Engagement, Benefits, and Challenges in Continuing Professional Development among Sri Lankan Dental Practitioners

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M. Y. P. Rathnayake, R.M.I.N Rathnayake, V. D. R. M. Rathnayake, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7994442/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 18 Apr, 2026 Read the published version in BMC Health Services Research → Version 1 posted 11 You are reading this latest preprint version Abstract Background Continuing Professional Development (CPD) enhances the expertise, clinical skills, and professional competencies of oral health practitioners, contributing to evidence-based practice, ethical conduct, and patient safety. While many countries require CPD for license renewal, participation in Sri Lanka remains voluntary and lacks formal regulation. Exploring dentists’ experiences, engagement, and challenges in CPD is crucial for designing a structured, locally relevant CPD system. This study aimed to evaluate the perceptions, participation patterns, perceived benefits, and barriers to CPD among dental professionals in Sri Lanka. Methods A descriptive cross-sectional study was conducted among dental surgeons registered with the Sri Lanka Medical Council. A pre-tested, self-administered questionnaire covering demographics, CPD participation, benefits, barriers, and perceptions was disseminated electronically via Google Forms. Data from 320 respondents were analyzed using descriptive statistics, chi-square tests, and binary logistic regression to explore associations between demographic factors and CPD engagement. Results Of the 320 respondents, 56.6% were female and 58.8% were aged 31–50 years. CPD participation in the last five years was high (88.8%), with 91.6% intending to engage in future activities. Attendance was higher among specialists/consultants and practitioners with longer work experience. Lectures (80.3%) and hands-on workshops (62.2%) were the most common CPD formats, with restorative dentistry (69.4%) and oral and maxillofacial surgery (56.5%) being the preferred clinical disciplines. The main motivators were improving knowledge (90.3%) and learning new skills (77.5%), while major barriers included location (76.6%), cost (59.7%) and busy schedules (52.2%). Binary logistic regression indicated that gender, age, and qualifications significantly influenced perceived knowledge gains and understanding, with specialists/consultants being more likely than other practitioners to support mandatory CPD and the consideration of CPD points for SLMC registration renewal (OR = 3.26, p = 0.007). Most respondents recognized CPD as essential for safe (93.2%) and evidence-based practice (91.3%), and 79% supported making CPD mandatory in Sri Lanka. Conclusions Sri Lankan dentists demonstrate strong engagement and positive perceptions of CPD, yet barriers related to accessibility, cost, and scheduling remain. Structured, flexible, and context-specific CPD programs, potentially integrated with a formal regulatory framework, are needed to standardize professional development, optimize participation, and enhance patient care. Continuing Professional Development dental practitioners participation barriers benefits Figures Figure 1 Figure 2 Introduction Continuing Professional Development (CPD) aims to consolidate the professional knowledge, skills, and competencies of all oral health care personnel to effectively meet patients’ needs. CPD has become pivotal in evidence-based dentistry, reflecting the rapidly evolving nature of dental practice [ 1 ]. The growing diversity of patient demographics and increasing expectations of oral health care services necessitate that dental practitioners engage in regular CPD programs to maintain clinical competency [ 3 ]. Moreover, CPD promotes ethical and professional integrity, supports the provision of standardized, high-quality care, and enhances skills through active participation in structured educational activities [ 4 ]. The rapid influx of scientific knowledge and technological innovations in dentistry underscores the importance of CPD for providing patients with the latest diagnostic, therapeutic, and preventive modalities, thereby enhancing public safety [ 5 ]. Moreover, CPD allows practitioners to identify areas requiring improvement, ensuring clinical currency and professional growth [ 6 ]. Globally, many countries mandate CPD for license renewal or re-registration, often requiring a specific number of hours or verifiable educational activities such as lectures, courses, and conferences, alongside non-verifiable activities like self-directed learning, journal reading, case discussions, and peer learning [ 7 ]. CPD may be classified as scientific—covering disciplines such as endodontics, oral surgery, oral medicine, radiology, preventive dentistry, and public health—or non-scientific, which includes practice management and dentolegal responsibilities [ 7 ]. Mandatory CPD has been implemented in many developed countries including the United Kingdom, New Zealand, Australia, Canada, and the United States, whereas some European and Asian countries regulate both the quantity and topics of CPD through research-based systems [ 1 , 8 – 10 ]. In Malaysia and Saudi Arabia, CPD is compulsory for maintaining practicing licenses, while other countries, such as India, have professional associations advocating for mandatory CPD for practitioners in various states [ 4 , 5 , 9 ]. Dental practitioners generally perceive CPD as a valuable tool to remain updated with changes in disease trends, materials, equipment, and techniques, while enhancing career development [ 3 , 8 ]. Studies from countries with mandatory CPD show higher participation rates, with dentists reporting improvements in knowledge, clinical skills, patient satisfaction, and overall efficiency [ 3 , 4 , 9 – 11 ]. Among subject-specific CPD, areas such as cosmetic and aesthetic dentistry, restorative dentistry, endodontics, and implantology are commonly preferred [ 3 , 10 , 12 ]. Participation patterns in CPD vary according to regulatory frameworks, professional experience, gender, and practice type. Dentists in countries with statutory CPD demonstrate higher engagement than in countries where participation is discretionary [ 1 , 8 ]. Studies in Sudan and Saudi Arabia have shown that specialists and male dentists participate more actively than general practitioners and female dentists, respectively [ 3 , 4 , 13 ]. Barriers to participation commonly reported include high clinical workload, cost, travel distance, lack of motivation, irrelevance of content, and limited access to web-based learning [ 14 ]. In Sri Lanka, CPD is neither a legal requirement nor linked to the renewal of dental registration. Although the Sri Lanka Medical Association (SLMA) introduced a National CPD Certificate (NCPDC) in 2010, it remains voluntary and has limited impact on prioritization among practitioners [ 6 ]. Barriers such as lack of financial incentives, private practice commitments, long travel distances, and limited online opportunities further restrict engagement [ 6 ]. While international and local CPD programs exist, there is no formal, regulated system offering verifiable CPD points for recertification, nor has any study assessed Sri Lankan dentists’ perceptions and participation. Given the expanding knowledge base in dentistry, all practitioners—whether recent graduates or experienced professionals—face inevitable gaps in knowledge. Existing CPD programs in Sri Lanka are provided by organizations such as the Sri Lanka Dental Association (SLDA) and the College of Dentistry and Stomatology (CDS), yet no studies have explored how dental practitioners perceive or participate in these activities. Assessing these perceptions is critical for developing a structured, validated CPD system that ensures competency, professional standards, and public safety. International studies indicate when provided in a structured and accessible manner CPD positively influences clinical practice, patient satisfaction, and career development promoting greater participation [ 1 , 11 ]. Therefore, assessing the perceptions and participation of dental professionals in Sri Lanka is crucial for developing a validated CPD system that is tailored to local needs, overcomes barriers, and promotes professional growth. Therefore, the present study aims, for the first time, to address a gap in the literature by systematically identifying the CPD needs of dental professionals in Sri Lanka, providing evidence to guide the development of a formally recognized, context-specific CPD framework. Materials and Methods This descriptive cross-sectional study was conducted among dental surgeons practicing in Sri Lanka, representing both government and private sectors across all districts. The study population included all dental surgeons registered with the Sri Lanka Medical Council (SLMC). Eligible participants were dental surgeons and consultants attached to the Ministry of Health, Ministry of Defense, Faculties of Dental Sciences, as well as private practitioners. Interns and retired dental surgeons were excluded. Data were collected using a pre-tested, self-administered questionnaire developed through a review of published literature (Annexure 1). The questionnaire comprised three sections: demographic details (Section A), participation in continuing educational activities (Section B), and benefits, barriers, and attitudes/perceptions regarding CPD (Section C). Content and face validity were ensured through expert review by specialists in sociology, community medicine, and dental public health. The study objectives and procedures were communicated to participants via email and WhatsApp prior to the dissemination of the questionnaire. Questionnaires were distributed electronically using a Google Form link, as no participants requested printed copies. Consent was obtained online before completing the survey, which also included details on study objectives and instructions. No personal identifiers were collected, and confidentiality was assured. To enhance response rates, three reminders were sent prior to the survey closing. Responses were downloaded into Microsoft Excel, coded numerically, and analyzed using SPSS version 29 (SPSS Inc., Chicago, IL, USA). Descriptive statistics were used to present means and standard deviations (SD) for continuous variables, as well as frequencies and percentages for categorical variables. The internal consistency of the attitude scale was evaluated using Cronbach’s alpha coefficient. Bivariate relationships were evaluated using chi-square tests. To explore the associations binary logistic regression analysis was performed. Odds ratio and 95% confident interval were used to measure the strength of the association. Statistical significance is set at p < 0.05. Ethical approval was obtained from the Ethics Review Committee of the Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. Results Responses were received from 320 Sri Lankan dental practitioners who were invited to participate in the survey. The majority of respondents were females (56.6%, n = 181) aged 31–50 years (58.8%) (Table 1). Most participants were married (n = 270, 84.4%). Over half of the respondents (n = 170, 53.3%) had 11–30 years of work experience. All respondents held a BDS qualification, while 21.6% had a postgraduate diploma and 18.1% were specialists/consultants with MD/MS (Table 1). In terms of practice type, 45% worked in the government sector, 10.9% in private practice exclusively, and 44.1% in both. The distribution of patient load varied between government and private practice settings. In government funded hospitals, the majority of respondents (76.6%) reported seeing more than 10 patients per day whereas, in private practice, most respondents (54.7%) reported seeing fewer than 5 patients per day. Most respondents (82.6%) were members of national professional associations, while 16.1% held both national and international memberships (Table 1). Regarding CPD participation, 88.8% (n = 284) have attended CPD within the last five years and they revealed their intention to participate in CPD over the next two years (91.6%). Chi-square tests showed no significant associations between CPD participation and age, gender, marital status, or practice type (p > 0.05). Participation was significantly higher among consultants (100%) compared to BDS only (85.1%) and postgraduate diploma holders (89.7%), χ²(2, N = 320) = 10.07, p = 0.006, and increased with work experience: 83.2% ( 30 years), χ²(2, N = 320) = 7.36, p = 0.025, with a significant linear trend, χ²(1, N = 320) = 6.35, p = 0.012. When asked about the associations or colleges organizing the CPD programs they attended, most participants reported programs organized by the SLDA (n = 233, 79.5%), the CDS of Sri Lanka (n = 134, 45.7%), and the Government Dental Surgeons’ Association (GDSA) (31.7%). Other national associations were cited less frequently (4.4–25.6%). Regarding international organizations, participants have attended CPD programs most commonly organized by the Asia Pacific Dental Congress (APDC) (n = 99, 76.2%) and the World Dental Federation (FDI, n = 41, 31.5%), while participation in programs organized by other international bodies ranged from 3.8% to 18.5%. The majority of respondents (52.5%) engaged in practicing general dentistry while other notable specializations included restorative dentistry (15.0%), orthodontics (10.0%), and oral and maxillofacial surgery (8.4%). Lectures (n = 257, 80.3%), hands-on lab workshops (n = 199, 62.2%), discussions with dental colleagues (60.9%), and web-based distance learning (59.7%) were the most common CPD activities (Fig. 1). Small-group tutorials (18.1%) and discussions with medical colleagues (32.8%) were the least attended formats. Figure 1 Restorative dentistry (69.4%), oral and maxillofacial surgery (56.5%), and endodontics (48.2%) were the most popular clinical CPD disciplines, while oral pathology (7.3%), periodontology (19.3%), and prosthodontics (20.9%) were the least attended (Fig. 2). Among non-clinical CPD activities, practice management (48%) and curriculum development (42.8%) were most common. Most participants reported that their primary reasons for attending CPD were improving knowledge (n = 289, 90.3%) and learning new skills (n = 248, 77.5%). Other reasons included supplementing undergraduate knowledge (n = 149, 46.6%), socialization (n = 147, 45.9%), and personal satisfaction (n = 138, 43.1%). Figure 2. Participants reported that the topic of the course/lecture/workshop (n = 264, 95.7%), lecturer identity (n = 220, 87.3%), and mode of delivery (n = 206, 86.9%) were the most influential factors affecting their CPD participation (Table 2). Cost of registration, family commitments, travel time, and travel costs were also identified as important. The loss of income had been identified as the least impacted factor by the study participants. Table 2 Factors Influencing Access to CPD Activities. Factors influencing the access to CPD Impacted No idea Not impacted N (%) N (%) N (%) Topic of the course/lecture workshop 264 (95.7) 3(1.1) 9 (3.3) Identity of lecturer/s 220 (87.3) 7(2.8) 25(9.9) Travelling cost 178 (76.4) 13(5.6) 42(18) Travel time 197 (80.7) 11(4.5) 36(14.8) Family commitments 201(80.1) 12(4.8) 38(15.1) Cost of registration 197 (79.8) 15(6.1) 35(14.2) Loss of income 123 (55.4) 23(10.4) 76(34.2) Involvement of practical component 167 (78.8) 20(9.4) 25(11.8) Making new contacts 126 (62.7) 37(18.4) 38(18.9) Day of the week 180 (77.6) 24(10.3) 28(12.1) Month of the year 107 (51.4) 36(17.3) 65(31.3) Time of the day 156 (70.6) 20(9) 45(20.4) Date being a holiday 165 (72.7) 28(12.3) 34(15) Mode of delivery 206 (86.9) 12(5.1) 19(8) The perceived benefits of CPD were reported by the majority of respondents (Table 3). Most dentists (85.9%, n = 275) indicated that CPD improved their knowledge of new treatment techniques and methods. A considerable proportion also identified better understanding of the subject (74.4%, n = 238) and being updated about new materials (71.9%, n = 230) as key benefits. Improved patient care was cited by 67.5% (n = 216) of participants, while 62.8% (n = 201) reported that CPD facilitated the use of evidence-based practice in their clinical work (Table 3). Several barriers to CPD participation were highlighted (Table 3). The most frequently reported barrier was the location or place of CPD activities (76.6%, n = 245), followed by cost (59.7%, n = 191). Family commitments (52.5%, n = 168) and busy schedules (52.2%, n = 167) were also commonly reported. Among the barriers reported, the least frequently cited factors were no incentives (5.6%), loss of income (22.2%), no duty leaves (22.5%), courses not being relevant (23.4%), and loss of a day per week (24.4%). These findings indicate that only a small proportion of participants considered these aspects as obstacles to attending CPD activities. Table 3 Perceived Benefits and Barriers to Continuing Professional Development (CPD) Among Dentists. Benefits Percentage (N) Knowledge of new treatment techniques/methods 85.9 (275) Better understanding of the subject 74.4 (238) Getting updated about new materials 71.9 (230) Improved patient care 67.5 (216) Using Evidence based practice 62.8 (201) Barriers Location /place 76.6 (245) Cost 59.7 (191) Family commitments 52.5 (168) Loss of a day per week 24.4 (78) Busy schedule 52.2 (167) Courses are not relevant 23.4 (75) Loss of income 22.2 (71) No duty leaves 22.5 (72) No incentives 5.6 (18) Two separate binary logistic regression models were performed to examine the effects of age, gender, work experience, and qualifications on dentists’ knowledge of new treatment techniques/methods and better understanding of the subject (Table 4). For the outcome knowledge of new treatment techniques/methods, the overall model was statistically significant (Omnibus test: χ²(7) = 15.70, p = 0.028) and demonstrated good fit (Hosmer-Lemeshow test: χ²(8) = 8.05, p = 0.429). Among the predictors, only gender was significantly associated with this outcome (Table 4). Male participants had 2.45 times higher odds of acquiring new treatment knowledge compared to female participants (OR = 2.45, 95% CI: 1.18–5.07, p = 0.016). Age, work experience, and qualifications were not significant. For the outcome better understanding of the subject, the overall model was also statistically significant (Omnibus test: χ²(7) = 18.41, p = 0.010) and showed excellent fit (Hosmer-Lemeshow test: χ²(8) = 1.59, p = 0.991). In this model, participants aged 31–50 years had 2.06 times higher odds of reporting a better understanding of the subject compared to those aged ≤ 30 years (OR = 2.06, 95% CI: 1.01–4.20, p = 0.048) (Table 4). Participants with BDS only qualifications had lower odds of reporting better understanding compared to those with postgraduate qualifications (OR = 0.42, 95% CI: 0.19–0.89, p = 0.024). Sex and work experience were not significant predictors. Table 4 Bivariate Analysis of Predictors for Knowledge and Understanding Gained from CPD Programs Knowledge of new treatment techniques/methods Better understanding of the subject Variable AOR 95% CI P value AOR 95% CI P value Age ≤ 30 years 2.094 0.544–8.061 0.282 1.029 0.343–3.090 0.960 31–50 2.289 0.807–6.495 0.120 2.056 1.006–4.202 0.048* ≥ 50 years - Sex Male 2.447 1.181–5.071 0.016* 1.503 0.872–2.591 0.142 Female - Work experience 30 years - - Qualifications BDS only 0.522 0.176–1.547 0.241 0.416 0.194–0.892 0.024* Specialists/ consultants 0.958 0.258–3.555 0.949 0.995 0.400–2.477 0.992 BDS with postgraduate diploma - - Most respondents agreed that CPD was essential for safe (93.2%) and evidence-based practice (91.3%). A large majority (79%) believed CPD should be mandatory in Sri Lanka. However, only 59.7% agreed that CPD points should be considered for SLMC registration renewal (Table 5). Binary logistic regression analyses were conducted to examine the influence of age, gender, work experience, and qualifications on two outcomes: the perception that CPD programs should be made mandatory for dentists in Sri Lanka, and that CPD points should be considered before renewing SLMC registration. In both models, the Omnibus Tests of Model Coefficients indicated that the predictors collectively improved the fit compared to the null model (Model 1: χ²(7) = 15.67, p = 0.028; Model 2: χ²(7) = 16.26, p = 0.023). The Model Summaries showed that the predictors explained a modest proportion of variance in the outcome (Model 1: Cox & Snell R² = 0.051, Nagelkerke R² = 0.086; Model 2: Cox & Snell R² = 0.053, Nagelkerke R² = 0.072). The Hosmer–Lemeshow tests indicated good model fit for both analyses (Model 1: χ²(8) = 1.70, p = 0.989; Model 2: χ²(8) = 8.29, p = 0.406). In both models, qualifications emerged as the only significant predictor. In the first model, specialists/consultants were 6.66 times more likely than the reference group to perceive that CPD programs should be made mandatory for dentists (p = 0.018). In the second model, specialists/consultants were 3.26 times more likely than the reference group to agree that CPD points should be considered before renewing SLMC registration (p = 0.007). Age, gender, and work experience did not significantly predict the outcome in either model. Table 5 Dentists’ Perceptions and Agreement Levels Regarding CPD Importance and Implementation in Sri Lanka. Item Agree / Strongly Agree % Neutral % Disagree / Strongly Disagree % I believe that CPD is important for safe clinical practice 93.2 2.8 4.1 I believe that CPD is important for evidence based clinical practice 91.3 4.7 4.1 I think more verifiable CPD programs should be conducted by Colleges and Associations 83.2 8.4 8.4 I think that CPD programs should be made mandatory for dentists in Sri Lanka 79.0 12.2 8.8 I would like the Faculty of Dental Sciences to conduct more CPD programs 76.5 14.7 8.8 I am satisfied with the CPD/CDE programs that I attended within the last 5 years 70.9 15.0 14.1 I achieved my objectives by participating in CPD programs in last 5 years 68.1 20.3 11.6 I think that CPD points should be considered before renewing the SLMC registration. 59.7 21.9 18.4 When respondents were asked to list their top priority CPD learning requirements, a wide range of topics and skill areas were highlighted. Respondents most frequently prioritized CPD in restorative dentistry, orthodontics, implant dentistry, and oral surgery. There was strong interest in hands-on workshops, practical skill development, and updates in digital dentistry. Other areas of interest included ethics, medical emergencies, preventive dentistry, and evidence-based practice, indicating a preference for comprehensive CPD programs combining specialty-specific, practical, and interdisciplinary knowledge. Discussion This study, conducted among dental professionals registered under the SLMC, provides valuable insights into CPD engagement, perceived benefits, and barriers within the Sri Lankan dental community. The regulatory bodies in many countries have made it compulsory that dentists follow CPD as a requirement for the renewal of their license or re-registration. There is evidence to support that CPD is effective in improving standard of care [ 10 , 11 , 15 , 16 ]. Several studies have reported that up to 70% of respondents have changed the way they practice dentistry after attending CPD with improved patient satisfaction (2). In Sri Lanka, given limited resources, CPD initiatives must be used effectively to achieve meaningful service improvements, yet participation remains entirely voluntary as CPD is not yet mandatory for medical and dental professionals, with registration renewal occurring on a five-year cycle. Despite its voluntary nature, the high levels of engagement observed in our study reflect the enthusiasm of practitioners for ongoing learning and professional growth. Responses were obtained from 320 dentists, which, although lower than reported in some international studies, exceeded those in other community-based surveys in Sri Lanka, where participant recruitment is often challenging [ 17 ]. Though the present study represented participants from all districts in Sri Lanka, higher responses were from urban areas such as Colombo and Kandy. The predominance of female respondents (56.6%) is consistent with the growing feminization of dentistry. Most participants were married (83.8%), and while over half did not have school-going children, marital and parental responsibilities may influence the time and flexibility available for CPD participation. Globally, dental care often relies on the private sector, with limited public coverage in countries like Australia, Canada, and the U.S., whereas countries such as Germany, Denmark, and Sweden provide broader public coverage, though the depth and scope of services covered can still be limited, often focusing on basic or emergency care [ 18 , 19 ]. In Sri Lanka, most people rely on public services but seek private care for treatments not available publicly, such as implants, or based on personal preference. Reflecting this pattern in government hospitals, the majority of respondents (76.6%) reported seeing more than 10 patients per day, whereas in private practice most (54.7%) saw fewer than five patients daily. These findings highlight differences in patient volume across practice settings, reflecting sector-specific workload patterns. Since the majority of respondents practice in the government sector (Table 1 ), the busy schedule may be a barrier to attending regular CPDs. In the Sri Lankan hospital setup, where dentists of all grades work alongside specialists, workplace CPD maximizes knowledge translation, benefiting practitioners, teams, the organization, and service users, particularly when institutions recognize and use the workplace itself as a valuable learning resource [ 18 ]. Membership in local and international dental associations such as the Sri Lanka Dental Association, International Association for Dental Research (IADR), and the FDI World Dental Federation provides dentists with a range of professional benefits, including advocacy, continuing education, networking, leadership opportunities, and access to scientific research and publications. CPD preferences closely mirrored clinical practice demands [ 9 ], reflecting the influence of professional