"","filename":"Figure4.png","url":"https://assets-eu.researchsquare.com/files/rs-5376940/v1/3eb49b0c05cff4fc4988fd95.png"},{"id":71544082,"identity":"a6fd6750-d46c-4d8b-be1a-9a57d7647af4","added_by":"auto","created_at":"2024-12-16 14:54:39","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":30776,"visible":true,"origin":"","legend":"\u003cp\u003eParticipants’ response to the advantages of online distancelearning\u003c/p\u003e","description":"","filename":"Figure5.png","url":"https://assets-eu.researchsquare.com/files/rs-5376940/v1/5acef77e8b7f630c6f7e5ff2.png"},{"id":92884425,"identity":"197c0f90-d249-4a8c-8531-445dda9f2586","added_by":"auto","created_at":"2025-10-06 16:12:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":890537,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5376940/v1/cc19d0d5-f4a3-4540-a8e6-e53c7b14dde5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Dental students’ perspective on the distance education system during COVID-19 pandemic: a cross-sectional study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCOVID-19, also known as coronavirus disease 2019 (COVID-19), has been recognized as a viral infection caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which created a public health crisis worldwide in late 2019 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Several measures have been taken to minimize the spread of contagion, including isolation, contact tracing, quarantine, social and physical distancing, hygiene measures and lockdown. Among these measures, social distancing has been the most widely used measure taken to protect people from the spread of the virus (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). The education system, being the backbone of a society as well as a country, was among the sectors that were severely affected by the pandemic. Medical education, specifically dental education, was no exception from being affected. Since social distancing was the need of the hour, the offline face-to-face classroom education system was interrupted worldwide. Learning in dentistry involves communication and treatment of patients through the oral cavity which is a reservoir for the COVID-19 virus. This exposes dental professionals to saliva, blood, and several other body fluids, which puts them at high risk of becoming infected as well as a source of viral spread to others (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Moreover, droplet- and aerosol-generating dental treatment procedures, such as tooth preparation, ultrasonic scaling, and cavity preparation, are considered among the most effective modes of transmission of the virus in a dental clinical setting (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e), (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Therefore, restricting the teaching system to virtual mode and the treatment aspect to emergency-only care seems to be a realistic choice to prevent the spread of COVID-19(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Virtual learning can take the form of online theory and practical classes, assignments, and assessments. The rapid development of online teaching platforms and smart devices such as mobile devices, laptops, and tablets has provided convenient ways for students to attend classes and contact teachers (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Students could continue to participate in live academic lectures in the web-based virtual environment, and they could also access these lectures whenever and wherever they needed them later. Virtual patients also aid dental students in developing clinical skills such as obtaining case histories, observing signs and symptoms, etc. (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Various instruments, such as PowerPoint presentations, live or recorded lectures, video demonstrations, case scenarios, online whiteboards, and virtual models, have been used (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). However, dentistry is a \u0026ldquo;professional artistry\u0026rdquo; by nature, as described by Robert Caplin et al. (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). The success of a dental treatment depends largely on the degree of skill the operator possesses. This \u0026ldquo;professional skill\u0026rdquo; is a combination of ability, expertise and cleverness, which dictates the ultimate outcome of a dental treatment (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Therefore, virtual methods of learning are of limited use in dental education, even though timely dissemination of information about COVID-19 by the Ministry of Health and the government has had a significant effect on knowledge and awareness (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e), (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Amir et al. evaluated the perspective of distance learning compared with that of classroom learning and concluded that most of the students agreed that learning combines both classroom and online modes(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). However, contradictory results have also been reported in several studies. Sarialioglu et al. evaluated the perceptions and attitudes of dental students toward online distance learning and concluded that dental students were unhappy with the disruption of traditional patterns of education (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). The results from another study conducted by Di Giacomo revealed that most of the students were not satisfied with online distance learning, especially the preclinical and clinical aspects of the curriculum (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). To our knowledge, very few studies have investigated the attitudes and perspectives of Indian dental students toward changes in the education system due to the COVID-19 pandemic. Therefore, the aim of our study was to evaluate the perspective of dental students at an Indian university toward newly implemented distance learning.