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Year : 2021  |  Volume : 11  |  Issue : 3  |  Page : 321-326

Academic performance and dental student satisfaction with emergency remote teaching of endodontics during COVID-19 pandemic: A retrospective cohort study

Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia

Date of Submission09-Feb-2021
Date of Decision22-Mar-2021
Date of Acceptance25-Mar-2021
Date of Web Publication3-Sep-2021

Correspondence Address:
Dr. Rahaf A Almohareb
Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P. O. Box: 84428, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sej.sej_30_21

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Introduction: The study aimed to evaluate the consequences of introducing online modalities for emergency remote teaching during the coronavirus disease 2019 pandemic, on students' learning satisfaction in the endodontic preclinical course and their performance in the summative examination.
Materials and Methods: On completion of the preclinical endodontic course, 39 students were E-mailed an online questionnaire investigating their overall satisfaction with online modalities used for emergency remote teaching. They were requested to evaluate their satisfaction with three methods of lecture delivery: conventional face to face, online synchronized and online asynchronized, in terms of comprehension and retention of knowledge, communication with the lecturer, time convenience, Internet or technical support, transportation for face-to-face lectures, and stress-free learning. Students' scores were compared to scores of students who took the course before the pandemic and received only conventional face-to-face teaching. Data were statistically analyzed.
Results: A response rate of 100% showed that 87% of the students were satisfied with the online modalities used for emergency remote teaching. Students were significantly less satisfied with online-asynchronized lectures in terms of communication with the lecturer (P < 0.001) and with online-synchronized lectures in terms of time convenience (P < 0.001). The students' examination performance was not affected by shifting to emergency remote teaching (P = 0.076).
Conclusion: Dental students were satisfied with online modalities used for emergency remote teaching in the preclinical endodontic course and their academic performance was not adversely affected.

Keywords: Coronavirus disease 2019, course, education, emergency remote teaching, online

How to cite this article:
Alkahtani FN, Almohareb RA, Barakat RM. Academic performance and dental student satisfaction with emergency remote teaching of endodontics during COVID-19 pandemic: A retrospective cohort study. Saudi Endod J 2021;11:321-6

How to cite this URL:
Alkahtani FN, Almohareb RA, Barakat RM. Academic performance and dental student satisfaction with emergency remote teaching of endodontics during COVID-19 pandemic: A retrospective cohort study. Saudi Endod J [serial online] 2021 [cited 2021 Dec 4];11:321-6. Available from: https://www.saudiendodj.com/text.asp?2021/11/3/321/325409

  Introduction Top

In March 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) outbreak as a pandemic and released a list of recommendations which included social distancing.[1] The mode of transmission was not determined and asymptomatic patients were considered as a possible source of carrying and transmitting the infection.[2],[3],[4] COVID-19 was considered an international crisis that caused an interruption of typical activities such as on-campus education.[5],[6],[7],[8] Therefore, all academic plans were required to be provided online.[9]

The entire shift to remote teaching was not possible in clinical and preclinical training in dentistry.[10],[11],[12],[13] The undergraduate endodontic didactic component was provided online for the first time in the dental college of Princess Nourah Bint Abdulrahman University (PNU), Riyadh, Saudi Arabia. The dental students and full-time faculty adopted the online approach in education within 10 days of campus lockdown. This type of urgent and unplanned transferable in the mode of course delivery was regarded as an emergency remote teaching rather than a typical online education.[14] The online education composure requires comprehensive planning of the online course concerning modality, pacing, and form of assessment.[14] The role of the instructor and students is carefully studied and their type of interaction and collective feedback will be determined before the beginning of the online course.[14] However, in emergency remote teaching, the faculty and students were not prepared for remote teaching and were required to adapt to the current circumstances urgently.[14] The preclinical endodontic course is a critical component of undergraduate dental education, as it provides students with fundamental lifelong skills in clinical diagnosis and management. The impact of online modalities used in emergency remote teaching on dental education needs further support in the literature. A recent cross-sectional study suggested that students and lecturers had a positive perspective of online learning used during COVID-19.[15] Moreover, lecture attendance was not correlated with academic performance in a clinical endodontic course taken in Saudi dental school.[16] Another study found a weak association between the didactic academic performance and preclinical skills which may advocate the use of online modalities for teaching the didactic component of endodontic courses in emergency remote teaching.[17]

Therefore, this study aimed to evaluate the consequences of introducing online modalities used in emergency remote teaching on students learning satisfaction. Moreover, it sought to compare these students' academic performance in the summative examination with that of their colleagues who were taught face to face in the prepandemic year.