affiliations on educational engagement. In our study, most dentists reported attending CPD programs organized by the SLDA, national dental colleges, and international bodies such as the Asia Pacific Dental Congress and FDI, suggesting that both local and international associations significantly shape CPD participation and align learning opportunities with clinical and professional priorities. Consistent with international findings [ 8 ], restorative dentistry was the most preferred area, corresponding to the population’s high restorative care needs. Interestingly, oral and maxillofacial surgery also ranked highly, perhaps reflecting individual career aspirations or gaps in undergraduate exposure as seen in studies from Ireland and Malaysia [ 19 , 20 ]. Endodontics was another popular field, aligning with findings from previous studies [ 8 , 12 ]. In contrast, implant dentistry and areas like periodontics and prosthodontics tend to be less sought after, possibly due to limited CPD opportunities or local practice patterns, which differs from some international trends. Non-clinical CPD attracted lower participation, suggesting a general preference for clinically oriented training [ 19 , 21 ]. Participation in CPD programs is associated with multiple benefits, including the acquisition of new skills and techniques, enhanced understanding of subject matter, and staying updated on new materials and practices. These findings align with previous studies [ 3 , 5 , 22 ], which demonstrate links between CPD engagement and outcomes such as evidence-based practice, improved patient care, and professional growth [ 22 , 23 ]. Practitioners clearly recognize CPD as a driver of clinical excellence, and its effectiveness is further enhanced when programs are interactive, context-specific, and tailored to their needs [ 24 ]. Barriers to participation are multifaceted and often context-dependent. Location and accessibility are consistently identified as major obstacles [ 10 ], with structural barriers such as the unavailability of opportunities at convenient locations making participation unachievable for many. Cost and time constraints (including busy schedules and family commitments) are also frequently cited as significant barriers. While course irrelevance or lack of perceived benefit is less commonly reported, it can still deter participation in some contexts [ 25 ]. Interestingly, loss of income and limited incentives are not consistently linked to reduced participation, suggesting that intrinsic motivation and perceived professional or personal benefits often outweigh financial concerns. Gender and age have been identified as important predictors of CPD engagement and outcomes, with some research noting barriers to CPD access for female practitioners and those in rural areas, which may contribute to differences in reported knowledge gains and engagement patterns [ 10 , 26 ]. Mid-career dentists (Table 4 ) often demonstrate higher motivation and benefit more from CPD, likely due to greater clinical exposure and a desire for skill enhancement, while postgraduate qualifications are associated with better understanding and maximized CPD benefits, highlighting the value of advanced training [ 26 , 27 ]. International comparisons reveal both similarities and differences. Like studies elsewhere, Sri Lankan dentists preferred lectures, workshops, and discussions with colleagues [ 8 , 10 , 19 ], while journal reading and book-based CPD were less common. Web-based CPD, although less preferred in some earlier studies [ 10 ], showed considerable acceptance in our sample, highlighting growing adaptability to online platforms. A similar study conducted with the participants of the APDC revealed that they had participated in CPD during the past 5 years, and the preferred methods were the didactic approaches followed by distance learning and web-based courses [ 12 ]. Factors influencing participation—including course topic, lecturer identity, and delivery format—were also consistent with international findings, underscoring the universal nature of these motivators. The strong consensus among respondents that CPD is essential for safe (97.1%) and evidence-based (95.1%) practice reinforces its perceived centrality in professional life. Furthermore, the majority supported mandatory CPD in Sri Lanka and favored program delivery through professional associations and academic institutions. The influence of qualifications on perceptions of CPD among dental practitioners is supported by research showing that specialists and consultants often demonstrate greater engagement with and positive attitudes toward CPD compared to general practitioners. For example, studies from Australia and Malaysia found that both dentists and specialists generally viewed mandatory CPD as reasonable and beneficial, with specialists tending to participate in more CPD hours and being more likely to change their practice as a result of CPD activities [ 9 – 10 ]. These findings suggest that higher qualifications may be associated with increased awareness of the importance of CPD for maintaining professional competence. These insights highlight the importance of designing CPD policies and awareness campaigns that address both specialists and general practitioners to promote broader acceptance and participation in CPD programs [ 5 ]. There are no recognized CPD providers and a properly regulated and recognized CPD system based on adult-learning principles with longitudinal curricular in Sri Lanka. Though certain organizations provide CPD points just accumulation of CPD points won’t enhance the practice and patient outcomes. However, fewer endorsed linking CPD points to SLMC registration renewal, reflecting diverse views on regulatory enforcement. Taken together, these findings highlight both the strengths and gaps in the current CPD landscape in Sri Lanka. While participation is commendably high, logistical barriers, disparities in specialty representation, and variability in program delivery remain challenges. Addressing these through decentralized program delivery, flexible formats, and greater emphasis on underrepresented areas (e.g., periodontics, prosthodontics, non-clinical CPD such as ethics/professionalism) could enhance uptake and impact. Moreover, structured frameworks—potentially including mandatory CPD—may help standardize professional development and sustain high-quality dental care in Sri Lanka. Limitations The questionnaire was disseminated via email and WhatsApp groups using a Google Form, a method that has gained popularity due to its rapid, convenient, and cost-effective nature. Despite multiple reminders, the number of respondents remained suboptimal, reflecting trends seen in previous local surveys. A low number of responses may introduce non-response bias, as those who chose to participate are likely to be more interested or engaged in the topic, potentially limiting the generalizability of the findings to all practicing dentists in Sri Lanka. Considerable effort was made to minimize this bias through repeated follow-up reminders via email and WhatsApp; however, collecting responses from the entire population proved challenging. This aligns with findings from a multilevel meta-regression analysis showing a steady decline in response rates among dentists and other healthcare professionals, in some cases reaching as low as 2% [ 28 ], and indicating that traditional mail surveys may sometimes yield higher response rates than online methods. The length of the questionnaire may also have discouraged participation, contributing to the lower number of responses. Furthermore, as the study relied on a self-administered questionnaire, recall bias and social desirability bias may have influenced responses, and the subjective nature of self-reporting may not accurately reflect actual levels of knowledge, perceptions, and practices. Conclusions This study provides the first comprehensive assessment of CPD participation, perceptions, and barriers among dental practitioners in Sri Lanka. The findings demonstrate high engagement and recognition of CPD’s role in enhancing clinical knowledge, skills, and evidence-based practice. Participation is influenced by factors such as professional qualifications, work experience, and gender, while barriers including location, cost, family commitments, and busy schedules limit full engagement. Preferences for clinically oriented CPD, particularly in restorative dentistry, oral and maxillofacial surgery, and endodontics, highlight the need to align educational programs with practitioners’ needs and population demands. These insights underscore the necessity of developing a structured, accessible, and context-specific CPD framework in Sri Lanka, potentially incorporating regulatory oversight, to standardize professional development, support lifelong learning, and ensure high-quality dental care for the population. Abbreviations APDC - Asia Pacific Dental Congress BDS – Bachelor of Dental Surgery CPD – Continuing Professional Development CDS - College of Dentistry and Stomatology FDI – Fédération Dentaire Internationale (World Dental Federation) GDSA - Government Dental Surgeons’ Association MD – Doctor of Medicine MS – Master of Surgery NCPDC – National Continuing Professional Development Certificate SD – Standard Deviation SLDA – Sri Lanka Dental Association SLMA - Sri Lanka Medical Association SLMC – Sri Lanka Medical Council SPSS – Statistical Package for the Social Sciences Declarations Ethics approval and consent to participate The study received approval from the Ethics Review Committee of the Faculty of Dental Sciences, University of Peradeniya. All procedures were carried out in compliance with the principles of the Declaration of Helsinki concerning research involving human participants. Informed consent Informed consent was obtained from all individual participants included in the study. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request Competing interests The authors declare that they have no competing interests Clinical trial number Not applicable Funding Not applicable Authors' contributions R.M.Y.P: Data collection, visualization, writing - original draft; R.M.I.N: Data collection, visualization, writing - original draft; V.D.R.M: Data collection, visualization, writing - original draft; NS: conceptualization, methodology, review and editing; All the authors read and edited the final manuscript. All the authors approved the submission of the manuscript. Acknowledgements We gratefully acknowledge the dental practitioners across Sri Lanka for their contribution to this study. References Bullock A, Bailey S, Cowpe J, Barnes E, Thomas H, Thomas R, et al. Continuing professional development systems and requirements for graduate dentists in the EU : survey results from the DentCPD project. Eur J Dent Educ. 2013;17(1). John V, Parashos P. Factors involved in the translation of continuing professional development programmes into clinical practice among Victorian dentists. Aust Dent J. 2007 Dec;52(4):305–14. Nazir M, Al-Ansari A, Alabdulaziz M, AlNasrallah Y, Alzain M. Reasons for and Barriers to Attending Continuing Education Activities and Priorities for Different Dental Specialties. Open Access Maced J Med Sci. 2018 Sept 22;6(9):1716–21. Al‐Ansari A, Nazir MA. Dentists’ responses about the effectiveness of continuing education activities. Eur J Dent Educ [Internet]. 2018 Nov [cited 2025 Oct 1];22(4). Available from: https://onlinelibrary.wiley.com/doi/10.1111/eje.12388 Nayak PP, Prasad KV, Jyothi C, Roopa GS, Sanga R. Preferences and barriers for continuing professional development among dental practitioners in the twin cities of Hubli-Dharwad, India. Journal of Indian Association of Public Health Dentistry. 2015 Oct 1;13(4):4296. Sabhapathi̇ge R, Deerasi̇Nghe D, Ranasi̇Nghe G. Continuous Professional Development (CPD) of doctors in Sri Lanka: a qualitative study. Int J Health Serv Res Policy. 2022 Apr 29;7(1):48–55. Meli Attard A, Bartolo A, Millar BJ. Dental Continuing Professional Development – Part I: Background on Dental Continuing Professional Development in Europe. Eur J Dent Educ. 2022 Aug;26(3):539–45. Abbott P, Burgess K, Wang E, Kim K. Analysis of Dentists Participation in Continuing Professional Development Courses from 2001-2006. Open Dent J. 2010 Aug 27;4(1):179–84. Hamid NFA, Affendi NHK, Anwar NESK, Tan NFIMNI. A survey on preference for continuing professional development among general dental practitioners in Malaysia: A pilot study. Eur J Gen Dent. 2018 May;7(02):41–5. Hopcraft MS, Manton DJ, Chong PL, Ko G, Ong PYS, Sribalachandran S, et al. Participation in continuing professional development by dental practitioners in Victoria, Australia in 2007. Eur J Dent Educ. 2010 Nov;14(4):227–34. Belfield CR, Morris ZS, Bullock AD, Frame JW. The benefits and costs of continuing professional development (CPD) for general dental practice: a discussion. Eur J Dent Educ. 2001 May;5(2):47–52. Chan WC, Ng CH, Yiu BK, Liu CY, Ip CM, Siu HH, et al. A survey on the preference for continuing professional dental education amongst general dental practitioners who attended the 26th Asia Pacific Dental Congress. Eur J Dent Educ. 2006 Nov;10(4):210–6. Gabani WO. Continuing professional development (CPD): Participation and perception among practicing dentists in the public sector in Khartoum state – Sudan 2018. Wisam Omer Gabani. 