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e First- to fourth-year undergraduate students studying professional Bachelor of Dental Surgery courses (BDS at the Manipal Academy of Higher Education (MAHE), Manipal, India, were the study participants. The study was conducted from January to December 2021. Students were informed about the study, and e-signed consent was obtained from them. This study was reported in compliance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. The study protocol was in accordance with the Helsinki Declaration and was reviewed and approved by the Institutional Ethical Committee (IEC no. 370/2021) as well as the Clinical Trial Registry of India (CTRI/2021/07/035258). The questionnaire was created via Google forms (Google LLC, California, USA). The questionnaire consists of 25 questions that include 5 sections (demographic details, acceptance, didactic learning, preclinical and clinical learning, and motivation). The response options for the questionnaire items represent a combination of \u0026lsquo;yes\u0026rsquo; or \u0026lsquo;no\u0026rsquo; responses and Likert-type scales (strongly disagree to strongly agree).\u003c/p\u003e \u003cp\u003eBefore the pandemic, the teaching method used in dentistry at MAHE was student-centered active blended learning. The teaching of theoretical aspects of the curriculum involves taking lecture classes face-to-face in the classroom via PowerPoint presentations, chalk and board presentations or a combination of them. Impartus web-based education tools (Impartus Innovations Private Limited, Bengaluru, India) were used to capture various lecture-based activities. Through this, students could access the lecture class, questions, learning objectives and syllabus of each course studied. For both preclinical and clinical aspects, question-based learning, outcome-based learning and collaborative learning approaches were used. For the clinical postings, the students were divided into small groups and were mentored by a subject teacher. Patients were given to the students to teach various clinical skills under the supervision of teaching faculties. Overall, the teaching system represented blended learning. Since the pandemic protocol mandated social distancing and work-from-home patterns in March 2020, the teaching system has shifted completely to distant learning. Lecture classes, doubt-clearing sessions, group discussions, and assessments were carried out via an online platform (Microsoft Teams, Microsoft LLC, USA). Preclinical and clinical portions of the syllabus in which psychomotor skills were required were substituted with video demonstrations and online simulation exercises.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis:\u003c/h2\u003e \u003cp\u003eDescriptive statistics were computed, and analysis was performed using SPSS software version 28.0 (IBM LLC, Armonk, New York). The chi-square test was used for statistical analysis. P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eDemographic data: Out of 800 undergraduate students who were studying dentistry at MAHE, Manipal, a total of 713 participants, comprising students in the 1st to 4th-year professional B.D.S., responded to and completed the questionnaire. This represented a response rate of 89.12%. The age of the students ranged from 17\u0026ndash;25 years. The age-wise and study year-wise frequency distributions are presented in Fig.\u0026nbsp;\u003cspan\u003e1\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan\u003e2\u003c/span\u003e. The students used mobile phones, laptops, tablets, or their combination to attend online classes (Fig.\u0026nbsp;\u003cspan\u003e3\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eAcceptance: The majority of the students (74.2%) had not been exposed to distance learning before this pandemic. They used laptops, mobiles, tablets, or combinations of these to attend classes. A total of 41.9% of the students felt that they were well-prepared for distance learning methods. One-fourth of the students (27.3%) did not have access to sufficient internet facilities. However, both online class timings and the surrounding environment were suitable for the majority of the students (84.3% and 73.2%, respectively) (Table\u0026nbsp;1).\u003c/p\u003e\n\u003cp\u003eIn terms of didactic learning, 73.9% of the students did not feel it was easier to concentrate in online classes than in offline lecture sessions, and 60.9% of the students felt that they could not learn the theoretical aspects adequately. More than half (57.4%) of the students reported that attending online classes was stressful. However, almost two-thirds of the students (69.3%) felt that they had ample opportunity to clear their doubts post e-lectures (Table\u0026nbsp;\u003cspan\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eTable-1: Acceptance\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eQuestions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOptions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eF value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col\u003e\n \u003cli\u003eApart from Covid-19 era, have you been exposed to distance e-learning before?