Dental News - Dental undergraduates in Pakistan feel under-prepared in key clinical areas

Jeremy Booth, Dental Tribune International

Tue. 20. June 2023

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ISLAMABAD, Pakistan: Dental colleges have proliferated in Pakistan since the 1990s in order to meet the country’s growing need for oral care; however, a recent study suggests that quality may not have kept pace with quantity. According to a recent nationwide study, undergraduate dental students and recent dental graduates in Pakistan feel that they lack experience and skills in endodontics, radiography and orthodontics.

Researchers from Pakistan, Saudi Arabia, the UK and Qatar evaluated the self-perceived preparedness of 543 undergraduates and 319 recent graduates working under supervision at public and private dental schools and hospitals around Pakistan. Using the validated Dental Undergraduates Preparedness Assessment Scale and comparing the total mean scores of participants with those from similar studies that have been conducted in other countries, the study found that dental undergraduates in Pakistan felt less prepared (61.1%) for clinical practice than undergraduates in Malaysia (79.5%) and the UK (74.0%).

Respondents reported the highest levels of preparedness for the clinical tasks of removing caries, administering dental nerve blocks and recording medical histories. However, deficiencies were observed in clinical knowledge and experience related to performing endodontic treatments in multi-rooted and single-rooted teeth, capturing bitewing radiographs and assessing orthodontic treatment needs. Fabricating cast partial dentures and providing crowns were also identified as areas of self-perceived weakness. Around 45% of respondents from private institutions and 39% of respondents from government-run institutions said that they had no experience in providing cast partial dentures, and regarding the provision of crowns according to principles of tooth preservation, around 57% of private sector respondents and 50% of public sector respondents reported having no experience.

“The present study has managed to capture the magnitude of these deficiencies in clinical skills”

“Given these are core skills expected from a general dental practitioner, these findings raise serious concerns regarding the breadth of clinical training in Pakistani dental institutions. The present study has managed to capture the magnitude of these deficiencies in clinical skills which was not achieved in a previous study on a relatively smaller study sample,” the study read.

Most respondents felt that they were well prepared to communicate with patients, to seek advice and help from supervisors and to protect patient confidentiality, all of which the authors attributed to a high standard of professionalism and ethics in the Pakistani dental educational programmes. However, lower levels of preparedness were reported for interpreting research relevant to dental practice, evaluating dental materials and products, and referring cases of suspected oral cancer.

The authors said that deficiencies among dental undergraduates relating to understanding and applying evidence-based dentistry are a global challenge and not unique to curricula in Pakistan. Similarly, the authors noted a lack of preparedness for identifying oral cancer in countries such as the UK and Malaysia. Because Pakistan has one of the highest global incidences of oral cancer, one might expect better ability to identify and refer. The authors suggested that the deficit in this regard may be due to inconsistent teaching and a lack of clinical exposure to patients with the disease.

The study was conducted during the COVID-19 pandemic, and the authors thus cautioned that “it is possible that the lower level of preparedness reported by the study participants may reflect the adverse impact of the pandemic on their teaching and training”. They added that the main limitation of the study was its reliance on data from self-evaluations, but said that its findings provided useful insights into the skills gained during dental studies in Pakistan and highlighted areas of weakness that warranted attention and remedial measures.

The study, titled “How well prepared are dental students and new graduates in Pakistan—a cross-sectional national study”, was published online on 13 January in the International Journal of Environmental Research and Public Health.