2019;8(8). Leggate M, Russell E. Attitudes and trends of primary care dentists to continuing professional development: a report from the Scottish dental practitioners survey 2000. Br Dent J. 2002 Oct;193(8):465–9. Gray SL, Howell C, Franklin CD. Post-impact evaluation of an e-learning cross-infection control CD-ROM provided to all general dental practitioners in England. Br Dent J. 2007 Nov;203(9):E20–E20. Maidment Y. A comparison of the perceived effects on Scottish general dental practitioners of peer review and other continuing professional development. Br Dent J. 2006 May;200(10):581–4. Dissanayaka DWVN, Wijeratne KMSL, Amarasinghe KADKD, Jayasinghe RD, Jayasooriya PR, Mendis BRRN, et al. A Preliminary Study on Early Detection of Oral Cancer with Opportunistic Screening: Insights from Dental Surgeons in Sri Lanka. Cancers. 2023 Nov 22;15(23):5511. Manley K, Martin A, Jackson C, Wright T. A realist synthesis of effective continuing professional development (CPD): A case study of healthcare practitioners’ CPD. Nurse Educ Today. 2018 Oct;69:134–41. Hamid NFA, Affendi NHK, Anwar NESK, Tan NFIMNI. A survey on preference for continuing professional development among general dental practitioners in Malaysia: A pilot study. Eur J Gen Dent. 2018 May;7(02):41–5. Stewart C, Kinirons M. Dentists’ requirements for continuing professional development in Ireland. A pilot study conducted at University College Cork. J Ir Dent Assoc. 2015;61(1):40–4. Skapetis T, Cheema S, El Mustapha M. Evaluation of clinical versus non-clinical continuing education in terms of preferences and value for oral healthcare workers. Med Educ Online. 2022 Dec 31;27(1):2125630. McBride A, Collins C, Osborne B, McVeigh H. Does continuing professional development enhance patient care? A survey of Irish based general practitioners: Successful implementation of mandatory CPD in Irish General Practice. BMC Med Educ. 2022 Dec;22(1):220. Ramani S, McMahon GT, Armstrong EG. Continuing professional development to foster behaviour change: From principles to practice in health professions education. Med Teach. 2019 Sept 2;41(9):1045–52. Benassi P, Sockalingam S. What works in medical education, where and why? Med Educ. 2019 Sept;53(9):848–9. Zamanifar A, Asgari I. Continuing professional development programs for general dentists in Isfahan province, Iran: Interests, priorities, and obstacles. Dent Res J. 2022;19:69. Barnes E, Bullock AD, Bailey SER, Cowpe JG, Karaharju‐Suvanto T. A review of continuing professional development for dentists in Europe. Eur J Dent Educ. 2012 Aug;16(3):166–78. Avramova N, Vasileva IM. The Role of Continuous Education in Career Progression and Satisfaction Among Dentists. Ann J Dent Med Assist. 2024;4(2):28–33. Cho YI, Johnson TP, Vangeest JB. Enhancing surveys of health care professionals: a meta-analysis of techniques to improve response. Eval Health Prof. 2013 Sept;36(3):382–407. Table 1 Table 1 is available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Annexure1.docx Table1.docx Cite Share Download PDF Status: Published Journal Publication published 18 Apr, 2026 Read the published version in BMC Health Services Research → Version 1 posted Editorial decision: Revision requested 06 Feb, 2026 Reviews received at journal 31 Jan, 2026 Reviews received at journal 15 Dec, 2025 Reviewers agreed at journal 15 Dec, 2025 Reviewers agreed at journal 13 Dec, 2025 Reviewers agreed at journal 10 Dec, 2025 Reviewers invited by journal 01 Dec, 2025 Editor invited by journal 04 Nov, 2025 Editor assigned by journal 04 Nov, 2025 Submission checks completed at journal 04 Nov, 2025 First submitted to journal 31 Oct, 2025 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. 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11:47:14","extension":"html","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":117015,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7994442/v1/ac988126dc405e123ef6ffa7.html"},{"id":97345955,"identity":"c5114297-4cd3-46b4-925a-8a76d2bd2ba3","added_by":"auto","created_at":"2025-12-03 11:47:14","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":69376,"visible":true,"origin":"","legend":"\u003cp\u003eParticipation in various types of CPD activities among Sri Lankan dentists.\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7994442/v1/120d0e1da3e2bb108697bd25.jpg"},{"id":97345957,"identity":"80082292-43d0-43ce-876c-4b4d23276d1c","added_by":"auto","created_at":"2025-12-03 11:47:14","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":67479,"visible":true,"origin":"","legend":"\u003cp\u003eParticipation Rates in Clinical CPD Activities by Dental Discipline.\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7994442/v1/73c4bc451faf14de2fc03f44.jpg"},{"id":107350716,"identity":"6a0286ff-ce64-42ff-9e1f-fa378b548f28","added_by":"auto","created_at":"2026-04-20 16:01:10","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":657271,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7994442/v1/e4768687-b1e8-4160-9df1-fdbca6d09706.pdf"},{"id":97345961,"identity":"f7bd62ee-f0f0-45c2-a205-bcfc70efaef4","added_by":"auto","created_at":"2025-12-03 11:47:14","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":140682,"visible":true,"origin":"","legend":"","description":"","filename":"Annexure1.docx","url":"https://assets-eu.researchsquare.com/files/rs-7994442/v1/3cdb67f5d7e8148b1ba0ab1c.docx"},{"id":97345960,"identity":"243050c0-560a-489c-b628-b68c7b73f8a4","added_by":"auto","created_at":"2025-12-03 11:47:14","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":16824,"visible":true,"origin":"","legend":"","description":"","filename":"Table1.docx","url":"https://assets-eu.researchsquare.com/files/rs-7994442/v1/a6f56947a1866b79e1b10545.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Engagement, Benefits, and Challenges in Continuing Professional Development among Sri Lankan Dental Practitioners","fulltext":[{"header":"Introduction","content":"\u003cp\u003eContinuing Professional Development (CPD) aims to consolidate the professional knowledge, skills, and competencies of all oral health care personnel to effectively meet patients\u0026rsquo; needs. CPD has become pivotal in evidence-based dentistry, reflecting the rapidly evolving nature of dental practice [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The growing diversity of patient demographics and increasing expectations of oral health care services necessitate that dental practitioners engage in regular CPD programs to maintain clinical competency [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Moreover, CPD promotes ethical and professional integrity, supports the provision of standardized, high-quality care, and enhances skills through active participation in structured educational activities [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe rapid influx of scientific knowledge and technological innovations in dentistry underscores the importance of CPD for providing patients with the latest diagnostic, therapeutic, and preventive modalities, thereby enhancing public safety [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Moreover, CPD allows practitioners to identify areas requiring improvement, ensuring clinical currency and professional growth [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Globally, many countries mandate CPD for license renewal or re-registration, often requiring a specific number of hours or verifiable educational activities such as lectures, courses, and conferences, alongside non-verifiable activities like self-directed learning, journal reading, case discussions, and peer learning [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. CPD may be classified as scientific\u0026mdash;covering disciplines such as endodontics, oral surgery, oral medicine, radiology, preventive dentistry, and public health\u0026mdash;or non-scientific, which includes practice management and dentolegal responsibilities [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eMandatory CPD has been implemented in many developed countries including the United Kingdom, New Zealand, Australia, Canada, and the United States, whereas some European and Asian countries regulate both the quantity and topics of CPD through research-based systems [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In Malaysia and Saudi Arabia, CPD is compulsory for maintaining practicing licenses, while other countries, such as India, have professional associations advocating for mandatory CPD for practitioners in various states [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDental practitioners generally perceive CPD as a valuable tool to remain updated with changes in disease trends, materials, equipment, and techniques, while enhancing career development [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Studies from countries with mandatory CPD show higher participation rates, with dentists reporting improvements in knowledge, clinical skills, patient satisfaction, and overall efficiency [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Among subject-specific CPD, areas such as cosmetic and aesthetic dentistry, restorative dentistry, endodontics, and implantology are commonly preferred [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eParticipation patterns in CPD vary according to regulatory frameworks, professional experience, gender, and practice type. Dentists in countries with statutory CPD demonstrate higher engagement than in countries where participation is discretionary [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Studies in Sudan and Saudi Arabia have shown that specialists and male dentists participate more actively than general practitioners and female dentists, respectively [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Barriers to participation commonly reported include high clinical workload, cost, travel distance, lack of motivation, irrelevance of content, and limited access to web-based learning [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn Sri Lanka, CPD is neither a legal requirement nor linked to the renewal of dental registration. Although the Sri Lanka Medical Association (SLMA) introduced a National CPD Certificate (NCPDC) in 2010, it remains voluntary and has limited impact on prioritization among practitioners [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Barriers such as lack of financial incentives, private practice commitments, long travel distances, and limited online opportunities further restrict engagement [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. While international and local CPD programs exist, there is no formal, regulated system offering verifiable CPD points for recertification, nor has any study assessed Sri Lankan dentists\u0026rsquo; perceptions and participation.\u003c/p\u003e\u003cp\u003eGiven the expanding knowledge base in dentistry, all practitioners\u0026mdash;whether recent graduates or experienced professionals\u0026mdash;face inevitable gaps in knowledge. Existing CPD programs in Sri Lanka are provided by organizations such as the Sri Lanka Dental Association (SLDA) and the College of Dentistry and Stomatology (CDS), yet no studies have explored how dental practitioners perceive or participate in these activities. Assessing these perceptions is critical for developing a structured, validated CPD system that ensures competency, professional standards, and public safety.\u003c/p\u003e\u003cp\u003eInternational studies indicate when provided in a structured and accessible manner CPD positively influences clinical practice, patient satisfaction, and career development promoting greater participation [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Therefore, assessing the perceptions and participation of dental professionals in Sri Lanka is crucial for developing a validated CPD system that is tailored to local needs, overcomes barriers, and promotes professional growth. Therefore, the present study aims, for the first time, to address a gap in the literature by systematically identifying the CPD needs of dental professionals in Sri Lanka, providing evidence to guide the development of a formally recognized, context-specific CPD framework.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThis descriptive cross-sectional study was conducted among dental surgeons practicing in Sri Lanka, representing both government and private sectors across all districts. The study population included all dental surgeons registered with the Sri Lanka Medical Council (SLMC). Eligible participants were dental surgeons and consultants attached to the Ministry of Health, Ministry of Defense, Faculties of Dental Sciences, as well as private practitioners. Interns and retired dental surgeons were excluded.