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e529\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"2\"\u003e\n \u003cli\u003eWere you well prepared in advance for the distance e-learning methods?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e414\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e58.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e299\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"3\"\u003e\n \u003cli\u003eWere distance e-learning session timings suitable for you?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e601\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e84.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"4\"\u003e\n \u003cli\u003eDid you have access to sufficient internet facility to participate in online classes?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e195\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e518\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e72.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"5\"\u003e\n \u003cli\u003eDid you have a suitable environment around while you attended online classes?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e191\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e522\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e73.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable\u003cdel cite=\"mailto:Editor%202\" datetime=\"2024-11-02T03:50\"\u003e-\u003c/del\u003e\u003cins cite=\"mailto:Editor%202\" datetime=\"2024-11-02T03:50\"\u003e\u0026nbsp;\u003c/ins\u003e2: Didactic learning\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eQuestions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOptions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cins cite=\"mailto:Editor\" datetime=\"2024-11-02T03:50\"\u003ef\u0026nbsp;\u003c/ins\u003e\u003cdel cite=\"mailto:Editor\" datetime=\"2024-11-02T03:50\"\u003ef-\u003c/del\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col\u003e\n \u003cli\u003eOnline classes are stressful\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e304\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e409\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e57.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"2\"\u003e\n \u003cli\u003eDo you feel easier to concentrate in online classes as compared to offline lecture sessions?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e527\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e73.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e186\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"3\"\u003e\n \u003cli\u003eDo you feel you have learnt the theoretical concepts adequately through distance e-learning?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e434\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e279\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e39.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"4\"\u003e\n \u003cli\u003eDo you feel online e-learning was a good option for understanding the theoretical part of your curriculum?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e413\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e57.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e300\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"5\"\u003e\n \u003cli\u003eWas there ample opportunity to clear your doubts during or post e-lectures?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e494\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e69.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"6\"\u003e\n \u003cli\u003eAt the time of online learning, did you feel that you could ask questions regarding the topic or subject being taught, more often compared to that during classroom lectures?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e387\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e54.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e326\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cdiv\u003e\u003cbr\u003e\u003c/div\u003e\n\u003cp\u003ePreclinical and clinical learning: In total, 73.9% and 65.9% of the students had preclinical and clinical components in their curriculum, respectively. The majority of the students felt that they could not grasp the concepts adequately (74.6% and 82% for preclinical and clinical aspects, respectively). A total of 83.7% of the students felt that the case-based scenarios, demonstrations and resources used for teaching preclinical and clinical portions were not as effective as handling live patients (Table \u003cspan\u003e3\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eTable\u003cdel cite=\"mailto:Editor%202\" datetime=\"2024-11-02T03:50\"\u003e-\u003c/del\u003e\u003cins cite=\"mailto:Editor%202\" datetime=\"2024-11-02T03:50\"\u003e\u0026nbsp;\u003c/ins\u003e3: Preclinical and clinical learning\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eQuestions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOption\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ef value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col\u003e\n \u003cli\u003eDid you have preclinical component(s) in your curriculum?