  Materials and Methods Top

Study design and subjects

This retrospective cohort study was conducted at Princess Nourah Bint Abdulrahman University; College of Dentistry (PNU-CD), after ethical approval was obtained from PNU Institutional Review Board (IRB # 20-0293).

The cohort was 39 undergraduate students at PNU-CD, who attended the preclinical endodontic course during the 2019–2020 academic years. The module (block) course given to 3rd-year dental students consists of a didactic component designed to provide students with a thorough knowledge of the fundamental principles of successful endodontic treatment, in addition to hands-on training in the simulation laboratory. The main teaching method of the didactic component is direct instruction through conventional face-to-face lectures. During the 2019–2020 academic years, due to the COVID-19 pandemic, this was no longer possible, and emergency remote teaching was adopted. Lectures had to be given online either in the form of online-synchronized lectures (virtual lectures) using Microsoft Teams platform (Microsoft Corporation, Redmond, Washington, United States.) or asynchronized (recorded) lectures posted on Blackboard LMS (Blackboard Inc., Washington, District of Columbia, United States.). The preclinical endodontic course was composed of nineteen lectures of which four were face-to-face lectures, eleven were online-synchronized, and four were online-asynchronized lectures.

Survey of student satisfaction with methods of lecture delivery

After all the lectures were delivered, and before taking their summative assessments, students were invited via E-mail to fill an online questionnaire regarding their satisfaction with the three methods of lecture delivery. Students were asked to rate their satisfaction according to three categories: satisfied, neutral, or unsatisfied. The first question inquired about students' overall satisfaction with online teaching during the course. The second question was about their preferences regarding the best method of lecture delivery used during the course. This was followed by a set of 18 questions asking the students to rate their satisfaction with the three methods used for lecture delivery in terms of comprehension and retention of knowledge, communication with the lecturer, stress-free learning, time convenience, Internet, and technical support in online modalities, and transportation for face-to-face teaching. The purpose of the survey was explained beforehand, and the voluntary and anonymity of participation were emphasized.

Student performance

Assessment of knowledge in the preclinical endodontic course is mainly conducted through two summative examinations, which consist of multiple-choice questions placed according to a fixed blueprint defining the number of questions per lecture. The questions must conform to specific guidelines monitored by the PNU-CD Assessment Unit. The ExamSoft platform (ExamSoft Worldwide Inc., Boca Raton, Florida, United States.) through which summative examinations were carried out also allows item analysis of student performance. On completion of the exams, students' overall scores were calculated, then compared to scores of dental students in the prepandemic preclinical endodontic course. Lectures and lecturers during the two consecutive academic years were identical and all 37 students enrolled in the course of the previous year had successfully passed.

Data analysis

Statistical analysis was performed using SPSS software version 24 (IBM Inc., Chicago, Illinois, United States). Descriptive quantitative analysis followed by Person Chi-square test and Fisher-Freeman-Halton exact test were carried out to analyze survey results, while the independent t-test was used to compare students' summative assessments scores. Statistical significance was set at a P < 0.05.

  Results Top

The survey response rate was 100%, in which the majority of the students (87%) were satisfied with the online modalities used for conducting emergency remote teaching. The most preferred route of lecture delivery was face-to-face teaching (41.03%) followed by online-synchronized teaching (33.33%). Less frequently, the dental students preferred asynchronized teaching in the form of recorded lectures (25.64%). The students' satisfaction with the three methods of lecture delivery according to the six investigated parameters is shown in [Table 1].
Table 1: The student's satisfaction with the three methods of lecture delivery according to the six investigated parameters

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The students were satisfied with their comprehension and retention of knowledge in the three investigated modalities [Table 1]. Although more students reported their satisfaction with the online-synchronized lecture in terms of comprehension and retention of knowledge, this did not up to the statistically significance; (P = 0.186) and (P = 0.472), respectively.

Regarding the convenience of timing, students were significantly less satisfied with the online-synchronized method compared to face-to-face and online-asynchronized lectures (P<0.001). They also reported less satisfaction with the online-synchronized method in terms of Internet and technical issues, but this was not statistically significant when compared to technical issues faced with online-asynchronized lectures or transportation inconveniences in face-to-face lectures (P = 0.338). There was, however, significantly less satisfaction with online-asynchronized lectures in terms of communication with the lecturer (P < 0.001).