\u003c/p\u003e\u003cp\u003eData were collected using a pre-tested, self-administered questionnaire developed through a review of published literature (Annexure 1). The questionnaire comprised three sections: demographic details (Section A), participation in continuing educational activities (Section B), and benefits, barriers, and attitudes/perceptions regarding CPD (Section C). Content and face validity were ensured through expert review by specialists in sociology, community medicine, and dental public health.\u003c/p\u003e\u003cp\u003eThe study objectives and procedures were communicated to participants via email and WhatsApp prior to the dissemination of the questionnaire. Questionnaires were distributed electronically using a Google Form link, as no participants requested printed copies. Consent was obtained online before completing the survey, which also included details on study objectives and instructions. No personal identifiers were collected, and confidentiality was assured. To enhance response rates, three reminders were sent prior to the survey closing.\u003c/p\u003e\u003cp\u003eResponses were downloaded into Microsoft Excel, coded numerically, and analyzed using SPSS version 29 (SPSS Inc., Chicago, IL, USA). Descriptive statistics were used to present means and standard deviations (SD) for continuous variables, as well as frequencies and percentages for categorical variables. The internal consistency of the attitude scale was evaluated using Cronbach\u0026rsquo;s alpha coefficient. Bivariate relationships were evaluated using chi-square tests. To explore the associations binary logistic regression analysis was performed. Odds ratio and 95% confident interval were used to measure the strength of the association. Statistical significance is set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Ethical approval was obtained from the Ethics Review Committee of the Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eResponses were received from 320 Sri Lankan dental practitioners who were invited to participate in the survey. The majority of respondents were females (56.6%, n\u0026thinsp;=\u0026thinsp;181) aged 31\u0026ndash;50 years (58.8%) (Table\u0026nbsp;1). Most participants were married (n\u0026thinsp;=\u0026thinsp;270, 84.4%). Over half of the respondents (n\u0026thinsp;=\u0026thinsp;170, 53.3%) had 11\u0026ndash;30 years of work experience. All respondents held a BDS qualification, while 21.6% had a postgraduate diploma and 18.1% were specialists/consultants with MD/MS (Table\u0026nbsp;1). In terms of practice type, 45% worked in the government sector, 10.9% in private practice exclusively, and 44.1% in both. The distribution of patient load varied between government and private practice settings. In government funded hospitals, the majority of respondents (76.6%) reported seeing more than 10 patients per day whereas, in private practice, most respondents (54.7%) reported seeing fewer than 5 patients per day. Most respondents (82.6%) were members of national professional associations, while 16.1% held both national and international memberships (Table\u0026nbsp;1).\u003c/p\u003e\n\u003cp\u003eRegarding CPD participation, 88.8% (n\u0026thinsp;=\u0026thinsp;284) have attended CPD within the last five years and they revealed their intention to participate in CPD over the next two years (91.6%). Chi-square tests showed no significant associations between CPD participation and age, gender, marital status, or practice type (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Participation was significantly higher among consultants (100%) compared to BDS only (85.1%) and postgraduate diploma holders (89.7%), \u0026chi;\u0026sup2;(2, N\u0026thinsp;=\u0026thinsp;320)\u0026thinsp;=\u0026thinsp;10.07, p\u0026thinsp;=\u0026thinsp;0.006, and increased with work experience: 83.2% (\u0026lt;\u0026thinsp;10 years), 92.9% (11\u0026ndash;30 years), and 92.3% (\u0026gt;\u0026thinsp;30 years), \u0026chi;\u0026sup2;(2, N\u0026thinsp;=\u0026thinsp;320)\u0026thinsp;=\u0026thinsp;7.36, p\u0026thinsp;=\u0026thinsp;0.025, with a significant linear trend, \u0026chi;\u0026sup2;(1, N\u0026thinsp;=\u0026thinsp;320)\u0026thinsp;=\u0026thinsp;6.35, p\u0026thinsp;=\u0026thinsp;0.012.\u003c/p\u003e\n\u003cdiv\u003eWhen asked about the associations or colleges organizing the CPD programs they attended, most participants reported programs organized by the SLDA (n\u0026thinsp;=\u0026thinsp;233, 79.5%), the CDS of Sri Lanka (n\u0026thinsp;=\u0026thinsp;134, 45.7%), and the Government Dental Surgeons\u0026rsquo; Association (GDSA) (31.7%). Other national associations were cited less frequently (4.4\u0026ndash;25.6%). Regarding international organizations, participants have attended CPD programs most commonly organized by the Asia Pacific Dental Congress (APDC) (n\u0026thinsp;=\u0026thinsp;99, 76.2%) and the World Dental Federation (FDI, n\u0026thinsp;=\u0026thinsp;41, 31.5%), while participation in programs organized by other international bodies ranged from 3.8% to 18.5%.\u003c/div\u003e\n\u003cp\u003eThe majority of respondents (52.5%) engaged in practicing general dentistry while other notable specializations included restorative dentistry (15.0%), orthodontics (10.0%), and oral and maxillofacial surgery (8.4%). Lectures (n\u0026thinsp;=\u0026thinsp;257, 80.3%), hands-on lab workshops (n\u0026thinsp;=\u0026thinsp;199, 62.2%), discussions with dental colleagues (60.9%), and web-based distance learning (59.7%) were the most common CPD activities (Fig. 1). Small-group tutorials (18.1%) and discussions with medical colleagues (32.8%) were the least attended formats.\u003c/p\u003e\n\u003cp\u003eFigure 1\u003c/p\u003e\n\u003cp\u003eRestorative dentistry (69.4%), oral and maxillofacial surgery (56.5%), and endodontics (48.2%) were the most popular clinical CPD disciplines, while oral pathology (7.3%), periodontology (19.3%), and prosthodontics (20.9%) were the least attended (Fig.\u0026nbsp;2). Among non-clinical CPD activities, practice management (48%) and curriculum development (42.8%) were most common. Most participants reported that their primary reasons for attending CPD were improving knowledge (n\u0026thinsp;=\u0026thinsp;289, 90.3%) and learning new skills (n\u0026thinsp;=\u0026thinsp;248, 77.5%). Other reasons included supplementing undergraduate knowledge (n\u0026thinsp;=\u0026thinsp;149, 46.6%), socialization (n\u0026thinsp;=\u0026thinsp;147, 45.9%), and personal satisfaction (n\u0026thinsp;=\u0026thinsp;138, 43.1%).\u003c/p\u003e\n\u003cp\u003eFigure 2.\u003c/p\u003e\n\u003cp\u003eParticipants reported that the topic of the course/lecture/workshop (n\u0026thinsp;=\u0026thinsp;264, 95.7%), lecturer identity (n\u0026thinsp;=\u0026thinsp;220, 87.3%), and mode of delivery (n\u0026thinsp;=\u0026thinsp;206, 86.9%) were the most influential factors affecting their CPD participation (Table\u0026nbsp;2). Cost of registration, family commitments, travel time, and travel costs were also identified as important. The loss of income had been identified as the least impacted factor by the study participants.\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 2\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eFactors Influencing Access to CPD Activities.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFactors influencing the access to CPD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eImpacted\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNo idea\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNot impacted\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTopic of the course/lecture workshop\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e264 (95.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3(1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 (3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIdentity of lecturer/s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e220 (87.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7(2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25(9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTravelling cost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e178 (76.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13(5.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42(18)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTravel time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e197 (80.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11(4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36(14.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFamily commitments\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e201(80.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12(4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38(15.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCost of registration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e197 (79.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15(6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35(14.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLoss of income\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e123 (55.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23(10.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e76(34.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInvolvement of practical component\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e167 (78.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20(9.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25(11.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMaking new contacts\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e126 (62.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37(18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38(18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDay of the week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e180 (77.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24(10.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28(12.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMonth of the year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e107 (51.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36(17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65(31.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTime of the day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e156 (70.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20(9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45(20.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDate being a holiday\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e165 (72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28(12.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34(15)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMode of delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e206 (86.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12(5.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19(8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe perceived benefits of CPD were reported by the majority of respondents (Table\u0026nbsp;3). Most dentists (85.9%, n\u0026thinsp;=\u0026thinsp;275) indicated that CPD improved their knowledge of new treatment techniques and methods. A considerable proportion also identified better understanding of the subject (74.4%, n\u0026thinsp;=\u0026thinsp;238) and being updated about new materials (71.9%, n\u0026thinsp;=\u0026thinsp;230) as key benefits. Improved patient care was cited by 67.5% (n\u0026thinsp;=\u0026thinsp;216) of participants, while 62.8% (n\u0026thinsp;=\u0026thinsp;201) reported that CPD facilitated the use of evidence-based practice in their clinical work (Table\u0026nbsp;3).\u003c/p\u003e\n\u003cp\u003eSeveral barriers to CPD participation were highlighted (Table\u0026nbsp;3). The most frequently reported barrier was the location or place of CPD activities (76.6%, n\u0026thinsp;=\u0026thinsp;245), followed by cost (59.7%, n\u0026thinsp;=\u0026thinsp;191). Family commitments (52.5%, n\u0026thinsp;=\u0026thinsp;168) and busy schedules (52.2%, n\u0026thinsp;=\u0026thinsp;167) were also commonly reported. Among the barriers reported, the least frequently cited factors were no incentives (5.6%), loss of income (22.2%), no duty leaves (22.5%), courses not being relevant (23.4%), and loss of a day per week (24.4%). These findings indicate that only a small proportion of participants considered these aspects as obstacles to attending CPD activities.\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 3\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003ePerceived Benefits and Barriers to Continuing Professional Development (CPD) Among Dentists.