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e186\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e527\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e73.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"2\"\u003e\n \u003cli\u003eIf yes, do you feel you have grabbed the preclinical concepts and practices adequately through distance e-learning sessions?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e532\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e181\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"3\"\u003e\n \u003cli\u003eDid you have clinical component(s) in your curriculum?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e470\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e65.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"4\"\u003e\n \u003cli\u003eIf yes, do you feel you have understood the clinical concepts and practices adequately through distance e-learning sessions?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e585\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"5\"\u003e\n \u003cli\u003eDo you feel the resources/demonstrations for teaching clinical/preclinical portions of the syllabus during e-learning process to be equally effective as handling the live patient?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e597\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e83.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable-4: Motivation\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eQuestion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOption\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ef\u003cdel cite=\"mailto:Editor\" datetime=\"2024-11-02T03:50\"\u003e-\u003c/del\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col\u003e\n \u003cli\u003eDid you find the case-based scenarios used during online teaching beneficial to develop clinical skills?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e415\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e58.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e298\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"2\"\u003e\n \u003cli\u003eDo you think lack of patient exposure can affect your future dental practice?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e616\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e86.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"3\"\u003e\n \u003cli\u003e\u0026nbsp;Does the implementation of the new distance education method motivate you to learn more?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e438\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e61.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e275\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e38.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003col start=\"4\"\u003e\n \u003cli\u003eDo you wish distance e-learning sessions to continue post Covid-19 period instead of offline equivalents?\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e483\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e65.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cdiv\u003e\u003cbr\u003e\u003c/div\u003e\n\u003cp\u003eMotivation: A total of 47.9% of the students strongly agreed that the lockdown severely affected their quality of education (Fig.\u0026nbsp;\u003cspan\u003e4\u003c/span\u003e). A total of 86.4% of the students felt that a lack of patient exposure would affect their future dental practice. A total of 61.4% of the students said that the newly implemented distance education system did not motivate them to learn more therefore, they did not want it to continue after the COVID-19 pandemic (65.8%) (Table\u0026nbsp;4).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis cross-sectional study was conducted to evaluate dental students\u0026rsquo; perceptions of and experience with the distance education system, which was implemented by MAHE Manipal, which is responsible for the COVID-19 pandemic. The first step taken by many dental educational institutions during the pandemic was to completely shut them down or restrict education and service delivery to emergencies only. When it was anticipated that the pandemic would last for a much longer period, the institutions started to implement new and different strategies to continue their education, research, and treatment activities with the lowest possible risk of infection for their students, patients, and staff. On the 11th of March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Originating in Wuhan Province in China, COVID-19 has spread to more than 200 countries worldwide(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). As of December 2021, more than 90\u0026nbsp;million people have been affected, with more than 1.8\u0026nbsp;million deaths, and this number is increasing each day (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). India is a densely populated country, and COVID-19 is a highly transmissible disease. Therefore, avoidance of crowding and physical distancing was mandatory to minimize the spread of the infection, especially in a country such as India, which is at even greater risk for rapid spread of infection. The United States Occupational Safety and Health Administration (US-OSHA) categorized