The majority of students associated online-asynchronized lectures with stress-free learning, but this did not prove to be statistically significant (P = 0.232). Regarding student performance in the summative examinations, students who underwent remote emergency teaching due to the COVID-19 pandemic showed noticeably higher mean value than those who attended only conventional face-to-face lectures the year before. However, the difference did not reach to the significant level due to low sample size (P = 0.076) [Table 2].
Table 2: Students' scores in the summative examination after emergency remote teaching compared to students' scores after conventional face-to-face teaching in the prepandemic year

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  Discussion Top

The majority of dental students in this study were satisfied with online modalities despite its improvised nature during emergency remote teaching. Dental students at Justus-Liebig-University Giessen had a similar positive attitude toward online teaching used during the COVID-19 pandemic.[15] The academic performance of dental students who received remote emergency teaching was similar to that of students who received conventional face-to-face teaching last year. A recent randomized trial found that students' academic performance was not affected when online modalities were used for giving lectures.[18] Systemic reviews found online teaching to be equally effective to conventional teaching methods in teaching clinical skills and were qualified as a potential alternative for undergraduate medical education.[19],[20]

Although students found that online-asynchronized lectures allow for stress-free learning and offer the advantage of time convenience, they significantly appreciated the ability to communicate and interact with lecturers in online-synchronized lectures. The same observation was noted by dental hygiene students, who also appreciated the convenience of online-asynchronized lectures in the dental terminology course. However, they found the experience isolating and lacked positive in-class interaction.[21] Medical students had also reported lower levels of commitment in association with the online-asynchronized format compared to conventional face to face during an electrocardiogram course. They found that interaction with the lecturer and time constraint increased their motivation to complete the course.[22] The present study suggests that online-synchronized lectures can overcome such limitations associated with online-asynchronized lectures because dental students were significantly more satisfied with online-synchronized lectures compared to online-asynchronized lectures when it came to communication and interaction with the lecturer.

Interestingly, online-synchronized lectures were regarded as the least satisfactory in terms of time convenience, in comparison to face-to-face and online-asynchronized lectures. The cause of this could be attributed to a constrained online schedule caused by overly exceeding the time allocated for the online-synchronized lecture in emergency remote teaching. This can be explained by the slower interaction between faculty and students in the lectures or because of the presence of technical difficulties encountered during the presentation. However, dental students were satisfied with the quality of Internet and technical support offered during emergency remote teaching.[22] Saudi dental students reported good access to the internet and they had a positive attitude toward online learning.[23],[24]

The shift from conventional face-to-face to emergency remote teaching did not affect dental students' performance in the summative endodontic examination. Students also perceived online modalities used in emergency remote teaching as satisfactory as face-to-face conventional teaching.

The COVID-19 pandemic period was marked with uncertainty and preliminary research was needed to assess and support decision-making in dental education. In this study, the academic performance of the participants was compared to that of students who received conventional face-to-face lectures the year before. The study design was a retrospective cohort in which the summative examination results of students who received emergency remote teaching in the preclinical course of endodontics were compared to students who received conventional face-to-face lectures. The study design allowed for small-scale comparison when most of the confounding factors potentially affecting the outcomes were minimized.[23] Although the preclinical endodontic course was taken in two different academic years, both groups of students were attending the same dental school, were taught by the same supervisors, had the same number of lectures, and had a summative examination that followed the same assessment criteria in question preparation and grading. Moreover, there were no missing data, retrospectively since the summative examination report for both groups was well documented, and available as a routine measure in the academic institution.[23] The findings of this study were promising and supported the use of emergency remote teaching as an alternative to conventional face-to-face teaching. However, the generalization of our results should be avoided because it studied a small size of cohort. Finally, the positive experience of remote emergency teaching potentially broke the stigma associated with online teaching for dental faculty and students. Increasingly, more research in this area is recommended to explore and expand the rule of online teaching in dental education.

  Conclusion Top

Within the limitation of this study, online modalities used in emergency remote teaching were as satisfactory as conventional face-to-face teaching in the preclinical endodontic course. The shift from conventional face-to-face to emergency remote teaching did not affect students' didactic knowledge as measured by their summative examination performance. Furthermore, students significantly favored online-synchronized lectures because this modality allowed for better communication and interaction with the lecturer. However, students were unsatisfied with the time allocated for online-synchronized lectures during emergency remote teaching. Further research is recommended to explore and expand the role of online teaching in dental education.

Financial support and sponsorship

This research was funded by the Deanship of Scientific Research at Princess Nourah bint Abdulrahman University through the Fast-track Research Funding Program.

Conflicts of interest

There are no conflicts of interest.

  References Top

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  [Table 1], [Table 2]


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