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eBenefits\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage (N)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKnowledge of new treatment techniques/methods\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e85.9 (275)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBetter understanding of the subject\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e74.4 (238)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGetting updated about new materials\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e71.9 (230)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImproved patient care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e67.5 (216)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUsing Evidence based practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e62.8 (201)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eBarriers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLocation /place\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e76.6 (245)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e59.7 (191)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFamily commitments\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e52.5 (168)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLoss of a day per week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24.4 (78)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBusy schedule\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e52.2 (167)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCourses are not relevant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23.4 (75)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLoss of income\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.2 (71)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo duty leaves\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.5 (72)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo incentives\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5.6 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTwo separate binary logistic regression models were performed to examine the effects of age, gender, work experience, and qualifications on dentists\u0026rsquo; knowledge of new treatment techniques/methods and better understanding of the subject (Table\u0026nbsp;4). For the outcome knowledge of new treatment techniques/methods, the overall model was statistically significant (Omnibus test: \u0026chi;\u0026sup2;(7)\u0026thinsp;=\u0026thinsp;15.70, p\u0026thinsp;=\u0026thinsp;0.028) and demonstrated good fit (Hosmer-Lemeshow test: \u0026chi;\u0026sup2;(8)\u0026thinsp;=\u0026thinsp;8.05, p\u0026thinsp;=\u0026thinsp;0.429). Among the predictors, only gender was significantly associated with this outcome (Table\u0026nbsp;4). Male participants had 2.45 times higher odds of acquiring new treatment knowledge compared to female participants (OR\u0026thinsp;=\u0026thinsp;2.45, 95% CI: 1.18\u0026ndash;5.07, p\u0026thinsp;=\u0026thinsp;0.016). Age, work experience, and qualifications were not significant. For the outcome better understanding of the subject, the overall model was also statistically significant (Omnibus test: \u0026chi;\u0026sup2;(7)\u0026thinsp;=\u0026thinsp;18.41, p\u0026thinsp;=\u0026thinsp;0.010) and showed excellent fit (Hosmer-Lemeshow test: \u0026chi;\u0026sup2;(8)\u0026thinsp;=\u0026thinsp;1.59, p\u0026thinsp;=\u0026thinsp;0.991). In this model, participants aged 31\u0026ndash;50 years had 2.06 times higher odds of reporting a better understanding of the subject compared to those aged\u0026thinsp;\u0026le;\u0026thinsp;30 years (OR\u0026thinsp;=\u0026thinsp;2.06, 95% CI: 1.01\u0026ndash;4.20, p\u0026thinsp;=\u0026thinsp;0.048) (Table\u0026nbsp;4). Participants with BDS only qualifications had lower odds of reporting better understanding compared to those with postgraduate qualifications (OR\u0026thinsp;=\u0026thinsp;0.42, 95% CI: 0.19\u0026ndash;0.89, p\u0026thinsp;=\u0026thinsp;0.024). Sex and work experience were not significant predictors.\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 4\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eBivariate Analysis of Predictors for Knowledge and Understanding Gained from CPD Programs\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eKnowledge of new treatment techniques/methods\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eBetter understanding of the subject\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026le;\u0026thinsp;30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.544\u0026ndash;8.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.282\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.343\u0026ndash;3.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.960\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31\u0026ndash;50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.289\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.807\u0026ndash;6.495\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.056\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.006\u0026ndash;4.202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.048*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ge;\u0026thinsp;50 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.447\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.181\u0026ndash;5.071\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.016*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.503\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.872\u0026ndash;2.591\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.142\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eWork experience\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.252\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.024\u0026ndash;2.691\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.710\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.374\u0026ndash;7.818\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.489\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u0026ndash;30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.521\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.057\u0026ndash;4.790\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.564\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.635\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.166\u0026ndash;2.425\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.506\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eQualifications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBDS only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.522\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.176\u0026ndash;1.547\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.241\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.416\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.194\u0026ndash;0.892\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.024*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpecialists/ consultants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.958\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.258\u0026ndash;3.555\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.949\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.995\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.400\u0026ndash;2.477\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.992\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBDS with postgraduate diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eMost respondents agreed that CPD was essential for safe (93.2%) and evidence-based practice (91.3%). A large majority (79%) believed CPD should be mandatory in Sri Lanka. However, only 59.7% agreed that CPD points should be considered for SLMC registration renewal (Table\u0026nbsp;5). Binary logistic regression analyses were conducted to examine the influence of age, gender, work experience, and qualifications on two outcomes: the perception that CPD programs should be made mandatory for dentists in Sri Lanka, and that CPD points should be considered before renewing SLMC registration. In both models, the Omnibus Tests of Model Coefficients indicated that the predictors collectively improved the fit compared to the null model (Model 1: \u0026chi;\u0026sup2;(7)\u0026thinsp;=\u0026thinsp;15.67, p\u0026thinsp;=\u0026thinsp;0.028; Model 2: \u0026chi;\u0026sup2;(7)\u0026thinsp;=\u0026thinsp;16.26, p\u0026thinsp;=\u0026thinsp;0.023). The Model Summaries showed that the predictors explained a modest proportion of variance in the outcome (Model 1: Cox \u0026amp; Snell R\u0026sup2; = 0.051, Nagelkerke R\u0026sup2; = 0.086; Model 2: Cox \u0026amp; Snell R\u0026sup2; = 0.053, Nagelkerke R\u0026sup2; = 0.072). The Hosmer\u0026ndash;Lemeshow tests indicated good model fit for both analyses (Model 1: \u0026chi;\u0026sup2;(8)\u0026thinsp;=\u0026thinsp;1.70, p\u0026thinsp;=\u0026thinsp;0.989; Model 2: \u0026chi;\u0026sup2;(8)\u0026thinsp;=\u0026thinsp;8.29, p\u0026thinsp;=\u0026thinsp;0.406). In both models, qualifications emerged as the only significant predictor. In the first model, specialists/consultants were 6.66 times more likely than the reference group to perceive that CPD programs should be made mandatory for dentists (p\u0026thinsp;=\u0026thinsp;0.018). In the second model, specialists/consultants were 3.26 times more likely than the reference group to agree that CPD points should be considered before renewing SLMC registration (p\u0026thinsp;=\u0026thinsp;0.007). Age, gender, and work experience did not significantly predict the outcome in either model.\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 5\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eDentists\u0026rsquo; Perceptions and Agreement Levels Regarding CPD Importance and Implementation in Sri Lanka.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eItem\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAgree / Strongly Agree %\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNeutral %\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDisagree / Strongly Disagree %\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI believe that CPD is important for safe clinical practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e93.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI believe that CPD is important for evidence based clinical practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e91.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI think more verifiable CPD programs should be conducted by Colleges and Associations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e83.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI think that CPD programs should be made mandatory for dentists in Sri Lanka\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e79.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI would like the Faculty of Dental Sciences to conduct more CPD programs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e76.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with the CPD/CDE programs that I attended within the last 5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e70.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI achieved my objectives by participating in CPD programs in last 5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e68.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI think that CPD points should be considered before renewing the SLMC registration.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e59.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eWhen respondents were asked to list their top priority CPD learning requirements, a wide range of topics and skill areas were highlighted. Respondents most frequently prioritized CPD in restorative dentistry, orthodontics, implant dentistry, and oral surgery. There was strong interest in hands-on workshops, practical skill development, and updates in digital dentistry. Other areas of interest included ethics, medical emergencies, preventive dentistry, and evidence-based practice, indicating a preference for comprehensive CPD programs combining specialty-specific, practical, and interdisciplinary knowledge.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study, conducted among dental professionals registered under the SLMC, provides valuable insights into CPD engagement, perceived benefits, and barriers within the Sri Lankan dental community. The regulatory bodies in many countries have made it compulsory that dentists follow CPD as a requirement for the renewal of their license or re-registration. There is evidence to support that CPD is effective in improving standard of care [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Several studies have reported that up to 70% of respondents have changed the way they practice dentistry after attending CPD with improved patient satisfaction (2). In Sri Lanka, given limited resources, CPD initiatives must be used effectively to achieve meaningful service improvements, yet participation remains entirely voluntary as CPD is not yet mandatory for medical and dental professionals, with registration renewal occurring on a five-year cycle. Despite its voluntary nature, the high levels of engagement observed in our study reflect the enthusiasm of practitioners for ongoing learning and professional growth.\u003c/p\u003e\u003cp\u003eResponses were obtained from 320 dentists, which, although lower than reported in some international studies, exceeded those in other community-based surveys in Sri Lanka, where participant recruitment is often challenging [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Though the present study represented participants from all districts in Sri Lanka, higher responses were from urban areas such as Colombo and Kandy. The predominance of female respondents (56.6%) is consistent with the growing feminization of dentistry. Most participants were married (83.8%), and while over half did not have school-going children, marital and parental responsibilities may influence the time and flexibility available for CPD participation.