dental treatments as very high risk due to several factors such as aerosol generation and exposure to saliva and blood(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Amid a pandemic, the greatest challenge for teachers in dental colleges was to decrease the spread of COVID-19 infection without the interruption of dental education. Distant learning methods have therefore been adopted by almost all universities worldwide(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDuring this period, MAHE, Manipal used various learning methods, such as lecture-based education (LBE), group learning (GL), problem-based education (PBE), and case-scenario-based learning (CSL). LBE focuses mainly on didactic learning, which consists of factual knowledge delivery on a particular topic. In GL, the students are divided into small groups, topics are discussed, assignments are given, and online tests are performed. PBE is the application of theoretical knowledge for the solution of practical problems. This approach was used mainly for preclinical exercises. The CSL was prepared to simulate clinical cases. In this method, students are given the history and other clinical findings of a patient. The students were then asked to apply their basic knowledge of the disease and assess the scenario, to accurately diagnose the condition and plan a line of treatment. In the present study, concerning the theoretical aspects of the curriculum, students expressed several advantages of online classes, such as convenient timing of the classes, convenience of attending classes from any place, ease of understanding, and no fear of missing classes, as they are recorded and saved for future reference (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). This, in turn, reduced the necessity of conducting revision classes on very important topics. The majority of the students also agreed that they had ample opportunity to clear their doubts after the lecture session and that they could ask questions regarding the topic taught more often than they had during classroom lectures. However, almost two-thirds of the students felt a lack of concentration in online classes compared with offline face-to-face lectures. This might be due to the lack of an appropriate environment for studying at a location that is distant from the teaching institute. In a review, Dhawan et al. discussed the drawbacks associated with online teaching and concluded that online teaching was not an alternative but rather a necessity during a pandemic (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Distance learning was more challenging in terms of the preclinical and clinical aspects of the curriculum. Despite these drawbacks, enormous efforts have been made to overcome these challenges. Several online tutorial programs were organized by the university to guide the faculty members in various online activities. E-modules were used to teach the students about practicing hands-on and various stimulating exercises for their clinical skills at home. However, the majority of the students felt that the preclinical and clinical aspects of the curriculum could be learned better via a face-to-face learning approach than from a distant approach. Dentistry is an occupation whose core element is work based upon the mastery of a complex body of knowledge and skills (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). The efficacy of dental treatments depends on the skill of the operator, which can be defined as practical knowledge in combination with ability, cleverness and expertise. Hence, dentistry is more of an art than a science (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). These skills could not be completely learned without exposure to preclinical models and patients, which might be the reason that the students were dissatisfied with distance learning. Our findings are in line with those of several other reviewed studies (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e), (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). However, the results of our study revealed mixed perceptions and attitudes toward online education during the COVID-19 pandemic. The negative feedback by the students might be due to mental stress created by several factors, such as staying at home suddenly, not being able to meet their peers, lockdown, isolation and back-to-back lecture classes (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). To date, there is no gold-standard approach to address such a pandemic situation. All the teaching methods implemented were on a trial-and-error basis. Although many students were satisfied with distance learning, they presented a predominantly negative perspective on the implementation of complete distance learning. The results of our present study showed that the face-to-face system was preferred by the students and that they did not want the distance learning system to continue for a long period of time. Their opinions, such as \u0026ldquo;lack of patient exposure would affect our future dental practice\u0026rdquo; and \u0026ldquo;implementation of the new distance learning method does not motivate us to learn more,\u0026rdquo; proved the same. Our results are consistent with those of a recent study performed by Noor et al., who concluded that e-learning can be accepted only partially and not as a single method of education in dentistry (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Therefore, with all the technological advancements, the education system in the future should be directed toward a hybrid method, i.e., in-person and clinical training should be combined with virtual education (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). The results of our survey can help take steps to manage the crisis and minimize its impact on the dental education system. This would also help institutions be better prepared for similar disruptions in the future.