\u003c/p\u003e\u003cp\u003eGlobally, dental care often relies on the private sector, with limited public coverage in countries like Australia, Canada, and the U.S., whereas countries such as Germany, Denmark, and Sweden provide broader public coverage, though the depth and scope of services covered can still be limited, often focusing on basic or emergency care [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. In Sri Lanka, most people rely on public services but seek private care for treatments not available publicly, such as implants, or based on personal preference. Reflecting this pattern in government hospitals, the majority of respondents (76.6%) reported seeing more than 10 patients per day, whereas in private practice most (54.7%) saw fewer than five patients daily. These findings highlight differences in patient volume across practice settings, reflecting sector-specific workload patterns. Since the majority of respondents practice in the government sector (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e), the busy schedule may be a barrier to attending regular CPDs. In the Sri Lankan hospital setup, where dentists of all grades work alongside specialists, workplace CPD maximizes knowledge translation, benefiting practitioners, teams, the organization, and service users, particularly when institutions recognize and use the workplace itself as a valuable learning resource [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eMembership in local and international dental associations such as the Sri Lanka Dental Association, International Association for Dental Research (IADR), and the FDI World Dental Federation provides dentists with a range of professional benefits, including advocacy, continuing education, networking, leadership opportunities, and access to scientific research and publications. CPD preferences closely mirrored clinical practice demands [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], reflecting the influence of professional affiliations on educational engagement. In our study, most dentists reported attending CPD programs organized by the SLDA, national dental colleges, and international bodies such as the Asia Pacific Dental Congress and FDI, suggesting that both local and international associations significantly shape CPD participation and align learning opportunities with clinical and professional priorities.\u003c/p\u003e\u003cp\u003eConsistent with international findings [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], restorative dentistry was the most preferred area, corresponding to the population\u0026rsquo;s high restorative care needs. Interestingly, oral and maxillofacial surgery also ranked highly, perhaps reflecting individual career aspirations or gaps in undergraduate exposure as seen in studies from Ireland and Malaysia [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Endodontics was another popular field, aligning with findings from previous studies [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. In contrast, implant dentistry and areas like periodontics and prosthodontics tend to be less sought after, possibly due to limited CPD opportunities or local practice patterns, which differs from some international trends. Non-clinical CPD attracted lower participation, suggesting a general preference for clinically oriented training [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eParticipation in CPD programs is associated with multiple benefits, including the acquisition of new skills and techniques, enhanced understanding of subject matter, and staying updated on new materials and practices. These findings align with previous studies [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], which demonstrate links between CPD engagement and outcomes such as evidence-based practice, improved patient care, and professional growth [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Practitioners clearly recognize CPD as a driver of clinical excellence, and its effectiveness is further enhanced when programs are interactive, context-specific, and tailored to their needs [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eBarriers to participation are multifaceted and often context-dependent. Location and accessibility are consistently identified as major obstacles [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], with structural barriers such as the unavailability of opportunities at convenient locations making participation unachievable for many. Cost and time constraints (including busy schedules and family commitments) are also frequently cited as significant barriers. While course irrelevance or lack of perceived benefit is less commonly reported, it can still deter participation in some contexts [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Interestingly, loss of income and limited incentives are not consistently linked to reduced participation, suggesting that intrinsic motivation and perceived professional or personal benefits often outweigh financial concerns.\u003c/p\u003e\u003cp\u003eGender and age have been identified as important predictors of CPD engagement and outcomes, with some research noting barriers to CPD access for female practitioners and those in rural areas, which may contribute to differences in reported knowledge gains and engagement patterns [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Mid-career dentists (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e) often demonstrate higher motivation and benefit more from CPD, likely due to greater clinical exposure and a desire for skill enhancement, while postgraduate qualifications are associated with better understanding and maximized CPD benefits, highlighting the value of advanced training [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eInternational comparisons reveal both similarities and differences. Like studies elsewhere, Sri Lankan dentists preferred lectures, workshops, and discussions with colleagues [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], while journal reading and book-based CPD were less common. Web-based CPD, although less preferred in some earlier studies [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], showed considerable acceptance in our sample, highlighting growing adaptability to online platforms. A similar study conducted with the participants of the APDC revealed that they had participated in CPD during the past 5 years, and the preferred methods were the didactic approaches followed by distance learning and web-based courses [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Factors influencing participation\u0026mdash;including course topic, lecturer identity, and delivery format\u0026mdash;were also consistent with international findings, underscoring the universal nature of these motivators.\u003c/p\u003e\u003cp\u003eThe strong consensus among respondents that CPD is essential for safe (97.1%) and evidence-based (95.1%) practice reinforces its perceived centrality in professional life. Furthermore, the majority supported mandatory CPD in Sri Lanka and favored program delivery through professional associations and academic institutions. The influence of qualifications on perceptions of CPD among dental practitioners is supported by research showing that specialists and consultants often demonstrate greater engagement with and positive attitudes toward CPD compared to general practitioners. For example, studies from Australia and Malaysia found that both dentists and specialists generally viewed mandatory CPD as reasonable and beneficial, with specialists tending to participate in more CPD hours and being more likely to change their practice as a result of CPD activities [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. These findings suggest that higher qualifications may be associated with increased awareness of the importance of CPD for maintaining professional competence. These insights highlight the importance of designing CPD policies and awareness campaigns that address both specialists and general practitioners to promote broader acceptance and participation in CPD programs [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThere are no recognized CPD providers and a properly regulated and recognized CPD system based on adult-learning principles with longitudinal curricular in Sri Lanka. Though certain organizations provide CPD points just accumulation of CPD points won\u0026rsquo;t enhance the practice and patient outcomes. However, fewer endorsed linking CPD points to SLMC registration renewal, reflecting diverse views on regulatory enforcement.\u003c/p\u003e\u003cp\u003eTaken together, these findings highlight both the strengths and gaps in the current CPD landscape in Sri Lanka. While participation is commendably high, logistical barriers, disparities in specialty representation, and variability in program delivery remain challenges. Addressing these through decentralized program delivery, flexible formats, and greater emphasis on underrepresented areas (e.g., periodontics, prosthodontics, non-clinical CPD such as ethics/professionalism) could enhance uptake and impact. Moreover, structured frameworks\u0026mdash;potentially including mandatory CPD\u0026mdash;may help standardize professional development and sustain high-quality dental care in Sri Lanka.\u003c/p\u003e"},{"header":"Limitations","content":"\u003cp\u003eThe questionnaire was disseminated via email and WhatsApp groups using a Google Form, a method that has gained popularity due to its rapid, convenient, and cost-effective nature. Despite multiple reminders, the number of respondents remained suboptimal, reflecting trends seen in previous local surveys. A low number of responses may introduce non-response bias, as those who chose to participate are likely to be more interested or engaged in the topic, potentially limiting the generalizability of the findings to all practicing dentists in Sri Lanka. Considerable effort was made to minimize this bias through repeated follow-up reminders via email and WhatsApp; however, collecting responses from the entire population proved challenging. This aligns with findings from a multilevel meta-regression analysis showing a steady decline in response rates among dentists and other healthcare professionals, in some cases reaching as low as 2% [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], and indicating that traditional mail surveys may sometimes yield higher response rates than online methods. The length of the questionnaire may also have discouraged participation, contributing to the lower number of responses. Furthermore, as the study relied on a self-administered questionnaire, recall bias and social desirability bias may have influenced responses, and the subjective nature of self-reporting may not accurately reflect actual levels of knowledge, perceptions, and practices.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study provides the first comprehensive assessment of CPD participation, perceptions, and barriers among dental practitioners in Sri Lanka. The findings demonstrate high engagement and recognition of CPD\u0026rsquo;s role in enhancing clinical knowledge, skills, and evidence-based practice. Participation is influenced by factors such as professional qualifications, work experience, and gender, while barriers including location, cost, family commitments, and busy schedules limit full engagement. Preferences for clinically oriented CPD, particularly in restorative dentistry, oral and maxillofacial surgery, and endodontics, highlight the need to align educational programs with practitioners\u0026rsquo; needs and population demands. These insights underscore the necessity of developing a structured, accessible, and context-specific CPD framework in Sri Lanka, potentially incorporating regulatory oversight, to standardize professional development, support lifelong learning, and ensure high-quality dental care for the population.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAPDC - Asia Pacific Dental Congress\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBDS \u0026ndash; Bachelor of Dental Surgery\u003c/p\u003e\n\u003cp\u003eCPD \u0026ndash; Continuing Professional Development\u003c/p\u003e\n\u003cp\u003eCDS - College of Dentistry and Stomatology\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFDI \u0026ndash; F\u0026eacute;d\u0026eacute;ration Dentaire Internationale (World Dental Federation)\u003c/p\u003e\n\u003cp\u003eGDSA - Government Dental Surgeons\u0026rsquo; Association\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMD \u0026ndash; Doctor of Medicine\u003c/p\u003e\n\u003cp\u003eMS \u0026ndash; Master of Surgery\u003c/p\u003e\n\u003cp\u003eNCPDC \u0026ndash; National Continuing Professional Development Certificate\u003c/p\u003e\n\u003cp\u003eSD \u0026ndash; Standard Deviation\u003c/p\u003e\n\u003cp\u003eSLDA \u0026ndash; Sri Lanka Dental Association\u003c/p\u003e\n\u003cp\u003eSLMA - Sri Lanka Medical Association\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSLMC \u0026ndash; Sri Lanka Medical Council\u003c/p\u003e\n\u003cp\u003eSPSS \u0026ndash; Statistical Package for the Social Sciences\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study received approval from the Ethics Review Committee of the Faculty of Dental Sciences, University of Peradeniya. All procedures were carried out in compliance with the principles of the Declaration of Helsinki concerning research involving human participants.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eInformed consent\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all individual participants included in the study.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eR.M.Y.P: Data collection, visualization, writing - original draft; R.M.I.N: Data collection, visualization, writing - original draft; V.D.R.M: Data collection, visualization, writing - original draft; NS: conceptualization, methodology, review and editing; All the authors read and edited the final manuscript. All the authors approved the submission of the manuscript.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe gratefully acknowledge the dental practitioners across Sri Lanka for their contribution to this study.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eBullock A, Bailey S, Cowpe J, Barnes E, Thomas H, Thomas R, et al. Continuing professional development systems and requirements for graduate dentists in the EU : survey results from the DentCPD project. Eur J Dent Educ. 2013;17(1).\u003c/li\u003e\n \u003cli\u003eJohn V, Parashos P. Factors involved in the translation of continuing professional development programmes into clinical practice among Victorian dentists. Aust Dent J. 2007 Dec;52(4):305–14. \u003c/li\u003e\n \u003cli\u003eNazir M, Al-Ansari A, Alabdulaziz M, AlNasrallah Y, Alzain M. Reasons for and Barriers to Attending Continuing Education Activities and Priorities for Different Dental Specialties. Open Access Maced J Med Sci. 2018 Sept 22;6(9):1716–21. \u003c/li\u003e\n \u003cli\u003eAl‐Ansari A, Nazir MA. Dentists’ responses about the effectiveness of continuing education activities. Eur J Dent Educ [Internet]. 2018 Nov [cited 2025 Oct 1];22(4). Available from: https://onlinelibrary.wiley.com/doi/10.1111/eje.12388\u003c/li\u003e\n \u003cli\u003eNayak PP, Prasad KV, Jyothi C, Roopa GS, Sanga R. Preferences and barriers for continuing professional development among dental practitioners in the twin cities of Hubli-Dharwad, India. Journal of Indian Association of Public Health Dentistry. 2015 Oct 1;13(4):4296.\u003c/li\u003e\n \u003cli\u003eSabhapathi̇ge R, Deerasi̇Nghe D, Ranasi̇Nghe G. Continuous Professional Development (CPD) of doctors in Sri Lanka: a qualitative study. Int J Health Serv Res Policy. 2022 Apr 29;7(1):48–55. \u003c/li\u003e\n \u003cli\u003eMeli Attard A, Bartolo A, Millar BJ. Dental Continuing Professional Development – Part I: Background on Dental Continuing Professional Development in Europe. Eur J Dent Educ. 2022 Aug;26(3):539–45. \u003c/li\u003e\n \u003cli\u003eAbbott P, Burgess K, Wang E, Kim K. Analysis of Dentists Participation in Continuing Professional Development Courses from 2001-2006. Open Dent J. 2010 Aug 27;4(1):179–84. \u003c/li\u003e\n \u003cli\u003eHamid NFA, Affendi NHK, Anwar NESK, Tan NFIMNI. A survey on preference for continuing professional development among general dental practitioners in Malaysia: A pilot study. Eur J Gen Dent. 2018 May;7(02):41–5. \u003c/li\u003e\n \u003cli\u003eHopcraft MS, Manton DJ, Chong PL, Ko G, Ong PYS, Sribalachandran S, et al. Participation in continuing professional development by dental practitioners in Victoria, Australia in 2007. Eur J Dent Educ. 2010 Nov;14(4):227–34. \u003c/li\u003e\n \u003cli\u003eBelfield CR, Morris ZS, Bullock AD, Frame JW. The benefits and costs of continuing professional development (CPD) for general dental practice: a discussion. Eur J Dent Educ. 2001 May;5(2):47–52. \u003c/li\u003e\n \u003cli\u003eChan WC, Ng CH, Yiu BK, Liu CY, Ip CM, Siu HH, et al. A survey on the preference for continuing professional dental education amongst general dental practitioners who attended the 26th Asia Pacific Dental Congress. Eur J Dent Educ. 2006 Nov;10(4):210–6. \u003c/li\u003e\n \u003cli\u003eGabani WO. Continuing professional development (CPD): Participation and perception among practicing dentists in the public sector in Khartoum state – Sudan 2018. Wisam Omer Gabani. 2019;8(8). \u003c/li\u003e\n \u003cli\u003eLeggate M, Russell E. Attitudes and trends of primary care dentists to continuing professional development: a report from the Scottish dental practitioners survey 2000. Br Dent J. 2002 Oct;193(8):465–9. \u003c/li\u003e\n \u003cli\u003eGray SL, Howell C, Franklin CD. Post-impact evaluation of an e-learning cross-infection control CD-ROM provided to all general dental practitioners in England. Br Dent J. 2007 Nov;203(9):E20–E20. \u003c/li\u003e\n \u003cli\u003eMaidment Y. A comparison of the perceived effects on Scottish general dental practitioners of peer review and other continuing professional development. Br Dent J. 2006 May;200(10):581–4. \u003c/li\u003e\n \u003cli\u003eDissanayaka DWVN, Wijeratne KMSL, Amarasinghe KADKD, Jayasinghe RD, Jayasooriya PR, Mendis BRRN, et al. A Preliminary Study on Early Detection of Oral Cancer with Opportunistic Screening: Insights from Dental Surgeons in Sri Lanka. Cancers. 2023 Nov 22;15(23):5511. \u003c/li\u003e\n \u003cli\u003eManley K, Martin A, Jackson C, Wright T. A realist synthesis of effective continuing professional development (CPD): A case study of healthcare practitioners’ CPD. Nurse Educ Today. 2018 Oct;69:134–41. \u003c/li\u003e\n \u003cli\u003eHamid NFA, Affendi NHK, Anwar NESK, Tan NFIMNI. A survey on preference for continuing professional development among general dental practitioners in Malaysia: A pilot study. Eur J Gen Dent. 2018 May;7(02):41–5. \u003c/li\u003e\n \u003cli\u003eStewart C, Kinirons M. Dentists’ requirements for continuing professional development in Ireland. A pilot study conducted at University College Cork. J Ir Dent Assoc. 2015;61(1):40–4. \u003c/li\u003e\n \u003cli\u003eSkapetis T, Cheema S, El Mustapha M. Evaluation of clinical versus non-clinical continuing education in terms of preferences and value for oral healthcare workers. Med Educ Online. 2022 Dec 31;27(1):2125630. \u003c/li\u003e\n \u003cli\u003eMcBride A, Collins C, Osborne B, McVeigh H. Does continuing professional development enhance patient care? A survey of Irish based general practitioners: Successful implementation of mandatory CPD in Irish General Practice. BMC Med Educ. 2022 Dec;22(1):220. \u003c/li\u003e\n \u003cli\u003eRamani S, McMahon GT, Armstrong EG. Continuing professional development to foster behaviour change: From principles to practice in health professions education. Med Teach. 2019 Sept 2;41(9):1045–52. \u003c/li\u003e\n \u003cli\u003eBenassi P, Sockalingam S. What works in medical education, where and why? Med Educ. 2019 Sept;53(9):848–9. \u003c/li\u003e\n \u003cli\u003eZamanifar A, Asgari I. Continuing professional development programs for general dentists in Isfahan province, Iran: Interests, priorities, and obstacles. Dent Res J. 2022;19:69. \u003c/li\u003e\n \u003cli\u003eBarnes E, Bullock AD, Bailey SER, Cowpe JG, Karaharju‐Suvanto T. A review of continuing professional development for dentists in Europe. Eur J Dent Educ. 2012 Aug;16(3):166–78. \u003c/li\u003e\n \u003cli\u003eAvramova N, Vasileva IM. The Role of Continuous Education in Career Progression and Satisfaction Among Dentists. Ann J Dent Med Assist. 2024;4(2):28–33. \u003c/li\u003e\n \u003cli\u003eCho YI, Johnson TP, Vangeest JB. Enhancing surveys of health care professionals: a meta-analysis of techniques to improve response. Eval Health Prof. 2013 Sept;36(3):382–407. \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Table 1","content":"\u003cp\u003eTable 1 is available in the Supplementary Files section.\u003c/p\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-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Continuing Professional Development, dental practitioners, participation, barriers, benefits","lastPublishedDoi":"10.21203/rs.3.rs-7994442/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7994442/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eContinuing Professional Development (CPD) enhances the expertise, clinical skills, and professional competencies of oral health practitioners, contributing to evidence-based practice, ethical conduct, and patient safety. While many countries require CPD for license renewal, participation in Sri Lanka remains voluntary and lacks formal regulation. Exploring dentists\u0026rsquo; experiences, engagement, and challenges in CPD is crucial for designing a structured, locally relevant CPD system. This study aimed to evaluate the perceptions, participation patterns, perceived benefits, and barriers to CPD among dental professionals in Sri Lanka.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA descriptive cross-sectional study was conducted among dental surgeons registered with the Sri Lanka Medical Council. A pre-tested, self-administered questionnaire covering demographics, CPD participation, benefits, barriers, and perceptions was disseminated electronically via Google Forms. Data from 320 respondents were analyzed using descriptive statistics, chi-square tests, and binary logistic regression to explore associations between demographic factors and CPD engagement.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eOf the 320 respondents, 56.6% were female and 58.8% were aged 31\u0026ndash;50 years. CPD participation in the last five years was high (88.8%), with 91.6% intending to engage in future activities. Attendance was higher among specialists/consultants and practitioners with longer work experience. Lectures (80.3%) and hands-on workshops (62.2%) were the most common CPD formats, with restorative dentistry (69.4%) and oral and maxillofacial surgery (56.5%) being the preferred clinical disciplines. The main motivators were improving knowledge (90.3%) and learning new skills (77.5%), while major barriers included location (76.6%), cost (59.7%) and busy schedules (52.2%). Binary logistic regression indicated that gender, age, and qualifications significantly influenced perceived knowledge gains and understanding, with specialists/consultants being more likely than other practitioners to support mandatory CPD and the consideration of CPD points for SLMC registration renewal (OR\u0026thinsp;=\u0026thinsp;3.26, p\u0026thinsp;=\u0026thinsp;0.007). Most respondents recognized CPD as essential for safe (93.2%) and evidence-based practice (91.3%), and 79% supported making CPD mandatory in Sri Lanka.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eSri Lankan dentists demonstrate strong engagement and positive perceptions of CPD, yet barriers related to accessibility, cost, and scheduling remain. Structured, flexible, and context-specific CPD programs, potentially integrated with a formal regulatory framework, are needed to standardize professional development, optimize participation, and enhance patient care.\u003c/p\u003e","manuscriptTitle":"Engagement, Benefits, and Challenges in Continuing Professional Development among Sri Lankan Dental Practitioners","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-03 11:47:09","doi":"10.21203/rs.3.rs-7994442/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-02-06T13:29:15+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-31T09:36:12+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-15T10:53:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"68045785072322812588156773952246183158","date":"2025-12-15T10:36:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"28454834202522588882005309172943739163","date":"2025-12-13T09:26:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"107153550702313984550450425860966051895","date":"2025-12-10T08:10:45+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-01T19:20:14+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-04T12:04:17+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-04T06:02:36+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-04T06:02:14+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2025-10-31T04:45:56+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c10bceaf-4afb-44f2-91e4-dbcdc19e5083","owner":[],"postedDate":"December 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-04-20T16:00:22+00:00","versionOfRecord":{"articleIdentity":"rs-7994442","link":"https://doi.org/10.1186/s12913-026-14584-1","journal":{"identity":"bmc-health-services-research","isVorOnly":false,"title":"BMC Health Services Research"},"publishedOn":"2026-04-18 15:56:59","publishedOnDateReadable":"April 18th, 2026"},"versionCreatedAt":"2025-12-03 11:47:09","video":"","vorDoi":"10.1186/s12913-026-14584-1","vorDoiUrl":"https://doi.org/10.1186/s12913-026-14584-1","workflowStages":[]},"version":"v1","identity":"rs-7994442","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7994442","identity":"rs-7994442","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}