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eDespite these challenges, dental students were able to adapt to the new learning methods of distance learning. Within the limitations of the study, it could be concluded that distance learning can only be an adjunct to conventional methods, especially in dentistry. Blended learning via hybrid methods, i.e., the use of both virtual platforms and face-to-face teaching, is the method of choice for dental education to ensure the quality of education and to be updated with technological advances.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eSK,MK,SS,BM- wrote main manuscriptDL- did statistical analysis and interpretation of dataAll authors- read and reviewed the manuscriptSK,MK,BM- prepared figures\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eTaylor CB, Fitzsimmons-Craft EE, Graham AK. Digital technology can revolutionize mental health services delivery: The COVID-19 crisis as a catalyst for change. Int J Eat Disord [Internet]. 2020 Jul 1 [cited 2024 Oct 30];53(7):1155\u0026ndash;7. Available from: https://pubmed.ncbi.nlm.nih.gov/32449523/\u003c/li\u003e\n\u003cli\u003eFarrokhi F, Mohebbi SZ, Farrokhi F, Khami MR. Impact of COVID-19 on dental education- a scoping review. BMC Med Educ [Internet]. 2021 Dec 1 [cited 2024 Oct 30];21(1):587. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8604706/\u003c/li\u003e\n\u003cli\u003eFricton J, Chen H. Using teledentistry to improve access to dental care for the underserved. Dent Clin North Am [Internet]. 2009 Jul [cited 2024 Oct 30];53(3):537\u0026ndash;48. Available from: https://pubmed.ncbi.nlm.nih.gov/19482128/\u003c/li\u003e\n\u003cli\u003eBarabari P, Moharamzadeh K. Novel Coronavirus (COVID-19) and Dentistry-A Comprehensive Review of Literature. Dent J (Basel) [Internet]. 2020 Jun 1 [cited 2024 Oct 30];8(2). Available from: https://pubmed.ncbi.nlm.nih.gov/32455612/\u003c/li\u003e\n\u003cli\u003eMeng L, Hua F, Bian Z. Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine. J Dent Res [Internet]. 2020 May 1 [cited 2024 Oct 30];99(5):481\u0026ndash;7. Available from: https://pubmed.ncbi.nlm.nih.gov/32162995/\u003c/li\u003e\n\u003cli\u003eFarooq I, Ali S, Alam Moheet I, Alhumaid J. COVID-19 outbreak, disruption of dental education, and the role of teledentistry. Pak J Med Sci [Internet]. 2020 Nov 1 [cited 2024 Oct 30];36(7):1726. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7674864/\u003c/li\u003e\n\u003cli\u003eSingh HK, Joshi A, Malepati RN, Najeeb S, Balakrishna P, Pannerselvam NK, et al. A survey of E-learning methods in nursing and medical education during COVID-19 pandemic in India. Nurse Educ Today [Internet]. 2021 Apr 1 [cited 2024 Oct 30];99. Available from: https://pubmed.ncbi.nlm.nih.gov/33607513/\u003c/li\u003e\n\u003cli\u003eChavarr\u0026iacute;a-Bola\u0026ntilde;os D, G\u0026oacute;mez-Fern\u0026aacute;ndez A, Dittel-Jim\u0026eacute;nez C, Montero-Aguilar M. E-Learning in Dental Schools in the Times of COVID-19: A Review and Analysis of an Educational Resource in Times of the COVID-19 Pandemic. Odovtos International Journal of Dental Sciences [Internet]. 2020 Aug 10 [cited 2024 Oct 30];22(3):69\u0026ndash;86. Available from: http://www.scielo.sa.cr/scielo.php?script=sci_arttext\u0026amp;pid=S2215-34112020000300069\u0026amp;lng=en\u0026amp;nrm=iso\u0026amp;tlng=en\u003c/li\u003e\n\u003cli\u003eCaplin RL. Dentistry - art or science? Has the clinical freedom of the dental professional been undermined by guidelines, authoritative guidance and expert opinion? Br Dent J [Internet]. 2021 Mar 1 [cited 2024 Oct 30];230(6):337\u0026ndash;43. Available from: https://pubmed.ncbi.nlm.nih.gov/33772186/\u003c/li\u003e\n\u003cli\u003eBennardo F, Buffone C, Fortunato L, Giudice A. COVID-19 is a challenge for dental education-A commentary. Eur J Dent Educ [Internet]. 2020 Nov 1 [cited 2024 Oct 30];24(4):822\u0026ndash;4. Available from: https://pubmed.ncbi.nlm.nih.gov/32542796/\u003c/li\u003e\n\u003cli\u003eQuadri MFA, Jafer MA, Alqahtani AS, Al mutahar SAB, Odabi NI, Daghriri AA, et al. Novel corona virus disease (COVID-19) awareness among the dental interns, dental auxiliaries and dental specialists in Saudi Arabia: A nationwide study. J Infect Public Health [Internet]. 2020 Jun 1 [cited 2024 Oct 30];13(6):856\u0026ndash;64. Available from: https://pubmed.ncbi.nlm.nih.gov/32475807/\u003c/li\u003e\n\u003cli\u003eAmir LR, Tanti I, Maharani DA, Wimardhani YS, Julia V, Sulijaya B, et al. Student perspective of classroom and distance learning during COVID-19 pandemic in the undergraduate dental study program Universitas Indonesia. BMC Med Educ [Internet]. 2020 Dec 1 [cited 2024 Oct 30];20(1):1\u0026ndash;8. Available from: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-020-02312-0\u003c/li\u003e\n\u003cli\u003eGungor AS, Uslu YS, Donmez N. Perceptions of dental students towards online education during the COVID-19 pandemic. Eur Oral Res [Internet]. 2021 [cited 2024 Oct 30];55(3):124\u0026ndash;32. Available from: https://pubmed.ncbi.nlm.nih.gov/34746783/\u003c/li\u003e\n\u003cli\u003eDi Giacomo P, Di Paolo C. COVID-19 AND DENTAL DISTANCE-BASED EDUCATION: students\u0026rsquo; perceptions in an Italian University. BMC Med Educ [Internet]. 2021 Dec 1 [cited 2024 Oct 30];21(1):1\u0026ndash;9. Available from: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-021-02840-3\u003c/li\u003e\n\u003cli\u003eCucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed [Internet]. 2020 [cited 2024 Oct 30];91(1):157\u0026ndash;60. Available from: https://pubmed.ncbi.nlm.nih.gov/32191675/\u003c/li\u003e\n\u003cli\u003eAdam D. The pandemic\u0026rsquo;s true death toll: millions more than official counts. Nature [Internet]. 2022 Jan 1 [cited 2024 Oct 30];601(7893):312\u0026ndash;5. Available from: https://pubmed.ncbi.nlm.nih.gov/35042997/\u003c/li\u003e\n\u003cli\u003eByrne SJ, Glasser S. Creativity as a framework for innovation in dental education. Frontiers in Oral Health [Internet]. 2023 [cited 2024 Oct 30];4:1233983. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10655018/\u003c/li\u003e\n\u003cli\u003eDhawan S. Online Learning: A Panacea in the Time of COVID-19 Crisis. https://doi.org/101177/0047239520934018 [Internet]. 2020 Jun 20 [cited 2024 Oct 30];49(1):5\u0026ndash;22. Available from: https://journals.sagepub.com/doi/full/10.1177/0047239520934018\u003c/li\u003e\n\u003cli\u003eEmami E. COVID-19: Perspective of a Dean of Dentistry. JDR Clin Trans Res [Internet]. 2020 Jul 1 [cited 2024 Oct 30];5(3):211\u0026ndash;3. Available from: https://pubmed.ncbi.nlm.nih.gov/32401587/\u003c/li\u003e\n\u003cli\u003eDeery C. The COVID-19 pandemic: implications for dental education. Evid Based Dent [Internet]. 2020 Jun 1 [cited 2024 Oct 30];21(2):46\u0026ndash;7. Available from: https://pubmed.ncbi.nlm.nih.gov/32591653/\u003c/li\u003e\n\u003cli\u003eAgius AM, Gatt G, Vento Zahra E, Busuttil A, Gainza-Cirauqui ML, Cortes ARG, et al. Self-reported dental student stressors and experiences during the COVID-19 pandemic. J Dent Educ [Internet]. 2021 Feb 1 [cited 2024 Oct 30];85(2):208\u0026ndash;15. Available from: https://pubmed.ncbi.nlm.nih.gov/32929725/\u003c/li\u003e\n\u003cli\u003eXiong J, Lipsitz O, Nasri F, Lui LMW, Gill H, Phan L, et al. Impact of COVID-19 pandemic on mental health in the general population: A systematic review. J Affect Disord [Internet]. 2020 Dec 1 [cited 2024 Oct 30];277:55\u0026ndash;64. Available from: https://pubmed.ncbi.nlm.nih.gov/32799105/\u003c/li\u003e\n\u003cli\u003eNoor R, Singh D, Agarwal A, Mansoori S, Ansari MI. Perception of dental students towards the online method of dental education during the COVID-19 pandemic. J Oral Biol Craniofac Res [Internet]. 2022 Mar 1 [cited 2024 Oct 30];12(2):223. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8848541/\u003c/li\u003e\n\u003cli\u003eSchlenz MA, Schmidt A, W\u0026ouml;stmann B, Kr\u0026auml;mer N, Schulz-Weidner N. Students\u0026rsquo; and lecturers\u0026rsquo; perspective on the implementation of online learning in dental education due to SARS-CoV-2 (COVID-19): A cross-sectional study. BMC Med Educ [Internet]. 2020 Oct 9 [cited 2024 Oct 30];20(1):1\u0026ndash;7. Available from: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-020-02266-3\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Distance learning, Dental education, COVID-19, Medical education, Technology","lastPublishedDoi":"10.21203/rs.3.rs-5376940/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5376940/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe COVID-19 pandemic has wreaked havoc on education in a variety of settings, particularly medical and dental teaching institutes. During the pandemic, distance learning has become necessary to ensure that education continues.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThe present study aims to analyze dental students\u0026rsquo; perceptions of the transition of education from traditional to distance learning.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis was a cross-sectional study consisting of a 25-statement online questionnaire that was anonymously administered to students studying dentistry at Manipal Academy of Higher Education, Manipal, India. The data collected were analyzed statistically via chi-square test.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003e A total of 713 out of 800 undergraduate dental students participated in the survey, resulting in an 89.12% response rate. A total of 73.9% of the students did not feel that it was easier to concentrate in online classes than in offline lectures, and 60.9% of the students felt that they could not learn the theoretical aspects adequately. Almost three-fourths of the students (73.9%) felt that lockdowns and distance education severely affected the quality of their dental education. A total of 86.4% of the students felt that a lack of patient exposure would affect their future dental practice. With respect to learning preferences, the majority of the students preferred a combination of traditional methods and online learning.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eDespite these difficulties, dental students were able to adapt to the new distance learning education system. 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